direct social work practice with clients who experience spiritual abuse
DESCRIPTION
This paper explores the importance of assessing aspects of a client’s spirituality as pertinent to social work direct practice. It recognizes that some of the problems and issues clients bring to therapy stem from or are influenced by their spiritual/religious beliefs and their involvement in faith-based groups. I argue that social work practitioners need to be aware of the phenomenon of spiritual abuse, a term coined by pastoral counselors to describe a misuse of power in spiritual/religious contexts that result in significant psychological distress and a disruption in individuals’ relations with their significant others and with their social environment. I evaluate a variety of theories and intervention modalities that can be applied to assess and address spiritual/religious issues presented by clients to select a theory that, in my opinion, can be applied successfully in working with clients who experience spiritual/religious abuse. Finally, I present the argument that spiritual abuse is an empowerment issue, and as such, it is especially pertinent to and congruent with social work practice with individuals, families and groups.Keywords: Spiritual abuse, religious abuse, spirituality, cognitive theory, narrative theory, cognitive behavioral therapy, object relations theory, relational family therapy.TRANSCRIPT
Running head: 1
Brenda L. Caballero
Winthrop University
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Abstract
This paper explores the importance of assessing aspects of a client’s spirituality as pertinent to
social work direct practice. It recognizes that some of the problems and issues clients bring to
therapy stem from or are influenced by their spiritual/religious beliefs and their involvement in
faith-based groups. I argue that social work practitioners need to be aware of the phenomenon of
spiritual abuse, a term coined by pastoral counselors to describe a misuse of power in
spiritual/religious contexts that result in significant psychological distress and a disruption in
individuals’ relations with their significant others and with their social environment. I evaluate a
variety of theories and intervention modalities that can be applied to assess and address
spiritual/religious issues presented by clients to select a theory that, in my opinion, can be
applied successfully in working with clients who experience spiritual/religious abuse. Finally, I
present the argument that spiritual abuse is an empowerment issue, and as such, it is especially
pertinent to and congruent with social work practice with individuals, families and groups.
Keywords: Spiritual abuse, religious abuse, spirituality, cognitive theory, narrative theory,
cognitive behavioral therapy, object relations theory, relational family therapy.
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In the practice of social work with individuals, families and groups we assess clients’
situations from a bio, psychosocial, spiritual perspective; looking for aspects of a client’s
emotions, cognition, behavior and social functioning that are influenced by the social
environment and the culture in which they live. As part of that systems perspective, in many
occasions, social workers encounter in their practice issues related to a client’s religious and
spiritual beliefs and their involvement in faith-based groups. For many individuals and
families, their affiliation to religious organizations is at the center of their lives. It greatly
shapes their world views, the meaning of their life’s processes, the way they define the
source and nature of their problems, the roles with which they identify themselves; and
ultimately, their own sense of identity. Scott Richards, Bartz, O’Grady (2009) argue that
when social work professionals have an understanding of a client’s spiritual worldviews,
they are not only able to establish better rapport with their clients, but also determine if there
are spiritual issues or concerns that need to be addressed as part of their interventions (p.
67).
Literature Review
The concept of spiritual abuse, also denominated religious abuse, was first addressed
and explored by social scientists in their study of cults or new religious movements (NRM).
“NRM’s are primarily religious groups/movements that operate apart from the dominant
culture—in our case, the Christian West—in which they are located and, in addition, seek
adherents from their host culture” (Healy, 2011). A diversity of helping professionals, in
their encounter with former members of such groups in practice, developed material to work
with them using diverse psychological models of cultic influence. In the attempt to
conceptualize this phenomenon, researchers and practitioners often encountered difficulty
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finding a clear-cut definition of what constitutes harmful, abusive or pathological behavior
within diverse religious, faith-based settings. Clients who came to therapy as a result of
traumatic experiences within cults, presented a number of psychological disturbances, and
significant emotional and existential difficulties. Australian Social Worker David Ward
(2010) indicate that research studies and clinical observations of individuals who had left
NRM’s led to the identification of philosophies, rituals and practices within such groups that
were clearly physically and emotionally abusive. Empirically oriented research, focused on
observable behaviors, was useful to identify forms of “cult abuse”: boundary violations by
cults’ leadership, coercion and unethical behavior resulting in marked and significant
emotional distress (p. 900).
