Perceptions of counselor educators about spiritual competencies.

Sauerheber, Jill Duba ; Dean, Janet B. ; Holeman, Virginia T. 等

Licensed professional counselors, counselor educators and supervisors have begun to address the place of religious issues in the therapy room as a subset of the current interest in the clinical integration of spiritual beliefs and practices (Cashwell, 2011; Duba & Greenwalt, 2008). Research suggests that the religious affiliations and practices of most mental health professionals may be markedly lower than that of the average American population (Delany, Miller, & Bisono, 2013; Fukuyama & Sevig, 1997; Pate & Bondi, 1992; Vitz, 2011; Walker, Gorsuch, & Tan, 2004). Consequently, when clients introduce religious beliefs and practices into the counseling process, many counseling professionals approach the topic with limited religious personal experience and more importantly limited understanding of how to leverage this specific aspect of clients' lives to advance therapeutic outcomes (Shafranske, 1996; Young, Cashwell, Wiggins-Frame, & Belaire, 2002). Because professional ethics codes require counselors to practice within their scope of competency, professional counselors may gain the necessary knowledge, attitudes, and skills in integrating religious issues into counseling through continuing education events or supervision and/or consultation. Noting the ascendance of spiritual and religious beliefs and practices in the counseling profession, Morgan (2007) identified spirituality, which includes religious spirituality, as the "fifth force" in counseling. Substantial movements like this eventually find a home in the curriculum of counselor education programs. How do counselor educators perceive changes in counselor education programs to order to increase trainees' competencies in working with religious related issues?

Ethical and accreditation-based reasons exist to justify the inclusion of religious competencies in counselor education programs. The Council for Accreditation of Counseling and Related Educational Programs (CACREP) has addressed the importance of training counseling students to be attentive and sensitive to religious diversity. Under the Social and Cultural Diversity section of Section II, Professional Identity, the 2009 CACREP Standards require curriculum experiences and studies to include an "understanding of the cultural context of relationships, issues, and trends in a multicultural society;" with multicultural being defined by CACREP as a "term denoting the diversity of racial, ethnic, and cultural heritage; socioeconomic status; age; gender; sexual orientation; and religious and spiritual beliefs, as well as physical, emotional, and mental abilities" (CACREP, 2009, p. 61, emphasis added).

The Association for Spiritual, Ethical, and Religious Values in Counseling (ASERVIC), a division of the American Counseling Association developed a set of competencies related to working with spiritual and religious issues in counseling. The ASERVIC competencies provide both students and counselor educators alike with a strong starting point; nevertheless, information about how or if these competencies are being addressed during any given student's academic career is lacking. The current literature suggests that the majority of students in counselor education programs (marriage and family or mental health tracks), as well as other graduate programs including marriage and family therapy (MFT) programs, and graduate psychology programs are not receiving adequate training in order to understand how to incorporate and work with religious factors during the therapy process (Kahle & Robbins, 2004; Prest, Russel, & D'Souza, 1999; Wolf & Stevens, 2001). Students still feel unprepared to address religious concerns with clients (Prest et al., 1999; Young et al., 2002). In fact, both students and counselor educators have been reported to want additional training regarding their work with religious and spiritual clients (Green, Benshoff, & Harris-Forbes, 2001; Kelly, 1994, 1997; Pate & High, 1995).

The current exploratory study, therefore, sought to gain a better understanding of how counselor educators perceive the inclusion of religious and spiritual competencies in CACREP-accredited counselor education programs. We hypothesized that counselor educators would rate the inclusion of knowledge and skills related to religious and spiritual competencies as more important than attitudes, and that attitudes were hypothesized to be less frequently included in training programs. Counselor educators were also expected to endorse particular religious-related issues that clients bring into counseling as important competency areas for their graduates. Finally, participants were expected to identify religious issues that counseling students tend to bring up in supervision, as well as experience in the practicum and internship.

Method

These hypotheses were explored by having representatives from counseling programs respond to a web-based survey regarding religious-related competencies in knowledge, skills, and attitudes that may or may not be addressed in their training programs. Second, counselor educators were expected to identify particular religious-related issues that clients bring into counseling which are grounds for referrals.

Participants

Participation solicitations were sent via e-mail to about 232 department chairs (or program coordinators) of CACREP-accredited counseling programs. The sample, however, consisted of the 44 participants ([n.sub.female] = 24, 54.5 percent; [n.sub.male] = 20, 45.5 percent) who had completed any research questions beyond the basic demographics, resulting in an overall response rate of 19 percent. The sample's mean age was 51.89 (SD = 9.42), and the majority described themselves as white (n = 37; 84.1 percent), with others describing themselves as American Indian / Alaskan Native (n = 2, 4.5%), Black / African American (n = 2, 4.5 percent), Hispanic or Latino/a (n = 1; 2.3 percent), or Blended racial / national heritage (n = 2; 4.5 percent).

A slight majority of this sample described themselves as being both religious and spiritual (n = 23; 52.3 percent), while 25 percent indicated they were spiritual but not religious (n = 11). The others described themselves as religious (n = 2; 4.5 percent), atheistic (n = 3; 6.8 percent), agnostic (n = 2; 4.5 percent), and unsure (n = 3; 6.8 percent). Participants also rated the degree to which they considered themselves religious and spiritual on a 5-point Likert scale. on average, participants saw themselves as somewhat religious (M = 3.11, SD = 1.56) but very spiritual (M = 4.59, SD = 0.66). There was much diversity in terms of the religious group with which participants affiliated. While 9 (20.5 percent) did not respond, the rest of the sample was fairly well divided among Catholic (n = 8; 18.2 percent), conservative Christian (n = 7; 15.9 percent), liberal Christian (n = 7; 15.9 percent), Jewish (n = 2; 4.5 percent), native religious (n = 1; 2.3 percent), other (n = 5; 11.4 percent), and none (n = 5; 11.4 percent).

