Bio-Psychosocial-Spiritual Assessment
- Nov 6, 2022
- 19 min read
Updated: Mar 3
Rationale behind a BPSS, sample questions, BPSS templates, assessing people without English
This page has three sections:
Background Material that provides the context for the topic
A suggested Practice Approach
A list of Supporting Material / References
Feedback welcome!
Background Material
BPSS Assessment is designed to give the social worker sufficient background to formulate a plan for the person, going-forward. Undertaking a BPSS assessment prior to looking at treatment options can be very useful in uncovering aspects of the service user’s life that may have remained hidden if problem solving commenced without the BPSS.
A BPSS assessment examines the biological, psychological, social and spiritual factors that impact on a person’s life. The following outline from the University of Nevada provides some idea of what information can be gathered, and the types of questions that can be used. Depending on the area of practice, social workers may choose to emphasise one or more of the four areas of the assessment and will, over time, develop their own approach to the BPSS.
University of Nevada, Reno. School of Medicine. (n.d.). Bio-Psycho Social-Spiritual Model. Retrieved September 21, 2020, from https://med.unr.edu/psychiatry/education/resources/bio-psycho-social-spiritual-model
For additional information on cultural issues: Gale, L. (2022). Biopsychosocial-spiritual assessment: An overview. Cinahl Information Systems.https://www.ebsco.com/sites/default/files/acquiadam-assets/Social-Work-Reference-Center-Skill-Biopsychosocial-Spiritual-Assessment.pdf
Biological
Past
Genetics:
Consider whether any blood relatives that have had psychiatric problems, substance use problems or suicide attempts/suicides.
History of Pregnancy and Birth:
Consider pregnancy variables: Was there in-utero exposure to nicotine, alcohol, medications or substances? Anything unusual about pregnancy?
Note birth complications, such as prematurity, birth trauma or extended periods of hospitalization.
Relevant Previous Illnesses
Present
Current Illnesses:
Identify current illnesses and any direct impact they may have.
Medications:
Assess current medication regimen. Consider possible side effects of current medications.
Substances:
Consider the influence of nicotine, alcohol and street drugs on current psychiatric symptoms.
Consider the possible effects of substance withdrawal.
Psychological
Past
Comment on any past history of trauma, as well as resiliency.
Consider the sources of positive self-image and positive role models.
Comment on the patient's experience with loss.
Comment on the patient's quality of relationships with important figures, such as grand parents, friends, significant teachers, or significant employers.
Present
Describe the recent events and experiences that precipitated the admission or appointment.
What are the current stressors? Do they have any symbolic meaning?
Assess and comment on coping skills, defense mechanisms, presence or absence of cognitive distortions.
Consider current developmental demands on the person, such as marriage, divorce, birth, children leaving home, loss, aging, etc. What stage of development is the patient at now? Is it appropriate?
Social
How adequate is the patient's current support system?
What is the current status of relationships with important figures?
What are the possible peer influences?
Consider the patient's current housing arrangement.
Comment on vocational/financial status.
Comment on any relevant legal problems.
Consider the role of agencies (e.g. Veteran's Administration, Child Protective Services, Criminal Justice System) on the patient.
Comment on cultural influences that may impact the current situation and that might impact treatment.
Spiritual
Comment on the role of spirituality in the patient's life.
How does spirituality contribute to the patient's ability to hope, their position on suicide if relevant, or their contact with a supportive community?
Cultural
Comment on race or ethnicity.
Comment on the cultural factors specific to the client or family’s region of origin, language, time of immigration.
Has racism or discrimination occurred? Impact on social systems of the person.
Bio-Psycho-Social-Spiritual Model: Examples of Kinds of Questions to ask During your Interviews
When you conduct your diagnostic interviews, you will want to compile information that will allow you to address the components of the bio-psycho-social-spiritual model. It is good to start with open-ended questions in each section, narrowing to closed-ended questions if the open-ended questions do not elicit the relevant material.
Biological
Past
Genetics:
Tell me about any family history of psychiatric problems or suicide attempts.