David Ward (2010) formulated a thesis on what he denominated toxic spirituality, or
spiritual beliefs and practices that “cease to be beneficial to the adherent, but instead become
a tool to inflict psycho-spiritual damage” (p. 899). Warp adopted the term spiritual abuse,
coined for the first time by pastoral counselors Johnson and VanVonderen (1991) to propose
the thesis that not all spiritually abusive behavior occurs in the context of cults. Johnson and
VanVonderen (1991) conceptualized spiritual abuse as “the mistreatment of a person who is
in need of help, support or greater spiritual empowerment, with the result of weakening,
undermining or decreasing that person’s spiritual empowerment” (p.20).
To explore the phenomenon of spiritual abuse within groups of Judeo-Christian
orientation, David Warp (2010) conducted a study on the experiences of individuals who left
a diversity of these groups, using Interpretative Phenomenological Analysis (IPA). IPA
consists of the analysis of the narratives of participants when describing their experience of
spiritual abuse, exploring not just the objective nature of the occurrences, but the subjective,
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internal processes of the person subjected to spiritual abuse, and the meanings they ascribe
to such experiences (Ward, 2010, p. 901). From the narratives of the individuals in the
study, Ward (2010) identified six core themes consisting of: (a) leadership representing God;
(b) spiritual bullying; (c) acceptance via performance; (d) spiritual neglect; (e) manifestation
of internal states; and (f) expanding external/internal tension (pp. 903-908). These identified
common themes through the participants’ narratives provided the base to propose a
definition of spiritual abuse, not just as a phenomenon related to cultic involvement, but as a
psychologically damaging experience that occurs when there is a misuse or abuse of power
in any religious or spiritual context. Similarly, spiritual abuse adversely affects the
interaction of the individual with the social environment. Emerging sub-themes in this
Ward’s study (2010) such as: collective consciousness, family impact, social isolation and
submission to authority, suggest that this form of abuse has far-reaching social
consequences. In this sense, Ward argues that spiritual abuse can be identified as social
problem on its own right (p. 902).
Spiritual Abuse and Clinical Work
A study exploring the impact on counselors of their work with spiritually abused
clients in the United Kingdom, identified a variety of treatment modalities in working with
this population (Guby & Jacobs, 2009). These treatment approaches included: (a) Person-
centered transpersonal; (b) Existential phenomenological; (c) Solution focused therapy; and
(d) Psychodynamic and Gestalt. The clients seen by the counsellors in this study were from
diverse Christian backgrounds, including the Church of England and Catholic
denominations. The common concerns identified by these professionals in their work with
spiritually abused clients are similar to the core themes in Ward’s study, but went further to
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include: (a) character assassination; (b) sexual abuse; (c) physical abuse and psychological
abuse, perpetrated by a leader who exerts an unhealthy form of power; (d) use of scriptures
considered ‘sacred’ by the adepts; and (e) use a leader’s ‘God-given authority’ to justify
abusive actions (Guby & Jacobs, 2009, p.191).
This small-scale study recognizes both the benefits and the disadvantages of clinical
approaches that emphasizes a worker’s empathic connection with the client, such as the
person-centered approach. As a benefit, connecting with a client’s emotional experience of
spiritual abuse, can lead to a better understanding of the client’s subjective experience and
inner processes, and provides the client with a model of healthy interpersonal relationships;
in contrast with the authoritative and domineering relationship established with the abusive
leader. As a disadvantage, it makes it more difficult for practitioners to distance themselves
from the traumatic material, opening themselves up to vicarious trauma, as the experiences
of their clients related to spiritual abuse have the potential to challenge their own cognitive
schemas and religious beliefs. Regardless of the practice framework chose to work with
these clients, Guby and Jacobs’s study (2009) recognizes the danger of a worker establishing
an agenda for the client and trying to influence a client’s views based on a practitioner’s own
spiritual philosophy (p. 202, para. 1).
