Spirituality among People with Disabilities: A Nationally Representative Study of Spiritual and Religious Profiles

Abstract

This study examined the relationship between eight dimensions of spirituality (and religion) and people with four different types of disability status: hearing, vision, physical mobility, and emotional or mental disabilities. The overarching aim was to identify specific spiritual–religious profiles within each disability population relative to the general population. To conduct this cross-sectional examination, the authors used nationally representative data from the General Social Survey in the United States. The results reveal unique spiritual and religious profiles across the four types of disability status examined, although people with emotional or mental disabilities may have the most distinct profile. Compared with their counterparts among the general public, people with hearing, physical, and emotional disabilities were more likely to report praying several times a day; people with all four types of disability were more likely to report having a turning point when they became less committed to religion. Understanding which spiritual and religious dimensions are disproportionately more likely to exist among a given population with a particular disability helps practitioners provide more effective services to members of that group.

Disability is an issue of prominent concern to social workers and other helping professionals. According to the U.S. Census Bureau, approximately 56.7 million people have a disability of some type (Brault, 2012). It is well established that having a disability is frequently associated with a diverse array of life challenges (Pandya, 2017). Some individuals experience isolation, stigma, and depression; others wrestle with questions related to their value, worth, and purpose (Zhang, 2013).

One factor that may assist people with disabilities to cope with the challenges they face is spirituality, and its closely related conceptual cousin, religion (Hosseini, Chaurasia, & Oremus, in press). Qualitative data suggest that spirituality is often a source of strength to members of this population (Starnino, 2014). Indeed, many people with disabilities report that spirituality is a central factor in facilitating adjustment and wellness (Liu, Thomas, Annadale, & Taylor, 2014).

The present study builds on this prior work by conducting a quantitative examination of the relationship between spirituality and disability using nationally representative data. More specifically, we examine the association between eight measures of spirituality and religion and four common types of disability status to identify specific spiritual and religious profiles. By understanding which spiritual and religious beliefs and experiences are particularly likely to occur among people with a given disability relative to the general population, social workers and other helping professionals are better positioned to address spirituality in an ethical and professional manner with members of these populations (Barclay, Rider, & Dombo, 2012).

Literature Review

The term “disability” encompasses a wide variety of experiences. Reflecting this reality, disabilities are commonly classified into different types or categories including communicative, physical, and emotional or mental (Brault, 2012). Communicative disabilities include vision and hearing impairments. Physical disabilities include problems walking, lifting, climbing, and other problems that impair mobility. Emotional or mental disabilities include learning problems, trouble concentrating, dementia, and other affective or cognitive impairments.

Because people with diverse types of disability tend to experience the world differently, it is important to examine factors that influence people’s lived reality by disability type. Research conducted with one group often has limited utility with another. For example, research conducted with people with hearing problems may have little validity with people with emotional or mental problems (Starnino, 2014). Consequently, scholars have called for research that focuses on different disability populations to increase the validity of the findings (Barclay et al., 2012).

Other factors can also influence how various disabilities are experienced. For instance, children born with disabilities can have different experiences relative to those who develop disabilities later in life (Schulz, 2005). Although the prevalence of disabilities is relatively consistent across racial groups, rates increase steadily as individuals age (Moberg, 2008). Whereas just 10 percent of adults ages 15 to 24 have a disability, over 70 percent of those 80 and older have a disability (Brault, 2012). Consequently, developing knowledge of strategies that help older adults cope with disability is an important area of scholarship (Hosseini et al., in press). In addition to age, spirituality is an influential factor in the lives of people with a disability (Liu et al., 2014).

Spirituality, Religion, and Disability

Although many definitions of spirituality exist (Canda & Furman, 2010), this construct is widely understood to reference a person’s relationship with God (Snider & McPhedran, 2014) or, more broadly, the sacred (Hodge, 2013). Spirituality is commonly understood in personal, relational terms; religion tends to be viewed as a socially shared set of beliefs and practices that can be, but is not necessarily, related to the sacred (Derezotes, 2006). Understood in this sense, spirituality might be considered the broader, more encompassing construct.

