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by Mike Fisher

It might be said that spirituality is about how we make sense of our purpose and meaning in life and is often used to describe our awareness of the transcendent. Given that a person's faith, spirituality and belief are a resource to them, it would seem quite reasonable that it should be incorporated as part of the therapeutic process of recovery. Indeed the National Institute for Clinical Excellence guidelines now include the "spiritual needs" of patients as an integral part of the provision that should be catered for in all healthcare settings.

However, in our pluralistic, increasingly secular society with its post-modern culture there is a growing interest and engagement with issues of spirituality, which is happening outside of the settings of conventional religion. Part of this can be explained, not so much as a loss of traditional faith, but more in terms of loss of trust in the establishment (governments, institutions, churches and so on) and the abandonment of the traditional meta-narratives that had become the accepted explanations for life.

This has given rise to a startling trend in many parts of our western culture where regular church attendance has dropped from 40% of the population to less the 2% in some places and with people currently leaving churches across the denominations at the rate of 3,000 people a week in the UK.

This pattern is also matched by an increase in interest in all aspects of spirituality and by many people seeking to pursue their journeys of faith outside of church or conventional religious structures. There is also an increasing trend in the informal and voluntary sectors to include spirituality as part of the provision of resources and services that they make available to their client groups.

In the last year I have been approached by organisations and projects concerned with mental health, addictions, the elderly and special needs who are all looking at addressing the issues of spirituality in one form or another. Some, such as Age Concern England, are looking at it from an almost wholly secular perspective.

With this as a context, how are we to understand issues of faith and spirituality and how, for those of us in the therapeutic arena, can we address this sensitively and effectively for those people that we are seeking to help on their journeys of recovery? How do we address the spiritual needs of those people who have a different faith or belief from ourselves or indeed those of no particular faith at all? Equally as challenging can be those people who claim the same faith as ourselves but seek to express it very differently.

An understanding of the interface of theology and therapy, or spirituality and psychology, is going to be important for therapists if the spiritual needs of those in recovery are not only going to be addressed, but are to be a true resource for them on their journey to wholeness. This will mean that we will need to have some resources and models to help our own understanding of spirituality in both clinical practice and pastoral care. It will also mean that we will need an appreciation of the different 'stages and states' of faith to understand why and how these are different.

Finally, but equally importantly, we will need to address our own reactions to people and their beliefs, when these are different from our own, perhaps strongly held, beliefs. Without this we will risk, as in any other areas of therapy, being an obstacle to recovery rather than an aid to it.

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