Relational family therapy. In an article exploring religious-related abuse in the
family, Mandelj B. Simonič (2013) addressed the emotional aspects involved in religious
abuse and also its transfer across family generations. The author argues that certain
interpretation of religious beliefs can lead to “dysfunctional patterns of behavior in family
relationships and disruptions in emotion regulation processes” (p. 339). Religious abuse
occurs in the family when a parent or spouse utilizes religious beliefs to excuse or justify
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physical or emotional abuse of his or her children and/or partner. Simonič (2013) proposes
the application of a Relational Family Therapy model in helping clients overcome the effects
of religious abuse and restore disruptions in emotion regulation processes in the family
system.
Relational family therapy (RFT) is a theoretical and clinical model that incorporates
aspects of self-psychology, object relations theory and interpersonal analysis. RTF explores
the client’s dysfunctional interpersonal dynamics in the family, understanding those
dynamics as mechanisms created to regulate painful emotions. From this perspective,
religious abuse is seen as a mean used by individuals to distance themselves from emotional
distress, avoiding their true source, which lies in the relations from the family of origin. The
goal of RTF is to assist religiously abused/abusive individuals to develop an awareness of
how they have been using faith as a hiding place, to disconnect emotionally from the other
family members, and to avoid personal responsibility. Simonič (2013) defines the
practitioner’s role as helping clients in the process of reframing their understanding of those
childhood experiences, and to gradually transform their notions of faith in a manner that is
no longer used to perpetuate abusive relationship patterns (p. 345).
Object relations theory. Object-Relations theory offers a unique framework to
understand spiritual concerns in the lives of clients, and its application in practice allows a
clinician to foster the client’s psychological and spiritual development simultaneously.
Gurney & Rogers (2007) argue that there is a cycle of relatedness between an individual’s
mental representations of the divine and his or her relationships, worldviews, and the
purpose and meaning he or she ascribes to life’s experiences (p.691). A person’s relation to
the sacred—whether viewed as positive, nurturing, available and responsive; or negative,
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demanding and punitive—stems from internalized templates of his or her primary
relationships with caregivers. Conversely, an individual’s relationships with others are
organized in ways that unconsciously reflect his or her construction of the sacred. As an
alternative, this theory proposes that spirituality can be conceptualized as a “compensatory
object” in the lives of those who experienced poor attachments in their early development
and turn to religion in times of crisis or distress. The sacred, then becomes the “idealized,
caretaking, and nurturing other” (Davis, Moriarty & Mauch, 2013)
Recovery and restoration for the client overcoming spiritual abuse involves assisting
clients in the process of separating and differentiating from the beliefs, practices and
expectations of abusive spiritual leaders and “embracing a unique and personal relationship
with the sacred” (Gurney & Rogers, 2007). In this process, the spiritual crisis experienced
by the client, his or her clash with the incongruences between his or her beliefs, and his or
her suffering within a religious context serves as a an element that instigates the formation
of a more individuated spirituality. The practitioner provides a safe, self-sustaining, and
nurturing environment for the exploration and critical reflection of those internalized beliefs.
The clinical work involves then the recreation of fundamental elements of significant past
relationships, and reworking and remodeling the person’s blueprint for relatedness. “As
reparation is experienced and the development of an integrated self begins, a new blueprint
for relatedness will be established” (Gurney & Rogers, 2007).
Cognitive-behavioral therapy. The experience of spiritual abuse fosters in the
person highly distorted views of reality, of self and others. Those distorted religious views
can be operationalized as “the rejection of doctrines with emphasis on renewal, repentance,
restoration, redemption, forgiveness, grace and mercy, but strongly embraces ideas that
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promote guilt, shame, unworthiness, personal destruction, and self-condemnation”
(Edwards, 2006). Clinical interventions using cognitive-behavioral therapy are relevant
with people whose view of religion and spirituality has been distorted by rigid beliefs and
spiritually oppressive teachings and practices. In the clinical work, religious and spiritual
cognitions can be challenged and corrected.