In people’s lived reality, however, the two constructs are often intertwined as people’s relationship with the transcendent is expressed, reinforced, and reinterpreted in religious settings (Canda & Furman, 2010). In keeping with this view, many members of the public use the terms spirituality and religion in a largely interchangeable manner (Koenig, 2015). The interconnected nature of the two concepts complicates attempts to parse the respective empirical effects (Snider & McPhedran, 2014). In this article, we follow the common practice of viewing spirituality as the more encompassing construct. Thus, for example, when discussing the empirical relationship between spirituality and health, the discussion includes both spirituality and religion unless otherwise noted.

A significant and growing body of research links spirituality with a diverse array of positive health outcomes (AbdAleati, Zaharim, & Mydin, 2016; Hosseini et al., in press; Koenig, 2015; Koenig, King, & Carson, 2012). For example, higher levels of spirituality tend to be positively associated with hope, self-esteem, social support, adaption to bereavement and inversely associated with anxiety, depression, loneliness, and suicide. Although most of the extant research has been conducted with general population or community samples, similar findings have frequently emerged using samples comprised of people with disabilities (Liu et al., 2014; Specht, King, Willoughby, Brown, & Smith, 2005).

For instance, Starnino (2014) and Starnino, Gomi, and Canda (2012) summarized the limited research on spirituality and people with serious mental illness. Starnino noted that individuals with this disability draw on spirituality as a source of strength to help them cope. More specifically, their spirituality helps foster hope for the future, personal growth, a sense of purpose and meaning regarding their disability, the creation of a positive self-image, and access to social support through involvement with a religious community or a transcendent Being.

To help explain such findings, theorists have pointed to the salutary scripts that spirituality can engender (Pargament, 2007). These scripts can be understood as cognitively based stories or narratives that engender health and wellness. Through repeated interactions with God or a sacred Other, narratives are formed that directly and indirectly foster mental well-being (Granqvist & Kirkpatrick, 2013).

The power of these narratives is accentuated by the fact that they are imbued with transcendent meaning and reinforced in religious settings by like-minded others. Common transcendent narratives that may be particularly relevant to people with disabilities include the belief that God endows each person with dignity and worth that is intrinsically based, cares about the pain and suffering people encounter in life, and has a redemptive plan for each person’s life experiences. Such narratives—when internalized, bestowed with sacred meaning, and reinforced by others—can foster positive health outcomes (Liu et al., 2014). In addition, theorists have noted the social support that flows from interacting with like-minded others in religious communities may positively affect wellness (Koenig et al., 2012).

It is important to note that the relationship between spirituality and health is not uniformly positive (Koenig et al., 2012). In aggregate, the relationship is positive but exceptions exist. This is due in part to the multidimensional nature of both spirituality and religion. Different dimensions of spirituality and religion can have various relationships with different health outcomes among different populations. These different populations include, at least potentially, people with different types of disabilities.

Aim and Importance of the Present Study

This line of reasoning implicitly highlights the need for research that examines multiple dimensions of spirituality and religion among people with different types of disabilities relative to their peers without disabilities. As Barclay et al. (2012) observed, additional quantitative research using nationally representative samples is needed to help guide social work practitioners’ interactions in the area of spirituality. In addition, they called for research that features samples of people with different types of disabilities.

In response to this call, the present study examined the association between eight measures of spirituality and religion and four common types of disability status. Put differently, the aim was to identify specific spiritual and religious profiles within each disability population relative to the general population. The study sought to identify these potentially differential spiritual and religious profiles among people with (1) hearing, (2) vision, (3) physical mobility, and (4) emotional or mental disabilities.

This study has important implications for clinical practice. The extant research suggests that various dimensions of spirituality and religion may be especially prominent among certain disability populations. Understanding which dimensions are particularly likely to manifest among a given population helps practitioners provide more effective services to members of that group. For example, if a certain spiritual practice is more likely to occur among people with vision problems, relative to those with no vision problems, practitioners can make a point of exploring the utility of the spiritual practice in clinical settings. In this way, identifying the specific spiritual and religious profiles within each disability population can help guide practice.

Method

Data

To conduct this cross-sectional study, we used data from the General Social Survey (GSS) (Smith, Marsden, & Hout, 2016). The GSS is widely regarded as one of the most reliable sources of information about beliefs and behaviors among the general public. It has been administered by the National Opinion Research Center at the University of Chicago since 1972. The GSS is designed to be nationally representative of noninstitutionalized adults. The survey is administered every two years and the response rate exceeds 70 percent.