Most of the participants in this sample were either program coordinators / directors (n = 17; 38.6 percent) or department heads (n = 8; 18.2 percent). Some, however, identified their position as tenured faculty (n = 16; 3.4 percent), non-tenured faculty (n = 2; 4.5 percent), or non-tenure-track faculty (n = 1; 2.3 percent). On average, participants had been in their current positions for 11.21 years (SD = 0.63). About half of the participants are currently affiliated with a "master's level only" program (n = 23; 52.3 percent), while the others are affiliated with a "master's and doctoral level" program (n = 18; 40.1 percent) or a "doctoral level only" program (n = 3; 6.8 percent).

Procedure and Materials

Potential participants received an email solicitation to complete a questionnaire posted on Survey Monkey. This questionnaire was developed after a review of the literature from journals affiliated with the American Counseling Association (e.g., Journal of Counseling and Development, Religion and Values) that dealt with recommended counselor competencies related to the integration of religion and spirituality in counseling, resulting in 48 individual sub-competencies. These sub-competencies fell into one of three competency categories: knowledge (15 items; i.e., what counselor trainees know), skills (17 items; i.e., what counselor trainees can do), or attitudes (16 items; i.e., what counselor trainees believe). Participants then responded to these items as follows:

Endorsement. For each of the 48 items, participants indicated on a Likert scale, ranging from 1 = "I don't believe this at all" to 5 = "I definitely believe this," the degree to which they believed that graduates of counselor education programs should demonstrate that particular sub-competency.

Inclusion. Along with an indication of their belief in the importance of each of the 121 items, participants indicated whether the training program with which they work currently address that sub-competency in its curricula using a yes/no response format.

Client issues. After responding to the sub-competencies, participants were invited to comment in narrative form on what client-related religious issues their students tend to face during their clinical experiences (e.g., practicum/internship).

Results

To explore any differences in perceived importance across the three competency areas--knowledge, skills, and attitudes, a one-way repeated-measures analysis of variance (ANOVA) was employed. A significant difference across the endorsement of the three competency areas was found, F (2, 40) = 76.41, p < .001. Post hoc paired-samples t-tests showed that each competency area was endorsed at a significantly different level than each of the other two. That is, Attitudes (M = 4.75, SD = .34) were significantly more greatly endorsed than Knowledge (M = 4.17, SD = .59), t(20) = 8.74, p < .001, and Skills (M = 4.46, SD = .51), t(20) = 5.38, p < .001. Also, Knowledge (M = 4.17, SD = .59) was significantly endorsed at a higher level than Skills (M = 4.46, SD = .51), t(20) = -4.79, p < .001 (see Figure 1).

Knowledge

The degree of belief in the importance of each of the 15 knowledge competencies was compared across the presence or absence of those competencies being addressed in the training program using a series of one-way ANOVAs. To account for inflation, but given the exploratory nature of this project, alpha was set at .02. All but two of the competencies showed a significant difference in degree of endorsement by its perceived presence in the training program. In 12 of the 15 competencies, those program directors who reported the inclusion of that competency in their training program more strongly believed that competency should be included in training than did those directors who reported the exclusion of that competency in their training program. In 5 of the 15 competencies, those reporting inclusion gave higher ratings than did those who did not know if that competency was addressed in their training program. In 2 of the 15 competencies, those reporting the exclusion gave lower ratings than did those not knowing if the competency was included. Means and standard deviations are shown in Table 1.

Skills

Similarly, a series of one-way ANoVAs was used to examine any differences in the degree of belief in the importance of each of the 17 knowledge skills competencies across the presence or absence of those competencies being addressed in the training program. Alpha was set at .02. Participants' ratings were significantly different for 11 of the 17 skills competencies across its perceived presence in the training program. For each of those 11 competencies, program directors in programs perceived to include each competency indicated a stronger conviction that each particular competency should be included in training than did those directors in programs perceived to exclude that particular competency. Similarly, they indicated stronger conviction than those directors who did not know if the competency was addressed for 3 competencies. In 1 of the 17 competencies, those reporting the exclusion gave lower ratings than did those not knowing if the competency was included. Means and standard deviations are shown in Table 2.

Attitudes

Finally, using a series of one-way ANOVAs, the degree of belief in the importance of each of the 16 attitude competencies was compared across the presence or absence of those competencies being addressed in the training program. Alpha was set at .02. Eight of the competencies showed a significant difference in degree of endorsement by its perceived presence in the training program. In five of the competencies, those program directors with inclusion of that competency in their training program more strongly believed that competency should be included in training than did those directors with exclusion of that competency in their training program. In 2 of the 15 competencies, those reporting inclusion indicated greater conviction than did those not knowing if the competency was included. In 5 of the 15 competencies, those reporting the exclusion gave different ratings than did those not knowing if the competency was included. Means and standard deviations are shown in Table 3.

[FIGURE 1 OMITTED]

Results from Narrative

Participants were invited to respond to two narrative questions including the following: (a) what religious issues have your counselor trainees encountered during practicum and internship; and (b) what religious issues have your counselor trainees presented during supervision. Fifteen participants responded to the first question, and twenty three responded to the second question.

Religious issues encountered by counselor trainees during practicum and internship. Responses to this question fell within 4 categories including: (a) client need and presenting issues, (b) personal conflict and over-identification; (c) religion as contrary to client wellness, and (d) counselor education and training. one respondent noted that there were no religious issues encountered.

