Spirituality in managed care

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Spirituality in managed care

Hello Everyone,

I am a second year Child and Youth Care student at Red River College and am researching the topic of religion and spirituality for my ethics class. Below are some questions I have that I would love to hear your opinions on. Please feel free to answer one or all of the questions.

1. Should it be the responsibility of CYCPs to be meeting the spiritual/religious needs of youth in care and should we be facilitating their exploration of their own spiritual journey?
2. Do CYCPs have the right/responsibility to limit the spiritual/ religious exploration of youth when it comes to alternative spiritualities such as Buddhism, the Muslim Faith, Shamanism, Aboriginal spirituality, and Wicca?
3. How do we, as CYCPs, look beyond our own religious/spiritual values to encourage spiritual growth in the youth we work with?

Thank you all for your time.
Jessica Lusk
Winnipeg, Canada
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Hi Jessica,

As a Child and Youth Care worker who works with youth at risk I believe that it is not my responsibility to meet the religious beliefs of youth in care. I believe this simply because I do not want my own spiritual life to overlap into the work I do with youth. That being said, I am always open to engaging with youth regarding any queries they might have in relation to"facilitating their exploration" including those they might have for me. I also believe that I do not have the right to limit anyone's exploration and would go so far as to say I would support the exploration of any "alternative spiritualities" because I think thatwhen one is open to the beliefs ofothers it cannot help but create inclusion rather than exclusion. I might have some curiosity about thisquestion and the intention of the CYCP's (although I'm not really sure what the initials stand for) who are doing the limiting. For #3 Do I need to look beyond in order to support the youth? Myintention is to be open to the youth's exploration without judgment, to support them to thrive.Although myown beliefs and values are a component of the package that makes upwho I am as a practitionerIcan encourage youth without that being part of the mix while at the same time Iam willing to discuss/disclosemy spiritualbeliefs if they are curious and it is appropriate.

Marjorie McQuarrie
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I think that one consideration would be that while the we may not want to sway the child's needs, the church can be a stable community organization which can provide long term support to high risk youth. These youth often have burned the bridges with family, and when looking at building a support network for the client, to be in place after we are gone the church may be one of few workable long term places.

Joyce Ottewell
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Dear Jessica,

1) I don't think it is your responisbility to guide anyone on their own spiritual journey. You may travel that road with them as a friend and witness their explroation and wonder.

2) I have great concern for the potentail abuse of power that can occur with careworkers around issues of religion and spirituality. Coming from a Friends tradition and living in the Bible Belt of the States one runs into many caregivers who feel it is their duty and responsibility to prosletize and preach to "non-believers" especially when they are in care contexts. Perhaps it is appropriate to talk about our own sources of strength and relationship with the Spirit, but it is as damaging to lead a youth into religion as it would be anto almost any other thing if they do not choose it or it is not relevant to their care and psace in the world. We do not know where they came from (unless we ask) what their family history or personal history are in relationship to the spirit. Many folks have been hurt by other's beliefs.

3) I personally feel that if a person is interested in as you say "alternative" faiths or spiritual practices, it is my duty as an open minded care-giver to support them in their exploration. There are some Christian faiths which beleive that gay folks will be going to hell for example. Perhaps leading someone towards that end is acutely problematic, but discouraging them from exploring pagan or buddhist religions that they have an interest in may be just as irresponsible and unprofessional, as well as spiritually unsound. Our relationship to the spirit is manifest in many ways and everyone's relationship is worthwile as long as it is productuve and supportive of life and support. For many youth in crisis it can be a tremendous source of stabilty and solitude in a world of horror and fear. Who are we too judge what form Love can come in? Mightn't our own faith be enhanced by listening to another's? Perhaps many folks have trouble with such a realitivist or a multiple-truth perspective, but I feel that our faiths are as different as our lifestyles, languages, personalities and hairdos. Squashing that individuality and exploration in a young person, especially in the realm of spirit goes counter to the ethic of youth development. Perhaps if you are having difficulty with the youth's exploration you need to check yourself and seek support from others. Their different faith should not challenge your own, and if it does then that is your place for growth not theirs. I hope you find peace in your journey with this young person and relish the opportunity for a spiritual journey that you are privileged to witness. The spirit works in wonderful and miraculous ways.

Peace,
Peter DeLong
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Trauma also comes out of very religious and spiritual based families-of- origin environments. Therefore, I would always caution CYCW's to monitor their own biases and not impose views on youth that could potentially trigger them. Also, I think it is our role to work with what we know (eg. drug use/abuse issues, self harm, etc...). I might be alone on this but use reflective practice and check your agency's policy on the matter and meet with your supervisor.