Clients come to therapy projecting the relationship with abusive leaders unto their
experience of God and their interpersonal relationships in general. In cognitive processing,
the clinician identifies, explores and assists the client in correcting cognitive errors that have
religious or spiritual content. Walker (2010) emphasizes the importance of keeping a non-
judgmental and supportively impartial attitude toward a client’s personal religiousness and
spirituality (p.178). One of the roles of the clinician in the context of CBT is to “normalize”
the client’s spiritual struggles, thus enabling the person to question distorted and oppressive
beliefs. While honoring a person’s religious roots and spiritual background, CBT can help
clients analyze how their religious belief system and derived values contribute to their
notion of self-worth and their “personal boundaries for behavior” (Edwards, 2006).
Narrative theory. Spiritual abuse is a form of oppression exercised by leaders
claiming divine authority and without accepting a proper accountability over the lives of the
members of their groups. Spiritually abusive systems saturate people’s minds with self-
denigrating beliefs that disempower them to assume control of their lives. To work with
clients who have lived the experience of spiritual abuse is a process of enhancing their
awareness of such oppressive forces and enable their liberation from those limiting cultural
influences. Narrative theory is based in the premise that a person’s life is an ongoing
process of constructing a personal narrative, what people believe about themselves, their
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sense of competence and contentment, and the position they occupy in the world (Blanton,
2005, p. 81). Personal narratives, defined as a person’s view of themselves and their
problems, are shaped by beliefs that have their roots in socio-cultural-religious contexts.
These beliefs, assumptions or ideologies—secular or religious—are oftentimes passively
assimilated, overpassing the filter of critical thinking, and crystallized in rigid personal
narratives that are perpetuated through generations (Blanton, 2007, p. 215).
The application of Narrative theory to spiritual issues have been also denominated
transformative narrative therapy more commonly utilized in pastoral counseling. De Beer
& Müller (2006) defines transformative narrative therapy as an expansion of the use of
narrative therapy in the spiritual domain through the application of three basic principles:
It is dialectical and paradoxical. It embraces the paradox of evil and good coexisting
and hope and despair living together. (…) a person is encouraged to integrate her or
his problem-saturated stories with alternative ones, resulting in a more encompassing
and a compelling new narrative.
It is symbolic. The transformation is more fundamental and far-reaching when it
occurs at a symbolic level. (…) Even negative events, whether early childhood abuse
or adult traumatic experiences, can become symbolic of something spiritual,
something positive.
It is heroic. It does not seek easy victories, nor does it aim at superficial solutions. It
demands taking a courageous stance in life; it requires an unwavering willingness to
confront and slay one’s dreaded dragon. The end result is that a victim’s journey is
transformed into a hero’s adventure. (p. 77).
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Spiritual Abuse and Cognitive Theory
From the perspective of cognitive theory, the domain of spirituality is conceptualized
as the core beliefs, and the values derived from those beliefs, that give meaning to a person’s
view of reality, to their life experiences and that motivate their actions. Johnson &
VanVonderen (1991) maintain that in spiritual abusive systems—where spirituality is used to
inflict psycho-spiritual damage—members struggle in the following areas: (a) the
development of a distorted image of God; (b) tendency toward extremes of perfectionism,
self-righteousness or shame, (c) development of a distorted self-identity, (d) a tendency to
the extremes of compliance or defiance in relation to authority, (e) problem in the area of
personal boundaries, (f) difficulty with personal responsibility, (g) lack of living skills, (h)
hard time admitting the abuse: the person have lost track of what normal is, it feels like they
are being disloyal to family, to church, even to God, and (i) difficulty with trust: hard time
trusting a spiritual system again (p.44).
Cognitive theory asserts that deeply held irrational beliefs about how things should
or must be are the root of a person’s most distressing emotions. These core beliefs or
schemas lead to faulty assumptions and result in dysfunctional coping skills: in the sense
that they prevent a person to succeed in achieving their life’s goals. Cognitive therapy
provides a suitable framework to work with clients who experience spiritual abuse mainly
because it is based in the premise that “even when some of a person’s beliefs are distorted,
the potential to correct them in light of contradictory evidence is great” (Walsh, 2010). In
cognitive therapy those cognitive deficits and distortions are explored and addressed. The
social worker assesses the client’s cognitive assumptions, identifies any distortions and
guides the client in reasoning through detailed, focused questioning with the purpose of
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uncovering the rationality of thought patterns. The social worker serves the role of coach
and educator, helping the client experiment with alternative ways of approaching challenges
that will promote goal attainment.