Client need and presenting issues. Six participants noted that students may face clients who want to incorporate their faith in the counseling context. For example, participants mentioned that this may be relevant for clients who are struggling with decisions about abortion, infidelity in marriage, sexuality, and/or sexual addictions. other participants noted that some clients have a desire to pray in counseling, and/or seek a counselor who is religiously similar. Still, one participant mentioned that students face clients who are behaving and thinking in ways that are contrary to their (clients') stated religious beliefs.

Personal conflict and over-identification. Eight of the fifteen participants noted that some students find it difficult to work with clients who have different religious beliefs, or with clients who engage in behaviors that conflict with their (students') religious beliefs. One participant mentioned, "Some have struggled with [incorporating the] ASERVIC competencies in that those competencies suggest working from within the client's belief systems; almost as if they fear that addressing spiritual/religious issues from a framework other than their own will cause harm to themselves." Still other respondents noted that students coming from a "Christian fundamentalist" perspective have struggled to provide counseling for gay clients. Finally, some students tend to over-identify with clients "who share the same beliefs they do" rather than being open to the unique nuances in any given religious faith perspective or denomination.

Religion as contrary to client wellness. Several respondents noted the challenge that students face when clients present with religious behavior or beliefs that put the client at risk or that in some ways compromise client wellness. One participant described it as "toxic religion." Another participant noted that sometimes students face clients who are using "religion [as a way or rationale] for dominating a partner." Another mentioned that some students face clients who have the perspective, "I am saved so if I kill myself it is ok," and further added, "this notion of once saved always saved seems to breed irresponsibility."

Counselor education and training. Three participants mentioned that the very nature and culture of their university is supportive of the religious and spiritual growth of all students. Along with this support, is the encouragement of students to accept diversity, to "participate in an ever increasing pluralistic world," and to "lovingly fall back on the sentiments of ... inclusion."

Religious issues presented by counselor trainees during supervision. Responses to this question fell within 5 categories including the following: (a) incorporation of religion in counseling, (b) personal conflict, (c) client presenting issues, (d) religion as contrary to client wellness, and (e) counselor education and training. Two participants responded that no religious issues were brought up in supervision.

Incorporation of counselor/client religion in counseling. Two participants mentioned that students will question whether or not it is "appropriate to address religion during counseling sessions without crossing boundaries in terms of personal values and beliefs." In addition, students may inquire about how to infuse their own religious beliefs in the counseling context. Further, two other participants mentioned that some students over-identify with clients, or assume that they (clients are religious.

Personal conflict. Eight participants noted that students have discussed their conflict and difficulty in working with clients who are religiously different, or who have "very different practices and beliefs." In fact, one participant mentioned that "many students tend to be myopic." Another mentioned that "religious intolerance" surfaces in supervision.

Client presenting issues. Eight participants noted that students will discuss clients who are struggling with particular issues and who want to incorporate their religion and faith into treatment. Regarding struggles with specific issues in light of religious commitments, students faced clients who wrestled with pregnancy/abortion, sexuality (homosexuality), forgiveness (sexual abuse, infidelity), and inter-faith couples. Regarding the incorporation of religion into treatment, students reported that some clients relied heavily on their personal faith and the support of their "religious group." other clients practice prayer as a way of healing or incorporated indigenous practices such as talking with the deceased.

Religion as contrary to client wellness. Supervisors noted that students brought up issues related to the following in supervision: clients who have a "toxic religion," clients using "religion to dominate a partner," and "clients who are very depressed because they felt condemned with no redemption by their religion."

Counselor education and training. Out of five participants who referred to counselor education and training of students, four alluded to the notion that students may not be receiving adequate training or experiences in working with religious, faith-based groups or diverse clients in general or developing spiritual wellness. Finally, one participant mentioned that religious related competencies cannot "be met if our faculty haven't done their work. If they make fun of these [religious] traditions ... we aren't teaching them anything."

Discussion

Implications for Counselor Education

These findings raise four concerns for counselor educators and supervisors in CACREP accredited programs. First, given the relative newness of an emphasis on the inclusion of religion in counseling sessions, it is unlikely that the majority of counselor education faculty received training in this area during their time as students. Counselor educators and supervisors may benefit from workshops, seminars, and round table discussions that focus on appropriate and respectful ways to incorporate instruction in this area in their program. At minimum this would include an awareness of the current empirical research that reports findings on religious match or mismatch between client/counselor (Duba & Greenwalt, 2008) and outcome research related to the implementation of religious-sensitive interventions (Hall, Dixon, & Mauzey, 2004; Ingersoll, 1998). Additionally, faculty and supervisors from secular or public institutions of higher education may benefit from dialogue with counselor educators and supervisors who work in religiously-based institutions of higher education where the integration of religious faith and counselor training is well established. At least four CACREP-accredited, faith-oriented counselor education programs have dealt with therapy issues around integration (e.g., Denver Seminary, Regent University, Mid-America Nazarene University, Indiana Wesleyan University). The experience of these faculty can enrich all who are beginning this journey of integration. Moreover, counselor educators and supervisors with expertise are encouraged to share their knowledge of how to include this component into their programs through presentations at ACA-related conferences and through publication in journals such as Counseling Education and Supervision. Such information is presented at conferences sponsored by the Christian Association for Psychological Studies and has been featured in numerous articles in the Journal of Psychology and Christianity. However, given that only 15.9% of this sample identified with conservative Christianity, it is unlikely that the majority of counselor educators from secular CACREP accredited programs would access these resources because of its distinct Christian perspective.