Surveys are primarily administered in face-to-face settings in households using computer-assisted interviewing technology (Smith et al., 2016). Interviews are conducted in either English or Spanish. Interviewers undergo extensive training to help ensure the internal validity of the collected data. For example, interviewers receive instruction on the intent of questions, discerning responses that suggest problems understanding questions, and potential clarifications that can be provided to respondents who have difficulty understanding questions.

Each survey features a set of core questions, which are asked every year, and unique questions, which are asked in specific years. In 2006, the GSS included a topical module on disabilities that was administered to a subset of the total sample. Although institutionalized adults fall outside the scope of the GSS, individuals with disabilities who live in households are part of the target population. In addition to demographic variables, this survey year also included a number of items that assessed spirituality and religion. As with the case with the module on disabilities, these items were often administered to a subsample of the overall sample. The items used in the present study are described in the following subsection. The research was conducted with the approval of a university institutional review board.

Measures

Spirituality and Religion

The study included items that measured eight different dimensions of spirituality and religion that may have relevance in clinical settings. The first two items measured frequency of prayer (coded dichotomously: 1 = several times a day, 0 = once a day to never) and confidence in God’s existence (1 = I know God really exists and I have no doubts about it, 0 = I have doubts about God’s existence or I don’t believe in God). The third item assessed belief in the Bible as God’s word (1 = word of God, 0 = Bible is inspired/fables/other). Because these items focus on respondents’ subjective connection with God (and His perceived word), they might be considered proxy measures of spirituality.

These three items were originally used with continuous response keys but were collapsed into dichotomous variables for two interrelated reasons. First, from a statistical perspective, the skewed distributions suggested the advisability of combining categories. Second, from a conceptual perspective, we were particularly interested in those respondents for whom spirituality was most salient (Schnabel & Bock, 2017). For example, individuals who pray several times a day may turn to their faith to cope with challenges in a way that others do not (Pargament, 2007). Such individuals arguably have a categorically different type of spirituality relative to those who pray infrequently or not at all. Thus, respondents who reported praying several times a day were classified in a different group relative to those who reported praying just once a day, several times a week, once a week, less than once a week, or never.

The next three questions assessed various types of point-in-time experiences. Individuals were asked if they have had a religious experience that changed their life, if they had a turning point in favor of religion, and if they had a turning point when they became less committed to religion. Responses were dichotomously coded (1 = yes, 0 = no). Depending on how respondents interpret these questions, these items might be considered proxy measures for spiritual or religious experiences that resulted in significant life changes.

Finally, two items assessed frequency of attendance at religious services (coded continuously: 0 = never to 8 = greater than weekly) and confidence in organized religion (1 = hardly any to 3 = a great deal). In the same way that the first three items might be considered proxy measures for spirituality, these two items can be viewed as proxy measures of religion.

Disability

The study included items that assessed four different types of disability: hearing, vision, physical mobility, and emotional or mental impairment. More specifically, individuals were asked, Do you have a hearing problem that prevents you from hearing what is said in normal conversation even with a hearing aid? Do you have a vision problem that prevents you from reading a newspaper even when wearing glasses or contacts? Do you have any condition that substantially limits one or more basic physical activities such as walking, climbing stairs, reaching, lifting, or carrying? Do you have any emotional or mental disability? Responses were dichotomously coded (1 = yes, 0 = no).

Control Variables

To better understand the relationship between spirituality and disability, several control variables were included in the study: age (measured in years), education (measured in years), gender (1 = male, 0 = female), race (1 = European American, 0 = African American and other), and marital status (1 = married, 0 = single).

Data Analysis

The data were analyzed using SPSS (Version 24.0). In the few cases in which respondents did not provide an answer, listwise deletion was used (Cohen & Cohen, 1983). All analyses were weighted using the WTSSALL variable (GSS Frequently Asked Questions, 2017).

To examine the associations between various dimensions of spirituality and religion and disability status, we used sequential logistic regression. The first block consisted of the demographic variables and the second block consisted of spirituality and religion variables. We used the backward likelihood method for each step to identity the most parsimonious set of variables (Field, 2009). Variance inflation factors were well below 10, indicating no evidence of multicollinearity across the four models. Cook’s distance values were all below 1, suggesting that no individual case had an undue effect on the model.

