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The Spiritual Competence Scale: A New Instrument for Assessing Spiritual

Competence at the Programmatic Level

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DOI: 10.1177/1049731506296168

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Research on Social Work Practice http://rsw.sagepub.com

The Spiritual Competence Scale: A New Instrument for Assessing Spiritual Competence at the
Programmatic Level
David R. Hodge
Research on Social Work Practice 2007; 17; 287
DOI: 10.1177/1049731506296168

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 The Spiritual Competence Scale: A New Instrument for
Assessing Spiritual Competence at the Programmatic Level

David R. Hodge
Arizona State University, West Campus

Cultural competence has become a central social work tenet enshrined in the profession’s ethical and educational
standards. Few measures of cultural competence exist, however, in spite of an increasing array of religious, eth-
nic, and racial groups in U.S. society. This article develops a new measure to assess cultural competence among
one family of cultural groups—spiritual and religious cultures. More specifically, this scale measures respondents’
perceptions of spiritual competence at the programmatic level. To develop the eight-item scale, a confirmatory
factor analysis was conducted with a random sample of graduate students affiliated with the National Association
of Social Workers (N = 303). The results suggest that the scale is a valid and reliable measure of the values dimen-
sion of spiritual competence. Although the instrument is designed to assess levels of competence in educational
programs, with modification it may also be possible to use the scale in agency settings and perhaps for individual
self-assessment as well.

Keywords: spiritual competence; spirituality; religion; cultural sensitivity; cultural competence

Spurred by a changing cultural landscape (U.S. Census
Bureau, 2000), cultural competence has become a central
social work value. As Dunn (2002) suggests, social work-
ers must develop cultural competency to provide effec-
tive services to clients. If social workers do not respect
clients’ cultures and associated norms and values,
their ability to fulfill the profession’s ethical mission of
providing services to all people may be jeopardized
(National Association of Social Workers [NASW], 1999).
Various conceptualizations of cultural competence
exist (Dunn, 2002). Among the more influential is the
conceptual framework offered by Sue, Arredondo, and
McDavis (1992). These observers view cultural compe-
tence as an active, ongoing process in which no one ever
fully “arrives.” This process can be characterized by the
following three interrelated dimensions: (a) developing
the appropriate beliefs and values to engage culturally
different worldviews, (b) knowledge of a culturally dif-
ferent worldview, and (c) developing skill sets and inter-
vention strategies that are relevant and sensitive to a
culturally different worldview.
Author’s Note: David R. Hodge, PhD, is an assistant professor at Arizona
State University-west campus and a senior nonresident fellow at University
of Pennsylvania's Program for Research on Religion and Urban Civil Society.
Correspondence concerning this article should be addressed to the author at:
Dept of Social Work, P. O. Box 37100, Phoenix, AZ 85069-7100.
Research on Social Work Practice, Vol. 17 No. 2, March 2007 287-295
DOI: 10.1177/1049731506296168
© 2007 Sage Publications
The significance of cultural competency is seen in the
prominence accorded the concept in the profession’s
ethical and educational standards. The NASW (1999)
Code of Ethics explicitly recognizes the importance of
cultural competence and social diversity. Standard 1.05,
for example, enjoins social workers to deliver culturally
competent services that are sensitive to differences
among people and cultural groups.
Consistent with the NASW (1999) Code of Ethics,
the Council on Social Work Education’s (CSWE, 2001)
Educational Policy and Accreditation Standards (EPAS)
implicitly highlight the concept of cultural competence.
For example, all social work programs must provide
content that educates students about diversity within and
between groups. Curriculum content should be designed
so that students are equipped to deliver services that
meet the needs of various groups and are culturally rel-
evant to the groups involved (CSWE, 2001, IV, B).
The importance of cultural competence to the profes-
sion is also evidenced by supplemental documents that
NASW has produced, such as the NASW (2001)
Standards for Cultural Competence in Social Work
Practice. This document represents an attempt to flesh out
the concept of cultural competence through the delin-
eation of 10 standards for culturally competent practice.
The CSWE’s (2001) EPAS also indicates that
programs should develop plans to evaluate program out-
comes (Standard 8: 8.0, 8.1). Similarly, Standard 10 of
the NASW (2001) Standards for Cultural Competence

