Rationale Essays

RATIONALE ESSAY ONE

INTRODUCTION

The Applied Human Behavior (AHB) program at Northern Arizona University, has prepared me to move beyond the idea of helping people into the how to ethically and effectively help people. The different learning outcomes have given me the knowledge, practical tools and self-awareness that I will need as I move forward in the behavioral health field, toward a master’s degree in social work, and ultimately into a professional role assisting those in hospice care and their families work through their grief.

The AHB program had five different learning outcome categories, Human Systems and Diversity, Practice and Intervention, Community Engagement and Responsibility, Professional Preparedness, and Personal Values and Development, which taught me to connect micro-level interventions with macro-level change while considering the person in environment. I learned that effective work is not just about empathy but is contingent upon understanding the systems that shape people’s lives as well. It taught me that theory, ethics, and empathy intersect and shape the world of social work and community practice. The program’s learning goals have transformed how I think about diversity, advocacy, and the human experience. It has broadened my academic knowledge and challenged me apply the textbook definitions and theories into practical skill sets. It has also given me a meaningful and practical understanding that I will use throughout my career. The understanding that ethical practice must be based on cultural humility, the tools for empowering clients, and the knowledge that professional codes of ethics protect the clients and the practitioners.

With assignments that ranged from community analyses to organizational evaluations I learned to connect micro-level interventions with macro-level change. One thing that surprised me the most about this holistic program is how seamlessly it merged science with empathy and compassion. The AHB curriculum required self-reflection, intentionally focusing on how my own values, biases, and life experiences impact my ability to help others. It made me realize that in order to be an effective social worker, I would have to create safe, unbiased environments where people can heal.

Additionally, the AHB program stressed ethical standards and practice by exploring confidentiality laws and analyzing structural barriers. The assignments throughout the program shaped my understanding of best practices to go beyond theory and technique to include self-reflection, accountability, and encompassing an ethical mindset. Effective practice is showing up with integrity, cultural competence, and a willingness to think critically while reflecting on my own biases. I can see how the work I’ve completed has prepared me for the next steps in my education and professional career.

LEARNING OBJECTIVES

Section 1: Human Systems & Diversity

The learning outcomes for Human Systems & Diversity emphasize how individuals and communities function within larger human systems and how social history shapes those systems. They focus on understanding how historical context and cultural diversity influence behavior. The two assignments which helped me understand these outcomes the most were Aging in Isolation (AHB 365) and the Organization Diversity Initiative: Foothills Caring Corps (AHB 390). The Aging in Isolation presentation helped me see how environmental design, transportation access, and policy decisions have created barriers for aging adults. By researching how physical and social environments contribute to loneliness among older adults, I saw firsthand how the social determinants of health including, mobility, housing, and community design, directly influence emotional wellbeing. This project linked historical and sociological perspectives to modern issues by illustrating how isolation stems from systemic neglect rather than personal choice. It showed how policies and cultural attitudes toward aging have long-term consequences in how people live. It also inspired me to think critically about long-term community planning and advocacy for age-related issues. The Diversity Initiative assignment let me go from theory to practice and put what I earned into action. A DEIB (Diversity Equity Inclusion and Belonging) analysis of Foothills Caring Corps showed how organizational structures can either help or hinder inclusion. This assignment taught me how to spot hidden biases in service delivery and propose strategies to create multicultural and equitable environments for outreach and volunteer engagement. It reminded me that to make DEIB strategies work, you need to take accountability, further staff training, and make effect plans. Working on this project also highlighted my ethical awareness and understanding of anti-discrimination laws as well as NASW guideline for diversity. Together, these two assignments taught me that human systems and diversity are not just ideas. Instead, they are the daily challenges that social workers must navigate with sensitivity.