Tokla Shaw
Child and Youth Care Kamloops, BC
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Dear Jessica,

Yes, as Child and Youth Care worker in my opinion one of the needs of children is the spiritual need which we could provide as an option to the children. I feel we as facilitators have some responsibilities to equip children with different skills for them to deal with their life. I have been running a children's facility for the past 8 years and the issue of spirituality was one of our interventions and this was not restrictive but children had the authority to choose which church to belong.

Felix Mwale
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Hi Jessica,

Regarding spirituality. As Child and Youth Care professionals we are responsible to ensure that youth in our care develop on 5 areas to make them "whole". One of these areas are spirituality. This will mean that opportunity be provided, time and space, for the youth to have opportunity for their spiritual development. We should also be aware that we cannot impose our own values on other people – children or adults. Spiritual development should also take into account of the youth. This will assist you to assist the young person to make a choice. When young people make a choice regarding to their spirituality that is not in line with the background it is also good to include the parents in such discussions. An example is that is someone wants to convert from Judaism to Muslim faith it is the responsibility of the CYCP to ask the young person to first discuss the decision with their parents.

Providing opportunities for young people to explore different religions should be available. This should be done in a structured manner. Literature around different religion could be made available. Young people could be taken to the various religious gathering to have a personal experience about the religion. The organisation could also arrange that someone from the religious group have a talk at the facility.
The attitude of CYCP staff towards different religions also play a role in the decision that the young person will make. We should only be the people that provide the opportunity.

I hope that this will help you.

Regards
Alfred Harris
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To answer your three questions:
1. I think YES. An individual's morals and values are often deep rooted in their religious beliefs or their faith, and very often it is only through religious instruction that children learn the valuable moral lessons. Of course, there will be a number of difficulties in doing this – a practitioner cannot provide instruction or guidance in religion that she is not familiar with or involved with herself. So I don't think that all CYPSs should necessarily be attempting to meet the religious needs of youth, but I believe every programme should have some staff that CAN provide this guidance. As children grow older and enter adolescence, they will also have critical questions about religion and faith, and will require some mature guidance on the subject.
2. This is a very difficult one! Professionally I would have to say that deliberately limiting or preventing a youth's further exploration of spiritual matters is more likely to produce a rebellious attitude. It is also not possible to really CONTROL a youth's exploration of these issues. One's viewpoint would depend greatly on one's own religious stance and personal beliefs, which is not easy to separate from one's professional views. I don't think curiosity about other religions will necessarily influence a youth to change their beliefs. I really depends on your responsibility and the role you have in relationship to the youth. If your role is taking on "parental" responsibilities, then I do believe you should responsibly guide youth in religious matters, and if that includes exploration of other religions, I would do that WITH the youth to ensure that they receive objective information.
3. I'm not sure we should be looking beyond our own religious values, and my opinion might upset a lot of people. I know that "professionally" we should be "objective", bla bla bla, but I have been working with children and youth for 10 years now and I wonder: Why are we often "professionally" doing different things than what we believe "personally"? How do you honestly and sincerely guide children and youth, when you personally have different viewpoints on what you are supposed to implement professionally? I think children pick up on this incongruence in our lives, and that diminishes the power of our roles. I think we should find programmes to work in, where the professional viewpoint matches our personal beliefs, so we can be 100% sincere and honest in our interactions with children and youth. This is obviously just my personal opinion – I won't even try to be "objective" when it comes to matter of religion.

Werner van der Westhuizen,
Village Director SOS Children's Villages
Port Elizabeth
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Hello Jessica,

As I see the matter of religion or spirituality should be left to the individual to explore. However, it is the responsibility of the worker to support the youth to practise his religion by helping him to connect with his religious or spiritual group and making sure the environment includes his religious values. At times, different religions require special care and attentions. Having said that there must always be a clear differentiation between a profession and religion. As a professional I am responsible to live up to the ethical guidelines of the organization.

Kasahun Tessema
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1. I feel as people in this field it is important for us to support/facilitate thier exploration of their own spiritual path.
2. No we should not limit their exploration, I feel we can express our concerns if some of their behavior/actions towards others becomes nonbeneficial, particularly if it becomes harmful, then we do need to step and address these actions and behavior.
3. We put our feelings aside and listen to them and their needs and what is best for them.
Thanks for the questions ... these are great ...