287
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288 RESEARCH ON SOCIAL WORK PRACTICE
in Social Work Practice state that the profession must
develop measures to assess cultural competence. If
social workers are to address cultural competency in
professional contexts, then it is important to be able to
measure the construct.
Measures designed to assess cultural competency are
comparatively rare, however. Reviews of cultural com-
petency measures indicate that only a handful of instru-
ments exist (Boyle & Springer, 2001; Kocarek, Talbot,
Batka, & Anderson, 2001; Ponterotto, Rieger, Barrett, &
Sparks, 1994). Furthermore, all of the extant measures
appear to be developed outside the discipline of social
work.
In addition, psychometric difficulties have arisen
with a number of these scales (Boyle & Springer, 2001;
Kocarek et al., 2001; Ponterotto et al., 1994). Sue et al.’s
(1992) conceptual work in particular has informed the
development of existing measures of cultural compe-
tence. As noted above, Sue and associates operationalize
cultural competency as an interrelated set of beliefs,
knowledge, and skills, which is consistent with the work
of others (Manoleas, 1994; NASW, 2001; Weaver,
1999). Factor analyses of existing measures, however,
have generally failed to support the tridimensional
conceptualization developed by Sue and associates
(Kocarek et al., 2001; Ponterotto et al., 1994).
Reliability coefficients have also been a problem in
some cases (Kocarek et al., 2001). For example, the
Multicultural Awareness-Knowledge-and-Skills Survey
(MAKASS) has been used with social work students
(Ben-David & Amit, 1999). With a sample of 334 Israeli
social work students, a Cronbach’s alpha of .55 was
obtained with the Awareness subscale, far below the .70
coefficient widely accepted to represent an acceptable
level of reliability (Nunnally, 1978). This is similar to
the coefficient obtained by other researchers using a
non–social work sample (Kocarek et al., 2001).
Also problematic is the length of time required to
complete many of the cultural competence measures.
Boyle and Springer (2001) report that roughly 25 min-
utes is needed to complete each of the four instruments
they reviewed. The time required to fill out such instru-
ments may preclude their use in settings where time
constraints are a consideration.
On assessing the current state of development, Boyle
and Springer (2001) called on researchers to develop
new instruments designed to measure cultural compe-
tency in social work educational and practice settings. In
addition, they indicated that research should focus on
measures that assess cultural competency with distinct
populations. In other words, rather than developing
broad, global measures of cultural competency, they
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posited that scholarship is best advanced by developing
narrower measures that focus on a particular subgroup
of individuals.
Accordingly, this article develops a measure of cul-
tural competency designed to assess sensitivity in the
area of spirituality and religion. More specifically, this
measure assesses respondents’ perceptions of spiritual
competence at the programmatic level. Although under-
studied, for many clients culture flows from, and is ani-
mated by, their spirituality (Hodge, 2005a; Richards &
Bergin, 2000; Van Hook, Hugen, & Aguilar, 2001). In
keeping with this reality, spirituality and/or religion is
an area highlighted in the NASW (1999) Code of Ethics,
the CSWE’s (2001) EPAS, and the NASW (2001)
Standards for Cultural Competence in Social Work
Practice. The NASW standards, for example, specifi-
cally lists religious and spiritual beliefs as a manifesta-
tion of cultural diversity and recommends that social
workers develop cultural competency in this domain.
In addition, interest in spirituality and religion among
social workers and the general public appears to be
increasing. Among Sheridan and Amato-von Hemert’s
(1999) sample of social work students (N = 205), 83%
reported interest in taking a course on spirituality and reli-
gion. The number of social work programs offering
courses in spirituality and religion more than tripled from
1995 to 2005 (Canda, 2005; Miller, 2001). As Canda
and Furman (1999) observed, professional interest in
spirituality and religion is exploding. Similarly, interest
in spirituality among the general public also seems to be
growing (Gallup & Lindsay, 1999), with survey data
suggesting that most clients desire to have their spiritual
beliefs and values integrated into the counseling dialogue
(Arnold, Avants, Margolin, & Marcotte, 2002; Bart, 1998;
Privette, Quackenbos, & Bundrick, 1994).
These developments, along with the profession’s eth-
ical and educational standards, suggest that a measure of
cultural competence is needed in the area of spirituality
and religion. As increasing numbers of social work
programs incorporate spiritual and religious content into
their curricula, it is critical that schools create an atmos-
phere in which spiritual competence is engendered.
Similar needs exist among social work agencies that
provide services to clients from spiritual and religious
cultures.
In light of the psychometric problems associated with
current measures and the corresponding need for new
instruments, this article develops a new measure of
spiritual competence. This measure taps the foundational
beliefs or values dimension of Sue et al.’s (1992) three-
dimensional conceptualization of cultural competence.
The scale is designed to assess perceptions of spiritual