When addressing spiritual issues in the context of cognitive theory the practitioner’s
role is not to question the validity of a client’s religious beliefs, but to guide them in
analyzing “how their religious belief system and related values contribute to their
conception of worth and their personal boundaries for behavior” (Edwards, 2006).
Cognitive therapy focuses on interventions that address a client’s distorted view of religion
and spirituality and its implications for their view of themselves, others, and their realities.
Clients who have lived the experience of spiritual abuse view religion as a force that is
emotionally and spiritually oppressive rather than a source of personal strength and
inspiration for the improvement of self and the betterment of society. Cognitive therapy is a
process in which the clinician and the client collaborate in a work of empirical investigation
and reality testing; considering new perspectives and alternatives for understanding reality
and the nature of problems, exploring and learning innovative problem solving.
In working with clients deal with the effects of spiritual abuse, the social worker
must endeavor to familiarize her/himself with the religious tradition and sacred texts that are
the foundation of a client’s belief system. Spiritually abusive systems are nothing but a
distortion of more orthodox views of the divine. Spiritually abusive leaders teach skillfully
manipulated and ill-interpreted notions derived from the foundational truths of universal
religious traditions. Those maladaptive interpretations can be treated in cognitive therapy as
testable hypotheses. The original sacred texts are then used by the practitioner to “examine
alternative interpretations and to generate contradictory evidence that support alternative
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beliefs which may allow for therapeutic change” (Edwards, 2006). Utilizing the same
sacred writings manipulated by abusive leaders, the clinician encourages the clients to
embrace their religious heritage considering alternative perspectives, rather than completely
abandoning their spiritual roots.
Trauma-focused Cognitive-Behavioral Therapy
Based on the Ward’s (2010) investigation exploring the subjective states of those
affected by spiritual abuse and the physical and psychological repercussions of their
experiences, it is reasonable to consider the experience of spiritual abuse as a source of
trauma for the purpose of clinical work. In many instances, spiritual abuse is accompanied
by real or perceived threats of harm, and even physical or sexual abuse by members of the
clergy. According to a study on victims of destructive cults (De la Peña, 2000), the
pathology in the context of the structural organization of some religious movements is
sufficient to generate psychic trauma in their adherents. De la Peña (2000) claims that
victims of the most destructive religious movements present symptoms of Posttraumatic
Stress Disorder (p. 192).
Walker (2010) proposes a model for addressing religious and spiritual issues in
trauma-focused cognitive behavior therapy that is also appropriate in the work with children
and adolescents. Walker (2010) suggests that, in the context of trauma treatment, it is
helpful to assess whether a client’s religious beliefs play a role in exacerbating a client’s
symptoms or relieving the effect of the trauma (p. 177). In the assessment stage, the
clinician explores clients’ core religious beliefs and values with open-ended questions with
the goal of obtaining information to evaluate clients’ psychosocial and spiritual functioning.
In the initial stages of the intervention, normalizing spiritual struggles is part of the
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psychoeducation piece in trauma-focused cognitive behavioral therapy (Walker, 2010). By
normalizing their struggle, and the projection of their relationship with the abusive leader
onto their notions of God, “we enable clients to question their wrathful and angry image of
God”, that will be probed and corrected on the subsequent stages of the intervention.
Elements of narrative theory are incorporated to TF-CBT. The use of stories or
narratives within the client’s religious tradition is helpful to enhance clients’ perspectives of
their traumatic experiences. The client is then encouraged to process their own experiences
and to create their own narratives. The clinician assists the client in creating this narrative,
inviting the client to reflect on what has changed since their involvement with the religious
group and what is different since the clinical work began. This reflection involves the
discovery of what the person has learned and what advice he or she might offer someone
else going through similar situations.
