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Using Spiritual Needs Assessments with Persons with Disabilities:
Ideas for Agencies

by Rev. Bill Gaventa

Determining a person’s interest in spiritual expression and religious activities should be part of any person-centered planning process. And while it involves more than asking whether someone wants to go to worship services or not, it does not have to be complicated.

Over the years, chaplains and agencies have developed forms called by names such as “Individual Faith Profile.” Common items covered are faith traditions, congregation membership, rites or sacraments that have been received or desired, faith involvement (worship, religious education, congregational programs, prayer, etc.), and areas of support needed for effective inclusion. More thorough “spirituality” profiles have described the spiritual interests and needs of an individual and then outlined an individualized plan for supporting a healthy spirituality. Additionally, there are literally hundreds of versions of spiritual needs assessments developed by hospitals and health care services as they recognize the importance of addressing spiritual needs and interests as part of holistic health care.

One very simple format for a spiritual assessment has been developed by Christina Puchalski, M.D., and others (Puchalski, 2000). She uses the acronym “FICA” to signify the format for initial exploration:

• F: Faith or Beliefs. What is a person’s faith or belief? What gives meaning? Does this person consider himself/herself to be spiritual or religious?
• I: Importance. How important is spirituality for this person?
• C: Community. What kind of communal expression does this take, or would the person want it to take?
• A: Address. How does this person/family want us, as health and human service providers, to address these needs and interests?

Another format developed by an interdisciplinary team in healthcare settings is George Fitchett’s “7x7” Model for Spiritual Assessment. This particular model outlines seven dimensions of holistic assessment: psychological, family systems, medical, psychosocial, cultural, spiritual, and social issues (e.g. poverty). In the spiritual dimension, seven areas are explored: belief and meaning, vocation, experience and emotions, courage and growth, ritual and practice, community, and authority and guidance (Fitchett, 1993).

More important than the particular assessment tool, though, is the sensitivity and commitment by service providers to this area of individual and family life. Why? For the following reasons:

• Opening this area of inquiry is opening an area that can have profound feelings and experiences associated with it. Asking an individual with a disability to “tell me your faith story,” in my experience, does not usually elicit a lukewarm response. Faith and congregations have been very important, either in a positive way or because of painful experiences and a lack of response to an individual’s hopes and needs. A process like the one above, adapted to your setting, is one that can be non-invasive, and can get more detailed and thorough depending on the person’s interests and wishes.
• Agencies often avoid spiritual supports because of a fear of proselytizing or a concern about “church/state” separation. A thoughtful and sensitive process and policy can help an agency avoid problems in those areas while addressing needs.
• A spiritual assessment could also be a way to involve community clergy and/or congregational volunteers. An agency which says, “We are not sure how to do this, but we know it is important. Could you help us?” might actually take the first significant steps towards collaboration with faith communities and supports. Or, stated another way, how often does your agency ask if someone might want their pastor, priest, rabbi, or someone else from their congregation to come to their IHP or person- centered planning meeting?

Thus, spiritual assessments should be more than a record-keeping exercise. They are a significant dimension of person-centered supports and community participation. A shortcoming of the process is that many people with developmental disabilities may not have had enough opportunity to provide “informed” answers because of limited experience with faith communities. Thus, the process needs to assess hopes, as well as past and current experience.

Finally, the spiritual assessment process requires commitment and follow-through from service providers – commitment to addressing an area that can touch people deeply, along with the determination to work with congregations to do what it takes to help find and/or build the supports that may be needed for participation in a faith community.

References

Fitchett, G. (1993). Assessing spiritual needs: A guide for caregivers. Minneapolis: Augsburg Press.

Puchalski, C.M. (2000). Spiritual assessment tool. Journal of Palliative Medicine 3(1), p 131.

Rev. Bill Gaventa is Coordinator of Community and Congregational Supports, and Assistant Professor, at The Boggs Center on Developmental Disabilities, University of Medicine and Dentistry of New Jersey, New Brunswick. He may be reached at 732/235-9304 or gaventwi@umdnj.edu.

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