competence at the programmatic level, specifically
educational programs and, with minor adaptations, other
programmatic settings such as social work agencies. With
further modification, however, it may also be possible to
adapt the instrument for self-assessment. Directly below,
the method used to develop this measure is delineated.
METHOD
Given the psychometric problems associated with
attempts to create a three-factor measure of cultural
competence, a decision was made to focus on the beliefs
dimension. Among the beliefs, knowledge, and skills
triad proposed by Sue and associates (1992), Manoleas
(1994) has argued that the beliefs or values dimension is
perhaps the most important element in cultural compe-
tence. Social work educational programs and agencies
must affirm the belief that different cultural expressions
have value and shape human interaction. It is this basic
belief system that, in effect, provides the foundation on
which the other dimensions of cultural competence rest
(Ben-David & Amit, 1999). Although shortcomings in
skill sets and knowledge of other cultural worldviews
are often overlooked if the appropriate attitudes exist,
the converse is less likely to occur.
To develop items for a spiritual competence scale, a
number of sources were examined. More specifically,
the conceptual work of Sue and associates (1992; Sue &
Sue, 1999) was consulted, along with the work of others
working in the area of cultural competence (D’Andrea,
Daniels, & Heck, 1991; LaFromboise, Coleman, &
Hernandez, 1991; Pruegger & Rogers, 1994; Sodowsky,
Taffe, Gutkin, & Wise, 1994). These sources were con-
sulted for the purposes of identifying common value
themes that would suggest the presence of an atmos-
phere conducive to cultural competence.
Value themes that emerged included the following:
acceptance of culturally different perspectives, respect
and sensitivity for different cultures and their associated
beliefs and narratives, openness to learning about differ-
ent cultures, the assignment of value or worth to different
cultures, and the desire to understand culturally different
views. Put differently, the literature suggests that the
degree to which these beliefs are held indicates the degree
to which cultural competence exists, at least as a poten-
tiality. Although it is important to marry these values with
particular skills, without these foundational values, cul-
turally competent practice is difficult if not impossible.
Items hypothesized to indicate the existence of these
values were constructed using a modified version of the
phrase completion method (Hodge & Gillespie, 2005).
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Hodge / SPIRITUAL COMPETENCE SCALE 289
With phrase completions, individuals are asked to
complete a phrase by selecting an option from an 11-
point response key that reflects the underlying theoreti-
cal continuum of the construct in question. This
approach may provide enhanced levels of reliability and
validity relative to Likert-type scales because it circum-
vents the multidimensionality innate in Likert-type
scales by presenting potential respondents with a single
dimension in conjunction with eliminating the extra
cognitive load associated with the use of item reversals.
In keeping with Manoleas’s (1994) recommendation
that measures be created for use in social work educa-
tion, items were designed for use in this setting. Items in
the MAKSS, for example, use phrases such as “the
human service professions” and focus on professions
such as “counseling and psychology.” This terminology
was replaced with phrases that oriented potential
respondents to social work education, although the
wording can easily be adapted to other social work
forums, such as agencies, classroom settings, and per-
haps even self-assessment, although focusing the items
at the program level helps minimize social desirability
bias while yielding information that may be just as use-
ful in assessing levels of spiritual competence.
A total of 16 items were developed that were hypoth-
esized to indicate the existence of cultural competence
in the realm of spirituality and religion. An initial
exploratory factor analysis was conducted with these
items using a stratified random sample of NASW-
member graduate students (N = 136). Based on the psy-
chometric properties of the items and the feedback of
the respondents, 4 items were retained and 4 items were
modified, resulting in a total of 8 items for analysis in
the present study. Table 1 lists the 8 items.
As can be seen, the items mention both spirituality
and religion. Although the NASW (1999) Code of
Ethics only mentions religion in its ethical standards, a
growing tendency exists to conceptualize spirituality
and religion as distinct but overlapping constructs
(Canda & Furman, 1999; Hodge, 2005b). Incorporating
both terms provides an inclusive measure that captures
sentiment among individuals who may orient toward
being spiritual but not religious and those who tend
toward being religious but not spiritual. In other words,
the instrument is designed to work with adherents of
both traditional and nontraditional worldviews.
The sample consisted of a random sample, stratified
by state to ensure geographic representation, of NASW-
member graduate students with phone numbers.
Although scales are typically developed using samples
drawn from one school or a single geographic area, such
approaches limit the generalizability of the results
290 RESEARCH ON SOCIAL WORK PRACTICE