Second, counselor educators and supervisors who do desire to incorporate training related to working with religious issues and religious clients in counseling face a challenge of how to add this component to an already full educational experience. A related challenge focuses on measurement of student-learning outcomes consistent with the 2009 CACREP standards. What kind of learning activities will facilitate the formation of counselors who are respectful of a wide array of religious expressions and competent to work with clients with religious-related concerns? Our data indicate that respondents valued an appropriate attitude most highly compared to knowledge and skills. yet this is the most subjective component of the three variables measured. one can test for knowledge and observe skills, but attitudes are more implied and often can be camouflaged. Who determines what an acceptable attitude is? How is this measured? Will students be evaluated as "acceptable" if they embrace attitudes that are contrary to those of their faculty even if the student achieves commendable scores in terms of knowledge and skills? Counselor education programs in Christian institutions of higher education (university, college, or seminary settings) that are not CACREP-accredited may already incorporate instruction on the integration of Christian theology and/or practices in their counselor training programs. Nevertheless they will face the same challenges in terms of student learning outcomes that CACREP accredited programs face. In addition these programs will need to consider the extent to which their graduates are competent to work with clients who represent a diverse range of spiritual traditions.

Third, because few faculty are expert in all major world religions, let alone more indigenous religions, it is imperative that counselor educators and supervisors develop respectful working relationship with religious leaders in their communities and take advantage of faculty in other departments whose expertise may be world religions. Developing a working knowledge of religious tenets is one thing. understanding how these tenets may be represented by a range of interpretations and practices of religious faith is quite another.

Fourth, counselor educators will need to reflect on how to create a safe learning environment within which students can explore their own religious heritage (or the absence of it) without fear of reprisal, condemnation, stereotyping, or judgment. This will be a dilemma that is magnified for highly religious students, for whom their religious identity is central to their sense of self and their life choices. To what degree are counselor educators and supervisors aware of theories of faith development so that they have a basis for understanding the likely pushes and pulls that students may experience as they learn about the integration of religious-related client issues in counseling settings, and seek to meet their counselor educators' approval? For example, some experiential exercises may seem innocuous to the instructor but not to a highly religious student.

The narrative data, while limited, spotlight the challenges that counselor educators and supervisors and students face when integrating client-related religious issues into counselor education. For highly religious students and clients, their religion is not an "add on" to their life, but a central orientation of their being. low-religious and moderately-religious students may actually face less conflict when working with clients of differing religious commitments than highly-religious students. If the incorporation of religion into counselor education programs becomes normative, then counselor educators will also need to develop and publish policies and procedures for managing the inevitable times when religious convictions conflict with training expectancies. In this way highly religious students can be fully informed about what is expected of them in the counselor education program.

Limitations

Four areas of limitations advise cautions interpretation of these results. our respondents were largely, Caucasian Christians. Persons of color and adherents of other religions are under-represented in this sample. While the identification of programs with CACREP accreditation helps to target the study, it in itself is also a limitation as differences may exist between faculty in CACREP accredited programs and non-CACREP accredited programs. Specifically, the majority of CACREP programs are housed in public universities, whereas other counselor education programs are part of schools with strong religious affiliations (such as seminaries). In schools with religious affiliations, religious issues are part and parcel of academic life, especially if the institution values the integration of their religious faith with academics. Finally, many respondents did not complete the survey, which provided a more limited data set than desired.

Future Research

The data gathering survey requires refinement in order to remove the perception of repeated items and to create a survey which is more likely to be completed. Second, how do CACREP programs (largely on secular university campuses) compare with counselor education programs housed within religiously-affiliated institution of higher education? Third, further research can explore how competencies related to the inclusion of religious related client variables and issues are presently being addressed in curriculum.

References

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Delaney, H. D., Miller, W. R., & Bisono, A. M. (2013). Religiosity and spirituality among psychologists: A survey of clinician members of the American Psychological Association. Spirituality in Clinical Practice, 1(S), 95-106. doi:10.1037/2326.4500.1.S.95

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Prest, L. A., Russel, R., & D'Souza, H. (1999). Spirituality and religion in training, practice and personal development. Journal of Family Therapy, 21, 60-77. doi: 10.1111/1467-6427.00104

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Walker, D. F., Gorsuch, R. L., & Tan, S. (2004). Therapists' integration of religion and spirituality in counseling: A meta-analysis. Counseling and Values, 49, 69-80.

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Jill Duba Sauerheber

Western Kentucky University

Janet B. Dean

Asbury University

Virginia T. Holeman

Asbury Theological Seminary

Jenna Haynes

Western Kentucky University

Jill Duba Sauerheber (Ph.D. in Counselor Education and Supervision, Kent State University) is an Associate Professor in the Department of Counseling and Student Affairs at Western Kentucky University. She is currently serving as president-elect of the North American Society of Adlerian Psychology; her interests include the integration of religion in counseling, counselor training and marital satisfaction.

Virginia T. Holeman (Ph.D. in Counselor Education, Kent State University) is Professor of Counseling at Asbury Theological Seminary (Wilmore, KY). Her research interests include interpersonal forgiveness, repentance, and reconciliation and the integration of theology and counseling practice.

Janet B. Dean (Ph.D. in Clinical Psychology, The Ohio State University) is Assistant Professor of Psychology at Asbury University (KY), Affiliate faculty at Asbury Theological Seminary (KY), and a licensed psychologist. Dr. Dean's interests include sexual identity development, mindfulness meditation, religious and spiritual issues in counselor education, and undergraduate education in psychology.

Jenna Haynes (M.A. in Clinical Mental Health Counseling, Western Kentucky University) will be a doctoral student at Virginia Tech University. Jenna has assisted faculty in numerous research projects and has served as the program's Chi Sigma Iota chapter president while she was a master's student.

