Forgiveness and Spirituality in Psychotherapy
Book Description: Forgiveness is a frequent challenge in life and a common concern of clients in psychotherapy. While it is easy to see the emotional benefits of forgiveness, actually forgiving a transgressor can be difficult. And the process may be either helped or hindered by the way one relates to the sacred. In some cases, spiritual transformation may be needed before one is able to forgive. This book presents a model of forgiveness and relational spirituality based on clinical practice and supported by empirical research. Everett L. Worthington, Jr., and Steven J. Sandage bring together decades of experience as both researchers and clinicians to show the differing ways in which spiritual and religious experiences can shape concerns, values, and practices that may facilitate or hinder forgiveness among clients. Their model highlights relational factors (attachment and differentiation) and action-oriented interventions for emotion regulation. Applications are described for short-term therapy, long-term therapy, couple and family therapy, and group therapy. Forgiveness is a frequent challenge in life and a common concern of clients in psychotherapy. While it is easy to see the emotional benefits of forgiveness, actually forgiving a transgressor can be difficult. And the process may be either helped or hindered by the way one relates to the sacred. In some cases, spiritual transformation may be needed before one is able to forgive. This book presents a model of forgiveness and relational spirituality based on clinical practice and supported by empirical research. Everett L. Worthington, Jr., and Steven J. Sandage bring together decades of experience as both researchers and clinicians to show the differing ways in which spiritual and religious experiences can shape concerns, values, and practices that may facilitate or hinder forgiveness among clients. Their model highlights relational factors (attachment and differentiation) and action-oriented interventions for emotion regulation. Applications are described for short-term therapy, long-term therapy, couple and family therapy, and group therapy.
eISBN: 978-1-4338-2032-8
Subjects: Psychology, Religion
By
Kerry Morrison, Psy.D
“Forgiveness and Spirituality in Psychotherapy: A Relational Approach”
By Everett L. Worthington, Jr. and Steven J. Sandage
American Psychological Association
Washington, D.C., 2016
Book offers useful theory, research information
Reviewed by Kerry Morrison, Psy.D.
Transgressions, losses, grief and trauma are fundamental issues in psychotherapy. Religious and spiritual beliefs are often challenged when significant life events occur. These beliefs or the lack of them, are often what clients wrestle with in order to make sense of their experiences.
Spirituality and religion can either facilitate or impede forgiveness. Positive or negative factors of faith-based beliefs are associated with forgiveness. Many people in crisis situations are often angry at their “God” or question their faith.
As a practitioner, I have found that some of the most meaningful therapeutic conversions and successful outcomes include discussion of these topics, as religious and spiritual beliefs often shape core beliefs.
Surveys have found that most psychotherapists are less religious than the general public. The topics of religion and spirituality are often avoided by therapists and are not addressed in many clinical training programs.
However, as Worthington & Sandage persuasively assert in their new publication, “Forgiveness & Spirituality in Psychotherapy,” these topics can be a doorway to the client’s personal existential world that would not have been possible had the therapist not allowed it to be part of the clinical conversation.
This book is a useful resource for students, early career therapists and seasoned practitioners as it highlights relevant theory and research with case examples from both brief and long-term psychotherapy for individuals, couples and groups.
The overview of the research on forgiveness done in the late 1990’s and the more recent research on forgiveness and spirituality provides a good framework and historical marker.
The authors’ emphasis on the relationship between therapist and client as the crucible that can serve to facilitate spiritual transformation to help clients forgive solidifies its usefulness to practitioners. They call their relational approach, Relational Spirituality.
The concept of forgiveness is emphasized as it is often at the center of the tensions surrounding these existential events and is believed to be what is needed in repairing conflicts and transgressions.
The authors’ present the REACH model of forgiveness, an acronym which emphasizes Recall, Emotional reprocessing, Altruistic giving of the gift of forgiveness, Commitment and Holding on to the forgiveness when doubts occurs.
Although I found this book interesting to read and clinically relevant, I thought it contained too much theory and I wanted more tools for clinical application, such as suggested questions to ask in the initial assessment/engagement phase, to set the tone of therapeutic exploration and deeper questions to explore about religion, spirituality and forgiveness in the heart of the treatment.