TABLE 1: Spiritual Competence Scale

1. To what degree does your social work program foster respect for religious and spiritual cultures?
–5 –4 –3 –2 –1 0 +1 +2 +3 +4 +5
Fosters extreme disrespect Fosters extreme respect
2. How acceptable is it in your social work program to share religious or spiritual views?
–5 –4 –3 –2 –1 0 +1 +2 +3 +4 +5
Completely unacceptable Completely acceptable
3. To what extent does your social work program foster sensitivity toward religious and spiritual beliefs?
–5 –4 –3 –2 –1 0 +1 +2 +3 +4 +5
Fosters extreme insensitivity Fosters extreme sensitivity
4. To what extent does the atmosphere in your social work program foster respect for religious and spiritual perspectives?
–5 –4 –3 –2 –1 0 +1 +2 +3 +4 +5
Fosters extreme disrespect Fosters extreme respect
5. To what degree are religious or spiritual believers free to be themselves in your social work program?
–5 –4 –3 –2 –1 0 +1 +2 +3 +4 +5
Must always censor or guard themselves Totally free to be themselves
6. If religious or spiritual perspectives are shared in your social work program, to what extent are they valued?
–5 –4 –3 –2 –1 0 +1 +2 +3 +4 +5
Totally disrespected Totally valued
7. To what extent does your social work program foster an empathetic understanding of religious and spiritual worldviews?
–5 –4 –3 –2 –1 0 +1 +2 +3 +4 +5
Fosters complete misunderstanding Fosters complete understanding
8. When it comes to learning about the religious and spiritual worldviews that clients commonly affirm, how much openness does your
program demonstrate?
–5 –4 –3 –2 –1 0 +1 +2 +3 +4 +5
Completely closed Completely open

