The Benefits of Religiously Integrated Psychotherapy

Source: Fahad Khan/Used with permission

Today, I share new findings from the Enhancing Practice-Based Evidence for Spiritually Integrated Psychotherapies project, focusing on a recent study by Dr. Fahad Khan and Dr. Hooman Keshavarzi. Their research, published in APA's journal, Spirituality in Clinical Practice, explores a therapy approach tailored for Muslims (Khan et al., 2025). I thank Khan and Keshavarzi for their assistance in writing this post.

A Background Case

Fifteen years ago, a Muslim couple from the Middle East came to my office for marital counseling. Although I had edited a book on psychotherapy and religious diversity, including a chapter on working with Muslims (Hedayat-Diba, 2014), I had never counseled Muslim clients before. I felt unprepared and lacked colleagues to consult or refer to.

I did my best. The couple seemed to appreciate my sincerity, but by the third session, the wife announced she would file for divorce. They never returned. I viewed this as a therapeutic failure, but at the time, resources for working with Muslim clients were limited. Fortunately, that is changing.

The Research Study

Using a practice-based evidence approach, Khan and Keshavarzi explored the clinical efficacy of an Islamic model of psychotherapy, Traditional Islamically Integrated Psychotherapy (TIIP; Keshavarzi et al., 2021). The practice-based research methodology allows researchers to collect valuable, real-world data from clinical settings (Barkham et al., 2010). Five clinicians trained in the TIIP model provided services to 107 patients in 420 sessions at the Khalil Center, an outpatient mental health facility headquartered in Chicago that addresses Muslim mental health concerns.

What Is TIIP? A Holistic Model

The TIIP model does not follow a rigid, manualized approach but instead integrates a distinct set of religiously and culturally tailored interventions. It grounds itself in Islamic principles and values and offers a holistic view of human nature by integrating evidence-based and Islamic spiritual interventions. The model centers on its comprehensive understanding of the human psyche, comprising four interconnected elements and their effects on the metaphysical heart (Qalb in Arabic). The qalb serves as the central command center of the psyche. Changes in any of the other four components ultimately manifest as health or pathology. According to TIIP, the four elements of the psyche are Cognition (ʿAql), Behavioral Inclinations (Nafs), Spirit (Ruh), and Emotions (Ihsās) (Keshavarzi et al., 2021).

What the Data Revealed

The results were highly encouraging: Patients receiving TIIP experienced a statistically significant reduction in psychological and functional distress. The effect size, measured by Cohen's d (0.62), indicated a medium-to-large effect and strongly supported the therapeutic benefits patients experienced.

The statistical analysis also revealed a nonlinear healing trajectory, with an initial reduction in psychological distress, a plateau, and then another decrease. This finding offers a realistic narrative of the healing process: initial relief from a strong therapeutic alliance and a spiritually safe environment (Murābatah), followed by the hard work and struggle of psychological change, and finally, the achievement of psychospiritual equilibrium (Iʿtidal) (Khan & Keshavarzi, 2023).

The data also provided a granular view of how TIIP therapists achieved these outcomes. A process measure, the Therapist Session Checklist, showed that therapists blended therapeutic approaches and interventions.

Source: Adapted from Khan et al. (2025)/Used with permission

As summarized in Table 1, the most frequently discussed topics during the therapy session were self-esteem/identity, religious/spiritual concerns, and relationship issues, including marriage and family of origin. This suggests that for a patient sample with predominantly collectivistic cultural backgrounds (South Asian and Arab/Middle Eastern descent), psychological concerns are often deeply intertwined with spiritual and family dynamics.

The most frequently used interventions during the sessions were cognitive (‘Aqlani) restructuring, positive thinking (Husn az-Zan), discussing hope, listening to spiritual issues, and discussing compassion. This provides evidence that the TIIP therapists used both mainstream interventions and Islamic spiritual practices and concepts.

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The most frequent therapeutic intentions during the sessions were facilitating insight, instilling hope, identifying problematic thoughts, and psychoeducation (giving information). This is consistent with the TIIP model's emphasis on introspection (Inkishāf) and the importance of a positive outlook rooted in Islamic beliefs, such as Husn az-Zan (positive thinking).

The study marks a significant milestone as the first to investigate the clinical effectiveness of a comprehensive, inherently Islamic model of psychotherapy. Although the study was not a randomized controlled trial, the practice-based evidence methodology helped the researchers explore and document real-world effectiveness. The study confirms that TIIP is effective and provides psychotherapists with an evidence-based treatment approach for helping Muslim clients. It also provides a critical foundation for future large-scale studies of psychotherapy among Muslims. The research paves the way for a more robust and culturally competent mental health care approach with Muslims that honors both the science of psychology and the spiritual essence of the human person.

Conclusion

Compared to 15 years ago, there are now significantly more resources to help therapists develop competency with Muslim clients. In addition to the research described here, several recent publications address mental health and psychotherapy with Muslims (Keshavarzi et al., 2021; Khan & Keshavarzi, 2023; Hedayat-Diba, 2014; York, 2023, 2024). Organizations like the Khalil Center, Alkaram Institute, Maristan, and the Institute for Muslim Mental Health support research, treatment, and training. Therapists now have greater support for culturally and spiritually informed care with Muslims.

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