Correspondence concerning this article should be addressed to Jill Duba Sauerheber at jillduba.sauerheber@wku.edu.

Table 1
Means and Standard Deviations for Knowledge Competencies
by Inclusion in Training Program

                                     Overall            Yes
                                      M (SD)           M (SD)

KNOWLEDGE

Can define religion                 4.40 (.98)    4.82 (.48) (ab)
                                                      (n = 28)

Can define spirituality             4.58 (.76)     4.81 (.59) (a)
                                                      (n = 32)

Can describe similarities and       4.49 (.86)     4.76 (.51) (a)
differences between religion and                      (n = 29)
spirituality

Can describe characteristics and    4.21 (.80)     4.94 (.25) (a)
qualities of "religious                               (n = 16)
wellness"

Can describe characteristics and    4.21 (.81)    4.92 (.28) (ab)
qualities of "sick religion"                          (n = 13)

Can describe various religious      4.24 (.88)     4.54 (.51) (a)
practices and traditions                              (n = 24)
including agnosticism and
atheism

Understand how religiosity is       4.74 (.59)     4.90 (.31) (a)
tied to the greater cultural                          (n = 30)
system

Understand how each particular      4.55 (.90)     4.88 (.33) (a)
religious  philosophy or faith                        (n = 17)
system impacts the client's
overall behavior (feeling,
thinking, & acting)

Understand how clients view         4.55 (.71)    4.95 (.22) (ab)
their problems  or manifestation                      (n = 21)
of psychological symptoms in
light of their religion

Be able to articulate one's own    4.23 (1.11)    4.93 (.26) (ab)
religious  development                                (n = 15)

Understands how religion shaped    4.42 (1.03)     4.88 (.33) (a)
one's life and identity                               (n = 26)
development (i.e., moral,
cognitive, psychosocial)

Understand religiosity within       4.47 (.89)       4.70 (.73)
the framework of developmental                        (n = 20)
stage models

Demonstrates knowledge regarding    4.73 (.45)     4.85 (.37) (a)
the religious context of salient                      (n = 20)
issues, such as definition of
marriage; dating and
cohabitation; roles within
marriage and families; child
bearing, birth control,
abortion, teenage pregnancy;
finances; dissolving
relationships, divorce,
annulment; managing family after
separation and/or divorce; death
and dying; and homosexuality in
couples and families

Knowledgeable of related            4.53 (.68)       4.75 (.44)
religious coping mechanisms that                      (n = 20)
could be recommended to clients
(e.g., support groups,
journaling, rituals, prayer,
scripture)

Knows specific religious           3.60 (1.19)     4.71 (.49) (a)
assessments for obtaining                             (n = 7)
relevant religious case history

                                          No               Unsure
                                        M (SD)             M (SD)

KNOWLEDGE

Can define religion                 3.25 (1.39) (a)    4.00 (.82) (b)
                                        in = 8)            (n = 7)

Can define spirituality               4.17 (.98)       3.60 (.55) (a)
                                        (n = 6)            (n = 5)

Can describe similarities and       3.67 (1.27) (a)      4.13 (.99)
differences between religion and        (n = 6)            (n = 8)
spirituality

Can describe characteristics and    3.36 (.51) (a)     4.06 (.68) (a)
qualities of "religious                (n = 11)           (n = 16)
wellness"

Can describe characteristics and    3.87 (.83) (a)     3.93 (.73) (b)
qualities of "sick religion"           (n = 15)           (n = 14)

Can describe various religious     3.30 (1.16) (ab)    4.50 (.54) (b)
practices and traditions               (n = 10)            (n = 8)
including agnosticism and
atheism

Understand how religiosity is       4.17 (1.17) (a)      4.50 (.55)
tied to the greater cultural            (n = 6)            (n = 6)
system

Understand how each particular      3.71 (1.60) (a)      4.56 (.73)
religious  philosophy or faith          (n =7)            (n = 16)
system impacts the client's
overall behavior (feeling,
thinking, & acting)

Understand how clients view         3.71 (1.11) (a)    4.33 (.49) (b)
their problems  or manifestation        (n = 7)           (n = 12)
of psychological symptoms in
light of their religion

Be able to articulate one's own     3.71 (1.44) (a)    3.90 (.88) (b)
religious  development                 (n = 14)           (n = 10)

Understands how religion shaped     3.80 (1.64) (a)      4.33 (.82)
one's life and identity                 (n = 5)            (n = 6)
development (i.e., moral,
cognitive, psychosocial)

Understand religiosity within         4.00 (1.32)        4.00 (1.07)
the framework of developmental          (n = 9)            (n = 8)
stage models

Demonstrates knowledge regarding    4.20 (.45) (a)       4.80 (.45)
the religious context of salient        (n = 5)            (n = 5)
issues, such as definition of
marriage; dating and
cohabitation; roles within
marriage and families; child
bearing, birth control,
abortion, teenage pregnancy;
finances; dissolving
relationships, divorce,
annulment; managing family after
separation and/or divorce; death
and dying; and homosexuality in
couples and families

Knowledgeable of related              4.00 (1.00)        4.33 (.58)
religious coping mechanisms that        (n = 7)            (n = 3)
could be recommended to clients
(e.g., support groups,
journaling, rituals, prayer,
scripture)

Knows specific religious            3.19 (1.17) (a)      3.43 (1.13)
assessments for obtaining              (n = 16)            (n = 7)
relevant religious case history

                                       F (df)          p

KNOWLEDGE

Can define religion                14.12 (2, 40)    .000 **

Can define spirituality             8.94 (2, 40)    .001 **

Can describe similarities and       6.14 (2, 40)    .005 *
differences between religion and
spirituality

