THE "SPIRITUAL-HOLISTIC INQUIRY PROCESS"
Accurate assessment (or evaluation) is an essential first step in providing care. It's useful whether you're a minister, a healing professional, or just a caring friend, in your daily life. It helps you know where to help, by figuring out what area is really troubling someone.
Introducing the S.H.I.P. – Spiritual-Holistic Inquiry Process, from NHM Ministrants. Initially geared towards holistic health practitioners and hospital chaplains, this framework has been found useful in a wide variety of settings, including drama therapy and even the exegesis of cities (PDF worksheet) and storyline development, for writers of fiction. The framework for the S.H.I.P. was informed by personal experience using psychological assessment tools as part of doctoral research, followed by chaplaincy training using spiritual assessment techniques at Stanford Hospital and Clinics.
Many assessment tools have been created, tailored to individual disciplines. For example, their focus is often on the spiritual, psychological, or medical. Rather than replacing one or more of these useful tools, consider the S.H.I.P. as an overarching framework, even as a vessel for carrying the details in a holistic way. The S.H.I.P. is offered in the conviction that a holistic approach – one that considers the whole person and life setting – will capture important clues to wellness and wholeness that are helpful to you in any of the healing disciplines, and in your daily life.
Learning the S.H.I.P.
Using the S.H.I.P. is simple. First, familiarize yourself with the framework, so it can inform your encounters. Next, try it out for yourself. It is meant to be so intuitive that just the knowledge of the areas of inquiry will prompt your questions and aid in recollection and documentation, after the fact. When we teach it, we ask students to teach it back to us. Here is the wonderful result:
The areas of inquiry set out below are kinesthetically easy to remember: simply consider the space around your own body: within you, outside and next to you, before and behind you, above and below you. The preposition descriptors we use – in ~ on ~ around // above ~ below // behind ~ before – relate to the following life areas: mind-body / roles / connectedness; spirituality / roots; life-story / outlook. You can also think of it spatially this way:
- in ~ on ~ around — A spiral, going from within your core, to on your skin, and encircling you. This is mental/body health, roles, and social support / relationships.
- above ~ below — A straight line, stretching from underneath your feet to above your head. Above you, the spiritual. Beneath you, roots.
- behind ~ before – Another line, going from behind your back to beyond the horizon stretching before you. This is the personal past and resilient hope in the future.
After watching the introductory video, you may want to read the detail pages. Supplement what you learn with your own understanding of each of the realms of human experience. Finally, consider this quick rating system:
- Red exclamation point(s) – big issue here
- Yellow "x" – did not yet assess, or still unclear
- Green check mark – area of relative wellness
Before you try this framework out on others, you may wish to consider a few examples from your recent experience, or use it for self-assessment. Placing self and others within this framework will help you gain a comfort with it.
A cautionary note: systems and frameworks are seductive. There can be a temptation to map people into a system, and forget their individual landscape. Remember, what we offer is just a guide, to help you find your way in your efforts to bring healing, hope, and harmony.
|THE S.H.I.P. (SPIRITUAL-HOLISTIC INQUIRY PROCESS) REFERENCE|
|ASSESSMENT AREA||IDEAL||IMBALANCE ! !!|
|IN: Mind-body. Physical and mental well-being. Daily self-care. Embodied internal landscape, including self-perception (young, old, weak, strong). Mental and physical stability. detail page||Body and mind in comfort and at ease. Sense of well-being. Healthy self-care, prevention steps, and treatment of diagnosable conditions where applicable. Clarity, understanding, and acceptance of one's physical and mental attributes.||Self-denial. Anorexia. Inattention to physical, mental or emotional needs. Wasting conditions. Untreated illnesses, resulting in anguish. Defenses weaken and body / mind succumbs to infirmity.Or: Gluttony. Excess. Addictions and the resulting wear on the body, mind, & spirit. Body self-attack (cancer, autoimmune, overproduction of antibodies, gout, GERD). Favoring mind or body above all else.|
|ON: External roles. Relation to societal norms. detail page||Role or station, in healthy context. Derives satisfaction from meaningful work. Able to see and relate to people beyond role, attainment, or status. Perception of vocation. Relationship to role is not so overpowering as to be subsuming of self.||Unable to cope with day-to-day requirements of role. Feeling of being overwhelmed, overworked, inadequate, or an imposter. Or: Over-identification with role, station or trappings. Confusion of role and self, resulting in loss of sense of self or other beyond the superficial. Alternatively: rebellion.|
|AROUND: Connectedness. Sense of community. Social competence and support. detail page||Harmonious balance between independence and belonging (social competence). Social support. Sense of connectedness to others, investment in community, compassion, service, co-responsibility. Sense of being supported / supporting others in community. Social capital.||Alienation. Loneliness. Disconnectedness. Isolation. Abandonment. Pain arising from experience of shunning. Awkwardness around others. Social anxiety. Or: Overly concerned with approval-seeking and acceptance. Overwhelming need to please others. Valuing status of social relationships disproportionately above other S.H.I.P. areas (e.g., confusing relationships with self-identity).|
|ABOVE. Outlook regarding the transcendent. Theological stance. Spiritual resources. detail page||Beliefs and perspectives regarding the transcendent provide grounding, comfort, hope, and meaning.The spiritual as an area of interest, growth. Beliefs can be articulated, and provide source of strength or purpose.||Area is not thought through. Inconsistencies in beliefs. Little or no interest; not perceived as a possible source of support. Lacking moral compass. Or: Source of discomfort, fear, or loathing. Closed-minded, reactive, judgmental or self-righteous attitude. Ideologue. Rigidity.|
