Working with Hindu Clients in a Spiritually Sensitive Manner David R. Hodge Although social work is witnessing growing interest in spiritual and religious issues, little guidance has appeared in the literature to assist practitioners in addressing the unique spirituality of rapidly increasing non-Western populations. This article discusses the significant cultural/spiritual beliefs, practices, and values of Hindus, the largest Asian religion in the United States. Possible conflicts emanating from the lack of congruence between the values of Hindu consumers, derived from the dharma—the sacred moral order—and the values of social workers, derived from a Western Enlightenment discourse, are highlighted. The author offers practice-oriented suggestions to facilitate cultural sensitivity and to further integrate the spiritual strengths of Hindus into the clinical dialogue. Key words: dharma; diversity; Hinduism; religion; spirituality W hen working with nonmainstream popula- tions, effective service provision is often contingent on the practitioner's level of cultural competence (Mizio, 1998; Poole, 1998). Cultural competence is predicated on developing an awareness of the two worldviews involved in the counseling dialogue, the consumer's and the practitioner's (McPhatter, 1997). Not only should workers strive to develop an empathetic under- standing of consumers' reality, but workers should also seek to acquire an awareness of their own culturally informed assumptions (Wambach 8c Van Soest, 1997). Based on the new awareness, social workers can implement interventions that are congruent with the consumer's beliefs, values, and practices. Lack of cultural competence can have serious ramifications, particularly when working with re- ligious traditions that practitioners may not be familiar with, such as Hinduism. Not only is effec- tive practice impeded, but harm may occur. Reddy and Hanna (1998) emphasized that practi- tioner application of typical Western secular val- ues and related interventions with Hindus in counseling settings my cause "confusion and fur- ther negative affect." Indeed, whereas Goodwin and Cramer (1998) found that 80 percent of the 70 Hindus in the study would use a counseling service, they also found that 76 percent of respon- dents "were insistent that the counselor should be someone who understood their culture inti- mately" (p. 422). Most social workers, however, have received no training on Hinduism during their graduate pro- grams (Canda 8c Furman, 1999), suggesting the need for practitioners to familiarize themselves with this population. This need may be particu- larly salient given that Hinduism is the largest Asian religion in the United States (Richards 8c Bergin, 1997) and is growing rapidly (Williams, 1997). Yet, only a few articles have appeared in the literature on Hinduism (Canda & Furman), and none has focused on orienting workers to in- teract with Hindu consumers. This article attempts to equip workers with a practice-oriented understanding of Hinduism. This articles highlights the centrality of commu- nity as a metaphor for understanding Hinduism CCC Code: 0037-8046/04 $3.00 O 2004 National Association of Social Workers, Inc. 27 and leads into a discussion of the dharma, the underlying sacred order that informs classical Hinduism. Hinduism Hinduism is a 12th-century Persian term used by Mushms to describe "the belief of the people of India" (Fenton et al, 1993, p. 21). Although there are more than 800 million Hindu adherents worldwide, 13 percent of the earth's population (Juthani, 1998), the overwhelming majority live in India, the cradle of Hinduism, where they are ap- proximately 85 percent of the population (Fenton et al.). Thus, Hinduism is closely tied to Indian history, geography, and culture. In the eyes of many Indians, and especially among the Hindu majority, Hindu culture and Indian culture are functionally equivalent (Fenton, 1988). Hindu self-awareness and self-identity affirms Hinduism as a single religious universe (Weightman, 1998). As Melton (1999) noted, there are a num- ber of commonly held beliefs, practices and val- ues, including a shared religious history in India. Conversely, it is important to note that there is an extraordinary degree of diversity within Hindu- ism. For example, even prevalent terminology, such as Brahman and dharma, can signify a wide range of divergent and discrete concepts among various spiritual traditions within the religiion (Reat, 1990). Consequently, it should be kept in mind that this article is intended to provide social workers with an "exploratory working hypothesis" with which to interact with Hindu clients, rather than a definitive framework. In other words, practition- ers should use the concepts developed in this ar- ticle as a starting point, while allowing consumers the freedom to adjust practitioners' understand- ing of their reality on the basis of their own inter- pretation of Hinduism. Centrality of Community For social workers raised and educated in a West- ern Enlightenment-derived worldview that em- phasizes personal autonomy, human rationality, and a positivist epistemology (Crocker, 1997; Jafari, 1993), the Hindu cosmology can represent a radically different model for understanding real- ity. Shweder and colleagues (1997) suggested that U.S. society stands in direct contrast with Hindu culture. The concepts of individualism, au- tonomy, materialism, and