Can describe characteristics and   32.04 (2, 40)    .000 **
qualities of "religious
wellness"

Can describe characteristics and   10.52 (2, 40)    .000 **
qualities of "sick religion"

Can describe various religious     11.24 (2, 39)    .000 **
practices and traditions
including agnosticism and
atheism

Understand how religiosity is       5.45 (2, 39)    .008 *
tied to the greater cultural
system

Understand how each particular      4.98 (2, 37)    .012 *
religious  philosophy or faith
system impacts the client's
overall behavior (feeling,
thinking, & acting)

Understand how clients view        14.82 (2, 37)    .000 **
their problems  or manifestation
of psychological symptoms in
light of their religion

Be able to articulate one's own     6.35 (2, 36)    .004 *
religious  development

Understands how religion shaped     5.72 (2, 34)    .007 *
one's life and identity
development (i.e., moral,
cognitive, psychosocial)

Understand religiosity within       2.38 (2, 34)    .108
the framework of developmental
stage models

Demonstrates knowledge regarding    5.58 (2, 27)    .009 *
the religious context of salient
issues, such as definition of
marriage; dating and
cohabitation; roles within
marriage and families; child
bearing, birth control,
abortion, teenage pregnancy;
finances; dissolving
relationships, divorce,
annulment; managing family after
separation and/or divorce; death
and dying; and homosexuality in
couples and families

Knowledgeable of related            3.95 (2, 27)    .031
religious coping mechanisms that
could be recommended to clients
(e.g., support groups,
journaling, rituals, prayer,
scripture)

Knows specific religious            5.30 (2, 27)    .011 *
assessments for obtaining
relevant religious case history

Table 2
Means and Standard Deviations for Skill Competencies by Inclusion
in Training Program

                                     Overall            Yes
                                      M (SD)           M (SD)

SKILLS

Can accurately interpret            4.56 (.60)     4.84 (.38) (a)
research outcome studies that                         (n = 19)
investigate religious issues in
counseling

Should discuss personal             4.82 (.45)       4.93 (.37)
discomfort with client's                              (n = 29)
religiosity during supervision

Should possess the ability to       4.87 (.41)    4.97 (.17) (ab)
avoid imposing own religious                          (n = 33)
beliefs and values on clients
whom have a similar religious
affiliation, as well as with
clients whom have different
religious affiliations

Be able to discuss with clients     4.63 (.75)       4.89 (.32)
about how best to incorporate                         (n = 19)
their religious beliefs and
values in the treatment goals
and interventions

Be able to implement strategies     4.38 (.92)     4.82 (.39) (a)
that access client's religious                        (n = 17)
beliefs and practices

Be able to implement counseling     4.78 (.54)     4.96 (.20) (a)
practices and techniques that                         (n = 24)
are sensitive and supportive of
client's religiosity

Be able to discuss in               5.00 (.00)       5.00 (.00)
supervision any related                               (n = 27)
ethical issues associated with
working with religious clients
that arise during counseling

Be able to discuss religious        4.85 (.44)    5.00 (.00) (ab)
value differences with client                         (n = 25)
in a respectful and
collaborative way

Participate in the activities of    3.16 (.35)     4.14 (.69) (a)
varying religions in order to                         (n = 7)
increase understanding and
empathy with a greater pool of
religious clients

Know how to collaborate with        4.44 (.76)     5.00 (.00) (a)
religious leaders                                     (n = 8)

Have a collaborative working        4.19 (.97)       4.75 (.46)
relationship with a number of                         (n = 8)
religious leaders in the
community

Seek supervision and/or             4.77 (.68)     4.96 (.20) (a)
consultation in order to improve                      (n = 24)
their understanding of religious
experiences and expressions

Be able incorporate basic           4.70 (.54)    4.90 (.30) (ab)
counseling skills with religious                      (n = 21)
issues present in counseling
context

Be able to meet the needs of        4.33 (.99)     4.72 (.58) (a)
religious clients who want to                         (n = 18)
incorporate their own values and
religious beliefs into the
counseling process

Be able to identify religious       4.15 (.01)       4.71 (.49)
pathology                                             (n = 7)

Demonstrate ability to use         4.28 (1.10)     4.92 (.28) (a)
client's religious frame of                           (n = 13)
reference during counseling
sessions

Be knowledgeable of religious       4.36 (.04)       5.00 (.00)
language or concepts that are                         (n = 9)
meaningful to religious clients

                                          No               Unsure
                                        M (SD)             M (SD)

SKILLS

Can accurately interpret            4.13 (.64) (a)       4.42 (.67)
research outcome studies that           (n = 8)           (n = 12)
investigate religious issues in
counseling

Should discuss personal               4.40 (.55)         4.60 (.55)
discomfort with client's                (n = 5)            (n = 5)
religiosity during supervision

Should possess the ability to       4.00 (.00) (a)     4.33 (1.16) (b)
avoid imposing own religious            (n = 2)            (n = 3)
beliefs and values on clients
whom have a similar religious
affiliation, as well as with
clients whom have different
religious affiliations

Be able to discuss with clients       4.14 (1.46)        4.50 (.52)
about how best to incorporate           (n = 7)           (n = 12)
their religious beliefs and
values in the treatment goals
and interventions

Be able to implement strategies     3.73 (1.35) (a)      4.33 (.50)
that access client's religious         (n = 11)            (n = 9)
beliefs and practices

Be able to implement counseling     4.43 (.79) (a)       4.40 (.89)
practices and techniques that          (n = 10)            (n = 8)
are sensitive and supportive of
client's religiosity

Be able to discuss in                 5.00 (.00)         5.00 (.00)
supervision any related                 (n = 3)            (n = 3)
ethical issues associated with
working with religious clients
that arise during counseling

