Moral Wounds and Moral Repair: The Dilemmas of Spirituality and Culturally Sensitive Practice

As our understanding of trauma is expanding, greater consideration is being given to factors such as moral injury and spirituality. Moral injury appears to be especially pertinent in the case of war-related trauma, as one may not only be the victim of, or witness to, troubling events but also be the perpetrator of acts that run counter to personal values. For some, moral beliefs and values and key elements of the assumptive world are intertwined with spiritual and religious matters. This article discusses moral injury and repair in the context of spiritually and culturally sensitive practice. Strategies for addressing issues such as moral anguish, loss of meaning, identity disturbance, guilt and shame, forgiveness, and spiritual struggle are discussed.

Hospitals and cultural diversity: social worker experiences and reflections

INTRODUCTION: Social work accrediting bodies mandate that workers analyse ways in which cultural values and structural forces shape client experiences and opportunities and that workers deconstruct mechanisms of exclusion and asymmetrical power relationships. This article reports the findings of a small-scale qualitative study of frontline hospital social workers’ experiences and understanding of their mandate for culturally sensitive practice.METHODS: The study involved one-hour, semi-structured interviews with 10 frontline hospital social workers. The interviews sought to understand how frontline workers and their organisations understood sensitive practice. Drawing on their own social cultural biographies, workers described organisational policy and practices that supported (or not) culturally sensitive practice. Narrative analysis was used to extract themes.FINDINGS: Data indicate that frontline hospital social workers demonstrated their professional mandate for culturally sensitive practice. Workers were firm in their view that working with the culturally other requires humility as well as a preparedness to value and engage the multiple cultural meanings that evolve in the patient–worker encounter.CONCLUSION: The findings highlight that mandating cultural sensitivity does not necessarily result in such practice. Cultural sensitivity requires an understanding of how cultural and social location may be implicated in sustaining the dominant cultural narrative and signals the need for workers, systems and organisations to facilitate appropriate learning experiences to explore culturally sensitive practice.