By RICH HEFFERN

The sacred and the secular were once entirely separate dimensions. A Catholic education traditionally prepared a student to live and flourish in both realms. Yet the course work preparing one for a career in the world was clearly separated in time and space from the daily Mass attendance, devotions or retreats that nourished the spirit.

Lately, however, these divisions have tumbled as dramatically as the Berlin Wall.

In institutions of higher education around the country, religious studies and spirituality in particular are beginning to be interwoven into course work, especially in programs preparing students for the helping professions. Whether it’s medicine, nursing, social work or psychology, practitioners out in the trenches notice that the people they reach out to have lives that are deeply intertwined with religion and matters of the spirit. They report that the professional must be prepared to deal with these matters in the people they serve. Also, many notice that their own spiritual development is becoming increasingly important to them, as they encounter challenges and recognize growth in both their work and personal lives.

This message is not lost on the colleges and universities that train those professionals.

At Loyola University in Chicago, training in spirituality and religious studies and personal formation in spirituality have been introduced into the coursework in both the undergraduate and graduate curriculum, in the School of Social Work and in the Neihoff School of Nursing.

A sense of enthusiasm derived from standing on the edge of new horizons pervades these efforts at Loyola.

Spirituality’s role

The popular image of a social worker features a professional trained to help his or her clients in the midst of a crisis meet their material and emotional needs. A terminal cancer patient is connected with a hospice. A recently unemployed single mother is directed to agencies that can help her keep food on the table. A young man newly diagnosed with schizophrenia is set up to be monitored for medicine compliance. These situations, frequently encountered in social work, are not only crises of need but usually also a crisis of spirit. One’s sense of meaning, of whom one is, of what life is about, are all shaken to the core. The social worker traditionally has not been well prepared to offer help here.

A recent trend in the education of social workers, however, is reversing this, and Catholic schools, such as Loyola University in Chicago, are in the forefront. This trend recognizes that spirituality and religious concerns are inherent in the human condition, so, in whatever setting a social worker is working, these issues will be relevant.

“In social work today we are seeing the great significance of religion and spirituality in people’s lives, and, as a school that trains these social workers, we are responding,” Jack Wall, associate dean of the School of Social Work at Loyola, told NCR. “Research, too, has been showing how much religion and spirituality correlate with physical and emotional health. Of course, religion can also be a hindrance in people’s lives, and we are preparing our students for that as well.”

“Social work’s cardinal rule is, ‘Start where the clients are.’ For some clients, religion and spirituality of various kinds are central, for others very peripheral,” said Wall. “The bottom line though is that social workers need to be prepared to deal with these concerns in interactions with their clients.”

The School of Social Work at Loyola has added a new graduate course, “The Role of Religion and Spirituality in Psychotherapy.” Also included in the curriculum is one called “Narrative: Social Justice and Social Work,” which focuses on the Jesuit tradition of vocation and social justice as part of service to others.

At Loyola, not only are the social work students trained to deal with clients’ spiritual needs, they are immersed in their own spiritual search as well, according to Wall. “Social workers can’t be very effective in helping their clients deal with issues of spirituality unless they themselves come to grips with and understand their own spiritual journey,” he said.

The department has created opportunities for faculty, students and staff to participate in the Ignatian spiritual exercises, an intensive spiritual experience developed by the founder of the Jesuit order, Ignatius of Loyola, over 400 years ago to assist people in getting in touch with their own spirituality and with the presence of God in their lives. Faculty, staff and students participate together in these exercises. Following this experience, held for the first time last spring at Loyola, two focus groups were conducted to assess the impact of these exercises on individuals’ social work practice and teaching. Two faculty members who participated in the exercises reported on the results of this experience at a national social work education conference in Dallas in the spring of 2000.

The University Ministries staff at Loyola also devised and conducted “Cojourners,” an initiative to bring students and faculty together to discuss spiritual issues as they affect social work practice. At noon meetings, a School of Social work faculty member would discuss his or her research in this area and talk about, for example, how different cultures express their spirituality in different ways. General issues of religion and spirituality in interdisciplinary work were also discussed.

