1 - Participates in a calm conversation about the person’s emergent problems 
2 - Sharing, on any level, of the patient’s concerns about  mental health symptoms or the patient’s concerns about  the consequences of his/her addictive behavior
​3 - Acceptance of assessment by a qualified addiction or mental illness counselor

18 - Addiction/Mental Illness Concerns - Helping peopsle understand and manage their mental illnesses remains a major piece of the work of a spiritual clinician. Not that spiritual clinicians need to master, or even engage diagnosis and treatment of mental disorders. But they do have a responsibility to participate actively in the vast and complex global project of assisting the 46% of the US population that will experience an at least temporarily disabling mental disorder in their lifetime.

         Only about a third of the people experiencing the various mood disorders, personality disorders, and other life troubling conditions are getting needed treatment. Clinical settings offer a window of opportunity for referral and spiritual clinicians can continually learn both about the various signs of this need, and the intricate process of referring.

          In a wide definition of spiritual need, mental illness must be included. Simply put, what gets depressed in depression and distorted in major anxiety disorders for example, in the human spirit. The fields of psychiatry, psychology, social work and counseling that have developed in the past 150 years provide help for spiritually painful conditions that were previously impossible to treat. As spiritual clinicians work in health care settings, they encounter several people every day who are needing but not receiving mental health care. The capacity to listen carefully and tease out a patient's core concerns will occasionally lead to gently facilitating assessment by a qualified professional for a treatable mental health condition. 

          For a spiritual clinician to address addiction even reasonably effectively however, requires a totally different set of experiences and skills. A typical addict, (which doesn't exist; they are all so different)) confounds the health care system for ten or twenty years until dramatic events bring him to a place of possible recovery. That often happens in a hospital. But there he often finds nobody ready to assist him due in part to his well established defensive fortress on the one hand, and the fast paced, highly focused, and production oriented staff on the other. A skilled spiritual clinician gives him the best chance at starting recovery with an approach that stubbornly and gently maintains a different focus from all practitioners around him. He focuses on the patient's own concerns about his condition.  They seem invisible, but they are there.

         Since the people around him see his plight long before he does, virtually all of them have concerns, from his wife and children, to his boss and professional caregivers. They are all too ready to share those concerns with him, who then defends himself at all cost, from the mountain of guilt and shame he would face if he allowed his own concerns to surface. Gentle queries about HIS concerns has the best likelihood that he will be able to share a single tiny one, and this can be expanded by further gentle queries.

        In addition, it is likely that he knows nothing substantive about addiction as an illness, though he will claim, "Hell, I've lived it!" At the precise moment when the word "alcoholism" is mentioned for example, there emerges a unique opportunity for him to begin seeing his condition in far less blaming terms.  Addressing that word, alcoholism (or addiction), well is a key to the conversation. When he can emotionally touch even a tiny piece of his massive regrets, and have it received without drama by a skilled listener, enormous relief encroaches on his miserable, "spiritually bankrupt" soul. That may motivate him to accept assessment from a qualified counselor. Such an approach requires gentle persistence and belief that beneath the solid and complex defensive structure--bravado, hostility, self-pitying victimization, etc.-- there indeed are concerns. Be assured that there are.