Section 2: Practice & Interventions

The second learning outcome, Practice and Interventions, is the most essential part of the AHB program where knowledge is turned into action. This outcome focuses on learning how to assess and plan in ways that facilitate growth and wellbeing for individuals, families, and communities. It is applying all facets of care including empathy, ethical judgment, and critical thinking to support lasting and meaningful change. The two assignments that best helped me connect theory and practice interventions the most were the Research Paper: Biological Foundations of Alzheimer’s Disease (AHB 365) and Case Study: Assessment and Short-Term Case Plan (AHB 425). The Alzheimer’s paper expanded my understanding of how the intersection of biology, psychology, and social factors effect human systems specifically with a neurodegenerative disease. Researching the current interventions like Lecanemab and lifestyle-based therapies required combining empirical data with humanistic insight. It cemented my understanding of the biopsychosocial model and how evidence-based practice can inform empathetic and compassionate care. Additionally, it reinforced that effective treatment requires seeing the whole person, not just their diagnosis or symptoms. The Case Study project transformed knowledge into practical skills. For this project, I had to create an assessment and a short-term plan for a client scenario. The scenario required applying ethical decision-making, goal setting, and documentation as well as identifying barriers and creating realistic interventions. It taught me to be both compassionate as well as objective while addressing and identifying the patient’s needs without making assumptions. During this process, I learned that effective interventions are grounded in facts and focus on the person while respecting the client’s voice and applying theories and best-practices.This outcome is emphasized throughout the program and many other assignments could have been matched to the other subsections. It is the pillar of the entire program and represents the bridge between education and real-world practice. Theoretical knowledge must always meet real-world understanding and nuance. I learned that even some of the most evidence-based plans fail if they do not respect client autonomy, culture, and capacity. In short, these assignments built my confidence to combine science with sensitivity which is a critical skill for effective practice.

Section 3: Community Engagement & Responsibility

Learning Outcome three centers on understanding how socioeconomics, community development, and policy effect the lives of individuals and families. The goal is to promote the understanding of how globalization impacts participation by analyzing the connections, recognizing the inequalities and taking responsibility for engaging in social change on local and global levels. The SWOT Analysis of the International Rescue Committee (IRC) (AHB 390) and the Global Citizenship presentation: Family Separation & Reunification (AHB 350) solidified my understanding of community responsibility. The SWOT analysis helped me see how social service organizations are a part of larger systems. Analyzing IRC’s strengths, weaknesses, opportunities, and threats illustrated how socioeconomics, public policy and partnerships not only influence an organization’s success but also effect client outcomes. It taught me that resource awareness and interagency collaboration are crucial to client success as well as to think systemically about equitable service delivery.The Global Citizenship presentation expanded my knowledge of how international polices impact local human wellbeing. In this assignment, I explored how immigration laws and political climates disrupt families and create multigenerational trauma. It solidified my understanding that social work must go beyond the individual and advocate for change to the structural forces that cause harm. The two assignments reminded me that being involved in the community is both a professional and moral responsibility. To overcome obstacles, real change requires both knowledge and advocacy.

Section 4: Professional Preparedness

The fourth learning outcome focuses on developing the professional abilities that ensure ethical and competent practice. It includes research literacy and adherence to legal and ethical guidelines to prepare people to enter the professional world with honesty. The Ethics Essay: HIPAA, Mandated Reporting & Client Rights (AHB 425) and the Literature Review: Efficacy of Ketamine-Assisted Psychotherapy (AHB 305W) both helped me strengthen my understanding and professional preparedness.The Ethics Essay helped me learn more about the legal aspects of social work, including HIPAA, informed consent, and the tension between confidentiality and mandated reporting. It taught me how to handle difficult ethical situations without compromising client confidentiality and that clear and concise documentation protects both me and the client.Completing the Literature Review helped me become better at reading, understanding and evaluating research. I learned to synthesize data and turn scientific findings into practical applications and best practices. I learned to think critically about scientific research and to address ethical considerations that arise with new treatments.These assignments strengthened my professional readiness by expanding my ethical knowledge and research skills. They also gave me the confidence to apply knowledge to real-world challenges combing theory with professional practice.