secularism that charac- terize Western, and especially U.S., culture are subordinate in Hindu society, where the concepts of community, interdependence, and divinity are primary, made salient, and implicitly institution- alized. Animated by the divine, Hindu culture tends to conceptualize the person as inherently part of a social body (Miller, 1994). Consequently, for most Hindus there is a great awareness of, and respect for, human interdependence and interconnectedness, which is understood to be the foundation of well-being. If an individual's ac- tions weaken the community to which the person belongs, they weaken the person. Instead of indi- viduals attempting to meet their own needs, people work together to care and provide for each other (Miller, 1994; Shweder et al., 1997). This interdependent social body is grounded in and is a manifestation of the Hindu dharma. Dharma—the Sacred Order The dharma has been suggested as the "funda- mental unifying principle of traditional Hindu- ism" (Fitzgerald, 1990, p. 112). Indeed, many In- dians use the term to signify their own religion (Corbett, 1994; Fenton et al., 1993; Weightman, 1998). In addition to religion, dharma also signi- fies eternal order, moral law, justice, righteous- ness, and personal duty (Fenton et al.; Juthani, 1998; Weightman). Dharma can be understood as an unseen, metaphysical moral order that perme- ates the universe. Because dharma represents the ultimate moral and sacred reality, ordering society and personal conduct to correspond with the de- sign of the universe is one's duty and brings integ- rity, harmony, and balance both societally and personally. Harmonizing beliefs, practices and values with the implicit sacred design, manifested as one's personal dharma, fosters corporate and individual well-being. Because the dharma is woven into the fabric of existence, Hinduism can be conceived of as all- encompassing, providing structure and coherence to all facets of life (MuUatti, 1995). The encom- passing nature of dharma represents a sharp con- trast with Western Enlightenment epistemology, which tends to dichotomize the secular and sacred into two different realms, public and private, and gives precedence to the former over the latter (Crocker, 1997). Therefore, for Westerners who construct reality from within an Enhghtenment framework, "Hinduism is more than a religion; it Social Wort/Volume 49, Number 1 /January 2004 28 is a way of life" (Siegel, Choldin & Orost, 1995, p. 131). Indeed, in addition to personal moral codes, values, ritual conduct, and other areas typically assigned to the private sphere, dharma forms the basis for family roles and the structure of tradi- tional Indian society. Family The dharma places a high priority on the family. For most Hindus, family is considered to be a critical stage on the path of action, discussed later in this article, which leads to ultimate spiritual liberation (Fenton et al., 1993). It is through the family that Hindus fulfill many religious obliga- tions. Consequently, a number of rituals and spiritual practices are connected with family life. Common life cycle rituals of Hindus in the United States, which typically involve the extended family whenever possible, include prenatal rituals, birth and childhood ceremonies such as naming the child, marriage, and cremation within 24 hours after death (Williams, 1988). As an expression of the path of devotion, families commonly have one or more family gods that are honored at home shrines (Mullatti, 1995). The individual dharma differs for women and men. Traditionally, wives are considered exten- sions of Hindu goddesses, responsible for trans- mitting cultural and religious knowledge— dharma—to their children and through them to the wider society (Reddy & Hanna, 1998). Con- versely, husbands have been responsible for pro- viding for the family and have final responsibility for family decisions (Mullatti, 1995). The marriage unites two family systems in a manner that approximates the Western bond be- tween blood relations. In keeping with the com- munity ethos of Hinduism, the individual is un- derstood to be embedded in a family that is embedded in an extended family, which in turn is embedded in an even wider kin network (Reddy & Hanna, 1998). The family, and often the kin net- work, may take an active role in guiding mate se- lection, up to and including arranged marriages. In essence, rather than marrying the one they love, Hindus love the one they marry. Western divorces based on the perception that one's emo- tional needs are no longer being satisfied by one's partner and the resulting suffering such divorces cause for the participants, particularly women (Smock, Manning, & Gupta, 1999) and children (Ross & Mirowsky, 1999; Wallerstein & Lewis, 1998), is comparatively rare among Hindus (Mullatti, 1995). Child rearing is typically child-centered, with children being seen as a gift from the divine. Having a son is often important to family mem- bers because only a male child can discharge the spiritual debt the husband owes his ancestors (Mullatti, 1995; Saraswathi & Pai, 1997). Little pressure is applied to children to become autono- mous and independent. Rather, children are so- cialized to see themselves as an integral part of a divinely ordered whole. For example, money may be held communally rather than individually in the form of personal allowances (Dhruvarajan, 