Tell me about any relatives that have been hospitalized for psychiatric masons. Tell me about any relatives that might have suffered from emotional problems. How were they treated and how did they respond to these treatments?
History of Pregnancy and Birth:
Tell me about your mother's pregnancy with you. Do you know if she smoked, drank, or used any medications?
What have you been told about your actual birth? Were there any birth complications?
Relevant Previous Illnesses:
Tell me about any major medical problems you have had in your life. Have you had any history of head injury, endocrine disorders (i.e. thyroid, adrenal), seizures, malignancies or neurological illnesses?
Present
Current Illnesses:
Can you describe your health right now? Do you have any illnesses right now? Do you worry that you have something that has not been diagnosed?
Medications:
Tell me about the prescribed and non-prescribed medications that you are taking? (Probe for medications that have psychoactive effects, such as steroids, beta blockers, pain medications, benzodiazepines, SSRI's, Herbal remedies).
Substances:
Can you tell me about your use of alcohol or take street drugs? (Probe for whether current substance use could account for patient's psychiatric symptoms).
Psychological
Past
How were you treated as a child? (Probe for trauma as well as evidence for family strengths).
Can you tell me about any trauma's you might have experienced in life? (Probe for military/combat, rape, violence, and serious illness).
Can you describe to me any losses you have experienced? How did you cope with this?
Tell me about your relationships like with important figures, such as parents, grandparents, friends, significant teachers, or significant employers.
How have medical problems or psychiatric problems in your past influenced your life today?
Present
Tell me about the recent events and experiences that bring you here today?
How have you already tried to solve your problems? (Probe for coping skills).
How do you usually cope with difficult life-situations? (Probe for and observe defense mechanisms).
Tell me about how you are coping with marriage, divorce, birth, children leaving home, loss aging, etc. (The point here is to get a sense of what is being demanded of the person at this time, developmentally).
How do current medical problems or psychiatric problems influence your life today?
Social
Tell me about who you tum to if you need help. Do you have friends or family you can turn to if you need help?
Tell me about who you rely on for company, support, and fun. Do you have friends or family that you can rely on for company, support, and fun?
Currently, describe the kind of social life that you have? How often do you get together with people you can relate to, and do you enjoy it?
When you were feeling better, describe the kind of social life you had. How often did you get together with people you could relate to?
Tell me about your present housing arrangement? Are you satisfied with it?
Tell me about your work life. Are you working? Is your work satisfying or do you need help in this area?
Tell me about your financial circumstances?
To help me understand you, can you tell me about cultural/family beliefs that might help me get a more clear sense of your life-circumstance/symptoms right now?
Spiritual
Can you describe your spiritual belief system?
Can you tell me about how you get spiritual needs met?
Can you tell me about your religious community?
Can you describe your childhood experience of religion?
Cultural
What is your cultural/racial identity? Preferred language?
Can you tell me about your experiences of immigration? Legal status?
Is the family still together?
Any beliefs about health and social services, treatment of illness, stigma attached to seeking help
Cultural practices: holidays, celebrations, religious celebrations
Experiences of oppression and discrimination
Values and beliefs about childbearing, child-rearing, work, education
Family: gender role expectations, importance of family, role expectations of children, parents and elders.
Bio Psycho Social Spiritual Treatment Plan
The Bio Psycho Social Spiritual formulation can guide the treatment planning process. All treatment plans should include comment in the four areas and a rationale.
Biological Treatment of current illness and associated symptoms. Medications.
Psychological Individual therapy, e.g. relaxation therapy, social skills training, coping skills development. Group Therapy.
Social Assistance with housing, job training, benefits groups. Encouraging hobbies, social activities, family meetings.
Spiritual Utilise resources: Organized religious activities, Meditation/Mindfulness training, Groups.
Cultural Accommodations necessary because of cultural background
Practice Approach
Three templates based on the above information follow this section on using BPSS with people who do not speak the English language. The templates can be forwarded to interested people in .docx form. Use the 'Contact' button on the home page to request the templates.
