A conceptual model of spirituality using a psychological approach

Introduction

Philosophically one of the most essential questions one can ask is, “What is the meaning of life?” The sincere attempt to answer this inquiry reveals the most basic assumptions about who we are, what our relationships are, and what are our beliefs. This question becomes intensified by our awareness of life as ephemeral. With the knowledge of our death we seek to find or make meaning out of life.

It is the crossroads of empiricism and rationalism, which provides philosophers with one point from which to begin a search for meaning. Empiricism is a path to knowledge through sensory experience (Slife & Williams, 1995). In contrast, the rationalist approach maintains that there are ‘innate ideas’ and that certain general propositions can be known to be true in advance (or absence) of empirical verification (Feinberg, 1985). It is the proposition of this study that spirituality emerges from the rationalist path. Spiritual beliefs involve assumptions about reality in the absence of evidence. Spirituality assumes that there is a spiritual reality in addition to the material ‘world’. Such a spiritual belief allows for the possibilities of an existence beyond the death of the human body. Whichever belief system we embrace, rationalism or empiricism, will come to bear upon our values, goals, actions, and the interpretation of our experiences (Ellis, 1962; Frankl, 1967; Maslow, 1968).

In 1822 the French philosopher Auguste Comte coined the term positivism. He proposed that social behavior could be studied and understood in a scientific manner, in contrast to explanations based in religion or superstition (Rubin & Babbie, 1997). Since the renaissance Western civilization has embarked primarily down the path of positivism and empiricism (Ray, 1996; Rubin & Babbie 1997). This study uses a positivistic approach to examine, identify, and conceptually define a rationalist belief system, spirituality.
Spiritual beliefs have the power to transform and maintain enormous changes in one’s perceptions, values, and behaviors. It can be a personal source of strength in coping with physical, emotional, or environmental stress. Recently there has been a growing interest in spirituality as related to mental health (Anderson & Worthen, 1997; Millison, 1995). The literature on spirituality in the social sciences is a problematic in that it lacks consistent conceptual (McGrath, 1997; Seaward, 1995) and operational (Jenkins, 1995; Warfield, 1996) definitions for spirituality.
Within this analytic context, several questions can be raised regarding the conceptualization of a model of spirituality. Do people have the same meaning for spirituality? What factors best represent the meaning of spirituality? How do these factors relate to one another?

Theoretical Framework

The spirituality model proposed in this study is developed within a framework of cognitive-behaviorism theory. This theoretical framework is a synthesis and elaboration upon the behavioral/cognitive approach to spirituality (Brown, Peterson, & Cunningham, 1988). This approach fits well with a cognitive-behavioral orientation in which human behavior is predicated on a cognitive interpretation and evaluation of a stimulus. This framework explains spirituality as a function of beliefs, values, behaviors, and experiences. It is a circular relationship in which beliefs give rise to values, which inform our behaviors, resulting in an experiential impact upon the spiritual belief system. There is no beginning or end to this circle, at different times any of the phases may be the catalyst toward a change in the belief system.

Beliefs are the core component of spirituality framework. Spiritual beliefs are driven by a humanistic innate need for seeking meaning and purpose (Frankl, 1967; Maslow, 1968). In a qualitative study, Canda (1988a) examined the spirituality of “helpers” across major religious orientations. An area of agreement was in the belief that there is an innate need for humans to search for meaning and purpose in their lives. A spiritual person has been on a quest for meaning and purpose, and emerges with confidence that life is deeply meaningful and that his or her own existence has purpose (Elkins, Hedstrom, Hughes, Leaf, & Saunders, 1988).