1993). In keeping vnth the child-centered approach, it is generally held that the gratification of the child's desires in conjunction with an environ- ment that fosters minimum frustration is most conducive for development (Saraswathi & Pai, 1997). Disciplinary "time outs" are often per- ceived as too distancing and controlling of the child's behavior. Correction is commonly applied by holding the child and discussing the situation, and perhaps spanking (Almeida, 1996), a disci- plinary measure that has been shown to enhance reasoning and ameliorate disruptive behavior (Larzelere, Sather, Schneider, Larson, & Pike, 1998). The Four Varnas For more than 2000 years, the dharma has been understood to prescribe the structuring of society into four varnas, or castes. Although this arrange- ment has been criticized by many Hindus and its salience seems to be decreasing, it bas provided India with a remarkably peaceful and stable social order for more than two millennia. In addition to many sub-varnas, four major varnas are recog- nized: the brahmans, who perform religious and spiritual duties, the kshatriyas, who govern and administrate, the vaisya, comprising merchants and farmers, and the sudras, who carry out menial tasks considered to be spiritually unclean (Fenton et al., 1993; Hiltebeitel, 1987). Ideally, this matrix of relationships is understood to work to the re- ciprocal advantage of all parties, with each one having duties necessary for the proper functioning of the whole (Hiltebeitel). All parties are needed and important to the health of society and benefit from a stable social system (Saraswathi 8c Pai, 1997). Hodge / Working with Hindu Clients in a Spiritually Sensitive Manner 29 The assignment of social roles is hereditary, in a manner analogous to Western society, where individuals are born into a particular set of envi- ronmental and personal attributes (for example, wealth, access to education, class status, intellec- tual and emotional intelligence) that enable them to attain certain social positions. However, the individualistic competitive di- mension that enables Westerners to achieve or maintain their personal social position is largely absent in Hinduism, where individuals know their position in the social structure from birth. Thus, the stable group orientation in Hinduism may foster a greater sense of community, intercon- nectedness, esteem, and security than is found in individualistic, competitive Western settings (Saraswathi & Pai, 1997; Shweder et al., 1997). Further- ^ ^ ^ more, through the process of karma and satnsara, the indi- vidual has the assurance of ob- taining what are often deemed to be more prominent social positions. Karma can be understood as a law of moral cause and effect. The Law of Karma and the Cycle of Rebirth Following the ethical duties of one's personal dharma allows one to accumulate good karma, while living selfishly results in the accumulation of bad karma (Fenton et al., 1993; Weightman, 1998). Karma can be understood as a law of moral cause and effect and is closely allied with belief in samsara, the cycle of birth and rebirth, or trans- migration, to which the soul is subject (Melton, 1999). Karma, in conjunction with samsara, pro- vides universal justice in the sense that actors reap the consequences of their unjust or meritorious actions in this and the next life. Therefore, karma and samsara provide a meta- physical explanation for life's inequities that are otherwise unexplained and consequently can be a source of encouragement during trials. Con- versely, karma also may engender a sense of hu- man agency and hope for a better future, because it states that individuals possess free will and have the ability and potential to improve their standing in this life and the life to come (Juthani, 1998; Karnik & Suri, 1993). Furthermore, knowing that one has the opportunity to experience life again has been shown to decrease death anxiety (Parsuram & Sharma, 1992). Moksha—Liberation from the World Although the central precept of Hinduism is dharma, right living in this world, moksha, or lib- eration from this world, is also an important con- cept (Weightman, 1998). To escape samsara, with its possibility of a virtually endless cycle of death and rebirth, moksha is often sought. To achieve moksha, the individual must avoid the accumula- tion of any karma, good or bad, because it is karma that affects the transmigration of the soul. Although there are many, nonexclusive, roads to moksha, typically three major paths are cited: the paths of illumination, action, and devotion (Corbett, 1994; Fenton et al., 1993; Melton, 1999; Weightman). The path of illumination, jnana yoga, is based on meditation, which in turn leads to spiritual knowledge that results in lib- ^ ^ ^ 1 ^ eration. Particularly on this path, moksha is understood to occur when one's true, spiritual self, or atman, achieves unity with the all en- compassing, monistic Abso- lute—Brahman—sometimes referred to as the world-soul. Illumination occurs through meditative disciplines, which reveal how the illu- sion of this present empirical world has prevented one from seeing the ultimate unity of one's atman with the Brahman. The path of action, or karma yoga, suggests that selfiess action based on the requirements of personal dharma leads to moksha. However, these actions must be done without concern for per- sonal gain. Egocentricity