Be able to discuss religious        4.25 (0.96) (a)    4.50 (.58) (b)
value differences with client           (n = 4)            (n = 4)
in a respectful and
collaborative way

Participate in the activities of    2.61 (1.46) (a)      3.57 (.79)
varying religions in order to          (n = 18)            (n = 7)
increase understanding and
empathy with a greater pool of
religious clients

Know how to collaborate with        4.00 (1.00) (a)      4.46 (.52)
religious leaders                      (n = 11)           (n = 13)

Have a collaborative working          3.94 (1.00)        4.13 (1.13)
relationship with a number of          (n = 16)            (n = 8)
religious leaders in the
community

Seek supervision and/or             3.75 (1.50) (a)      4.50 (.71)
consultation in order to improve        (n = 4)            (n = 2)
their understanding of religious
experiences and expressions

Be able incorporate basic           4.20 (.84) (a)     4.25 (.50) (b)
counseling skills with religious        (n = 5)            (n = 4)
issues present in counseling
context

Be able to meet the needs of        3.63 (1.41) (a)      4.00 (.82)
religious clients who want to           (n = 8)            (n = 4)
incorporate their own values and
religious beliefs into the
counseling process

Be able to identify religious         3.80 (1.32)        4.11 (.78)
pathology                              (n = 10)            (n = 9)

Demonstrate ability to use         2.83 (1.17) (ab)    4.33 (.82) (b)
client's religious frame of             (n = 6)            (n = 6)
reference during counseling
sessions

Be knowledgeable of religious         3.88 (1.36)        4.13 (.99)
language or concepts that are           (n = 8)            (n = 8)
meaningful to religious clients

                                       F(df)           p

SKILLS

Can accurately interpret            5.71 (2, 36)    .007 *
research outcome studies that
investigate religious issues in
counseling

Should discuss personal             4.26 (2, 36)    .022
discomfort with client's
religiosity during supervision

Should possess the ability to      13.02 (2, 35)    .000 **
avoid imposing own religious
beliefs and values on clients
whom have a similar religious
affiliation, as well as with
clients whom have different
religious affiliations

Be able to discuss with clients     3.17 (2, 35)    .054
about how best to incorporate
their religious beliefs and
values in the treatment goals
and interventions

Be able to implement strategies     6.04 (2, 34)    .006 *
that access client's religious
beliefs and practices

Be able to implement counseling     4.92 (2, 3)     .013 *
practices and techniques that
are sensitive and supportive of
client's religiosity

Be able to discuss in
supervision any related
ethical issues associated with
working with religious clients
that arise during counseling

Be able to discuss religious        9.97 (2, 30)    .000 **
value differences with client
in a respectful and
collaborative way

Participate in the activities of    4.52 (2, 29)    .019 *
varying religions in order to
increase understanding and
empathy with a greater pool of
religious clients

Know how to collaborate with        5.09 (2, 36)    .013 *
religious leaders

Have a collaborative working        2.04 (2, 29)    .148
relationship with a number of
religious leaders in the
community

Seek supervision and/or             8.48 (2, 27)    .001 *
consultation in order to improve
their understanding of religious
experiences and expressions

Be able incorporate basic           7.41 (2, 27)    .003 *
counseling skills with religious
issues present in counseling
context

Be able to meet the needs of        4.51 (2, 27)    .020 *
religious clients who want to
incorporate their own values and
religious beliefs into the
counseling process

Be able to identify religious       1.82 (2, 23)    .185
pathology

Demonstrate ability to use         17.81 (2, 22)    .000 **
client's religious frame of
reference during counseling
sessions

Be knowledgeable of religious       3.35 (2, 22)    .054
language or concepts that are
meaningful to religious clients

Table 3
Means and Standard Deviations for Attitude Competencies
by Inclusion in Training Program

                                     Overall           Yes
                                     M (SD)           M (SD)

ATTITUDES

Be aware of how their own          4.92 (.48)     5.00 (.00) (a)
religious beliefs, or lack                           (n = 33)
thereof has impacted their
attitudes, values and biases
about mental health

Be able to recognize discomfort    4.85 (.43)     5.00 (.00) (a)
associated with particular                           (n = 30)
religious tenets

Be aware of reactions to clients   4.95 (.22)     5.00 (.00) (a)
who have different religious                         (n = 34)
views from one's own

Be aware of how one's own          4.90 (.38)     4.97 (.19) (a)
religious constructs impact                          (n = 29)
clinical decision making

Be able to recognize the           4.46 (.02)       4.76 (.97)
limitations of one's own                             (n = 17)
knowledge base as it pertains to
his/her affiliated religion

Be aware of tendency towards       4.53 (.70)    5.00 (.00) (ab)
dogmatism (or the relative                           (n = 21)
openness or closedness in
receiving, understanding, and
acting upon stimulus
information) as it pertains to
religious clients religious
issues

Be able to acknowledge when the    4.91 (.29)       4.95 (.22)
client's religious practices                         (n = 21)
are conflictual with the
treatment strategy

Be aware of how client's           4.85 (.36)     4.96 (.20) (a)
religious beliefs, values, and                       (n = 25)
practices may serve an auxiliary
role in counseling

Be aware of the related ethical    4.97 (.17)     5.00 (.00) (a)
issues associated with working                       (n = 28)
with religious clients

Be cognizant of potential          4.66 (.55)       4.83 (.39)
barriers to successful                               (n = 12)
collaboration with religiously
affiliated community resources
and religious leaders

Be aware when client's religious   4.88 (.33)       5.00 (.00)
beliefs, values, and practices                       (n = 18)
may hinder attainment of
client's stated counseling goa.