Section 5: Personal Values & Development

The fifth and final learning outcome emphasizes the need for personal reflection and professional growth. The purpose is to help people think critically, manage their emotions, and become more self-aware by examining their values, biases and other emotional responses. The two assignments that demonstrated this the best for me were the Trauma and Treatment Research Paper (AHB 450) and the Research Paper on Ketamine-Assisted Therapy (AHB 305W).The trauma and treatment paper helped me learn about trauma-informed therapies like EMDR and somatic therapy. This helped me see how important it is to create a safe and supportive environment. Empathy, safety, and self-care are fundamental, yet but by learning to recognize my own triggers and boundaries I understood that caring for others starts with managing and caring for myself. My other research paper, on Ketamine, taught me more about how science and ethics need to work together to provide effect treatment. It remined me how vulnerable participants in research studies can be and stressed the need to be objective while being empathic. Together, these assignments reminded me that being an effective social worker starts with knowing myself and fostering a commitment to lifelong reflection and learning.

CONCLUSION

Completing the Applied Human Behavior program has changed how I see myself and the world around me. I now understand that effective practice in human services requires a mix of ongoing education, personal reflection, compassion, and ethics. Further, the program revealed how interconnected professional and personal development are and I leave with a better understanding of myself. The continued personal reflection helped me to uncover strengths I was unaware I possessed, like the ability to synthesize theories into actions and it also revealed weaknesses which I need to address, specifically my biases. I will carry the lessons learned and knowledge gained to not only improve my life, but the lives of my clients as well. The area that had the most impact on me was how many of the assignments I can connect to the Practice and Intervention learning outcome. Nearly every course contained a practical assignment whose skills I will utilize in my career. I used to think of intervention as a way to fix a client’s problem. I know see that successful intervention requires more than just having a plan, it’s a collaborative process that requires empathy and patience. Additionally, this program showed me the intricate power in systems-level advocacy and how helping an individual also means paying attention to the resources, policies, and communities that affect that individual. The AHB program balanced compassion and empathy with knowledge and practical applications. It has prepared me to make meaningful contributions into the lives of my clients and myself with purpose and hope.

RATIONALE ESSAY TWO

Pre-Research Discussion

In social work practice, few experiences challenge both clients and professionals as deeply as the process of dying and grieving. When facing their own death or the death of a loved one, people often wrestle with existential questions. They want to be at peace, and seek
connection, forgiveness, and meaning. This existential spiritual side is paramount to the human condition yet remains one of the least understood parts of care. It is essential for grief and hospice care social workers to integrate spiritual care with dignity and compassion as part of a holistic practice.

Many people use the terms palliative care and hospice care interchangeably, however there is a clear distinction between them. While both types of care offer medical and emotional support, palliative care focuses on patients going through the healing process, whereas hospice
care is for individuals who have come to the end of their life and are no longer seeking a cure. Interdisciplinary teams of physicians, nurses, chaplains and social workers focus on comfort, dignity, and emotional and spiritual wellbeing for not only the patient but for their families as
well. Social workers play a crucial role in helping families navigate difficult emotions and cope with the loss experienced at the end of life.

Spirituality is more than just religion and goes beyond any denomination or sect. It is a sense of purpose, peace, and connection and seeks to answer the existential questions often experienced at the end of life. For many clients, spirituality, influences how they face suffering
and loss. Yet many professionals feel ill-equipped and unprepared for spiritual conversations with their dying clients. A national study disclosed that only one third of social workers reported receiving formal training in spiritual care (Pomeroy, Hai, & Cole, 2019), which reveals a gap between client needs and professional readiness.The six sources cited and summarized in this annotated bibliography explore how spirituality can be incorporated to bring meaning and healing in hospice care and grief therapy. They encompass social work education research, national practice standards, initiatives like the 3 Wishes Program (3WP), and the resurgence of End-of-Life Doulas (EOLD). Together, they illustrate that spirituality is a vital part of the human experience, especially at the end of life. Social workers who learn to address the spiritual concerns of their clients and their families will be better able to deliver holistic support with dignity at the end of life.