results in the accumula- tion of karma and emphasizes separateness, which in turn inhibits union with the Brahman. Thus, in the way of action, moksha is achieved through performing actions based on the dharma in a spirit of detachment and selfiessness. As men- tioned earlier marriage and family, in which one has the opportunity to selfiessly serve others, are intimately tied into this path. Within the path of devotion, bhaktiyoga, lib- eration is obtained through devotion to a deity, or deities, with Shiva and Krishna being the most prominent in an extensive pantheon of deities. For instance, Krishna, an avatar, or incarnation of the Vedic deity, Vishnu, and the most popular deity of north India (WiUiams, 1988), is held by adher- ents to be the personal God who stands behind the impersonal Brahman. Krishna is worshipped Social Wor/c/ Volume 49, Number ] /January 2004 30 through various actions, including prayer and puja, or ritual offerings performed at household shrines or in a temple. Because Krishna is the creator of karma, he can be enjoined by the worship of his devotees to exempt followers from its effects and to grant liberation from samsara into an eternal life with Krishna (Fenton et al., 1993). As discussed earlier, most Hindu households have one room dedicated exclusively to puja and adopt one or more family gods (Fenton, 1988). Although the home shrine and temple are both considered residences of the gods, the family shrine is primarily responsible for transmitting religious beliefs and practices, particularly for Hindus in the United States (Williams, 1988). Although living in harmony with the dharma imposes a number of constraints on conduct, Hindus have considerable freedom in seeking moksha (Weightman, 1998). There are a number of sacred writings in Hinduism that serve to in- form the faith, including the Vedas, the Laws of Manu, the Upanishads, and the Bhagavad-Gita, the most popular text (Corbett, 1994; Williams, 1988). However, these scriptures play a relatively minor role in Hinduism, especially when com- pared with the Bible in Christianity or the Koran in Islam, although Hindu scriptures often assume increased prominence in U.S. settings as devo- tional texts (Williams, 1988). Transformative religious experience based on spiritual disciplines, rather than doctrinal con- cerns, is of central concern for most Hindus (Puhakka, 1995). Thus, in practice, Hindus tend to draw from all three paths, emphasizing various components on the basis of their caste, education, geographic location, personal tastes, stage of life, and so forth. However, for most Hindus, includ- ing those living in the United States, some combi- nation of the latter two paths is usually followed (Corbett, 1994; Miller, 1995). Hindus in the United States Hinduism has had a significant influence in U.S. history. Benjamin Franklin, John Adams, Tran- scendentalists such Ralph Waldo Emerson and Henry David Thoreau, and the New Age move- ment were all influenced in varying degrees by Hinduism (Tweed, 1997). Missionary efforts by Svami Vivekananda, prompted by his success at the 1893 World Parliament of Religions held in Chicago, led to the establishment of Vedanta Cen- ters throughout the United States. More recent missionary successes have been Swami Prabhupada and Maharishi Mahesh Yogi who, respectively, founded the International Society of Krishna Consciousness, or more popularly, the Hare Krishna movement, and transcendental meditation (TM). It is interesting and in contrast with Indian Hindus that the relatively less popular path of illumination, jnana yoga, has held the most attraction for U.S. converts, particularly in its TM form (Tweed; Williams, 1997). Although missionary activity by notable Hindu gurus or teachers has resulted in a number of con- verts and increased awareness of Hindu concepts among the general population, immigration has led to the rapid increase in the U.S. Hindu com- munity (Williams, 1997). Almost all Hindus in the United States are first or second generation immigrants. The repeal of the Asian Exclusion Act in 1965, which was introduced in 1917 because of heightened nationalist sentiment during World War I, has resulted in a dramatic population in- crease that shows few signs of abating (Melton, 1999). Ascertaining the exact number of Hindus in the United States is difficult because of a 1957 Congressional prohibition that prevents the United States government from collecting infor- mation on religious affiliation to safeguard reli- gious privacy (Williams, 1998). Figures ranging from just under half a miUion (Kosmin & Lachman, 1993) to about 5 million (Canda & Furman, 1999) have appeared in the literature. However, perhaps the best estimate is approxi- mately 1 million, a number that suggests that Hinduism is the largest Asian religion in the na- tion, with slightly more adherents than Buddhism (Richards & Bergin, 1997). The cohort of Hindu immigrants who entered during the post-1965 immigration are among the best educated and most professionally advanced and successful of any population, partly because of U.S. immigration regulations that favored professional and educational status (Williams, 1998). However, with the passage of the Family Reunification Act of 1990, immigration policy granted preference to relatives of earlier immi- grants. These latter arrivals are generally not as highly educated as their predecessors and conse- quently