- Around 70 percent of Americans describe themselves as religious or spiritual.
- Most clinicians lack training in broaching and integrating topics related to religion and spirituality.
- By omitting religion and spirituality, there is a large potential moderator of mental health outcomes being unaddressed by therapists.
By Britt Duncan, M.A., and Douglas E. Lewis, Jr., Psy.D., on behalf of the Atlanta Behavioral Health Advocates
Why do psychologists infrequently choose to incorporate spirituality and/or religion in treatment planning?
Historically, pivotal leaders within the field of psychology took a pointed stance against the involvement of religion in the field. Sigmund Freud, for example, held a belief that the practice of religion was a psychotic illusion. He has had an indelible influence on the field of psychology, as his theories are still felt despite today’s zeitgeist of infusing equity, diversity, and inclusion in clinical practice. While religion and spirituality have a seat at the metaphorical table with the relatively recent development of the Society for the Psychology of Religion and Spirituality Within the American Psychological Association, clinicians still seem hesitant to bridge the gap within the therapy room.
Training sites that tout their commitment to diversity tend to focus on race, ethnicity, gender, and sexual orientation. In particular, budding clinicians may be taught how to address or consider such differences in the therapy room, and perhaps even before treatment commences, in that many clinicians explicitly ask for this information during intake and initial paperwork. It seems rare, in contrast, to see paperwork that places emphasis on or asks about a client’s religious and spiritual background.
Some researchers have found that 25 percent of psychologists are trained in how to meet a client’s spiritual needs (Schiffman, 2022). Yet, according to surveys, 66 percent of Americans indicated that religion is important in their lives. Other findings have indicated that psychologists often understand that spiritual issues are important in their clinical practice, but most feel unprepared to broach the religious and spiritual concerns of their clients. There is also extant research that supports the notion that religion and spirituality can be important and essential for helping individuals navigate stress—and perhaps serve as a protective factor against negative mental health outcomes. Taken together, why is there still hesitancy to discuss spirituality in therapy?
One is left to assume that clinicians hesitate because either they do not feel competent or sufficiently knowledgeable in the subject matter or they perceive other areas of an individual’s identity as more important. Regardless, we cannot know at the outset which aspect of an individual’s identity is foremost, and consequently, we must make an effort to understand the client’s world, which may be heavily influenced by spirituality.
Many of the current psychological phenomena can be connected to spirituality. As an example, acts of meditation and manifestation within mindfulness are very similar to the act of prayer. Additionally, many religions promote the “unburdening” of problems, such as the confessional within Catholicism. Developing spiritually rooted coping skills for clients can be extremely helpful in navigating the stressors in their lives. It has even been shown to be effective when other resources are limited. Drawing connections between spirituality and psychological phenomena could also assist in reducing the stigma of psychotherapy within religious communities and among clinicians themselves.
Training directors, supervisors, and clinicians alike should perceive all cultural identity markers as having equal importance unless informed otherwise by their clients. By failing to attend to a client’s spirituality, there is a missed opportunity to gain a full understanding of our client’s worldview and symptoms. Just as we discuss sexual orientation, race, ethnicity, and gender, we must all make an effort to understand all the potential stressors and strengths for our clients and push beyond what makes us uncomfortable.
Integrating spirituality into your clinical practice
Here are some ways you can incorporate spirituality into your clinical practice:
- During intake or initial paperwork, ask clients about their spirituality and religious background.
- This does not have to be the focus of therapy, but it can help provide insight into the client’s world and culture.
- Questions can be along the lines of discussing how important religion or spirituality is to the client, the influence it may have on their values and beliefs, and if issues related to their religion or spirituality are relevant to the reasons for seeking treatment.
- If you never broach this topic or ask these questions, clients may assume that these are not issues to be discussed with therapists.
- Be aware of your limits concerning this area of competency and when to seek outside support, resources, and consultation from members of the clergy and other experts.
- Consider your own countertransference pertaining to your client’s religious identity.
- View your client’s religion as a potential source of strength and coping and something to be utilized within therapy.
To find a therapist, please visit the Psychology Today Therapy Directory.
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