Spirituality is more than just religion and goes beyond any denomination or sect. It is a sense of purpose, peace, and connection and seeks to answer the existential questions often experienced at the end of life. For many clients, spirituality, influences how they face suffering and loss. Yet many professionals feel ill-equipped and unprepared for spiritual conversations with their dying clients. A national study disclosed that only one third of social workers reported receiving formal training in spiritual care (Pomeroy, Hai, & Cole, 2019), which reveals a gap
between client needs and professional readiness. The six sources cited and summarized in this annotated bibliography explore how
spirituality can be incorporated to bring meaning and healing in hospice care and grief therapy.They encompass social work education research, national practice standards, initiatives like the 3 Wishes Program (3WP), and the resurgence of End-of-Life Doulas (EOLD). Together, they illustrate that spirituality is a vital part of the human experience, especially at the end of life. Social workers who learn to address the spiritual concerns of their clients and their families will be better able to deliver holistic support with dignity at the end of life.

Annotated Bibliography

American Society on Aging, & Rush, M. (2022). The end-of-life doula. Generations: Journal of
the American Society on Aging, 46(3), 1–8. https://www-jstor-org.libproxy.nau.edu/stable/pdf/48707877

In this article Rush (2022) describes the growing field of End-of-Life Doulas (EOLD) and how their role is becoming vital to end-of-life spiritual care. EOLDs are trained, non-medical companions who help clients and families with the emotional, spiritual and
practical needs from diagnosis to death and bereavement. She uses real-life stories and cases to highlight how doulas help hospice teams by spending time with clients, performing spiritual rituals, and helping families deal with death and grief. EOLDs help
people maintain dignity and ensure that death occurs in a way that feels meaningful and personal. EOLDs focus on being present and empowering their clients and families. While the paper offers a compelling collaborative model for end-of-life care, it is
descriptive and not scientific. It does not offer any quantitative data, but the stories illustrate that EOLDs fill an essential gap and offer the emotional and spiritual support needed by so many as their life comes to an end. Their work complements formal hospice teams by offering a model of accessible, human-centered care, that honors both the dying process and those left behind (Rush, 2022).

Ferrell, B. R., Twaddle, M. L., Melnick, A., & Meier, D. E. (2018). National Consensus Project Clinical Practice Guidelines for Quality Palliative Care Guidelines, 4th Edition. Journal of Palliative Medicine, 21(12), 1684–1689. https://doi.org/10.1089/jpm.2018.0431

In this article Rush (2022) describes the growing field of End-of-Life Doulas (EOLD) and how their role is becoming vital to end-of-life spiritual care. EOLDs are trained, non- medical companions who help clients and families with the emotional, spiritual and
practical needs from diagnosis to death and bereavement. She uses real-life stories and cases to highlight how doulas help hospice teams by spending time with clients, performing spiritual rituals, and helping families deal with death and grief. EOLDs help people maintain dignity and ensure that death occurs in a way that feels meaningful and personal. EOLDs focus on being present and empowering their clients and families. While the paper offers a compelling collaborative model for end-of-life care, it is descriptive and not scientific. It does not offer any quantitative data, but the stories illustrate that EOLDs fill an essential gap and offer the emotional and spiritual support needed by so many as their life comes to an end. Their work complements formal hospice teams by offering a model of accessible, human-centered care, that honors both the dying process and those left behind (Rush, 2022).

Ferrell et al. (2018) developed the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care, which outlines eight categories of competent palliative care and clearly incorporates spiritually into the standard of practice. The authors stress that spiritual support should be treated as a measurable and primary part of client care and not an optional afterthought. Ferrell et al. use clinical evidence to create guidelines to ensure that everyone receives equitable and person-centered care. The guidelines stress the need for regular spiritual screenings and assessments and using a collaborative interdisciplinary team of chaplains, social workers, and nurses.

The guidelines formalize adding spirituality into the dimensions of holistic care. The emphasis on cultural humility serves as a reminder to social workers that spirituality looks different for everyone and client care must be inclusive to all worldviews. It stresses the moral duty to accept cultural and belief diversity. Their guidelines establish clear standards for hospice social workers to implement spiritual assessments, ensure accurate documentation and measurable evaluations, and a framework to advocate for approaches that integrate emotional and spiritual needs. These principles help professionals recognize how existential pain like guilt, regret, and unfinished business can be address though structured dialogue (Ferrell et al., 2018).