may face additional challenges adapting to their new home because of language barriers, employment problems, difficulty gaining access Hodge / Working with Hindu Clients in a Spihtuaiiy Sensitive Manner 31 to services, and other impediments. (Almeida, 1996). Hindu Social Supports Most Hindus have settled in urban areas (Corbett, 1994). New York City, Los Angeles, San Francisco, Chicago, and Atlanta all have significant Hindu communities (Corbett; Fenton, 1988; Williams, 1988). New York State is home to just over one- third of U.S. Hindus, and California (10 percent). New Jersey (7 percent), and Illinois (7 percent) also have substantial populations (Kosmin & Lachman, 1993). The mushrooming growth has led to the estab- lishment of an extensive number of institutions to support Hindus in the United States. Currently, there are more than 412 Hindu centers in the United States, including an accredited university in Fairfield, Iowa, the Maharishi University of Management (Tweed, 1997). This total also in- cludes more than 50 major temples built since 1976 in cities throughout the United States, al- though full operation has been hindered to some extent by the lack of brahman priests (Williams, 1997). More than 500 Hindu organizations, number- ing in size from a few individuals to more than 15,000, have also been established (Williams, 1988), although a number of the 412 centers noted would also be included in this category. These organizations frequently offer a wide range of programs and provide social support for Hindu immigrants (Fenton, 1988; Miller, 1995). As with temples, Hindu organizations, 90 percent of which were begun by lay personnel, have been hampered by the lack of qualified gurus, or spiri- tual teachers (Williams, 1988). There are two particularly widely read periodi- cals that help support and inform the American Hindu community (Miller, 1995). India Abroad offers news and information on activities related to ethnically specialized organizations, whereas Hinduism Today provides a mainstream Hindu perspective on contemporary issues. Both publi- cations are available online. Demographics Although Kosmin and Lachman's (1993) national data on religious groups may have underrepre- sented the Hindu population, particularly its more disadvantaged segment, it clearly reveals the middle- to upper-income status of the U.S. Hindu community, a finding that has been widely repli- cated in regional studies (Dhruvarajan, 1993; Fenton, 1988; Miller, 1995; Williams, 1988). When 30 major U.S. religious groups were com- pared on annual household income, Hindus {N = 142) ranked 10th, ahead of Catholics, Lutherans, and Baptists. When ranked according to level of education, Hindus were second, behind Unitar- ians. Forty-seven percent of Hindus were college graduates, more than twice the national average. Similarly, in the area of employment, Hindus ranked first, with 64 percent reporting full-time employment (Kosmin & Lachman, 1993). Con- versely, they finished second-to-last in home own- ership, with only 47 percent of respondents indi- cating they owned their own home. Significantly, Hindus were the most likely to live in homoge- neous households. Roughly 95 percent of Hindus in multiple adult households lived in settings in which all adults were of the same religioun. Value Conflicts In general, the extant research suggests that first- generation Hindu immigrants successfully accul- turate; that is, they maintain their own value sys- tem while negotiating with the host culture to appropriate values and norms useful for adapting to the latter (Dhruvarajan, 1993; Fenton, 1988; Williams, 1988). For instance, Dhruvarajan found that first-generation Hindus generally retain their belief in interdependence, ritual worship, and complementary family roles, regardless of how long they had lived in North America. Similarly, Williams (1988) found that 85 percent of Hindus {N= 224) had a home shrine, 80 percent per- formed morning puja each day, and almost 60 percent visited a temple weekly. Fenton and Ralston (1998) also documented majority partici- pation in home religious practices, although at somewhat lower rates than Williams. High levels of education and English fluency usually enable Hindus to master the outward me- chanics of cultural adaptation quickly and effi- ciently (Joy & Dholakia, 1991). Concurrently, the same decentralized fiexibility, manifested in the centrality of family as the seat of spiritual devo- tion that enabled Hinduism to survive repeated attempts at subjugation, facilitates a relatively smooth transition to a new cultural setting (Will- iams, 1997). However, in addition to the problems encoun- tered by other Americans, Hindus may experience Social Work/Volume 49, Number 1 /January 2004 32 a number of value-related stress points in the United States, particularly with their children (Joy & Dholakia, 1991). Whereas Indian culture sup- ports following one's dharma, the Western En- lightenment-derived values that permeate U.S. culture frequently mitigate against fulfilling one's dharma (Fenton, 1988; Fitzgerald, 1990). The same flexibility and lack of doctrinal insti- tutionalization that eases acculturation may also lead to assimilation or the complete adoption of the host culture. Although many U.S.