Nevertheless, I think that this is a useful read for time-strapped practitioners who want to understand this approach and improve their clinical efficacy by integrating the religious and psycho-spiritual approach into their work, as I believe that this is a key aspect of therapy that is missing.
Kerry Morrison, Psy.D. is a licensed psychologist in private practice in Greenfield, Mass.
Learn more about the book: Forgiveness and Spirituality in Psychotherapy: A Relational Approach
Emeritus Commonwealth Professor (tenured)
Licensed Clinical Psychologist, Virginia
Ph.D. (1978), University of Missouri-Columbia
APS Fellow
APA Fellow (Div 17 Counseling Psychology and Div 36 Religion and Spirituality)
Fall 2017 begins my 40th year at VCU. I will retire October 1, 2017. Although I will be gone for a while after that date, by the end of the fall 2017 semester, I will be back and working daily at VCU in the Department of Psychology. I am not accepting graduate students.
Doctoral Program Affiliations
Primary: Counseling Psychology
Secondary: Social Psychology, Health Psychology and Developmental Psychology
Websites
Research Interests
My research is primarily in the field of positive psychology (with a primary research interest in forgiveness, a secondary interest in humility and other interests in gratitude, patience and other virtues). My second research interest is in religion and spirituality (in life and in counseling). My third research interest is in the Hope-Focused Couple Approach to counseling, enrichment and education.
Select Publications
Woodyatt, L., Worthington, E. L., Jr., Wenzel, M., & Griffin, B. J. (Eds.). (in press). Handbook of self-forgiveness. New York: Springer.
Worthington, E. L., Jr., & Allison, S. T. ([soon to be] in press). Heroic humility: What the science of humility can say to people raised on self-focus. Washington, DC: American Psychological Association.
Worthington, E. L., Jr., Davis, D. E., & Hook, J. N. (Eds.). (2017). Handbook of humility: Theory, research, and application. New York: Routledge.
Toussaint, L. L., Worthington, E. L., Jr., & Williams, D. (Eds.). (2015). Forgiveness and health: Scientific evidence and theories relating forgiveness to better health. New York: Springer.
Worthington, E. L., Jr., & Sandage, S. J. (2015). Forgiveness and spirituality in psychotherapy: A relational approach. Washington, DC: American Psychological Association.
Recent Courses
- Introduction to Psychology, undergraduate level
- Positive Psychology, undergraduate level
- Spotlight on Research – Forgiveness: Theory, Research, & Practice, undergraduate level (5 weeks)
- Forgiveness: Theory, Research, and Practice, graduate level
- Principles of Psychological Measurement, graduate level
- Research in Counseling Psychology, graduate level
Recent Grants
Can Forgiveness Research Be Strengthened in South Africa and West Africa?
Amount: $938,248
Role: Principal Investigator
Source: Templeton World Charity Foundation
Period: 9/2015 – 9/2017
Forgiveness in Africa
Amount: $938,248
Role: Principal Investigator
Source: Templeton World Charity Foundation
Period: 9/2014 – 9/2017
Relational Humility
Amount: $344,584
Role: Principal Investigator
Source: John Templeton Foundation
Period: 1/2010 – 12/2014
Number: 14979
Forgiveness in Christian Colleges
Amount: $72,000
Role: Principal Investigator
Source: Fetzer Institute
Period: 6/2009 – 5/2011
Recent Awards
- 2016, Outstanding Faculty Award, State Council of Higher Education in Virginia
- 2016, Norman Munn Distinguished Visiting Scholar Award, Flinders University, October-November 2017
- 2015, Elder Recognition Award for Distinguished Contributions to Counseling Psychology, APA Division 17 (Society for Counseling Psychology)
- 2014, Doctor of Humane Letters (Honorary Doctorate), Pepperdine University
- 2014, Commonwealth Professor (Honorary Title), Virginia Commonwealth University
- 2012, William Bier Award for Sustained Professional Contributions, APA Division 36 (Society for Psychology of Religion and Spirituality)
News Features
Video
Profile
Steven J. Sandage Albert and Jessie Danielsen Professor of Psychology of Religion and Theology
Steve grew up in Iowa as the son of two former teachers and was confirmed in the United Methodist Church. He studied psychology at Iowa State University where he developed an interest in connections between mental health, spirituality, and ministry, which he also pursued in seminary. This led to working as a chaplain in prisons, a geriatric facility, and a group home for boys, which further shaped his desire to integrate psychology and theology in understanding human development and healing. He and his wife Danielle ventured out to Virginia for his doctoral program in counseling psychology and her graduate studies in social work, and this was the context where he started to focus on marriage and family therapy as a clinical specialization. He completed his clinical internship at the Federal Corrections Institute (Petersburg, Virginia) where he did specialty rotations in HIV services and forensic assessment. Following completion of their graduate degrees, they moved to Minnesota where Steve joined the faculty in marriage and family therapy at Bethel Seminary and started a clinical practice. In 2013 and after sixteen years at Bethel, Steve accepted the Danielsen Chair position at Boston University School of Theology and the Danielsen Institute, where he also serves as Research Director and Senior Staff Psychologist. He holds a joint appointment at BU in the Department of Psychological and Brain Sciences.