Results

Descriptive Statistics

Characteristics of the study sample are presented in Table 1. Among adults in the United States, close to a third (29.9 percent, n = 891) pray several times a day. Almost two-thirds (63.1 percent, n = 1,874) definitely believe God exists, and roughly a third (33.7 percent, n = 995) believe the Bible represents God’s word. Roughly 40 percent reported having some type of spiritual or religious experience that changed their life or altered their orientation toward religion, either positively or negatively. The mean value for religious attendance (M = 3.57, SD = 2.79) indicates that the average American attends services somewhere between several times a year and once a month. Finally, the typical respondent had only some confidence in organized religion (M = 2.03, SD = 0.68).

Regarding disability, the most prominent type of disability reported was related to physical mobility. Roughly 16 percent (n = 451) of the sample reported having limited ability to engage in basic physical activities such as walking or lifting. The prevalence of other types of disabilities was quite similar. Roughly 5 percent of adults reported either a hearing, vision, or emotional or mental disability.

The mean age was approximately 45 years (M = 45.34, SD = 16.55) and the average respondent had completed just over 13 years of education (M = 13.25, SD = 3.21), or the equivalent of one year of college. Just over half the sample were female (54.4 percent, n = 2,454) and married (56.3 percent, n = 2,535), and a clear majority were European American (72.3 percent, n = 3,259).

Bivariate Analysis

As implied earlier, many questions within the GSS are administered to a subsample of the entire sample. Due to the rotating nature of the question administration, the sample size in some cells was relatively small. Cross-tabulation tables were constructed with each categorical measure and each disability variable. The cells were subsequently examined to ensure that the expected frequencies in each cell were greater than one and no more than 20 percent of cells in each table were less than five (Field, 2009). All variables in the study satisfied these criteria.

Logistic Regression Models

Four logistic regression models were constructed to examine the association between spirituality and religion and disability status, after taking into account the effects of potential confounders. The final models were significant for hearing [χ²(6, N = 871) = 71.70, p < .001], vision [χ²(6, N = 869) = 53.47, p < .001], physical mobility [χ²(7, N = 868) = 137.89, p < .001], and emotional or mental disability [χ²(7, N = 867) = 60.91, p < .001]. Given these values for the overall model, it is appropriate to examine the individual relationships between the spirituality and religion variables and various types of disability. Odds ratios are reported for each variable in the final model along with their respective 95 percent confidence intervals. Subtracting 1 from the reported ratio and multiplying the result by 100 indicates the percentage increase or decrease in the odds of a person with a particular disability engaging in a specific spiritual or religious belief or practice relative to those without that particular disability (Spicer, 2005).

Block 1 in Table 2 presents the relationship between each demographic variable and disability status, controlling for the effects of all covariates. Disability status was associated with age and education in three of the four models. People with a hearing, vision, or physical disability were more likely to be older than their counterparts without the disability. Put differently, the older the respondent, the more likely he or she was to report a hearing, vision, or physical disability. Similarly, people with hearing, vision, or physical problems tended to complete fewer years of education than their counterparts without these problems. No difference in age or education existed for people with an emotional or mental disability relative to those with no emotional or mental disability. Disability status was associated with marital status across all four models. People with a disability were more likely to be single relative to their counterparts with no disability. No differences emerged regarding gender or race across the four models.

Block 2 (see Table 2) features the relationship between each measure of spirituality and religion and disability status, controlling for the effects of all covariates. The prayer variable was related to disability in three of the four models. Compared with their counterparts without hearing, physical, and emotional disabilities, people with these disabilities were more likely to report praying several times a day. People with all four types of disability were more likely to report having a turning point when they became less committed to religion.

Of particular note are the odds ratios for people with emotional or mental disabilities. Compared with their counterparts with no emotional or mental disability, individuals with an emotional or mental disability were 5.47 (2.34–12.78) times more likely to report a point in time when they turned away from religion. Although interpreting effect sizes is a subjective task that is context dependent, odds ratios in the 2.5 to 3.0 range can be viewed as a medium effect and ratios greater than 4.0 represent a large effect (Ferguson, 2009; Rosenthal, 1996).

Regarding attendance at religious services, people with physical and emotional disabilities were less likely to attend than those without physical and emotional disabilities. Respondents with vision disabilities were more likely to report that God definitely exists and the Bible is the actual word of God. People with hearing disabilities were less likely to report confidence in organized religion, whereas those with physical mobility impairments were more likely to report confidence relative to those without the impairments. Finally, people with emotional disabilities were more likely to report having a life-changing religious experience.