In October 2024 I added a fourth template, based on the work of Sutherland et al. (2024). In their article the authors describe an approach to the BPSS used in the Health Department of Queensland, Australia. They discuss a template consisting of nine areas together with three concluding areas of overall assessment, intervention and plan. Their work also includes a description of the nine areas and offers prompts that may guide questions to elicit more comprehensive information.
The five key steps to undertaking a risk assessment
Peart, V. (2026, January 28). The five key steps to undertaking a risk assessment. Social Work News. https://www.mysocialworknews.com/article/the-5-key-steps-to-undertaking-a-risk-assessment
A risk assessment is a structured way of thinking. The aim is clarity. Get clear on the harm. Gather evidence, not impressions. Analyse meanings and patterns. Weigh risk against protection. Plan proportionately and review regularly.
1. Be clear on the risk
A good risk assessment starts with a clear statement of the harm at the cause of the issue. Not “concerns around parenting.” Be specific. Describe the risk in one clear sentence.
Risk of physical harm to a child due to domestic abuse.
Risk of neglect due to chronic substance misuse.
Risk of self-harm due to mental health crisis.
Risk of exploitation due to missing episodes and peer association.
2. Gather evidence, not impressions
Risk assessment is built on evidence—what has been seen, what others have observed, what has been recorded, and what the person themselves says. It also includes what is missing, because gaps matter. The mistake social workers make when under pressure is relying on impressions. “Mum seems fine.” “Dad was calm.” “The house felt okay.” Those things are worth noting, but they are not enough.
Gather dates, patterns, frequency, and change over time. What the child says in their own words. Observations on arrival, during the visit, and on leaving. These details make the risk assessment more defensible because they show the analysis, not just the conclusion. One account is a story. Three aligned accounts are a pattern.
3. Analyse the meaning, not just the facts
Analysis is where risk assessment becomes professional judgement. Ask: what do these facts mean for harm. What do they suggest about likelihood, severity, and immediacy. What do they say about the person’s capacity to change, to protect, to comply, and to sustain improvement when professionals step back.
Good analysis also holds more than one explanation. A parent may appear resistant because they are obstructive, or because they are frightened, depressed, or cognitively overwhelmed. Test these hypotheses.
Identify triggers and patterns. When does risk spike? After contact. On weekends. After payday. During school holidays. Knowing the rhythm of risk helps with planning interventions that actually work.
4. Weigh risk against protective factors
Risk assessment is about balancing risk with protection. Protective factors can be people, routines, services, insight, motivation, and external oversight.
A consistent grandparent.
A child’s strong school attachment.
A parent who engages with treatment and can demonstrate change over time.
A stable home.
A safety network that will act when needed.
The mistake is to assume protective factors exist because they are named. “Nan is supportive.” Supportive how, and when. “The partner helps.” Protective factors must be tested. If they are real, they should show up in behaviour. When protective factors are solid, they shape safety planning. They give confidence. Without them, a plan does not exist.
5. Create a proportionate plan and review it
A risk assessment is pointless without an action plan. The plan should be proportionate. Not over intrusive, not under powered. It should match the level of risk and be rooted in what is known, not what one hopes will happen. A good plan includes what will happen next, who will do it, when it will happen, and what would trigger escalation or de-escalation. What “better” looks like. Should be clearly stated.
Risk assessment must be reviewed regularly because risk changes. Children grow. Adults relapse. Relationships shift. Services change. Assessment needs to move with reality, not remain frozen in last month’s picture.
Final thoughts
Social workers who do these five things consistently, will be able to say, with honesty and confidence, that their judgement was sound, your process was defensible, and they did the best they could with the information they had at the time.
Supporting Material
Assessing people who do not speak English
Minas, H. (2012). Specialist assessment pf people who do not speak English. In G. Meadows, J. Farhall., E. Fossey, M. Grigg F. McDermott, & B. Singh (Eds.), Mental health in Australia: Collaborative community practice (3rd ed., pp. 421-422). Oxford University Press.