As part of the psychoeducation component in TF-CBT, the clinician can expose the
client to books or audiovisual material related to spiritual abuse, including testimonies of
former members of spiritually abusive churches. The clinician can provide assignments and
tasks to facilitate the exploration of cognitive distortions. With the use of sacred texts of the
client’s own religious tradition, the client can be asked to find parallels to their spiritual
struggle in stories from the scriptures. Most religious texts have narratives that intend to
make meaning of suffering and teach to overcome adversity through faith. The clinician can
assigned the client the task of identifying Bible characters or historical figures who struggle
with their faith, or made bad choices and were able to restore their lives and be successful in
the end Nonetheless, Walker (2010) discourages clinicians to attempt to answer clients’
existential questions, but rather help them process their thoughts and feelings about the
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divine. For instance, the use of an “empty chair technique in which the client alternates
between asking God questions and stating what they think God’s responses” (Walker, 2010,
p. 179) can be useful.
Spiritually toxic teachings instill in adherents a tendency to overgeneralization and
dichotomous thinking patterns. This tendency is reflected in the client’s use of “strongly
worded statements” (Edwards, 2006) that contains words and phrases such as “ought”,
“should have”, and “must” in describing their experiences. As part of the behavioral
component of TF-CBT, the clinician can use the teaching of self-talk to assist clients in
reflecting on their words and their unique interpretation of those messages. When clients are
able to identify harmful thoughts and words in their own internal dialogue, the clinician can
direct them to create a different script that reflect a less rigid view of God. An example of
these thinking patterns can be statements such as “unpardonable sin”, “bad decisions are
made by bad people”, “doubting means you are spiritually weak and a backslider”.
The practice of mindfulness in TF-CBT is compatible with most religious traditions
if the clinician has the cultural sensitivity to adapt the technique to a particular client’s
spirituality. Highly conservative clients with a religious fundamentalist orientation might be
alarmed at the idea of a clinician teaching them to meditate. This practice can be adapted to
incorporate a client’s own spiritual practices and beliefs, like concentrating on the words of
Bible verses or the “Jesus Prayer”. Similar passages from the Torah or the Quran could be
identified in collaboration with clients of Jewish or Islamic traditions. Sacred texts can be
extremely useful to challenge dysfunctional and maladaptive thoughts and replace them with
highly positive, inspirational and constructive perspectives that are congruent with the
client’s own religious background.
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Conclusion
Spiritual abuse is an issue of oppression that involves the misuse of power to
undermine a person’s strengths and to weaken a person’s sense of worth, value, competency
and self-efficacy. Spiritually abusive leaders consistently violate their followers’ personal
boundaries and their rights to self-determination. An empowerment based social work
practice needs to acknowledge this phenomenon and recognize its impact in the personal,
familial, social and spiritual struggles some clients bring to social work interventions. Most
theories used in social work practice provide a useful framework to assess and address
issues related to spirituality and are suitable in the intervention with clients who experience
spiritual abuse.
The experience of spiritual abuse generates cognitive distortions, maladaptive
thought processes, and erroneous assumptions. A cognitive theory approach in social work
practice focus on the evolution of these cognitive patterns and their impact on a client’s
internalized representation of the world that, in turn, influences a person’s configurations of
thought, action and problem solving. Cognitive interventions, such as TF-CBT, are
applicable in correcting clients’ erroneous beliefs with the potential of helping them adjust
cognitive possesses in a manner that facilitates their understanding of their spirituality and
how it impacts the attainment of their life’s goals.
However, it is important for the social work practitioner to be aware of the
limitations of cognitive theory in working with children and adults with cognitive
limitations. On the other hand, its emphasis on rationality may be unappealing for clients
whose spirituality relies more on emotional or instinctual experiences and responses.
Cognitive theory claims of “objectivity”, have the potential risk of the practitioner
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overlooking the ways in which their own values can influence what is defined as “erroneous
thinking”. An awareness of one’s own biases, as well as knowledge of and respect for a
client’s religious or spiritual roots can lead to a more sensible application of this cognitive
theory in addressing spiritual issues.
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