-born youths affirm classic Hindu norms, such as ar- ranged marriages, modesty, and respect for others (Miller, 1995), in aggregate they may be more in- clined to assimilate than youths from other spiri- tual traditions, such as Islam, which have firmly institutionalized norms (Ghuman, 1997). Con- cern within the Hindu community that youths are in danger of losing their heritage has led to the establishment of summer camps, temple "Sunday schools," and other instructional activities de- signed to institutionalize, preserve, and transmit Hindu values that were implicitly institutionalized in India (Fenton, 1988; Miller, 1995; Ralston, 1998; Williams, 1988). These value conflicts have ramifications for the majority of social workers who have been raised and professionally trained in the dominant cul- ture. Indeed, fewer than 1 percent of social work- ers (N= 1,616) self-identify as Hindus (Canda & Furman, 1999). As Jafari (1993) noted, the En- lightenment-based discourse that serves to inform the Western counseling project enculturates a specific set of values and norms. For example, this meta-narrative tends to give precedence to certain values over others: individualism over community, egalitarian roles over complementary roles, and a material concept of reality over a spiritual concept of reality. Workers may tend to impose values drawn from their own meta-narra- tive on clients simply because they seem "nor- mal," "universal," or "right" within the context of the discourse in which they have been raised and educated. For example, Fenton (1988) found that the value most Hindus {N= 225) desired to preserve is family, which was ranked most important by more than 60 percent of respondents, roughly three times more often than any other single cul- tural value. However, the values associated with the Hindu construction of family conflict with those upheld by the dominant culture. Conse- quently, some individuals operating under West- ern Enlightenment concepts call the desire to have a son to perform the sacred rites owed to ances- tors a "prejudice" (Almeida, 1996, p. 403), whereas the sacred dharma that prescribes differ- ent roles for women and men is referred to an "ideology" that serves to "camouflage injustice" while deceiving women into desiring a position of "bondage" (Siegel et al., 1995, pp. 132-134). From the perspective of the Enlightenment- based meta-narrative, the desires of Hindu women cannot be trusted, because only Western discourse perceives reality accurately and is uni- versally true. Such academic literature does little to equip social workers to further the goals of Hindu clients who desire to retain their construc- tion of family, and it does not demonstrate re- spect for personal autonomy. As Reddy and Hanna (1998) stated, "it cannot be overempha- sized that enforcing or applying Western cultural values on these clients or stressing the typical view of Western individuality may result in confusion and further negative affect... [and] is also likely to have a negative impact on the integrity of the family system" (p. 393). Therefore, Hindus may be reluctant to receive services from social work- ers because of concerns that they will attempt to impose their Western Enlightenment-derived val- ues (Goodwin & Cramer, 1998). As Cornett (1992) noted, effective therapy is predicated on respecting client autonomy. Social workers must be aware that Hindus may not share many of their value assumptions and closely monitor their own reactions to ensure that they avoid imposing their own values on Hindu cli- ents. Starting from a nexus of interdependent family and a sacred epistemology, Hindus com- monly affirm chastity outside of marriage, limited dating and arranged marriages, heterosexuality, role distinctions for women and men, and mod- esty (Almeida, 1996; Fenton, 1988; Juthani, 1998; Miller, 1995; Williams, 1988). So practitioners who affirm the "normality" of constructs such as sexual fulfillment at all life stages, dating, homo- sexuality, and egalitarianism must be especially vigilant to ensure that they respect the autonomy of Hindu clients. Practice Implications It is important to again note the diversity that oc- curs among self-identified Hindus. Although a general trend exists between time spent in the Hodge / Working witii Hindu Clients in a Spirituaiiy Sensitive Manner 33 United States and assimilation into the main- stream culture, first-generation Hindus may be as secularized and individualist as other Americans (Fenton, 1988). Conversely, second- and third- generation Hindus may strongly affirm classic Hindu values (Miller, 1995). Moksha, may be a motivating factor for some and not others. Thus, the following suggestions are meant to expand workers' consciousness regarding the possibilities that may have salience among Hindu consumers, rather than to provide practitioners with set pat- terns of interaction. School social workers and family practitioners in particular may wish to make note of the variation that can occur between generations. With this caution in mind, and as implied throughout this article, the psy- chological makeup of many ^ ^ ^ Hindus is modally different from westerners. Because of the Hindu emphasis on selfiessness, detachment, and a dharma-ori- ented epistemology, some Hin- dus may appear to have an "un- derdeveloped ego" from a psychodynamic perspective (Roland, 1997).Inotherwords, in certain cases they may lack ^ ^ ^ ^ ^ the independent, self-reliant, self-directing ego of Western individualism. Thus, as Roland noted, some