(Boyle & Springer, 2001; Hill & Hood, 1999; Kocarek
et al., 2001; Ponterotto et al., 1994). Developing and
validating the instrument with a nationally representa-
tive sample of NASW graduate students enhances the
validity of the instrument.
A telephone survey methodology was used for a
number of reasons. At the time of study, 10,124 NASW-
member students were enrolled in MSW programs. Of
these, 9,834 (97.1%) had phones. Thus, the number of
individuals with listed phone numbers comes close to
approximating the universe of NASW graduate student
members. Furthermore, telephone surveys tend to foster
more accurate responses and higher response rates com-
pared to surveys administered through the mail (Babbie,
1998). The response rate was a particular concern
given the low rate of return other researchers have
obtained using mailed surveys with lists provided by
professional memberships (Canda & Furman, 1999;
Furman, Benson, Grimwood, & Canda, 2004; Gartner,
Harmatz, Hohmann, Larson, & Gartner, 1990; Ressler
& Hodge, 2005). Consequently, a decision was made to
spend the additional resources to administer the survey
over the telephone.
Calls were placed in the spring semester to ensure
that as many students as possible had completed at least
one semester of social work education. To minimize the
inconvenience to students, the survey was conducted
during the middle third of the semester. Eight call backs
were used to maximize the response rate.
Out of 494 potential respondents, 303 individuals
agreed to complete the survey and 49 individuals declined
to participate, and in a further 142 instances, no one was
reached at the listed number. Following the common
practice of excluding unreached potential respondents
yields a response rate of 86.1%, which is well above the
50.0% rate widely accepted as adequate for analysis and
generalization to the wider population (Babbie, 1998).
Six cases had missing data. Five cases had one miss-
ing value, whereas one case had two missing values.
The EM algorithm procedure was used to impute miss-
ing data. All variables were transformed so that the
skewness and kurtosis values fell within a range of –1 to

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+1, values that approximate a normal distribution
(Schumacker & Lomax, 1996).
In addition to the eight spiritual competence items
and demographic items, a number of items were
included to test concurrent and divergent validity.
Cultural competence is widely viewed as existing along
a continuum (Manoleas, 1994; Sue et al., 1992). For
instance, Manoleas (1994) posits a continuum ranging
from culturally destructive to culturally proficient.
Particular beliefs and practices are thought to be associ-
ated with each end of the continuum.
To test concurrent validity, a number of items from
the Code of Ethics were used. As implied above, the
NASW (1999) Code of Ethics lists four standards that
explicitly mention religion (1.05c, 2.01b, 4.02, and
6.04d) and at least two standards that implicitly refer to
religion (1.05a, 1.05b) as a protected category toward
which social workers should exhibit sensitivity.
Compliance with the profession’s ethical standards is
widely held to represent attitudes and practices that fall
on the culturally proficient end of the cultural compe-
tence continuum.
Individuals were read each ethical standard. They
were then asked to assess the profession’s level of com-
pliance with the standard on an 11-point response key,
which ranged from complete violation of the ethical
standard (–5) to complete compliance with the ethical
standard (+5). A constant was added to each item so that
the values ranged from 1 to 11, and the items were aver-
aged to form a scale with higher values indicating
higher levels of ethical compliance. The alpha coeffi-
cient for the six items was .922. As implied above, it
was hypothesized that perceptions of spiritual compe-
tence would be positively correlated with perceptions of
compliance with the Code of Ethics’s standards that
address religion.
To test divergent validity, a measure of religious dis-
crimination was included. Discrimination falls at the
culturally destructive end of Manoleas’s (1994) contin-
uum and is widely seen as representing a construct
incompatible with cultural competence. Individuals
were asked, “To what extent, if any, is religious dis-
crimination a problem in your social work program.”
Individuals indicated their response on an 11-point
response key ranging from not a problem at all to reli-
gious discrimination permeates every aspect of the
program. It was hypothesized that perceptions of reli-
gious discrimination would be negatively associated
with perceptions of spiritual competence.
Table 2 reports the demographic characteristics for
the sample. Consistent with the NASW membership
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Hodge / SPIRITUAL COMPETENCE SCALE 291
(Gibelman & Schervish, 1997), the sample was primar-
ily female and White. The average respondent had spent
approximately 6 years in the profession of social work.
Counting the current semester as 1, the mean for
number of semesters of graduate education was more
than 4, suggesting the respondents had sufficient educa-
tional exposure to be able to assess the level of spiritual
competence in their respective programs. Put differ-
ently, the length of respondent exposure enhances the
validity of the findings, which are discussed next.
RESULTS
To obtain a spiritual competence scale, a confirma-
tory factor analysis was conducted. This factor analysis
was followed by a second factor analysis to ensure that
the factor solutions were stable. Given an N of 303, it
was possible to split the sample into two subsamples, a
study sample and a cross-validation sample.
Based on knowledge obtained during the initial
exploratory factor analysis, it was possible to make
some projections about the psychometric properties of
the items. With expected communality levels above .50
and expected factor loadings above .60 in least four
instances, stable factor solutions can be expected with a
sample size of approximately 150 (Guadagnoli &
Velicer, 1988; MacCallum, Widaman, Zhang, & Hong,
1999). Results using the study sample (n = 150) are
reported below.
Analysis proceeded by computing a correlation
matrix and inspecting the interitem correlations. As can
be seen in Table 3, interitem correlations ranged from
.469 to .750. This range suggests (a) that a relationship
exists among the variables and (b) that item redundancy
is not an issue (Kline, 1998).
To ensure these assumptions were correct, two tests
were conducted, beginning with Barlett’s test of
Sphericity. This test was highly significant (χ2 = 770.33,
df = 28, p < .0001), indicating a relationship exists among
the variables in the matrix. To test for multicollinearity,
the value of the determinant for the correlation matrix
was computed. A value of .005 was obtained. Because
this value exceeds .00001, multicollinearity was judged
not to be a problem (Field, 2000).
To test the sampling adequacy, the Kaiser-Meyer-
Olkin (KMO) statistic was computed. Values range
between 0 and 1. Values closer to 0 indicate that the pat-
terns of correlations are diffused, whereas values closer
to 1 indicate that the patterns of correlations are com-
pact and therefore likely suitable for factor analysis.
292 RESEARCH ON SOCIAL WORK PRACTICE

