Charles Topper has written one of the most edifying books in the field of pastoral counseling. He has used research by well-known persons (Burke, Capps, Pruyser, Clinebell, Maslow and others), and has developed innovative ideas and practices for spiritual care. This book goes beyond theory.
Dr. Topper is a professor of counseling, licensed professional counselor, clinical supervisor, chaplain, and Roman Catholic priest. As he explains, in the past decade spirituality has finally been taken seriously by psychologists and community counselors. In 1994, the American Psychiatric Association added "religious or spiritual problem" to its diagnostic manual. Topper states that counselors, both pastoral and community, previously used a psychological model with clients. What is needed today is an integration of the spiritual dimension with the psychological, so that one treats the whole person.
The author defines spirituality "as the universal yearning for meaning and connection beyond self that everyone naturally has." (p. 6) It may or may not be associated with a particular religion. "People are born with a spiritual nature, but not with automatic spiritual insight." (p. 11) Caregivers work with the whole person: physical, psychological, and spiritual. Taking ideas from several sources, Charles Topper lists these spiritual needs: finding meaning in life, giving and receiving love, discovering forgiveness, hope, and creativity.
This book is written for counselors in the community and for pastoral counselors. Both groups of counselors, Topper explains, need to be aware of their own spirituality or religious knowledge, so they can integrate that with their psychological expertise when working with clients. To facilitate awareness of one's own spirituality, Topper uses a method we usually reserve for our students. Throughout the book he has Reflection Questions to enable us as counselors to look within ourselves. He also includes a few exercises, such as watching a TV sitcom or soap opera to discern the spiritual needs of the characters and sharpen our abilities to see the spiritual needs of our clients and of ourselves. Topper stresses that too many pastoral counselors do not practice some kind of spiritual care (meditation, prayer, etc.) themselves. They need to learn how to empty themselves so they have room for the spiritual concerns of the client. Another way we can improve our abilities as spiritual caregivers is to discover a spiritual image for ourselves. Some see themselves as a midwife, a wounded celebrator, a gardener, a good shepherd, or a "wise fool who in simplicity calls and challenges the other to spiritual growth." (p. 106)
Going beyond our ability to discern the client's problems, Dr. Topper describes spiritual well-being as "harmony with self, others, a Higher Power, and the environment." (p. 25) In this book, the author gives specific ideas to help clients attain well-being. He outlines case studies with the helpee's spiritual needs stated followed by specific suggestions for spiritual care.
One of the most helpful ideas for caregivers is to use a spiritual assessment instrument. Topper includes three of these questionaires, and where to obtain them. They are to be filled out by the client, and can be used as starting points for discussion. Obviously, hospital chaplains may choose not to use a questionnaire, but to be direct about whatever is happening with and to the patient. Or in other cases where a questionnaire might intimidate a client, the spiritual caregiver may in her or his mind be aware of which of Fowler's stages apply to a specific client.
One interesting thought that enables counselors to view the whole picture is to think of the spiritual goals of various centuries. The 20th century focused on helping clients solve their individual human problems. In this century, we need to focus on community so that diverse groups of people experience reconciliation in their relationships with others while also finding internal healing.
As someone who has taken Clinical Pastoral Education, I would recommend this book as an excellent introduction to pastoral/spiritual care for persons taking CPE. It could be required reading for those persons taking CPE. Other caregivers, including spiritual directors, would benefit from the information on how to offer spiritual care in a non-offensive manner to clients with or without a religious orientation. Charles Topper's creative ideas and interventions add considerably to the knowledge base for counselors.