Hin- dus can appear to exhibit vague boundaries be- tween self and others and demonstrate a weak conscience or superego, because Hindus often follow the highly contextualized emotional cues and values of others rather than the imperatives of Western individualism. Cultural sensitivity is demonstrated by recog- nizing that Western Enlightenment-derived theo- ries are not universally applicable, and corre- spondingly, adapting clinical strategies to comply with the psychological and value orientation of the Hindu cosmology (Roland, 1997). For ex- ample, Balodhi (1996) suggested that Hindu con- sumers may make extensive use of religious my- thology to communicate underlying problems. By using nondirect communication styles, consumers are able to share their own story while safeguard- ing the emotional space of the community's other members. Therefore, workers should incorporate a similar sensitivity regarding the direct commu- nication of emotions into their questions and re- Balodhi suggested that Hindu consumers may make extensive use of religious mythology to communicate underlying problems. sponses to conform to the implicit value of re- spect for the emotional well-being of others. Supportive direct questioning combined with empathetic listening skills are appropriate means for exploration of presenting problems and allevi- ating concerns Hindus may have over possible value confiicts (Juthani, 1998). As implied earlier, straightforward self-revelation of personal experi- ence and emotional trials may not occur, because such practices are often deemed to be too self- focused (Almeida, 1996). A carefully nuanced di- rect approach may be beneficial when combined with a sensitivity to the use of metaphor and story to communicate underlying problems. A direct approach can be effective in the sense that Hindus may perceive the structure of the counseling rela- tionship to be ordered so that ^ ^ ^ ^ workers are responsible for taking initiative, or demon- strating leadership, in ad- dressing pertinent issues (Juthani). In keeping with the cen- trality of the family unit, in- volving all family members in the therapeutic dialogue is usually advisable (Juthani, ^ ^ ^ ^ 1998). Individual goals are acceptable insofar as they do not subordinate the collective ethos (Joy & Dholakia, 1991). Thus, interventions that balance autonomy and interdependence are likely to be well received (Reddy & Hanna, 1998). The family unit can also be a significant source of social support. Extended family members may be aware of cultural resources, such as a local Hindu youth group, a childcare service, or a devo- tional worship group, that can be marshaled to ameUorate problems (Juthani, 1998). In light of the recent growth in Hindu organizations and programs, new immigrants and even those who are well-established may not be aware of the avail- able options. A genogram covering at least three generations can be especially helpful in identifying significant family members. Showing deference to the husband as the key decision maker by addressing him first, for ex- ample, communicates respect for the family unit as a whole as well as for the dharma (Reddy & Hanna, 1998). Similarly, direct eye contact with older family members may be perceived as being disrespectful (Almeida, 1996). Caste may be a Social Work / Volume 49, Number 1 /January 2004 34 significant factor in socialization, family func- tions, and the selection of marriage partners re- gardless of the degree of parental involvement (Fenton, 1988; Williams, 1988). The construct of adolescence, at least in the Western sense, does not exist in classical Hindu- ism. Therefore, it is advisable to inform the par- ents of the difficulties youths in the United States typically encounter while supporting the decisions of the family unit. Thus, for example, instead of taking a position in support of an adolescent's struggle for fi-eedom and independence, it is usu- ally more profitable to seek a solution v^dthin the context of the family's framework of autonomy and interconnectedness (Almeida, 1996). Group interventions would seem to harmo- nize well with a Hindu cosmology. However, it is important that group-based programs be congru- ent with Hindus' belief in other-centeredness. For example, 12-step programs are considered to be to self-centered, as well as lacking any avenue for family involvement (Almeida, 1996). In short, group dynamics should be adjusted to be compat- ible with Hindu norms. Tapping into spiritual strengths can help ame- liorate problems and sends the message that the consumer's culture has relevance in addressing life challenges. Using spiritual resources may be particularly efficacious because the religious devo- tion of Hindu immigrants may increase in the United States (WiUiams, 1998). Taking a spiritual history may be an appropri- ate means of understanding the spiritual capabili- ties and experiences that have been developed over time and inform the consumer's spiritual universe (Hodge, 2001). Alternatively, Hodge (2000) has developed a spiritual eco-map to iden- tify and operationalize spiritual strengths that ex- ist in consumers' environment. This diagram- matic instrument can be used to visually depict the salience of spiritual assets, including those dis- cussed in this article, all of which should generally be incorporated into any assessment procedure. Finally, because all spheres of Hindu life are