While behaviors may be more easily measured than beliefs it would be difficult to quantify a differential spirituality ‘score’ for various acts (e.g., prayer verses altruistic behavior). Another obstacle towards measuring the spirituality of a behavior is that within a cognitive/behavioral framework the spirituality of an act is grounded in reference to the individual’s own belief system. As such, preparing tea may be very spiritual to a person within a Zen tradition and inconsequential to others.
For the above reasons the belief system has been chosen as a logical point of departure for the conceptualization of spirituality. A complete theory of spirituality would include a conceptualization of the other components of the spirituality framework (i.e., spiritual values, behaviors, and experiences). The author proposes that first the spiritual belief component should be conceptualized and validated, then the other components of the framework can be constructed upon this foundation.

Statement of Problem

A number of studies cited in professional journals of social work, nursing, psychology, psychiatry, and medicine all show a positive correlation between spirituality and mental/physical health (Corrington, 1989; Cousins, 1976; Fehring, Brennan, & Keller, 1987; Halstead & Fernsler, 1994; Koss, 1987; Krippner & Villoldo, 1976; Oxman, Freeman, & Manheimer, 1995; Simonton, Mathews, & Creighton, 1978; Sullivan, 1993). A weakness in them is their use of different definitions and measures of spirituality.

Despite evidence supporting the relationship between spirituality and mental/physical health, very little research has examined the construct of spirituality. Specifically, there is no tacit agreement as to what spirituality is. Such ambiguity threatens the validity of the increasing body of research regarding spirituality. A recognized model of spirituality needs to be developed in order for social work professionals to incorporate spirituality into practice, research, policy, and education.

Significance of the Study

Identifying a model of spirituality has several implications for social work education, practice, and research. The importance of spirituality to Americans is illustrated by the recent results of national surveys. In response to the query “How important would you say religion is in your own life?” 61% of the respondents answered ‘very important’, 27% answered ‘fairly important’, 11% ‘not very important’, and 1% had no opinion (Gallup, 1998). Regarding a belief in God, 62% ‘have no doubts’, 15% ‘believe but have doubts’, 4% ‘believe sometimes’, 4% ‘believe in a higher power’, 3% ‘don’t know’, and 2% ‘don’t believe’. In response to the question “Do you believe in a life after death?” 72% answered yes, 17% said no, and 10% were undecided (Mitchell, 1996). With a majority of the population claiming to have spiritual beliefs it becomes imperative for social workers to address this aspect of the individual. First, an agreed upon model would create a framework for the education and training of social workers regarding spiritual aspects of the individual. A model would provide a clear conceptualization for students and practitioners who are unfamiliar with spiritual concepts.

Second, spirituality has recently been recognized as being in the realm of mental health practice by its inclusion of “V62.89 Religious or spiritual problem” (p. 685) and “316.00 Other or unspecified psychological factors affecting a medical condition,” with one example being “religious factors” (p. 678) in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (American Psychiatric Association, 1994). A model would offer practitioners a valuable tool for assessing the spiritual aspect of the client’s psycho-social system. Not only could a practitioner utilize the structure of a model for assessment, the responses to these deeply personal questions could also serve as a point of departure for therapy (Aponte, 1996; Frankl, 1963; Jung, 1933; Rogers, 1980). Such an avenue could create an opportunity to reframe the client’s experiences within the context of spiritual development by reiterating the innate value of personhood and the interpretation of life as meaningful and purposeful.

Thirdly, an agreed upon model of spirituality is relevant to policy issues. The Council on Social Work Education’s (CSWE) Curriculum policy statement in 1992 recognized religious diversity as an important area for study. Recently many social work educators have supported the inclusion of spirituality in professional education (Carroll, 1997). Similarly, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has created policy regarding spirituality. JCAHO in its 1994 Accreditation Manual for Hospitals mandated that the assessment of patients receiving treatment for alcoholism or drug addiction specifically includes “the spiritual orientation of the patient”. Without an agreed upon conceptualization it becomes unclear how to implement or verify the implementation of policies pertaining to spirituality.