The following guidelines provide basic advice on administering assessment instruments with or without an interpreter to consumers with low English proficiency or who come from cultural backgrounds that are different from those in which the instruments were developed. Their focus is on mental health assessment, but some may also be relevant to the biopsychosocial assessment approach.
Assess whether the person is sufficiently proficient in English to communicate effectively about mental health issues and to demonstrate cognitive functioning.
Communication about mental health issues is one of the most challenging tasks in a second language; therefore it is important to assess English proficiency accurately.
Even if English proficiency is satisfactory, cultural factors may significantly influence consumer responses.
Knowledge and skills assessment instruments such as the MMSE and WAIS are heavily reliant on education and experience in and familiarity with the host culture.
Determine what level of education the person has received and in what country the education was received. Note that lack of education does not equate necessarily with lack of capacity. Clinicians should inquire about opportunities for education, particularly with refugees.
Immigrants and refugees from some communities may have had little or no formal education but may demonstrate sound survival skills and daily functioning. Consider alternative forms of assessment of functioning, rather than normal cognitive assessment.
Mental illness manifestations and social functioning are all influenced by culture: consider to what extent culture and the language contribute to and distort score outcomes.
When in doubt, seek cultural consultation or refer to an experienced bilingual mental health professional.
If the person has low English proficiency and the instrument is administered in English, the results may be invalid, and scores may not accurately reflect the person’s functioning.
If the person has low English proficiency, it is preferable to use pre-translated instruments that have been validated and normed for the target group. If a translated version of a test is available, establish whether it has been validated and normed for the local target group. However, in most cases such instruments will be unavailable for the person’s language and cultural group.
If an existing measure is to be formally translated, the translated instrument should be conceptually and psychometrically equivalent to and measure the same domains as the original instrument.The following are examples of templates. Different organisations have different approaches to the BPSS (or its equivalent).
Helping clients navigate religious trauma
Walsh, D., & Koch, G. (2023, November 15). Helping clients navigate religious trauma. Counseling Today. https://ct.counseling.org/2023/11/helping-clients-navigate-religious-trauma/#respond
As counsellors, we seek to support others in their search for meaning, wholeness and healing. This journey can lead us to work with clients who have had various experiences — both positive and negative — with religion and spirituality. Therefore, we must be prepared to address issues of religion and spirituality when appropriate, especially for those who have survived religious and spiritual trauma.
Many researchers in the social sciences describe religion as a shared set of practices and beliefs and spirituality as a personal relationship with God(s) or a Higher Power. Based on this understanding, an individual could experience spirituality through organized religion, be spiritual but not religious, or participate in religion but not be spiritual. An increasing number of individuals are leaving the religion they were raised in or not identifying with any religious tradition due to changing beliefs or finding community elsewhere.
The Association for Spiritual, Ethical and Religious Values in Counseling (ASERVIC), a division of the American Counseling Association, identified 14 competencies across six areas for addressing religion and spirituality in counselling. These competencies are of particular importance when working with survivors of religious/spiritual trauma to avoid further traumatization or inappropriate care.
Culture and Worldview
1. The professional counsellor can describe the similarities and differences between spirituality and religion, including the basic beliefs of various spiritual systems, major world religions, agnosticism, and atheism.
2. The professional counsellor recognizes that the client’s beliefs (or absence of beliefs) about spirituality and/or religion are central to his or her worldview and can influence psychosocial functioning.
Counsellor Self-Awareness
3. The professional counsellor actively explores his or her own attitudes, beliefs, and values about spirituality and/or religion.
4. The professional counsellor continuously evaluates the influence of his or her own spiritual and/or religious beliefs and values on the client and the counselling process.
5. The professional counsellor can identify the limits of his or her understanding of the client’s spiritual and/or religious perspective and is acquainted with religious and spiritual resources, including leaders, who can be avenues for consultation and to whom the counsellor can refer.
Human and Spiritual Development
6. The professional counsellor can describe and apply various models of spiritual and/or religious development and their relationship to human development.
Communication
7. The professional counsellor responds to client communications about spirituality and/or religion with acceptance and sensitivity.