Martin Stowe
America
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Hey Jessica,

I am from Winnipeg myself and a youth worker. I don't know if it should be a responsibility to teach religion, however being a Catholic myself, I do think youth workers should be allowed to discuss religion with clients and it should even be encouraged for those counsellors who feel comfortable doing so. The reason being that many youth in care lack a sense of belonging and a religion or faith may allow this sense of belonging. We allow it in the form of so called NATIVE STUDIES, why not other religions as well?

Joseph
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Hello Jessica,

I think if we are talking about meeting the needs of youth, then there is no cut off point. Why attend to physical and emotional needs and leave spiritual needs out? Having said that, my experience has been that we have done poorly in this area perhaps because often we as youth workers may not attend to our own spiritual growth.

On your second question, I can remember several debates at work. Often we were worried about harm issues. we could be lacking knowledge about the religion or practices associated with it. It might even go against what some believed. What were the family's views? What might a board of directors think? I would like to say that the answers were smooth ones but I don't think they were. I think I come down on the side of limiting when there are harm issues for the youth and that could probably lead to another discussion. I would also say I don't think my religion of birth and spiritual growth always go hand in hand. I don't look beyond my spiritual values to encourage spiritual growth in youth. I come as a package and that is an important part of me. I'm not trying to convert. My reading suggests that there are a lot of wonderful spiritual teachings in various religons. I would like to think that there might be opportunities to connect with youth on a more spiritual level.

Charlie Coleman
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I think as youth care workers it is our responsibility to assist young people with a holistic approach to life which includes spirituality as well as their physical and mental well being. If youth care workers are not available to facilitate this aspect of their care, who is going to do this? I think that spiritual and religious exploration can be a very healthy manner of connecting with a young person and assisting them with their journey through life. As with anything, the youth care worker would need to be open to discussion about various alternatives of spirituality and be with the young person through this process. As with any values there is a way to incorporate them into your day-to-day interactions with young people. We ask young people to look beyond themselves every day when we are assisting them with family and personal issues that arise. So the question remains.....If we dont do it, then who will?

Donna Banks-Jones

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1. I don't believe that any human being can meet the spiritual/religious beliefs of another but I do believe that we should facilitate exploration of any youth's spiritual journey.
2. I don't feel that we have any right to limit spiritual/religious exploration, especially not of the major faith groups that you mention, but youth in care may be vulnerable to exploitation by 'religious' cults that have more to do with power than faith.
3. By accepting them for who they are and respecting their 'difference'

Alice Forsyth
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Jessica,

I believe before we enter spirituality and religious areas with children in care, we must first define both for the children and the adults who care for them. This is a broad area and without clear definitions of both spirituality and religion we can do more harm than good.

It isn't necessarily the responsibility of CYCPs to meet these needs. It is however our responsibility to educate ourselves in an effort to remain culturally competent and aware of the many beliefs, religions, spiritualities of the children we serve and the families they come from. Without competence in these areas, again, we can do more harm than good.

For example, there are several Wabanaki children in our residential treatment center. Without cultural understanding of their history, background, our own bias towards religious and spiritual beliefs of this group, or in general of religion or spirituality, can again do more harm than good.

Spiritual growth and religious growth seem two different areas. We look beyond our own by studying and gaining solid knowledge before we help others look at theirs.

You ask tough questions and I would love to see your report. The issue is big and obviously controversial. In regards to childcare, we should be patient, knowledgeable, and competent in understanding how and what we believe, before we encourage them to look at their beliefs.

I struggle with this issue in my center and folks sometimes cringe when I approach the subject of religious awareness and spirituality. I think it must be a group effort and not necessarily left to direct care. The first step is seems is awareness of what the kids seem interested in and believe, the second seems gaining the knowledge to discuss spirituality and religion as two issues, as well as the knowledge of what we actually believe ourselves. The third step is perhaps using the skill we gain from the first two steps to explore the subject with kids without bias.

Just some thoughts. Good luck.
Jean Dickson
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Well said Jean. I am a "Stoney" Youth worker and lately, I've noticed that First Nation children in care are not given full oportunity to gain access to their cultural and tradional backgrounds. In Alberta, as long as they have "access" to an "Aboriginal Liaison" of sorts is the most common solution.

With that said, it would still be questionable if a youth worker who would be "Mohawk" descent offering "spiritual" teachings to a "Cree" youth. Keep in mind to be "politically" correct and safe, some First Nation communities might refer to the "Assimilation" process and have some valid points to question how Child and Youth Care agencies utilize "best" practices.