Coming full circle

These efforts to help students develop their own spiritual lives involved a dynamic relationship between students and faculty, according to Wall. Students and staff together go through the Ignatian exercises. Involvement with the exercises takes over 30 weeks. Students meet weekly in a small-group discussion with a Jesuit. Also, spiritual direction is available to students for 30 weeks. Participants meet weekly or biweekly with a spiritual director. Sr. [Janet] Schumacher, former director of University Ministries, was available to meet with students on lunch periods. Students and faculty discussed spirituality with her. This informal, casual exploration of spirituality was optional for students.

Also, retreat opportunities are provided to students, as well as presentations to practicum supervisors when the students venture out into the local community to do their social work internships.

What makes this emerging national trend in the education of social workers all the more fascinating is that the social work profession’s origins are rooted in the Christian tradition of care for others and social justice, said Wall. In Chicago, for example, in the early 20th century, the settlement house movement made dramatic gains in helping immigrants become productive citizens in the city. The most famous of these was Hull House, founded by Jane Addams, a graduate of Illinois’ Rockford Female Seminary, a pacifist and a Nobel Prize winner. The impetus for the settlement house movement was initially religious.

Urban social services are still often delivered primarily by church-affiliated groups such as Catholic Charities or Lutheran Ministries.

Over time, however, social work, in its efforts to become more professionally respectable in an increasingly secular world, lost its interest in religion and matters of the spirit. Over the last half century, the education of social workers was heavily grounded in the scientific method, with students learning statistics and how to write up their research in the passionless language of science journal abstracts.

Now social work is coming full circle, said Wall, back to its religious roots.

“It’s easier to do this in a religious institution than a public one,” said Wall, “but it is going on there as well. The culture is more accepting of spirituality than ever before.”

“Surveys show that a majority of social workers pray for their clients,” sometimes without asking their permission, said Robin Russel, an associate professor of social work at the University of Nebraska in Omaha and current director of the Society for Spirituality and Social Work, quoted in an article in The Chronicle of Higher Education. “Social workers are already doing this stuff -- and we want to train them to do it in an ethical way.”

Innovative approaches

This year Catholic University in Washington hosted the annual conference of the national Society for Spirituality and Social Work. The theme this year was “The Creative Power of Spiritual Diversity.” These conferences are designed to provide participants an opportunity to share innovative approaches to integrating spirituality and religion into practice and education. Sessions were offered that introduced participants to a variety of meditative, prayerful and silent practices. An Arts Forum to share spiritually inspired creative works such as poetry, music and visual arts allowed participants to share creations and the inspiration for his/her work.

A textbook is available nationwide, titled “Spirituality in Social Work Practice,” by Ronald Bullis, published by Taylor & Francis, Washington. Many articles in social work journals also focus on religious and spiritual concerns.

The following course objective description for one program aptly sums up the goals of integrating spirituality into social work practice:

Spiritually sensitive social work practice means students must develop skills and insight into responding competently and ethically to diverse spiritual and religious perspectives in social work practice with clients who have experienced a death in the family, loss of job, poverty, addiction, homelessness, physical and sexual abuse, etc. The human phenomenon of spiritual transformation must be explored as well as the impact of religious fundamentalism on social work practice. Students must genuinely respect and effectively utilize their own spiritual values and religious beliefs.

“As a graduate student, you are always using your head, but not your heart,” said Heather Jones, a student in Loyola’s School of Social Work who has participated in the Cojourners program. “The beauty of this program is the opportunity to work with the heart and to strengthen skills that have been useful to me in my own social work practice as an intern.” Jones participated by meeting once a week with Sr. [Janet] Schumacher for spiritual direction.

“I work with older adults in my internship,” she said, “people who are coming to terms with their own mortality and thus are constantly bringing up religious concerns. I am better able to answer their questions and to provide resources for them.”

Supporting the spirit

Nursing has always been more than starting IVs or bringing bedpans. Nurses, like social workers, encounter people at stressful moments in their lives, times of heightened struggle with spiritual and religious issues. Often nurses hold a person’s hand while they are dying. Nurses are ideally placed to offer comfort and support patients in spiritual distress.