8. The professional counsellor uses spiritual and/or religious concepts that are consistent with the client’s spiritual and/or religious perspectives and that are acceptable to the client.
9. The professional counsellor can recognize spiritual and/or religious themes in client communication and is able to address these with the client when they are therapeutically relevant.
Assessment
10. During the intake and assessment processes, the professional counsellor strives to understand a client’s spiritual and/or religious perspective by gathering information from the client and/or other sources.
Diagnosis and Treatment
11. When making a diagnosis, the professional counsellor recognizes that the client’s spiritual and/or religious perspectives can a) enhance well-being; b) contribute to client problems; and/or c) exacerbate symptoms.
12. The professional counsellor sets goals with the client that are consistent with the client’s spiritual and/or religious perspectives.
13. The professional counsellor is able to a) modify therapeutic techniques to include a client’s spiritual and/or religious perspectives, and b) utilize spiritual and/or religious practices as techniques when appropriate and acceptable to a client’s viewpoint.
14. The professional counsellor can therapeutically apply theory and current research supporting the inclusion of a client’s spiritual and/or religious perspectives and practices.
The impact of religious/spiritual trauma
Religion and spirituality can have a positive impact on overall well-being, but they can also be harmful, damaging or traumatic. Religious/spiritual trauma is similar to other types of trauma, and it can overlap or co-occur with physical, sexual or emotional trauma. However, religious/spiritual trauma can be a particularly life-altering experience because religion and spirituality are often lenses through which people view the world. Religious/spiritual trauma can thus impact a person’s sense of identity, their core beliefs and values, and their perception of safety in the world. Moreover, it can deeply alter or damage an individual’s relationship and previous understanding of that which they consider to be sacred. Because religious/spiritual trauma can deeply impact clients’ mental health, counsellors have a responsibility to develop the knowledge, skills and awareness to support clients who have experienced this type of trauma.
Working with clients experiencing religious/spiritual trauma
Like with other forms of trauma, individuals who experience religious/spiritual trauma vary in their responses and reactions. Some clients may try to preserve their previously held religious/spiritual beliefs, while others may change or abandon their beliefs. As counsellors, we may see clients who are conflicted or who do not know how they want to respond to the religious/spiritual trauma.
Key components of care for clients who have experienced religious/spiritual trauma include the following:
Cultivate safety through a trauma-informed approach. When clients have experienced religious/spiritual trauma, they often have a natural and automatic instinct toward self-protection and preservation that may be expressed as guardedness within the therapeutic space. Counsellors must carefully consider how they build the therapeutic relationship and create safety with this population. Seemingly small considerations such as asking permission and allowing clients a sense of control can have a significant impact. “I’m curious about how that experience felt to you. Would you feel comfortable sharing more about it?”
Perform an initial and ongoing assessment of risk. It is extremely important for counsellors to assess the client for risk of suicide, self-harm and other safety concerns. This risk assessment should be conducted during intake and accompanied by appropriate follow-up assessments, including assessing if the client is at risk for further religious/spiritual trauma. It is helpful to get a broad sense of what the trauma is, how the client understands the religious/spiritual trauma and where they currently are regarding their personal religion or spirituality, e.g. the client’s current level of engagement with religion.
Remember, regulation before intervention. Clients who have experienced any trauma (including religious/spiritual trauma) may experience symptoms of nervous system dysregulation throughout their daily lives. It is important to make sure clients are not experiencing overwhelm or flooding in the therapy space because this will inhibit the client’s ability to experience the clinical interventions as intended. Grounding and mindfulness interventions (such as progressive muscle relaxation, 5-4-3-2-1 sensation naming activities or gentle stretching) can be helpful when working with this population. For example, the counsellor could ask the client to rate their level of distress on a 10-point scale (least distressed to most distressed) before, after and at various times during a session if the client shares something about the traumatic experience. Pausing and conducting grounding exercises may be appropriate depending on the rating.