Last, a model has utility for research because it offers a framework for empirical measurement (i.e., the strength of a belief system). Moreover, a model of spirituality with clearly defined dimensions would provide a framework for the construction of a spirituality scale. Such an empirical measure would create opportunities for research to investigate the relationships between spirituality and other variables, including physical health, mental health, aging, gender, culture, and life satisfaction. Studies could also investigate what kind of interventions can increase the strength of spiritual beliefs. A spirituality scale may be particularly relevant for practitioners in areas regarding spiritual issues such as in pastoral counseling.

Statement of Purpose

The intent of this study was to conceptualize a model of spirituality. The purposes of the study were fourfold: to examine dimensions of spiritual beliefs; to identify dimensions of spiritual beliefs; to conceptually define these dimensions, as well as their inter-relationships; and to produce a graphic illustration of a model of spirituality. The following research questions guided the investigation of the dimensions in the proposed construct of spirituality:

1. What are the dimensions involved in spiritual beliefs?
2. What are the relationships among these dimensions?
3. Are these dimensions associated with the extent to which a person self identifies as spiritual, religious, or a believer in God?
4. How do people describe their spiritual beliefs?
5. How do people define spirituality for themselves?
6. How do people think about the relationship between spiritual activities and change?
7. How is spirituality related to ego boundaries?
8. What would be a visual model that could illustrate the relationships among dimensions of spiritual beliefs?

Theoretical Definitions of Terms

This study utilized terminology in the literature from diverse disciplines such as behavioral science, and social research. Some of the definitions for these terms are not used consistently in this literature. The following definitions were chosen based on their clarity and goodness of fit for the purposes of this study. Being that the purpose of this study was to conceptualize a model of spirituality it is essential that the definitions be explicitly established for the terms: conceptualization, model, and theory.

1. Conceptualization – is the basis for the written or formal theory (Reynolds, 1971, p.21). It involves “a series of processes by which theoretical constructs, ideas, and concepts are clarified, distinguished, and given definitions that make it possible to reach a reasonable degree of consensus and understanding of the theoretical ideas we are trying to express” (Blalock, 1982, p. 11).

2. Model – is a theory that has been constructed around a narrow focus, which has been explicitly tested and examined. A model is a visual tool used to illustrate, simulate, or predict the behavior of specific variables (Slife & William, 1995).

3. Theory – a formal description of an idea (Reynolds, 1971) or a statement of relationship between two or more phenomena (Slife & Williams, 1995).

This study began with a review of the professional literature in the social sciences. It was found that there are many different definitions for spirituality. As a result of the review no one single definition emerged as useful for the conceptualization of a model. These various definitions are critiqued and discussed at length in Chapter II.

Conceptualization involves a process by which concepts are clarified and given definitions that make it possible to reach a reasonable degree of consensus and understanding. The review of the literature did not offer a consensus on the definition of spirituality. As such the author began the conceptualization of a model of spirituality by examining the meaning and definitions used in the Webster’s New Collegiate Dictionary (1993). Based upon these definitions the author extrapolated the term non-material as a basic tenet of spiritual belief. Questions were constructed utilizing this tenet and its supporting concepts in order to gather data regarding subject’s spiritual beliefs. The tenet of a belief in a non-material reality was based on the following operational definitions from the dictionary:

1. Supernatural – of or relating to an order of existence beyond the visible observable universe; especially of or relating to God or a god, demigod, spirit, or devil.
2. Spirit – a supernatural being or essence. The immaterial intelligence or sentient part of a person.
3. Spiritual – of or relating to supernatural beings or phenomena.
4. Spirituality – the quality or state of being spiritual.
6. Material – relating to or concerned with physical rather than spiritual or intellectual things.

These dictionary definitions are problematic as each involves the use of another ambiguous term in a series of regression. The regression was followed in an attempt to reach a useful term from which to build a conceptualization of spirituality. The dictionary defined spirituality as a state of being spiritual. Spiritual was defined as relating to supernatural beings. Spirit was also defined in reference to the supernatural. Supernatural was defined as relating to an order of existence beyond the visible observable universe (i.e., God or a god, demigod, spirit, or devil). The term material offers juxtaposition as it is defined as not related to the spiritual.
Based on these related definitions the author inferred that the spiritual is not material. Spirituality pertains to a belief in an order of existence beyond the visible observable universe. As such spirituality involves a belief in a non-material universe.