Be able to recognize if the        4.47 (.82)     4.89 (.32) (a)
client's faith perspective is                        (n = 18)
enhancing or constraining
his/her personal growth

Demonstrate sensitivity to the     4.81 (.49)       4.94 (.24)
potential role of cilient's                          (n = 17)
religious faith during crisis
counseling

Demonstrate awareness of one's     4.96 (.20)       4.96 (.20)
own religious biases and                             (n = 24)
religious prejudices

Be working on his/her spiritual    3.56 (.42)       4.67 (.52)
development in conjunction with                      (n = 6)
his/her professional counseling
development

Display sensitivity to client's    4.92 (.28)       4.95 (.22)
religious experiences that are                       (n = 20)
related to treatment goals

                                          No               Unsure
                                        M (SD)             M (SD)

ATTITUDES

Be aware of how their own          4.00 (1.73) (ab)    5.00 (.00) (b)
religious beliefs, or lack             (n = 3)            (n = 3)
thereof has impacted their
attitudes, values and biases
about mental health

Be able to recognize discomfort     4.80 (.45) (b)    3.75 (.55) (ab)
associated with particular             (n = 5)            (n = 4)
religious tenets

Be aware of reactions to clients   4.50 (.58) (ab)     5.00 (.00) (b)
who have different religious           (n = 4)            (n = 1)
views from one's own

Be aware of how one's own          4.40 (.89) (ab)     5.00 (.00) (b)
religious constructs impact            (n = 5)            (n = 5)
clinical decision making

Be able to recognize the             4.38 (1.19)         4.08 (.90)
limitations of one's own               (n = 8)            (n = 12)
knowledge base as it pertains to
his/her affiliated religion

Be aware of tendency towards        3.80 (.45) (a)     3.90 (.74) (b)
dogmatism (or the relative             (n = 5)            (n = 10)
openness or closedness in
receiving, understanding, and
acting upon stimulus
information) as it pertains to
religious clients religious
issues

Be able to acknowledge when the       4.80 (.45)         4.86 (.38)
client's religious practices           (n = 5)            (n = 7)
are conflictual with the
treatment strategy

Be aware of how client's              4.67 (.58)       4.40 (.55) (a)
religious beliefs, values, and         (n = 3)            (n = 5)
practices may serve an auxiliary
role in counseling

Be aware of the related ethical    4.50 (.71) (ab)     5.00 (.00) (b)
issues associated with working         (n = 2)            (n = 3)
with religious clients

Be cognizant of potential             4.67 (.49)         4.38 (.74)
barriers to successful                 (n = 12)           (n = 8)
collaboration with religiously
affiliated community resources
and religious leaders

Be aware when client's religious      4.60 (.55)         4.80 (.42)
beliefs, values, and practices         (n = 5)            (n = 10)
may hinder attainment of
client's stated counseling goa.

Be able to recognize if the        3.50 (1.05) (a)       4.17 (.75)
client's faith perspective is          (n = 6)            (n = 6)
enhancing or constraining
his/her personal growth

Demonstrate sensitivity to the        4.67 (.58)         4.50 (.84)
potential role of cilient's            (n = 3)            (n = 6)
religious faith during crisis
counseling

Demonstrate awareness of one's        5.00 (.00)
own religious biases and               (n = 2)
religious prejudices

Be working on his/her spiritual      2.93 (1.54)         4.00 (.71)
development in conjunction with        (n = 14)           (n = 5)
his/her professional counseling
development

Display sensitivity to client's       4.75 (.50)          5.00 ( )
religious experiences that are         (n = 5)            (n = 1)
related to treatment goals

                                       F (df)          p

ATTITUDES

Be aware of how their own           8.31 (2, 36)     .001 *
religious beliefs, or lack
thereof has impacted their
attitudes, values and biases
about mental health

Be able to recognize discomfort    64.18 (2, 36)    .000 **
associated with particular
religious tenets

Be aware of reactions to clients   16.15 (2, 36)    .000 **
who have different religious
views from one's own

Be aware of how one's own           6.15 (2, 36)     .005 *
religious constructs impact
clinical decision making

Be able to recognize the            1.68 (2, 34)      .202
limitations of one's own
knowledge base as it pertains to
his/her affiliated religion

Be aware of tendency towards       32.63 (2, 33)    .000 **
dogmatism (or the relative
openness or closedness in
receiving, understanding, and
acting upon stimulus
information) as it pertains to
religious clients religious
issues

Be able to acknowledge when the     0.68 (2, 30)      .516
client's religious practices
are conflictual with the
treatment strategy

Be aware of how client's            7.51 (2, 30)     .002 *
religious beliefs, values, and
practices may serve an auxiliary
role in counseling

Be aware of the related ethical    14.09 (2, 30)    .000 **
issues associated with working
with religious clients

Be cognizant of potential           1.79 (2, 29)      .186
barriers to successful
collaboration with religiously
affiliated community resources
and religious leaders

Be aware when client's religious    3.83 (2, 30)      .033
beliefs, values, and practices
may hinder attainment of
client's stated counseling goa.

Be able to recognize if the        12.49 (2, 27)    .000 **
client's faith perspective is
enhancing or constraining
his/her personal growth

Demonstrate sensitivity to the      2.10 (2, 23)      .146
potential role of cilient's
religious faith during crisis
counseling

Demonstrate awareness of one's      .08 (2, 24)       .779
own religious biases and
religious prejudices

Be working on his/her spiritual     4.46 (2, 22)      .024
development in conjunction with
his/her professional counseling
development

Display sensitivity to client's     .091 (2, 22)      .419
religious experiences that are
related to treatment goals