Domain V: Collaborate with Clients to Apply a Contextualized, Systemic Lens to Case Conceptualization
Change is most likely to occur when counsellors negotiate actively with clients to set both the preferred outcomes and the processes through which change will occur. Within the CRSJ counselling model (Collins, 2015), Core Competency 15 focuses the collaborative efforts of counsellor and client on identifying the most culturally responsive and socially just change processes, which may include targeted change in the contexts of the client’s live experiences. Based on the process of case conceptualization, learners can identify the most appropriate locus of intervention, including potential systems level change (Ratts & Pedersen, 2014; Ratts, Singh, Nassar-McMillan, Butler, & McCullough, 2015). I encourage learners to consider multilevel interventions at the microlevel (e.g., individuals, couples, families); mesolevel (e.g., schools, organizations, communities); or macrolevel (e.g., broader social, economic, and political systems), and to collaborate actively with clients to establish change processes that are culturally responsive and socially just. This may involve adapting traditional counselling theories, critiquing counselling processes for their cultural relevance and responsivity, and expanding counsellor roles to be more fully responsive (Arthur & Collins, 2016; Houshmand, Spanierman, & De Stephano, 2017).
Religion and spirituality have only recently begun to be centralized in discussions of multicultural counselling competency. Review the Spiritual Competencies put out by the Association for Spiritual, Ethical, and Religious Values in Counseling (2009). Notice that these competencies apply broadly to working with clients from all religious or spiritual perspectives (etic approach); however, they also embed the expectation that counsellors will honour and create space to integrate each client’s worldviews (emic approach) into counselling practice.
Apply the spiritual competencies to your critical discussion of the following case scenario.
Liz comes to counselling because she has recently lost her partner to cancer, and she is feeling depressed, lethargic, and unable to “get back on her feet.” She describes their relationship as loving, long-term, mutually respectful, and the centre of her life. She can’t make meaning of this loss and is struggling to hold onto any sense of purpose in life. She and her partner retired 15 years ago, after years of working in a not-for-profit agency advocating for persons with disabilities. In the last 10 years, she has developed a degenerative osteoarthritis and is in considerable pain most of the time. She and her partner assumed she would be the first to die. Now, without her partner and with her physical deterioration more rapid of late, she cannot envision coping with the demands of daily life. The only spark of energy you notice during the session is when she talks about the 2015 Canadian Supreme Court ruling on medical assistance in dying (MAID). She notes that she does not believe in an afterlife. Although she positions herself as an atheist, she sees herself as a spiritual person. Her life meaning has always been tied to her relationships, her work, and her sense of contribution to the larger communities to which she belongs.
Attend carefully to your own spiritual or religious worldview, noting any tensions or challenges that may arise for you in working with Liz from within her spiritual values and perspectives. What multicultural and social justice principles might you draw on to ensure you do not impose your own values or worldview on this client? How might you be optimally inclusive of her beliefs, drawing on the Spiritual Competencies.
Now that you we have a rich discussion started about working with Liz, let’s change up the scenario. .
[Permanent link: https://crsjguide.pressbooks.com/chapter/cc15/#clientspirituality]
Arthur, N., & Collins, S., (2016). Multicultural counselling in the Canadian context. In N. Gazzola, M. Buchanan, O. Sutherland, & S. Nuttgens (Eds.), Handbook of Counselling and Psychotherapy in Canada (pp. 73-93). Ottawa, ON: Canadian Counselling and Psychotherapy Association.
Association for Spiritual, Ethical, and Religious Values in Counselling. (2009). Competencies for addressing spiritual and religious issues in counselling. Retrieved from http://www.aservic.org/resources/spiritual-competencies/
Collins, S. (2018). Embracing cultural responsivity and social justice: Re-shaping professional identity in counselling psychology [Epub version]. Victoria, BC: Counselling Concepts. Retrieved from http://www.counsellingconcepts.ca
Houshmand, S., Spanierman, L. B., & De Stephano, J. (2017). Racial microaggressions: A primer with implications for counseling practice. International Journal of Advanced Counselling, 39, 203-216. http://dx.doi.org/10.1007/s10447-017-9292-0
Ratts, M. J., & Pedersen, P. B. (2014). Preface. In M. J. Ratts & P. B. Pedersen (Eds.), Counseling for multiculturalism and social justice: Integration, theory, and application (4th ed., pp. ix-xiii). Alexandria, VA: American Counseling Association.
Ratts, M. J., Singh, A. A., Nassar-McMillan, S., Butler, S. K., & McCullough, J. R. (2015). Multicultural and social justice competencies. Retrieved from Association for Multicultural Counseling and Development, Division of American Counselling Association website: http://www.counseling.org/docs/default-source/competencies/multicultural-and-social-justice-counseling-competencies.pdf?sfvrsn=14
Instead of not believing in an afterlife, Liz is actually a very devout Catholic for whom the appeal of MAID is very strong emotionally, but is considered morally wrong within her religious community and her own belief system. She worries that she risks her position in the afterlife, yet she is increasingly convinced that this is what she wants and needs.