His books include To Forgive is Human, The Faces of Forgiveness, Transforming Spirituality, The Skillful Soul of the Psychotherapist, Forgiveness and Spirituality: A Relational Approach, Relational Integration of Psychology, Christian Theology: Theory, Research, and Practice, and Relational Spirituality in Psychotherapy: Healing Suffering and Promoting Growth. He does research in areas that include positive psychology, psychology of religion, intercultural competence and social justice, psychotherapy processes and outcome, psychopathology, and clinical training. His research has been funded by the Lilly Endowment, the Fetzer Institute, and the John Templeton Foundation. He received the Narramore Award for excellence in the integration of psychology ant theology from the Christian Association of Psychological Studies. He is on the editorial boards of the Journal of Clinical Psychology; Psychotherapy; and the Journal of Spiritual Formation and Soul Care. Sandage also practices as a Licensed Psychologist with clinical specializations that include couple and family therapy, multicultural therapy, and spiritually-integrative therapy. The American Psychological Association (APA) produced a clinical demonstration of Sandage doing couples therapy. He also provides diversity training and consultation to educators, mental healthcare practitioners, religious leaders, and business leaders.
Publications
Books
Sandage, S.J., Rupert, D., Stavros, G.S., & Devor, N.G. (2020). Relational spirituality in psychotherapy: Healing suffering and promoting growth. Washington, DC: American Psychological Association.
Sandage, S.J., & Brown, J.K. (2018). Relational integration in psychology and Christian theology: Theory, research, and practice. New York, NY: Routledge.
Worthington, E.L., Jr., & Sandage, S.J. (2016). Forgiveness and spirituality: A relational approach. Washington, DC: American Psychological Association.
Stavros, G., & Sandage, S.J. (Eds.). (2014). The skillful soul of the psychotherapist: The Link between spirituality and clinical excellence. Lanham, MD: Rowman & Littlefield.
Shults, F. L., & Sandage, S. J. (2006). Transforming spirituality: Integrating theology and psychology. Grand Rapids, MI: Baker Academic.
Shults, F. L., & Sandage, S. J. (2003). The faces of forgiveness: Searching for wholeness and salvation. Grand Rapids, MI: Baker Academic.
Winner of first Narramore Award for excellence in the integration of psychology and theology by the Christian Association for Psychological Studies (2005).
McCullough, M. E., Sandage, S. J., & Worthington, E. L., Jr. (1997). To forgive is human. Downers Grove, IL: InterVarsity Press
Selected Peer-Reviewed Journal Articles
Sandage, S.J., Jankowski, P.J., Paine, D.R., Exline, J.J., Ruffing, E.G., Rupert, D., Stavros, G.S., & Bronstein, M. (2020). Testing a relational spirituality model of psychotherapy clients’ preferences and functioning. Journal of Spirituality in Mental Health, DOI: 10.1080/19349637.2020.1791781
Bell, C.A., Crabtree, S.A., Hall, E.L., & Sandage, S.J. (2020). Research in counselling and psychotherapy Post Covid-19 Counselling and Psychotherapy Research, DOI: 10.1002/capr.12334
Ruffing, E.G., Bell, C.A., & Sandage, S.J. (2020). PTSD symptoms in religious leaders: Prevalence, stressors, and associations with narcissism. Archive for the Psychology of Religion, DOI: 10.1177/0084672420926261
Jankowski, P. J., Sandage, S. J., Bell, C. A., Davis, D. E., Porter, E., Jessen, M., Motzny, C. L., Ross, K. V., & Owen, J. (2020). Virtue, Flourishing, and Positive Psychology in Psychotherapy: An Overview and Research Prospectus. Psychotherapy, 57, 291-309.