Djrain
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Hi Jessica,

I know I am getting in late on the discussion. We here in Edmonton are taking a course (Child and Youth Care Practice with Individuals) for the Degree program of Child and Youth Care a great book and easy to read is: Wiggins Frame (2003) Integrating Spirituality and Religion into Counseling. The format is easy and it is very thought provoking in some of the questions that you pose on your request. You can also refer to the CYCAA Code of Ethics as well, regarding some of the issues around informed consent.

My own opinion is yes, we are responsible in that we should be assisting them in their journey but not enforcing it either. I think this is an area that is often forgotten about and many of these children/youth previously before coming into care have had their own personal experiences when attached to their families that indeed they did attend church or go to a group that was affiliated some way to their spiritually and or faith. Can we meet their needs, probably not in the practical sense (maybe getting them there or connected) but we can assist and guide them towards the resources and their own inner resources by having open and very honest conversations about this area. Keeping in mind informed consent and talking about introducing this aspect first before delving into it.

Another area is to question our own beliefs and how this may challenge / hinder us from having these conversations around this topic. Maybe it is our own uncomfortability that hinders us as helpers. The book I referred to has great activities inside and questions to help us question ourselves and apply some of the theory that is behind the frameworks. I know from experience that I had a scenario that because I was not really aware of the basic practices of this group of Christians I did a faux paau in giving a gift to one of my adolescent boys during the holidays. I found out later only by asking the foster parent that this is not typically celebrated on the usual Dec 25th holiday. Clearly her beliefs and values is a main motivator to how she lives and practices her daily life events including weekly worship at Church. This allowed me some insight that we need to start asking questions, primarily the clients, families we work with. We often find hidden strengths and qualities in their faith, spirtuality and religion.

Good luck in your assignment,

Mel Fjell Youth / Family Aid Worker
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... and, replying to Jean:

I wasn't implying that access to a cultural liaison was enough ... I'm actually not in favor of it. I think simply helping kids mature and let them make their own decision should be the focus. Even in First Nation Communities, you can never tell. Some are Catholic, Methodist, Buhddist etc.

Djrain
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I am delighted to see a discussion about integrating religion and spirituality on CYC-Net. It's an important question, whether or not it's within our scope of Child and Youth Care practice to venture into this area with children, youth, and families. In the Child and Youth Care degree course, mentioned by Mel Fjell, we have referred to definitions of the Child and Youth Care profession, and the UN Charter of Rights for Children, as well as the current mandate for Alberta Children's Services, all of which include the spiritual needs of our clients as a focus of our service (along with the cognitive, physical, emotional, and social domains). To my mind, the question then becomes not so much should we address this area, but what is best practice in responding to the spiritual needs of those we serve? Child and Youth Care codes of ethics inform our practice here, as in all aspects of our work. The ethical guideline of "do no harm", for example, has two sides to reflect on. In Integrating Religion and Spirituality into Counselling, Wiggins Frame suggests it may be just as harmful to neglect or avoid the spiritual needs of a client, as trying to push a vulnerable client into adopting our own religious or spiritual perspectives. There is a vast body of literature emerging on children's spirituality, which suggests that spirituality is innate, and that most, if not all children have spiritual experiences: children often find that adults do not believe their spiritual experiences and so they learn not to talk about them. So, I think the ethical guideline of child-centered practice is helpful here: if Child and Youth Care Workers take their lead from their clients, we can respond within the client's worldview, thus meeting their developmental needs, without harm. Of course, informed consent is essential, and working within agency and program policy. And, we have the ethical responsibility not to work beyond our level of competence. Wiggins Frame points out the lack of direct training around integrating religion and spirituality into practice, in the helping professions. I am happy to see signs that we are beginning to address this area in Child and Youth Care educational programs, conferences, and professional journals. The biggest question seems to be how to support spiritual development in children, youth, and families. I would be interested in ideas from other Child and Youth Care Workers on this issue!

Louise Bureau
CYCWorker/Instructor Child and Youth Care Program
Grant MacEwan College
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Reply to djrain:

Good points.

I don't think access to a liaison is enough or best practice. I know we are not doing as well as I would like and am currently working on my dissertation to measure cultural competency of direct care counselors. The awareness, knowledge, and skill of the counselors should really be of natives in general and the culture and traditions of kids they care for specifically.

There is still such a long way to go to meet the needs of all the kids in care. I would love to see what you are doing in your area. Currently, there are only 3 Wabanaki in care at this facility and their cultural background seems the least of the staff member's concern. All things in time, but I am certainly making an attempt to bring this issue to the forefront to best serve everyone.

Jean

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Spirituality in managed care