con- sidered to be religious, it may be helpful to em- phasize the strategies of moksha. Hinduism is a religious tradition rich in ritual, the most prominent being daily puja. Rituals, such as puja, re-enact the individual's relationship with the Absolute, reinforcing the participant's connection with the Divine (Jacobs, 1992). In turn, these practices can serve to ease anxiety and dread, defeat loneliness, promote a sense of secu- rity, and establish a sense of being loved and ap- preciated (Levin, 1994). Rituals have been associ- ated with a wide array of positive outcomes (Levin; Worthington, Kurusu, McCuUough, 8c Sandage, 1996), including resilience and coping (Pargament, 1997). Workers can encourage cli- ents to further operationalize these strengths by, for example, replacing maladaptive behavior with ritualistic behavior, increasing the frequency of rituals perceived to engender positive outcomes, and reinforcing the salubrious messages rituals implicitly transmit (Hodge, 2000,2001). Although many rituals can be conducted by lay people, workers should be aware that many of the more personally significant rituals (for example, life cycle rituals) require brahmans (Hertel, 1998). Because brahman priests are not a preferred im- migration category in the eyes of immigration of- ficials, there is a substantial shortage of qualified individuals to perform certain rituals. Thus, there may be structural barriers to carrying out certain rituals. Another ritual that may be particularly impor- tant is Hindu meditation, which has been linked with salutary outcomes in diverse areas. Reviews indicate that meditation has been used to amelio- rate various problems, including depression, hy- pertension, type A coronary-prone behavior, stuttering, and substance abuse (Keefe, 1996; Singh, 1992). Thus, meditation techniques, drawn from the way of illumination, may be an effective intervention. Singh (1992) suggested that biofeedback techniques and auto-genic training may be inter- ventions that are congruent with both Hindu and Western worldviews. Similarly, Sheikh, Kunzendorf, and Sheikh (1996) reported that vi- sualization and imagery can be effective interven- tions. Therapeutically meaningful images can be drawn from the rich Hindu pantheon of religious imagery. Pilgrimages to festivals, events that bear some similarity to religious revivals, and prominent temples, both in the United States and in India, can be a significant intervention, fostering reflec- tion on the ultimate aims of life, a reordering of priorities, and social support. Many Hindus who participate in such endeavors refer to them as "once in a lifetime" experiences (Williams, 1988). Rangaswami (1994) suggested that facilitating Hindus' desire to seek moksha can have positive Hodge / Working with Hindu Clients in a Spiritually Sensitive Manner 35 benefits. The spiritual pursuit can foster motiva- tion and enhanced purpose in life while diminish- ing the scope of current problems. Workers should also be aware of Ayurvedic treatment, which has official status as an indig- enous health care system in India and Nepal (Jilek, 1994) and is widely used to overcome problems. Derived from the Vedas, Ayurvedic therapy aims at correcting imbalances and restor- ing equilibrium by replacing negative emotions with positive ones, for example (Crawford, 1989). Finally, demons, which are addressed in Ayurvedic treatment, are real beings in the Hindu cosmology and consequently, are not necessarily a sign of psychosis. Conclusion This article attempts to facilitate cultural sensi- tivity by acquainting social work practitioners with Hindu cosmology so that social work prac- tice can be harmonized with the dharma. Not only will valuable therapeutic resources lie dor- mant if workers are unfamiliar with the Hindu cosmology, but harm may occur because of a lack of knowledge. Effective practice with consumers from various religious traditions is dependent on achieving a measure of cultural competence re- garding their traditions. Finally, as a further step, workers who regularly encounter Hindu clients may wish to read Seplowin's (1992) article on karma therapy as well as Singh's (1992) article on integrating concepts from Eastern psychology and spirituality into treatment. • References Almeida, R. (1996). Hindu, Christian and Muslim families. In M. McGoldrick, ]. Giordano, 8c J. K. Pearce (Eds.), Ethnicity and family therapy (pp. 395- 423). New York: Guilford Press. Balodhi, J. P. (1996). 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The author thanks Swapna Kommidi, Uma Murugan, and Pratima Pandeyfor their comments and encourage- ment regarding this article. Original manuscript received December 2, 1999 Final revision received May 1, 2000 Accepted June 22, 2000 THE CENTER FOR THE STUDY OF SOCIAL WORK PRACTICE announces the recipients of SOCIAL WORK RESEARCH FELLOWSHIPS, 2003-04 Jacqueline Corcoran Virginia Commonwealth University Richard Embry and Aron Shlonsky Columbia University David Zanis University of Maryland The Center for the Study of Social Work Practice is a joint program of the Columbia Uni- versity School of Social Work and the Jevnsh Board of Family and Children's Services. The Center's competitively-awarded Social Work Research Fellowships seek to strengthen so- cial work practice through significant advances in evidence-based research. Social Worlc/ Volume 49, Number ] /January 2004 38