TABLE 2: Sample Characteristics

Characteristic n Missing % M SD Mdn Min Max

Age 296 7 35.48 10.48 32 22 72

Gender 299 4
Female 265 87.5
Male 34 11.2
Marital status 298 5
Single 109 39.0
Married 142 46.9
Widowed 4 1.3
Separated 7 2.3
Divorced 28 9.2
Partnered 8 2.6
Race 296 7
White 230 75.9
Black 31 10.2
Hispanic 15 5.0
Asian 10 3.3
Native American 3 1.0
Other 7 2.3
# of semesters in social work 300 3 4.07 1.65 4.0 1 10
# of years in social work 300 3 5.51 5.94 3.0 0 32
Religious faith 300 3
Protestant 106 3 35.0
Liberal 41 13.5
Mainline 37 12.2
Evangelical 24 7.9
Other 1 0.3
Catholic 73 0 24.1
Liberal 45 14.9
Moderate 20 6.6
Traditional 8 2.6
Jewish 21 0 6.9
Reform 11 3.6
Conservative 4 1.3
Orthodox 1 0.3
Other 5 1.7
Other type of faith 77 0 25.4
None 23 0 7.6

NOTE: N = 303.

TABLE 3: Interitem Correlations for Spiritual Competence Scale

1 2 3 4 5 6 7

1
2 .575
3 .663 .611
4 .662 .675 .750
5 .489 .709 .620 .667
6 .522 .652 .615 .637 .685
7 .534 .520 .613 .618 .617 .595
8 .490 .476 .586 .542 .548 .469 .462

Values below .5 indicate that either more data should be
gathered or different variables should be used, whereas
values above .90 are considered excellent (Kaiser,
1974). In this case, the KMO statistic was .920, which
suggests that the factor analysis should yield distinct
and reliable factors (Field, 2000).
An anti-image correlation matrix was also computed,
and the KMO statistic for each variable was examined.
All values exceeded .90, indicating that none should be
excluded from the analysis (Kaiser, 1974). In short,
initial analysis of the data confirmed its suitability for
factor analysis.