“With the shortage of nurses, nurse practitioners are looking for renewal both for themselves and for the patients they encounter in their work,” says Sheila Haas, dean of Loyola’s Marcella Neihoff School of Nursing. “They want to provide spiritual resources but they don’t know how. Under the umbrella of the School of Nursing, we want to provide some resources and direction for these students.”

A new certificate program in Spiritual Care for Health Care Providers was recently inaugurated to meet these needs. Two core courses are provided: Theoretical Foundations of Spiritual Care for Health Care Providers, and Concepts and Applications in Care of the Human Spirit. A number of electives are available, including courses titled “Theologies of Suffering,” “Foundations of Spirituality,” “Spirituality for Ministry” and others.

Some elective courses are provided by Loyola’s Institute of Pastoral Studies. Another elective is “Using the Arts to Minister to Self and Others,” which is offered in Rome, Italy, during an annual summer program in Europe for Loyola students.

In addition to housing this certification program, the newly established Center for Spirituality and Spiritual Care in the School of Nursing will propel initiatives such as: development of spirituality and spiritual care threads throughout the undergraduate and graduate nursing curriculum, creation of course work on spiritual leadership, seminars addressing spirituality and spiritual care, and research colloquia on spirituality and spiritual care.

Loyola’s Neihoff School of Nursing is the oldest academic nursing program in Illinois. The master’s degree program has been rated in the top 10 percent of all National League for Nursing-accredited programs by U.S. News and World Reports’ issue on best graduate schools.

Ann Solari-Twadell is director of the International Parish Nurse Resource Center in Park Ridge, Ill. She is also a doctoral candidate at Loyola’s nursing school and helped to get the spirituality in nursing care initiative off the ground. According to Solari-Twadell, there are now 60 sites around the country offering a core curriculum emphasizing spiritual care in the nursing profession. “Many of these graduates go to work as parish nurses. Many are people who were already doing nursing with a heavy component of spiritual care,” she told NCR.

“Increasingly the health care system is telling us that spirituality has a big place in the whole health picture, but in terms of actualizing this connection in hospitals, long-term health facilities, community clinics, etc., we have a long way to go,” Solari-Twadell said. She said that the emerging emphasis on faith-based initiatives will prove an impetus to push this health care/spirituality connection even further. “This will bring the connections between nursing and religious concerns even more to the forefront,” she said. “Where will the people be trained who will work in these faith-based programs that provide health care? Not in seminaries, but in the nursing schools.”

A nurse who wants to integrate spiritual concerns into health care has to be able to separate spirituality from religiosity, she said. “You can talk with some patients only in terms of their religion; others are turned off by such talk, claiming to be spiritual but not religious.”

Like social work, nursing has roots in religion, especially in the Catholic tradition. One of the central charisms of many women’s religious orders was nursing. Catholic hospitals in the first half of the 20th century were often staffed solely by nurses who were also religious sisters.

Nurses work with physicians, and increasingly medical schools are promoting this holistic view, said Solari-Twadell. In fact, a few medical schools are on the cutting edge of the trend. Christina Puchalski, a physician/teacher at George Washington University in Washington, has been active in promoting training for medical students in spirituality and religious concerns. In her proposed curriculum, future doctors are urged to do spiritual assessments when performing the first work-up on a new patient.

Loyola is ideally situated to train students for a more wholistic approach to their future profession and for more personal comfort with their own spirituality, said Loyola’s Dean Haas. “As a Catholic university, Loyola has been doing this for years -- offering time for prayer, devotions and retreats and instructing students in faith and spiritual matters.”

Humans are biological-psychological-spiritual beings. The spirituality of those who care for humans in distress is the spirituality of the companion, of the friend who walks alongside, helping, sharing, or sometimes just sitting empty-handed. The spirituality of the helping professional is one of presence, of being there for others.

At Loyola in Chicago, the future helpers, those who will be holding hands with those in spiritual crises, are being supported.

Rich Heffern is NCR opinion editor and the editor of this special section. His e-mail address is rheffern@natcath.org

National Catholic Reporter, September 28, 2001 [corrected 10/19/2001]

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