The helping relationship and well-being in clinical social work clients and spiritual seekers: Relationships between type and strength of helping relationship and physical, psychological, social, and spiritual well-being

To promote overall welt-being in clients, clinical social workers need to understand how the helping relationship can promote biopsychosocial-spiritual well-being. Social workers have lacked an empirical base to understand this process, especially as it affects spiritual well-being. Spiritual guidance traditions in Vipassana meditation instruction and Christian spiritual direction possess experience in promoting spiritual well-being. This study used a theoretical framework developed from Ken Wilber's transpersonal integral theory and John Bowlby's attachment theory. This study employed quantitative (survey, N = 101) and qualitative methods (interview and follow-up, n = 14) to explore help-seekers' views of the type (clinical social work or spiritual guidance) and strength (structural and interpersonal) of helping relationship in promoting help-seekers' biopsychosocial-spiritual well-being. In the quantitative phase, spiritual seekers reported greater physical, social, and spiritual well-being than did clinical social work clients. There was no difference in psychological well-being. Help-seekers with less physical well-being reported stronger helping relationships; help-seekers reporting stronger interpersonal bonds with helpers reported greater spiritual well-being. In the qualitative phase, the helping relationship appeared to promote all areas of well-being. Spiritual well-being appeared to guide and influence other areas. Growth in well-being moved in a complex holarchical pattern of increasing complexity and inclusiveness from egocentricity to all-embracing love. Greater well-being involved greater senses of meaning and connection, sometimes including psychic and mystic experiences of union and flow. Effective helping relationships were warm and authentic, focused on help-seeker well-being, and led help-seekers to rely on what emerged as the Transcendent Secure Base (TSB) beyond attachment theory's human secure base of the helping relationship. This TSB of love and wisdom was experienced in mystic union and in everyday experiences of meaning and connection and was manifested especially in help-seekers extending help to others. It is recommended that clinical social workers: understand that well-being transcends conventional biopsychosocial health to include increasingly influential spiritual or transpersonal experiences that enhance biopsychosocial well-being; acknowledge and validate TSB experiences in clients; and, to be most effective, cultivate a personal awareness of TSB through comprehensive biopsychosocial-spiritual practices, thus being able to provide knowledgeable and authentic modeling and encouragement to clients.