Social workers and other health care professionals often ignore spirituality, which is part of patients' ability to cope with advanced cancer. However, the social work perspective encourages a holistic approach, including engagement with patients about spiritual issues. Respecting patients' integrity, a social worker can assess their spirituality with the goal of supporting and encouraging effective coping. Because social workers, at times, can deal more easily with patients' spiritual issues than chaplains can, it is important to view this role as appropriate for social work. The authors offer suggestions to practitioners regarding assessment of the contribution of a patient's spirituality to coping, including noting evidence of the patient's religious affiliation and responding to spiritual references and existential pondering. Interventions that support and reinforce patients' spirituality involve active listening and use of self to help patients explore the essentially unanswerable questions regarding life and death. Referral to a chaplain is particularly important when a patient raises questions about theology or religious rituals.
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