|BELOW. Sense of connection to family history, roots. detail page||Strong sense of roots leading to greater self-understanding and grounding. Source of joy.||Rejection, disconnection, or alienation from one's roots. Family history perceived as a source of strain or shame. Or: Overly idealized family history. Familial or clan tribalism leading to misplaced loyalties, superiority, overzealousness, generational hatreds, and persecutions.|
|BEHIND. Perception of personal past (life story). detail page||Reasonably well-developed, acceptable, useful self-narrative or life-story which is flexible and adaptable, growing more nuanced with understanding and age.||Denial, rejection, or delusion (positive or negative) regarding past. Or: Unwilling to let go or forgive others (or God) or to self-forgive (unable to accept and let-go of the past). Too focused on the past in a nostalgic way (living in the past).|
|BEFORE. What lies ahead, and the resiliency of hope. Planning. Perception of future. detail page||Able to envision positive outcomes. Flexible and resilient in maintaining a hopeful, positive attitude in the face of changing circumstances.||Unable to perceive any positive future for self or others. Burdened with foreboding. Or: Overly optimistic to the point of making costly, unrealistic plans.|
|Created by Rev. Dr. Lauren Speeth on December 3, 2011 and updated/renamed on July 2, 2013. Copyright © NHM Ministrants. All Rights Reserved. Members of the healing professions may consider this methodology in their day-to-day work helping others; see the Center website, www.ministrants.com for disclaimer and legal/ethical considerations prior to use.|
Step 2: Apply It
Originally envisioned as a tool for interfaith hospital chaplains, the S.H.I.P. (Spiritual-Holistic Inquiry Process) has been found useful in a wide variety of settings, including: hospital chaplaincy, ministerial counseling, and use by other health care professionals (the client or patient encounter); drama therapy; self-Assessment; analysis of artistic works; analysis of cities; biblical exegesis. On our examples page, you will find a few such analyses, to help you get started. You may also want to visit our detail pages for tips, questions, and even drama therapy suggestions: in ~ on ~ around // above ~ below // behind ~ before
Step 3: Follow-Up (Documenting, Tracking Progress)
While some clinical settings may allow for the taking of notes, often notes are taken after the encounter has ended. These notes – even when taken soon after a client meeting or patient encounter – can be helpful in tracking progress or informing future conversations. Use of the following table can jog the memory, after the fact. Be mindful of privacy concerns (e.g., if a hospital setting, HIPAA requirements), and take care to maintain the utmost confidentiality.
|THE S.H.I.P. (SPIRITUAL-HOLISTIC INQUIRY PROCESS) NOTE SHEET|
|(From ship shape to problematic)|
|ON||Relation to role & responsibilities.|
|ABOVE||Relation to the transcendent.|
|BELOW||Relation to family roots.|
|BEHIND||Self-narrative, personal past.|
|BEFORE||Outlook, resiliency of hope.|
Created by Rev. Dr. Lauren Speeth on December 3, 2011 and updated June, 2013. Copyright © NHM Ministrants. All Rights Reserved. Members of the healing professions may consider this methodology in their day to day work helping others; see the Center website, www.ministrants.com for disclaimer and legal/ethical considerations prior to use.
The Spiritual-Holistic Assessment Process (also referred to as framework, tool, or methodology), information and other content made available through this site is provided for educational purposes only and is not intended as a substitute for professional advice, guidance, training, assessment, therapy or treatment of any kind. The information and products provided through this site have not been evaluated by any governing body or licensing authority and are not approved to assess, diagnose, treat, cure or prevent any disease or disorder. You should consult with a trained or licensed professional before relying on any information or product on this site. We do not warrant or guarantee that this site or the content provided are current, accurate, or error-free.Use of the S.H.I.P. is controlled. The S.H.I.P. may only be made by a properly trained practitioner in a proper setting with our consent. If you have completed our course "The Contemplative Christian: A Journey Along the Healers' Path" then you have received this training and may use the S.H.I.P. in your work. Others who believe they may qualify to use the S.H.I.P. please contact us for more information.
As with all such tools, there are ethical considerations to be remembered. These go beyond maintaining privacy, which is not only an ethical but also a legal requirement. First, if you haven't been trained in the proper application of assessment tools, do not use S.H.I.P.. Second, S.H.I.P. was developed for use in a teamwork setting, where mental and physical records can be obtained. Do not attempt to address someone's mental, spiritual and physical states as a private practitioner, unless you are recognized as a fully qualified practitioner in these disciplines. Competence is an ethical requirement, and a necessity for the patient's well-being. Another ethical requirement is respecting not only an individual's dignity and worth, but also their spiritual beliefs, rather than imposing one's own beliefs, either about the world or about the transcendent. When a practitioner in a position of authority does impose views in a moment of physical or emotional pain, this can be dubbed spiritual violence. Not only is this unhelpful, it can also backfire, leaving the person whom you were trying to entice feeling more alienated from your sphere than they had been before the encounter.
We wish you blessings in your healing ministry and look forward to hearing back about how this offering might be improved for the benefit of others.
Researchers, NHM Ministrants may be able to help you offset some of the cost of undertaking a well designed and controlled study validating the usefulness of the Spiritual-Holistic Inquiry Process, and perhaps even working up questions for a standardized assessment tool. Credentialed researchers in association with accredited universities (or graduate students, under direction) only. Please contact us for details.
 During CPE training at Stanford Hospital, the author was taught and primarily used the following two: Faith/Hope/Charity, and FICA (Faith & belief, Importance/influence, Community, Address in Care). Reference: Handout from Fr. John Hester's didactic of June 16, 2011, at Stanford Hospital and Clinics. Puchalski, Christina, "FICA: A Spiritual Assessment." Journal of Palliative Care, 1999.