Crabtree, S.A., Bell, C.A., Rupert, D., Sandage, S.J., Devor, N.G., & Stavros, G.S. (2020). Humility, differentiation of self, and clinical training in spiritual and religious competence, Journal of Spirituality in Mental Health, DOI: 10.1080/19349637.2020.1737627
Ruffing, E.G., Devor, N.G., & Sandage, S.J. (2020). Humility challenges and facilitating factors among religious leaders: A qualitative study. Journal of Spirituality in Mental Health, 22, 111-133. doi: 10.1080/19349637.2018.1520184
Wolfteich, C.E., Ruffing, E.G., Crabtree, S.A., Devor, N.G., & Sandage, S.J. (2019). Humility and religious leadership: A qualitative study of theology and practice. Journal of Spirituality and Mental Health, DOI: 10.1080/19349637.2019.1691967
Paine, D.R., & Sandage, S.J. (2019). Disappointment in God and relational spirituality: Moderator effects for meditative prayer. Journal of Psychology and Theology. Online first publication. doi: 10.1177/0091647119870296
Moon, S.H., & Sandage, S.J. (2019). Cultural humility for Persons of Color: Critique of current theory and practice. Journal of Psychology and Theology, 47, 76-86, doi: 10.1177/0091647119842407
Jankowski, P.J., Sandage, S.J., Bell, C.A., Rupert, D., Bronstein, M., & Stavros, G.S. (2019). Latent trajectories of change for clients at a psychodynamic training clinic. Journal of Clinical Psychology, 1-22. https://doi.org/10.1002/jclp.22769
Bell, C.A., Jankowski, P.J., & Sandage, S.J. (2018). Early treatment narcissism associated with later social and sexual functioning among psychotherapy clients. Counselling & Psychotherapy Research, doi: 10.1002/capr.12199
Ruffing, E.G., Devor, N.G., & Sandage, S.J. (2018). Humility challenges and facilitating factors among religious leaders: A qualitative study. Journal of Spirituality in Mental Health, doi: 10.1080/19349637.2018.1520184
Ruffing, E.G., Devor, N.G., Paine, D.R., & Sandage, S.J. (2018). Humility and narcissism in clergy: A relational spirituality framework. Pastoral Psychology. https://doi.org/10.1007/s11089-018-0830-4
Moon, S.H., Morgan, T., & Sandage, S.J. (2018). The need for intercultural competence assessment and training for police officers. Journal of Forensic Psychology Research and Practice, doi: 10.1080/24732850.2018.1510274
Choi, H.A., West, A.D., Sandage, S.J., & Bell, C.A. (2018). Relational spirituality, mature alterity, and spiritual service among ministry leaders: An empirical study. Pastoral Psychology, doi: 10.1007/s11089-018-0846-9
Porter, S.L., Sandage, S.J., Wang, D.C., & Hill, P.C. (2018). Measuring the spiritual, character, and moral formation of seminarians: In search of a meta-theory of spiritual change. Journal of Spiritual Formation and Soul Care.
Rupert, D., Moon, S.H., & Sandage, S.J. (2018). Clinical training groups for spirituality and religion in psychotherapy. Journal of Spirituality in Mental Health. doi: 10.1080/19349637.2018.1465879
Paine, D.R., Sandage, S.J., Ruffing, E.G., & Hill, P.C. (2018). Religious and spiritual salience, well-being, and psychosocial functioning among psychotherapy clients: Moderator effects for humility. Journal of Religion and Health. doi: 10.1007/s10943-018-0612-4
Jankowski, P.J., Sandage, S.J., Bell, C.A., Ruffing, E.G., & Adams, C. (2018). Humility and well-being: Testing a relational spirituality model among religious leaders. Journal of Religion and Health. doi: 10.1007/s10943-018-0580-8
Correa, J., & Sandage, S.J. (2018). Relational spirituality as scaffolding for cognitive-behavioral therapy: A case study of spirituality in clinical practice. Spirituality in Clinical Practice, 5, 54-63.