Duration Neglect
Peart, V. (2026, February 17). Duration neglect: Why clients don’t see what social workers see. Social Work News. https://www.mysocialworknews.com/article/duration-neglect-why-clients-don-t-see-what-social-workers-see
What is duration neglect?
When something harmful happens once, it stands out. When it happens every day, it becomes the background because the nervous system recalibrates. What once triggered alarm becomes “just how things are.” This is a human survival mechanism. This is duration neglect in action. Duration neglect is about exposure over time. The slow drip of unmet needs or care across months and years. The normalisation of adversity as people adapt. A failure to recognise harm when it is chronic, low-level, and long-term, rather than acute and dramatic.
Where the concept comes from
The idea of duration neglect draws on several overlapping bodies of research.
When people live under sustained pressure, their baseline for what feels “normal” shifts.
Repeated exposure to adversity shapes cognition, memory, and meaning making. People minimise, rationalise, or compartmentalise harm because acknowledging it fully would be overwhelming.
Chronic neglect can be just as damaging to development as overt abuse, particularly in early childhood, precisely because it operates over time rather than through single events.
Duration neglect helps explain why harm that is obvious in hindsight is often invisible to those living inside it.
Why social workers see something different
Social workers hold years of information at once. They scroll through historical records to see repetition, escalation, and stagnation. In contrast, clients experience life sequentially. Day to day. Week to week. Crisis to crisis. They experience their life as survival in the present moment, where “We’re coping now”.
The cumulative impact of long-term neglect and abuse
Children exposed to long-term neglect may experience:
Delayed cognitive development
Poor emotional regulation
Difficulties forming secure attachments
Increased risk of mental health problems
Long-term physical health consequences
And yet, because neglect does not always leave visible marks, it is more likely to be minimised, both by systems and by families themselves.
For adults, long term domestic abuse, coercive control, poverty, addiction, or mental ill health can become so embedded that individuals struggle to identify it as harm. “Nothing really bad has happened.”
Applying duration neglect to social work practice
Understanding duration neglect should fundamentally change how social workers approach assessment, engagement, and intervention.
When someone appears dismissive of long-term harm, it is often an invitation to explore, not confront.
Rather than focusing on individual incidents, gently map patterns over time to see accumulation not blame.
When social workers recognise that people adapt to neglect, the tone shifts from accusatory to curious.
Duration neglect means acknowledging loss, grief, and missed opportunities. That is hard for people.
A more humane interpretation
Ultimately, duration neglect reminds social workers that people are not ignoring harm out of malice or manipulation. They are responding as humans do when harm is stretched over time. If this is held alongside safeguarding responsibilities social workers still, act, intervene, protect. But they do so with a clearer understanding of why the people may not see what social workers see.
Social work is not just about recognising harm. It is about recognising how humans learn to live with it.
The Peak-end Rule
Peart, V. (2026, February 26th). Why people remember the best or worst and forget the rest: the peak-end rule. https://www.mysocialworknews.com/article/why-people-remember-the-best-or-worst-and-forget-the-rest-the-peak-end-rule
What is the peak-end rule?
The peak-end rule describes how human beings remember experiences. Rather than remembering events as a full, accurate average of everything that happened, we tend to judge experiences based on:
The most intense point (the peak, good or bad), and
The ending of the experience, particularly the most recent part.
This means that two different experiences can be remembered in almost identical ways if their peak moments and endings are similar. Why? Because memory is not an objective recording device. It is a meaning-making system.
For example, a social worker might be sitting with a parent who has lived through years of instability, neglect or harmful relationships, and they say: “Things are actually fine now.” Their long chronology tells a very different story. What is often happening is the person is weighting their understanding of their life heavily towards the most intense moments they remember, and how things feel now. If the current period is calmer than what came before, it can overshadow years of harm. From the inside, that feels truthful. From the outside, it looks baffling.
Duration neglect and the peak-end rule together
Duration neglect and the peak-end rule reinforce each other. Duration neglect explains how people adapt to long-term adversity and lose sight of cumulative harm. The peak-end rule explains which parts of that long experience dominate memory and meaning. Together, they help explain why:
People focus on recent improvements and downplay long histories.