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TABLE 4: Principle Components Factor Loadings With Varimax
Rotation
Item Loading
1 .763
2 .812
3 .849
4 .865
5 .830
6 .804
7 .795
8 .729
A principle components factor analysis was conducted
using varimax rotation followed by promax rotation
(Tinsley & Tinsley, 1987). Both methods of rotation pro-
duced virtually identical results. To determine the number
of factors, Kaiser’s criterion was used in addition to an
examination of the scree plot. In contrast to the muddy
factor solutions obtained with existing measures of cul-
tural competence, both methods indicated the existence of
a single factor. An eigenvalue of 5.21 that accounted for
65.10% of the variance was obtained.
The factor loadings are reported in Table 4. As can be
seen, all items load strongly, with values ranging from
.729 to .865. Thus, Guadagnoli and Velicer’s (1988)
criteria of at least four items loading in excess of .60 or
greater was satisfied. Similarly, the criteria established by
MacCallum et al. (1999) was satisfied, with the commu-
nalities for all items exceeding .50. Given that these two
empirically created criteria were met, it is likely that the
present sample size produces stable factor solutions.
Analysis with the cross-validation sample further
confirmed the one factor solution. A principle compo-
nents factor analysis using varimax and promax rotation
was conducted. Examination of the scree plot indicated
the existence of a single factor as did Kaiser’s criterion.
An eigenvalue of 5.29 that accounted for 66.07% of the
variance was obtained. Factor loadings ranged from
.730 to .860.
Reliability analysis indicated the eight-item scale
was highly reliable. For the total sample (N = 303), a
Cronbach’s alpha coefficient of .923 was obtained.
The measures of convergent and divergent validity per-
formed as hypothesized. The Ethics scale, composed of
the six religion items, evidenced a high degree of internal
constancy, with a Cronbach’s alpha of .921. As posited,
the Spiritual Competence Scale was positively correlated
with the Ethics scale (r = .415, p < .001).
On the other hand, the Spiritual Competence Scale
was inversely associated with perceptions of religious
discrimination. As hypothesized, the Spiritual Competence
Scale was negatively correlated with perceptions of
religious discrimination (r = –.420, p < .001.) These two
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Hodge / SPIRITUAL COMPETENCE SCALE 293
findings further enhance the validity of the scale by reveal-
ing that the construct of spiritual competence is related to
other constructs in a manner that is consistent with theory.
DISCUSSION AND APPLICATIONS TO
PRACTICE
As Boyle and Springer (2001) observed, instrumenta-
tion in the field of cultural competence is in its infancy.
This article seeks to advance the state of knowledge by
developing a new measure of spiritual competence that
can be used in social work education and other social
work settings. The psychometric properties of the scale
suggest that it functions as a highly reliable and valid
measure of a single construct—the foundational values
dimension of spiritual competence.
In addition, the study design and sample strengthen
the reliability and validity of the measure. Study partic-
ipants were NASW-affiliated, graduate-level social
work students characterized by significant exposure to
their educational programs. The geographical dispersion
of the sample suggests that the results are not an artifact
of characteristics unique to one school or a single geo-
graphic area (Kocarek et al., 2001).
Independent of any particular faith tradition, the
Spiritual Competence Scale taps values that are essen-
tial for culturally competent practice with spiritual and
religious believers: openness, acceptance, respect, and
sensitivity, along with a desire to understand and assign
value to different spiritually-based cultures, perspec-
tives, worldviews, beliefs, and narratives. As implied in
the introduction, to work effectively with clients for
whom spirituality and religion are salient life dimen-
sions, social workers must develop and exhibit these
values (Richards & Bergin, 2005).
Scores are calculated by adding a constant to eliminate
negative integers and averaging the items together, result-
ing in a scale ranging from 1 to 11, with higher values
indicating higher levels of spiritual competence. The
Spiritual Competence Scale can be filled out in minutes,
allowing it to be used in a wide variety of settings.
As noted above, although the scale addresses spiritual
and religious competence in social work education, it
may also be possible to revise the wording of the scale to
suit other applications (LaFromboise et al., 1991).
Perceptions of spiritual competence in a class on
