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  153 CHAPTER SIX CONCLUSION Introduction  The present chapter summarizes and integrates the entire study and provides directions for future work. First it recapitulates the nature and purpose of the study, followed  by a review of the literature. The quantitative and qualitative methodologies are then described. This is followed by a description of the quantitative findings, a description of the qualitative findings, and an extended discussion of both sets of findings and what the two sets of findings appear to mean in light of each other. The chapter concludes with the study's theoretical, clinical, educational, and research implications for social work and directions for future research.  Background Social work’s mission is “to enhance human well-being and help meet basic human needs of all people” (National Association of Social Workers, 1999). These naturally are intimately interrelated and can be regarded as the same goal (see Griffin, 1986; Maslow, 1968; Towle, 1945). Social work and other scholars have advanced the notion of human  beings as biopsychosocial-spiritual beings (see Canda & Furman, 1999; Robbins, Canda, & Chatterjee, 1998), hence as having physical, psychological, social, and spiritual areas of well- being. Social workers have traditionally seen the helping relationship as a principal vehicle for enhancing well-being (e.g., Perlman, 1979; Richmond, 1922/ 1971), a notion supported  by considerable research (e.g., Horvath & Symonds, 1991). The understanding of human beings as biopsychosocial-spiritual as well as the  154 understanding of the helping relationship as a principal vehicle for enhancing well-being are shared by spiritual guidance traditions, such as Buddhist Vipassana meditation instruction and Christian spiritual direction (see Neufelder & Coelho, 1982; Gunaratana, 2001; Kornfield, 1977). Since social workers report a lack of training in addressing spiritual well- being in particular (Canda & Furman, 1999), the spiritual guidance traditions may be able to  provide knowledge that will be helpful to social workers in enhancing all forms of well-being in their clients.  Purpose of the Study The study sought understanding of how, from the viewpoints of help-seekers, well- being is promoted in help-seekers, particularly through the helping relationship. The areas of well-being addressed were physical, psychological, social, and spiritual. The helping relationship was broken down both by type and by strength. The types of helping relationships addressed were clinical social work and spiritual guidance relationships. Spiritual guidance relationships were further subdivided into Buddhist Vipassana meditation instruction relationships and Christian spiritual direction relationships. Strength of helping relationship was subdivided into a structural component (addressing problem definition, goals, and tasks) and an interpersonal component (addressing the interpersonal affective  bond). All human beings, and thus all clinical social work clients, are presumed by some leading theorists to be biopsychosocial-spiritual beings. Therefore, clinical social workers should seek to address and, if need be, enhance clients’ physical, psychological, social, and spiritual well-being (Robbins, Chatterjee, & Canda, 1998). Social workers, though they  155 appear generally to believe that spiritual well-being is highly important, do not generally feel well-prepared to address this area (Canda & Furman, 1999; Derezotes, 1995). This means that in one arguably universal aspect of well-being, clients encounter social workers who are likely to feel ill-prepared to be of help. The purpose of this study, then, was to provide clinical social workers with empirical evidence to guide them in using the helping relationship to promote overall biopsychosocial-spiritual well-being. This purpose was supported by a two-phase quantitative-qualitative approach, providing objective and subjective strategies to understand the matter in question. The quantitative phase used reliable and valid measures to address well-being and the helping relationship, permitting statistical analyses of data The qualitative phase used a semistructured questionnaire with follow-up questions to elicit help-seekers’ personal understandings of well-being and how it is enhanced, of the helping relationship, and of their interactions   Overview of the Literature The central organizing concept to the literature review was the ways in which well- being is enhanced by the helping relationship. Both theoretical and empirical literature concerning well-being and the helping relationship were reviewed. Theoretical literature on well-being revolved around Wilber’s (2000) notion of human functioning as tied to complex holarchical development. Theoretical literature on the helping relationship was arranged around Poulin and Young's (1997) analysis of the helping relationship into a structural component and an interpersonal component and Bowlby’s (1982, 1988) concept of the attachment relationship and the relationship between the secure base and exploration .    156 Empirical literature was arranged around the connection between well-being and the helping relationship. Finally, an integration of the central theories was proposed.  Dependent Variable: Well-Being The overall theory used to address the nature of well-being was transpersonal theory as developed by Wilber (2000) in his Integral formulation. Central concepts addressed were holarchy, levels, lines of development, and quadrants. The concept of holarchy, taken from systems theory, is that systems (including human beings) are arranged into hierarchies of holons, holons being systems which contain or are contained by other systems. Each system in a holarchy transcends and includes simpler, less differentiated systems, and is transcended and included by more complex and differentiated systems. In Wilber’s theory (as in systems theory in general [e.g., Bertalanffy, 1968]), human development occurs holarchically, with new capabilities emerging sequentially and transcending and including existing capabilities. For instance, the emergence of the capacity for formal operational thought occurs after the emergence of the capacity for concrete operational thought; it both   transcends (goes beyond) concrete operational thought and includes concrete operational thought. Human functioning is presumed to be multilevel; Wilber customarily presents nine or ten levels, although these can be subdivided further. The levels can also be grouped into three realms, prepersonal, personal, and transpersonal (Wilber, 1986a). The prepersonal realm is characterized by the emergence of sensorimotor intelligence, emotion, and magical thinking. Overall, the prepersonal realm worldview is egocentric, with a general lack of ability to see oneself in perspective or to understand the perspectives of others. The personal realm is characterized by the emergence of a relatively clear self-other distinction. This includes the  157 ability to take the perspectives of others, first in the relatively simple manner of concretely understanding rules in a game, a schoolroom or society, leading to a sociocentric orientation. This capacity becomes more complex as one begins to understand the existence of multiple  perspectives and rules and the concept of rules and perspectives abstractly. This often involves a capacity to question the nature of rules and roles. Eventually it culminates in a worldcentric orientation, involving the ability to consider and value the perspectives of all humanity and even all living beings. The transpersonal realm involves a growing capacity to transcend self-boundaries, let go of personal separateness and to experience union with the natural world, with the divine, and eventually to go beyond any conventionally understandable sense of self. The transpersonal orientation can be described as theocentric (God-centered) or pneumocentric (spirit-centered). Levels, in Wilber’s thought, can exist in terms of both experience (or state) and stage (or trait). For instance, a young child generally operating in one of the prepersonal realm stages may have a transpersonal experience (or state). The transpersonal experience, however, would be interpreted at or assimilated to the child’s predominantly prepersonal level of understanding. An experience or state, then, is relatively passing, while a stage or trait is relatively enduring. Stages emerge sequentially and develop holarchically, but states may arise very much non-sequentially. Developmental lines (A. Freud, 1965; Wilber, 1997, 2000) are areas of function that develop holarchically but also tend to develop unevenly. Thus it is possible to be highly developed cognitively (i.e., on the cognitive line) but relatively undeveloped on the emotional, social, or moral lines or to have developed healthily on some lines and
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