Jankowski, P.J., Sandage, S.J., Whitney, M., Bissonette, C., Johnson, A.J., Crabtree, S.A., & Jensen, M.L. (2018). Religious beliefs and domestic violence myths: A construct validation study. Psychology of Religion and Spirituality. doi:10.1037/rel0000154
Tung, E.S., Ruffing, E.G., Paine, D.R., Jankowski, P.J., & Sandage, S.J. (2017). Attachment to God as a mediator of the relationship between God representations and mental health. Journal of Spirituality and Mental Health. https://doi.org/10.1080/19349637.2017.1396197
Sandage, S.J., Moon, S.H., Glenn, E.S., Paine, D.R., Kehoe, L.E., Rupert, D., Bronstein, M., & Hassen, S.C. (2017). Relational dynamics between psychotherapy clients and clinic administrative staff: A pilot study. Psychodynamic Practice, 23, 249-268. doi: 10.1080/14753634.2017.1335226
Bell, C.A., Sandage, S.J., Morgan, T.D., & Hague, D.J. (2017). Relational spirituality, humility, and commitments to social justice and intercultural competence. Journal of Psychology and Christianity, 36, 210-221.
Paine. D.R. & Sandage, S.J. (2017). Religious involvement and depression: The mediating effect of relational spirituality. Journal of Religion and Health, 56, 269-283. doi: 10.1007/s10943-016-0282-z
Paine, D.R., Moon, S.H., Sandage, S.J., Langford, R., Patel, S., Hollingsworth, A., Bronstein, M., & Salimi, B. (2017). Group therapy for loss: Intersubjectivity and attachment in healing. International Journal of Group Therapy, 67, 565-589.
Sandage, S.J., Jankowski, P.J., Crabtree, S.A., Schweer-Collins, M.L. (2017). Calvinism, Arminianism, gender views, and relationality: An empirical investigation of worldview differences. Journal of Psychology and Theology, 45, 17-32.
Hydinger, K., Sandage, S.J., Rambo, S., & Jankowski, P.J. (2017). Penal substitutionary atonement and concern for suffering: An empirical study. Journal of Psychology and Theology, 45, 33-45.
Sandage, S.J., Jankowski, P.J., Bissonette, C.D., & Paine, D.R. (2017). Vulnerable narcissism, forgiveness, humility, and depression: Mediator effects for differentiation of self. Psychoanalytic Psychology, 34, 300-310.
Morgan, J., & Sandage, S.J. (2016). A developmental model of interreligious competence. Archive for the Psychology of Religion, 38, 129-158
Wolfteich, C., Keefe-Perry, C., Sandage, S.J., & Paine, D.R. (2016). Humility: Empirical psychological research in dialogue with practical theology, Part II. International Journal of Practical Theology, 20, 184-202.
Wolfteich, C., Keefe-Perry, C., Sandage, S.J., & Paine, D.R. (2016). Humility: Empirical psychological research in dialogue with practical theology, Part I. International Journal of Practical Theology, 20, 143-155.
Kehoe, L.E., Hassen, S.C., & Sandage, S.J. (2016). Relational ecologies of psychotherapy: Administrative attachment in liminal office space. Psychodynamic Practice, 22, 6-21.
Paine, D.R., Jankowski, P.J., & Sandage, S.J. (2016). Humility as a predictor of intercultural competence: Mediator effects for differentiation of self. The Family Journal, 24, 15-22.
Tomlinson, J., Glenn, E.S., Paine, D.R., & Sandage, S.J. (2016). What is the “Relational” in relational spirituality? A review of definitions and research directions. Journal of Spirituality and Mental Health, 18, 55-75.