Discussion

Despite the importance of spirituality to people with disabilities, relatively little research exists on this subject (Starnino, 2014). Consequently, observers have called for additional quantitative research using nationally representative samples to help inform practitioners’ interactions regarding the spiritual beliefs, practices, and experiences of clients with disabilities (Barclay et al., 2012). To address this gap in the literature, the present study examined the association between eight measures of spirituality and religion and four different types of disability status. The goal of this examination was to identify specific spiritual and religious profiles within each disability population relative to the general population. As such, the study provides a nationally representative picture of spirituality and religion among people with hearing, vision, physical mobility, and emotional or mental disabilities relative to their counterparts among the public.

The results reveal an instructive picture of spirituality and religion among people with disabilities. One of the more notable findings concerns prayer. People with hearing, physical, and emotional disabilities were more likely to report praying several times a day than those without the equivalent disabilities among the general population. This finding is consistent with prior research documenting the importance of prayer among people with various kinds of disabilities (Liu et al., 2014; Marini & Glover-Graf, 2011; Rodriguez, Glover-Graf, & Blanco, 2013; Turner, Hatton, Shah, Stansfield, & Rahim, 2004). In addition to confirming prior findings, it extents them by providing a nationally representative picture of this practice among people with four different types of disabilities.

Another significant finding pertained to experiencing a turning point in life when respondents become less committed to religion. This finding is consistent with prior research suggesting that people with disabilities often experience points in time when they wrestle with God about their disability (Gallagher, Phillips, Lee, & Carroll, 2015; Marini & Glover-Graf, 2011). The breadth of the results obtained in the present study is notable. People with all four types of disabilities were more likely to report having such a turning point than those without the equivalent disability. Another notable finding was that people with physical and emotional disabilities were less likely to attend religious services than those without the corresponding disability.

Unique spiritual profiles emerged across all four types of disability examined in the present study. Of these, the most distinctive profile may belong to those with emotional or mental disabilities. For instance, members of this group were roughly five and a half times more likely to experience a point in time when they turned away from religion. This was the variable with the largest effect size in the study, although the wide confidence intervals (that is, 2.34–12.78) suggest that caution is warranted in making any assessment about effect size. As implied earlier, these findings have significant implications for engaging spirituality in practice with people with different types of disabilities (Barclay et al., 2012).

Implications for Practice

The results underscore the importance of conducting a spiritual assessment to better understand the role that spirituality plays in the lives of people with disabilities (Hodge, 2015). The results illustrate the rich, vibrant spiritual landscape that frequently exists in people’s lives. Compared with their counterparts among the general public, individuals with disabilities are much more likely to report an array of clinically relevant spiritual beliefs, practices, and experiences. To work effectively with such individuals, it is important to know their unique spiritual beliefs, experiences, and practices so that services can be appropriately tailored.

As illustrated in Table 3, spiritual assessment is typically conceptualized as a two-stage process in which a brief assessment is administered to all clients followed, if clinically warranted, by a comprehensive assessment (Hodge, 2015). Put differently, the purpose of the brief assessment is to determine the potential impact of spirituality, if any, on service provision and whether an additional comprehensive assessment is needed. In many situations, the results of the brief assessment will reveal that spirituality is not relevant to service provision, in which case the assessment process terminates. If the results of the brief assessment suggest that spirituality may intersect with service provision, then an additional comprehensive assessment is warranted. Table 3 depicts one brief protocol—the iCARING Brief Assessment—along with a list of options for conducting comprehensive assessments. Additional information about these approaches and their respective strengths and limitations can be found elsewhere (Hodge, 2015).

During the assessment, the salience of prayer might be explored. As noted earlier, cognitive scripts that are endowed with sacred meaning can have a significant effect on health and wellness (Pargament, 2007). Practitioners proficient in cognitive–behavioral therapy (CBT) might work with clients to identify salutary spiritual beliefs that are relevant to the challenges currently encountered (Starnino, 2014). Once relevant beliefs are identified, practitioners can explore the possibility of creating health-promotive self-statements that double as prayers or otherwise incorporate and reflect clients’ spiritual beliefs and values.