spirituality and religion, human diversity, or some other
specific class can be examined by changing the phrasing.
For example, if an assessment of a human diversity class
was desired, the wording “your social work program”
could be changed to “your human diversity class.”
294 RESEARCH ON SOCIAL WORK PRACTICE
Other applications might include social work agen-
cies and other human service providers. For example,
the scale might be used in a faith-based drug and alco-
hol treatment program by revising the wording “your
social work program” to read “your program.”
Cross-tabulating the results by consumers’ spiritual
traditions may provide useful information about the rel-
ative level of competency exhibited with different tradi-
tions. Breaking out perceptions by groups can help to
identify areas of strength and areas requiring additional
attention. If one group, for instance, consistently per-
ceives low levels of spiritual competence to exist rela-
tive to other groups, then steps might be taken to explore
the reasons for these perceptions.
With additional rewording, it may also be possible to
use the scale for self-assessment. It is important to reit-
erate, however, that adapting the wording so that respon-
dents report on their own attitudes raises concerns about
social desirability response bias (Boyle & Springer,
2001; Sodowsky et al., 1994).
The limitations associated with this study must also be
acknowledged. As discussed above, this instrument only
taps one dimension of Sue and associates’ (1992) com-
monly used tridimensional conceptualization of cultural
competence. Consequently, although a high score on the
scale may indicate the presence of the beliefs dimension
of spiritual competence, it does not necessarily indicate
the presence of the skills or knowledge dimensions of
spiritual competence. As noted above, however, com-
mentators have suggested that the beliefs dimension is
the most important of the three dimensions. Also note-
worthy is that the scale was developed at the macro level
rather than the micro level and measures perceptions of
competence rather than actual competence. There is no
guarantee that perceived levels of competence at the
program or agency level necessarily translate into actual
cultural competence at the individual level in practice
situations.
It is also important to acknowledge that many social
work students are not members of NASW (Lennon,
2005). Further study is needed to confirm the validity of
the instrument with students who are not affiliated with
NASW, particularly among populations with different
spiritual or religious demographics. In addition to
replicating this study with non-NASW samples, further
research is needed to establish the psychometric properties
of the instrument in various class and agency settings and
as a self-assessment measure. Longitudinal research is
needed to clarify the association between levels of spiri-
tual competence and client outcomes. The extant data
suggest that clients from a number of spiritual and reli-
gious cultures perceive low levels of spiritual competence
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© 2007 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.
among helping professionals (Altareb, 1996; Furman,
Perry, & Goldale, 1996; Pellebon, 2000; Richards &
Bergin, 2000). Research is needed to understand the link-
ages among education, practice, and client perceptions.
Research on spiritual competence is particularly press-
ing because social workers, along with other mental health
professionals, are increasingly being required to interact
with clients’ spiritual lives (Plante & Sherman, 2001). For
instance, the Joint Commission on Accreditation of
Healthcare Organizations (JCAHO, 2001), which accred-
its most hospitals and many other health care organi-
zations in the United States, now recommends the
administration of a spiritual assessment (Hodge, 2006).
Given that social workers will be interacting with
clients’ spirituality, it is critical that research be con-
ducted to ensure that clients receive services that are
characterized by spiritual competence.
Finally, it might also be noted that other population-
specific measures of cultural competence are needed.
Research might explore the psychometric properties of an
adapted form of the spiritual competence measure. For
example, in place of inquiring about respect for religious
and spiritual cultures, items might inquire about respect
for Hispanic and Latino cultures. As the United States
becomes increasingly diverse, researchers must develop
instruments that help social workers adapt to the emerging
multicultural reality. The Spiritual Competence Scale rep-
resents an initial first step down that road.
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