Hainlen, R., Jankowski, P.J., Paine, D.R., & Sandage, S.J. (2016). Attachment predicting forgiveness, well-being, and social justice commitment: Mediator effects for differentiation of self. Contemporary Family Therapy, 38, 172-183. doi: 10.1007/s10591-015-9359-1
Sandage, S.J., Jankowski, P.J., Crabtree, S., & Schweer, M. (2015). Attachment, spirituality pathology, and God images: Mediator and moderator effects. Mental Health, Religion, and Culture, 18, 795-808.
Sandage, S.J., Long, B., Moen, R., Jankowski, P.J., Worthington, E.L., Jr., Wade, N.G., & Rye, M.S. (2015). Forgiveness in the treatment of borderline personality disorder: A quasi-experimental study. Journal of Clinical Psychology, 71, 625-640. doi: 10.1002/jclp.22185
Sandage, S.J., Paine, D.R., & Hill, P.C. (2015). Spiritual barriers to humility: A multidimensional study. Mental Health, Religion, and Culture, 18, 207-217. doi: 10.1080/13674676.2015.1038229
Sandage, S.J., & Brown, J.K. (2015). Relational integration, Part I: Differentiated relationality between psychology and theology. Journal of Psychology & Theology, 43, 165-178.
Brown, J.K., & Sandage, S.J. (2015). Relational integration, Part II: Relational integration as developmental and intercultural. Journal of Psychology & Theology, 43, 179-191.
Paine, D.R., & Sandage, S.J. (2015). More prayer, less hope: Empirical findings on spirituality instability. Journal of Spirituality in Mental Health, 17, 223-238.
Paine, D.R., Sandage, S.J., Rupert, D., Devor, N.G., & Bronstein, M. (2015). Humility as a psychotherapeutic virtue: Spiritual, philosophical, and psychological foundations. Journal of Spirituality in Mental Health, 17, 3-25.
Select Chapters in Edited Books
Sandage, S.J., Bell, C.A., Moon, S.H., & Ruffing, E.G. (in press). Religious and spiritual problems in couples. In L.Sperry, K. Helm-Lewis, & J. Carlson, The disordered couple (2nd ed.). New York, NY: Routledge.
Sandage, S.J., Crabtree, S.A., & Bell, C.A. (in press). Forgiveness and culture: Conceptual issues. In E. L. Worthington, Jr. & N. Wade, (Eds.). Handbook of forgiveness (2nd ed). New York: Brunner-Routledge.
Boettscher, H.T., Sandage, S.J., Latin, H.M. & Barlow, D.H. (in press). Transdiagnostic treatment for enhancing positive affect and well-being. In J. Gruber (Ed.), Positive emotion and psychopathology. New York: Oxford University Press.
Sandage, S.J., Paine, D.R., & Morgan, J. (2019). Relational spirituality, differentiation, and mature alterity. In T.M. Crisp, S.L. Porter, & G.A. Van Tenselhof (Eds.), Psychology and spiritual formation in dialogue: Moral and spiritual change in Christian perspective. Downers Grove, IL: InterVarsity Press Academic.
Hague, D.J., Glenn, E., Paine, D.R., & Sandage, S.J. (2019). Spirituality and interculturality. In L. Zsolnai & B. Flanagan, The Routledge international handbook of spirituality and society in the professions. New York: Routledge.
Paine, D.R., Moon, S.H., Hauge, D.J., & Sandage, S.J. (2018). Cultural and racial perspectives on positive psychologies of humility. In T. Lomas, N. Brown, & F. Eiroa-Orosa (Eds.), The Routledge international handbook of critical positive psychology (pp. 281-298). New York, NY: Routledge.
Ruffing, E.G., Moon, S.H., Krier, J., Paine, D.R., Wolff, E., & Sandage, S.J. (2017). Self-forgiveness in couple and family therapy. In L. Woodyatt, M. Wenzel, B. Griffin, E.L. Worthington, Jr. (Eds.), Handbook of the psychology of self-forgiveness (pp. 193-206). New York, NY; Springer.
Sandage, S.J., Paine, D.R., Rupert, D., Bronstein, M., & O’Rourke. (2017). Humility in psychotherapy. In E.L. Worthington, Jr., D.E. Davis, & J. Hook (Eds.), Handbook of humility (pp. 301-315). New York: Routledge.