Take, for example, clients wrestling with self-worth, a common issue among those with disabilities (Zhang, 2013). In traditional CBT, clients are taught to identify maladaptive beliefs and replace them with salutary self-statements (for example, I am a worthwhile person with positive and negative traits) (Hodge, 2015). For spiritually motivated clients, practitioners might work with clients to restate the underlying therapeutic concept using language drawn from clients’ spiritual worldview (for example, I have dignity and worth because I am created in the image of God). The same therapeutic concept could also be crafted as a prayer (for example, “Thank you, Father, for creating me in your image. Because I am created in your image, I have innate dignity and worth”).

Such sacred self-statements may be implemented more consistently by clients because they are perceived as more relevant to their personal value system (Starnino, 2014; Starnino et al., 2012). In addition, they provide a transcendent rationale for believing the self-statement. God, rather than the self, is implicitly framed as the authority in the statement. Furthermore, clients’ religious communities may also reinforce the veracity of such statements. Together, these factors can provide a powerful counterpoint to the messages people with disabilities often receive from the larger society regarding their worth and value.

Another issue practitioners might consider during the assessment is spiritually based disappointment (Gallagher et al., 2015; Marini & Glover-Graf, 2011). For example, in some cases, clients may wrestle with God about their disability. Social workers can play an important role in helping clients work through such disappointments and reconnect to sources of strength within their faith.

Practitioners should also be alert to clients’ past and present relationship with their religious communities during the assessment process. Variation exists in any congregation. Interactions with people who are not accepting of people with disabilities can result in emotional wounding. Furthermore, some congregations may overlook the needs of people with various types of disabilities. Services needed for people with disabilities to actively participate in congregational life may not be available.

The results suggest that people with emotional and mental disabilities may need additional support and guidance in dealing with these challenges. Whereas people with all four types of disability examined in this study reported experiencing a point in time when they turned away from their religion, those wrestling with emotional or mental disabilities may have more difficulty making the transition back to sources of strength within their faith. As Starnino (2014) implied, social workers can often play a crucial role in helping people with emotional or mental disabilities negotiate a place within a religious community. For example, this might be accomplished by collaborating with clients’ clergy. Clergy may be able to connect people with disabilities to appropriate congregants or services if they are alerted to these issues.

Clients’ interest in attending religious services might also be explored, particularly among those with physical mobility issues. Clients with such disabilities may want to participate in the life of a local congregation but have difficult attending (Hosseini et al., in press). In such cases, practitioners might help broker transportation options.

Facilitating participation in spiritual and religious activities is important, at least in part, because of the associated health benefits (Koenig et al., 2012). Such participation may be especially important for older adults. Recent reviews of the relevant research suggest that spirituality and religion can help slow cognitive decline (Agli, Bailly, & Ferrand, 2014; Hosseini et al., in press). It should be emphasized, however, that participation in spiritual and religious activities should always reflect the wishes of the client.

Limitations

Although the results can plausibly be generalized to the groups focused on in the study, they cannot be generalized to all people with disabilities, or even all people with hearing, vision, physical mobility, and emotional and mental impairments. The population targeted by the GSS is adults living in households, which means individuals living in group homes or other institutional settings were not sampled (Smith et al., 2016). People with severe disabilities may, however, be disproportionately likely to reside in such settings. Consequently, the results may not be valid for individuals with disabilities who are institutionalized and, perhaps, for those with more pronounced disabilities.

The use of self-report is another limitation as people may over- or underreport phenomena for a variety of reasons. The study did not measure the severity of the reported disabilities. As alluded to in the previous paragraph, it is possible that results may not be valid with more (or less) pronounced forms of disability. The GSS includes an extensive array of measures. It is possible that some of the included variables—such as geographic region or annual income—may have been related to key study constructs. We did not include additional control variables due to statistical concerns (related to the use of rotated questions, missing data, and so on). However, the inclusion of some of these variables might affect the study findings. Likewise, the use of collapsed variables results in the loss of information.

Finally, the data for the present study were collected in 2006. It is unknown how applicable the results are in the present societal context. Spiritual beliefs and practices, however, tend to be relatively stable over time (Newport, 2012). This suggests that the results have some validity in terms of working with people with disabilities.

Conclusion

To the best of our knowledge, this is the first nationally representative study on spirituality and disability to appear in the social work literature. The results highlight several areas that practitioners working with people with various types of disability might profitably explore in clinical venues. Time is typically limited in practice settings. Understanding key areas to explore with clients with different types of disabilities helps ensure that important areas are not inadvertently overlooked. Thus, this study makes an important contribution to those working with individuals with hearing, vision, physical mobility, and emotional and mental disabilities.

References