Gardner, F. (2024). A social work contribution in end-of-life care: incorporating critical spirituality. Palliative Care and Social Practice, 18.
https://doi.org/10.1177/26323524241282683

Gardner introduces ‘critical spirituality’, a framework that corresponds with the social work principles of equity, justice, and self-reflection. She asserts that spiritual care must encompass both personal and systemic aspects of suffering including social injustice,
cultural marginalization, and institutional barriers. Using reflective case examples, she encourages practitioners to explore their own world view and biases as a basis for authentic client interaction and humility in spiritual conversations. She also stresses the
need for spiritual assessment tools that show cultural humility and community-based points of view.

Gardener reframes spiritual care as a form of advocacy. She uses the person-in- environment perspective to illustrate how discrimination and economic hardship can affect a client’s ability to find peace at the end of life. Her conceptional approach
broadens the understanding of spirituality beyond faith-based interventions and compels social workers to integrate advocacy into end-of-life care; addressing spirituality is also addressing power, access, and belonging. Her article is a reminder that creating dignity in death also means confronting the barriers that prevent it (Gardner, 2024).

Gijsberts, M.-J. H. E., 1, Liefbroer, A. I., 2, Otten, R., 3, Olsman, E., 4,5, End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Faculty of Religion and Theology, Vrije Universiteit Amsterdam, VU University Library, Vrije Universiteit Amsterdam, Department of Medical Ethics & Health Law, Leiden University Medical Center, & Department of Spiritual Care, Hospice Bardo. (2019). Spiritual care in palliative care: A systematic review of the recent European literature. In Med. Sci. (Vol. 7, Issue 25, pp. 2–21) [Journal-article]. https://doi.org/10.3390/medsci7020025

This systemic review of 53 European studies analyzes spiritual care practices, challenges, and outcomes in palliative care. Gijserts et al. identify presence, active listening, empowerment, and fostering peace as the most effective methods for alleviating spiritual suffering. Studies consistently showed that patients who received intentional spiritual support experienced less anxiety, had improved emotional wellbeing, and experienced a stronger sense of meaning. The quantitative studies show improvements in patients’ mental health and sense of meaning, while qualitative data shows that professionals who engaged in spiritual care reported feeling more confident in their work, as well as greater patient empathy.

The authors further emphasize that spirituality is not about religious beliefs but goes deeper into the fundamental human need for connection and transcendence. Their findings support incorporating spirituality into holistic care model and that spiritual care should be a measured aspect of quality healthcare. However, the review also discusses barriers to implementation, including lack of time, training, and institutional support as well as the need for increased interdisciplinary cooperation. It asserts that spiritual care
should be measurable part of quality care and offers evidence for policy reform and educational initiatives within social work (Gijsberts et al., 2019).

Neville, T. H., Taich, Z., Walling, A. M., Bear, D., Cook, D. J., Tseng, C., & Wenger, N. S. (2022). The 3 Wishes program improves families’ experience of emotional and spiritual support at the end of life. Journal of General Internal Medicine, 38(1), 115–121. https://doi.org/10.1007/s11606-022-07638-7

Neille et al. evaluated the impact of the ‘3 Wishes Program’ (3WP), which aims for clinicians to fulfill three personalized wishes for terminally ill patients and their families in an effort to enhance dignity and meaning at the end of life. The authors surveyed and
interviewed participants in the 3WP program. Families and patients reported greater satisfaction with spiritual and emotional support, while clinicians involved in the wish fulfillment reported improved team morale and a renewed connection to purpose. Although the study lacked randomization, its qualitative depth offers significant evidence of compassion as a measurable clinical intervention. Additionally, it was reported that the 3WP can be utilized and adapted to many different clinical settings. The results of this review demonstrate that humanizing rituals like playing a favorite song, or composing personalized messages help families find peace and spiritual closure.

For social workers, the 3WP illustrates how rituals, and storytelling can be utilized in hospice care and grief therapy. It connects science and humanity by demonstrating that symbolic actions, rooted in empathy can bring peace to patients, their families and all those who grieve; offering a tangible way to transform loss into meaning (Neville et al., 2022).