One positive professional interaction can outweigh years of negative ones.
A short calm period can feel more significant than a long unsafe one.
Where social workers see neglect, repetition of harm, missed opportunities and a pattern across many years, clients feel relief that things are calmer now, pride in surviving, and hope based on recent stability. For the client, the “ending” of the story so far feels positive. For the social worker, it looks dangerously incomplete and a constant source of tension.
The professional risk of misunderstanding this
When social workers don’t understand the peak-end rule they may assume people are minimising harm, being dishonest, manipulating professionals and lacking insight. This assumption can harden tone, reduce empathy, and damage relationships when people are remembering their lives the way humans naturally do.
How this applies to assessments
Assessments are particularly vulnerable to peak-end distortions. If a family engages well at the end of an assessment period, or if a parent is articulate and reflective at the point of interview, that can dominate professional impressions, even when the historical evidence tells a different story. Good social work counteracts the peak-end rule deliberately by:
Using chronologies rigorously
Giving appropriate weight to patterns, not just snapshots
Remaining alert to how recency can distort judgement.
Explaining concerns without invalidating experience
One of the most useful practical applications of this concept is in how social workers talk to people. They can acknowledge the emotional truth of improvement without losing sight of cumulative risk. Instead of saying: “You don’t seem to be recognising how bad this has been”, a worker might say: “It makes sense that things feel better now, especially compared to how bad they were before. What I’m also holding is the longer picture, and I want us to look at both together.”
A more humane practice lens
When you place duration neglect and the peak-end rule side by side, a more humane picture of human behaviour emerges. People are unreliable narrators because memory is selective, adaptive and biased towards survival. Social workers should hold two truths at once:
People’s experiences of improvement and relief are real.
The cumulative impact of long-term harm is also real.
The result will be less frustration, less adversarial, and more effective social work.
References
Association for Spiritual, Ethical, and Religious Values in Counselling. (n.d.). Spiritual and religious competencies. https://aservic.org/spiritual-and-religious-competencies/
Gale, L. (2022). Biopsychosocial-spiritual assessment: An overview. Cinahl Information Systems. https://www.ebsco.com/sites/default/files/acquiadam-assets/Social-Work-Reference-Center-Skill-Biopsychosocial-Spiritual-Assessment.pdf]
Minas, H. (2012). Specialist assessment pf people who do not speak English. In G. Meadows, J. Farhall., E. Fossey, M. Grigg F. McDermott, & B. Singh (Eds.), Mental health in Australia: Collaborative community practice (3rd ed., pp. 421-422). Oxford University Press.
Peart, V. (2026, January 28). The five key steps to undertaking a risk assessment. Social Work News. https://www.mysocialworknews.com/article/the-5-key-steps-to-undertaking-a-risk-assessment
Peart, V. (2026, February 17). Duration neglect: Why clients don’t see what social workers see. Social Work News. https://www.mysocialworknews.com/article/duration-neglect-why-clients-don-t-see-what-social-workers-see
Peart, V. (2026, February 26). Why people remember the best or worst and forget the rest: the peak-end rule. https://www.mysocialworknews.com/article/why-people-remember-the-best-or-worst-and-forget-the-rest-the-peak-end-rule
Sutherland, K., Cumming, S., McCawley, A-L., Rossini, G., Wishart L., & Finnigan, S. (2025): A structured template for social work psychosocial assessments and formulations in healthcare. Australian Social Work, 78(1), 4-14. https://doi.org/10.1080/0312407X.2024.2322741
University of Nevada, Reno. School of Medicine. (n.d.). Bio-Psycho Social-Spiritual Model. Retrieved September 21, 2020, from https://med.unr.edu/psychiatry/education/resources/bio-psycho-social-spiritual-model]
Walsh, D., & Koch, G. (2023, November 15). Helping clients navigate religious trauma. Counseling Today. https://ct.counseling.org/2023/11/helping-clients-navigate-religious-trauma/#respond