The term ‘non-material’ is fundamental to operationally defining spirituality in this study. Non-material was defined as existing beyond the visible, observable, or measurable universe. Based on these definitions, this study conceptually defined ‘spiritual beliefs’ as pertaining to a belief in a reality that is non-material. It was the goal of this study to identify several factors within the context of this belief system.

Assumptions

An assumption of this study that spirituality is fundamentally a belief system. Furthermore, that this belief system can be known and conceptualized via scientific methodology. There are many variations of the scientific method. Since the Enlightenment a common characteristic of the scientific method has been empiricism (Hoover & Donovan, 1995; Rubin & Babbie, 1997; Slife & Williams, 1995). Empiricism is an epistemology or a science of knowing (Rubin & Babbie, 1997).

The philosophy of positivism is closely related to the epistemology of empiricism. Epistemology concerns the nature, origins, and limits of knowledge. From a positivistic perspective the purpose of science is to help scientists formulate a coherent view or model or the world. From this position, scientists gain confidence about certain regularities on the basis of experiments, from which they formulate constructs that they use to explain those regularities. Positivists deal with the observable. They believe that all constructs used to explain the world ought to be based on observation. For positivists there is no value in claiming that a construct is important if there is no observable phenomenon for the construct to explain (Slife & Williams, 1995).

The methodology used in this study was grounded in positivism. Yet it was not exclusively positivistic. The scientific method used in this study is called logico-empirical. The pillars of this method are logic (or rationality) and observation. From a logico-empirical perspective a “scientific understanding of the world must make sense and correspond with what we observe” (Rubin & Babbie, 1997, p. 42). This study is based on the following assumptions about spirituality:

1. There are fundamental characteristics of spiritual beliefs that are
universal.
2. Spirituality involves beliefs about the nature of reality.
3. Spiritual beliefs involve several factors that are interrelated.
4. The fundamental characteristics of spiritual beliefs can be known and
measured.

Delimitations

1. Alpha reliability and factor analysis were used to explore the relationships between the variables hypothesized to be related to spirituality.

2. The model was built based data gathered via questionnaires utilizing Likert scaled responses. This format forced mutually exclusive responses ranging from ‘strongly disagree’ to ‘strongly agree’. The middle choice was ‘undecided’. This structure did not allow for a response that was inclusive of agreeing and disagreeing. Such a paradoxical response may be representative of spiritual beliefs.

3. The use of questionnaires limited the richness of the data to the context of the ‘questions’. The use of written language is problematic for the following reasons: a) subjects make their own interpretations for meaning, b) the English language may be limited in providing contextual symbols for a spiritual reality, and c) the processing of language and use of reasoning may create reactivity suppressing spiritual awareness.

4. Qualitative methods were used to refine the conceptualizations of the identified dimensions of spiritual beliefs. In qualitative research the investigator is the primary instrument in the gathering and analyzing data. A human instrument is limited in that mistakes are made, opportunities are missed, and personal biases interfere (Merriam, 1998).

Conclusion

The purpose of this study was to conceptualize a model of spirituality. Chapter 2 presents a review of the literature in the social sciences to support the claims that spirituality is important to social work and that there presently no agreed upon conceptualization for spirituality. Chapter 3 describes the methodology used to develop a conceptualization of a model. The methodology involves two phases. The first phase used quantitative methods in order to identify and examine spiritual beliefs along hypothesized dimensions. The second phase utilized a qualitative method to richly describe these dimensions and their relationships. Chapter 4 presents the results of the quantitative and qualitative phases. Chapter 5 presents a discussion on the development of a model based the results. Additionally the limitations of the study are discussed along with recommendations based on this research.

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