Pomeroy, E. C., Hai, A. H., & Cole, A. H. (2019). Social work practitioners’ educational needs in developing spiritual competency in End-of-Life care and grief. Journal of Social Work Education, 57(2), 264–286. https://doi.org/10.1080/10437797.2019.1670306

Pomeroy et al. conducted a survey of 437 social workers across the country to identify strengths and weaknesses in spiritual competency: specifically, their preparedness in incorporating spirituality in end-of-life and grief work. Most participants revealed
discomfort in initiating spiritual talks as well as having received inadequate training in conducting spiritual assessments and even starting spiritual conversations. The authors advocate for incorporating spirituality into core social work curriculums via experimental
learning, case consulting, and reflective supervision. The findings also suggested that practitioners who felt spiritually competent reported stronger rapport with their clients and improved grief outcomes.

This study revealed a significant gap in social work education. Only about 30 percent of respondents reported receiving any structured instruction in spiritual care, despite working regularly with death, dying, and bereavement. The authors also argued that spiritual competency should be regarded as a professional skill, not an optional interest, advocating that effective spiritual support requires training, comfort with difficult conversations, and self-awareness. It further emphasized the ethical responsibility of educational programs to prepare social workers to address spiritual distress in culturally sensitive ways (Pomeroy et al., 2019).

Post Research Discussion

After completing this research, my perception of spiritual care evolved from seeing it as supplementary to recognizing it as essential in hospice and grief counseling work. The literature consistently demonstrates that when spirituality is approached through a structured assessment with cooperation, and cultural humility it has measurable effects on emotional outcomes. Research by Neville et al. (2022) illustrates how creative and personalized approaches can alleviate suffering and provide meaning to patients and their families. A clear trend in the literature is the shift towards structure and inclusivity. Ferrell et al. (2018) lay the foundation for professional spiritual care by defining it as a quantifiable aspect of quality care. Their guidelines turn compassion into practice by requiring spiritual assessments,
documentation, and collaboration. Gardner (2024), on the other hand, adopts a social justice perspective and reminds us that spirituality is interconnected with power, culture, and access.Taken together, these viewpoints shift the focus from simply including spirituality to
understanding and recognizing it as fundamental to the human experience and its ability to foster peace and dignity.

The theme of meaning-making also appears throughout the literature. Neville et al. (2022) demonstrate that incorporating personalized rituals like the 3WP can strengthen family bonds and provide comfort for families after the death of their loved one. Rush (2022)
compliments these findings in advocating for EOLDs to help facilitate rituals and other personalized acts of meaning that honor the dying process and create a sense of sacred closure for clients and their families.

Both systemic and educational effects are also significant throughout this review. Gardner (2024) and Pomeroy et al. (2019) reveal that spiritual competency must be intentionally developed through reflection and learning experiences. With many social workers reporting that
they haven’t received adequate training in spiritual care, Pomeroy et al. (2019) call for a shift in social work education to focus on spirituality through the use of reflective journaling, supervision, and experiential training. While Rush (2022) highlights the importance of community-based and interdisciplinary approaches to fully integrate spiritual care. The research suggests that spirituality is a clinical and ethical obligation to holistic care.

The research significantly impacts the practices of social workers. It confirms that integrating spirituality aligns with the social work principles of dignity, self-determination, and cultural humility and further reinforces that social workers are uniquely positioned to attend to
the emotional, social, and spiritual needs at the end of life.

The essence of this research and its impact is captured in the Hawaiian practice of Ho’oponopono, a prayer for peace and reconciliation. The prayer speaks directly to the spiritual needs and emotional closer needed at the end of life. “I’m sorry. Please forgive me. Thank you. I love you." These words embody the spiritual desires to restore connection and make peace which is paramount for hospice clients and their families.

On a personal note, as I move closer to graduate school and starting a career, this research has helped me reframe my future role as a hospice caseworker or bereavement counselor. I intend to use these findings by to support a collaborative model that honors empathy and individual meaning at end-of-life care for clients and families.