The Subtle Art of Spiritual Integration in Psychotherapy

Elegant menorah shines in synagogue

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Today, I share new findings from the Enhancing Practice-Based Evidence for Spiritually Integrated Psychotherapies project, focusing on a recent study by Ofra Mayseless and Marianna Ruah-Midbar Shapiro, which was published in Spirituality in Clinical Practice (Mayseless and Shapiro, 2025). Their findings offer valuable insights for all psychotherapists who want to integrate faith and spirituality into their work. I thank Dr. Mayseless and Dr. Shapiro for their permission to share their research findings.

The Research Study

The study is the first to explore how certified psychotherapists in Israel incorporate Jewish spirituality into their clinical practice. This issue is important well beyond Israel or Jewish psychotherapists. Therapists from various backgrounds face similar questions: How much of our own spiritual beliefs should we bring into the therapy room? When does doing so support the process? When might it become too much? How can we as therapists stay true to our beliefs and values? How can we achieve this without alienating clients, pushing beliefs onto them, or harming trust?

Methods

Using a qualitative research design, the researchers conducted individual interviews (lasting about 2 hours each) with 15 certified Israeli psychotherapists who indicated that they incorporate Jewish spirituality into their clinical practice. The therapists represented a range of spiritual perspectives, including nine who identified as religious, three as secular and spiritual, two as ultra-Orthodox, and one as "secular and a believer in some superpower or energy.” The therapists came from various clinical backgrounds, and included 5 women and 10 men, ages 33-74, averaging 18 years of experience. They served clients across a variety of spiritual backgrounds, from secular to Reform, Conservative, and ultra-Orthodox Jews, as well as some non-Jews. During the interviews, therapists were asked to describe their clinical approaches, spiritual views, interventions, and dilemmas. Two research assistants used thematic analysis to identify the most prominent themes in the qualitative data and then engaged in ongoing discussions with the lead researchers to clarify and refine them.

Findings

The primary theme from the qualitative data analysis was that therapists generally exercise caution in explicitly presenting their work as “Jewish spiritual psychotherapy” or introducing Jewish spiritual content too early in therapy. Although the therapists consider themselves to be integrating Jewish spirituality, most avoid using clear religious language or framing therapy in explicitly Jewish spiritual terms early in treatment. They fear that doing so could alienate clients, make the therapy appear sectarian, or trigger concerns about religious coercion or proselytizing.

The second major theme was that, despite this caution, the therapists regularly integrate Jewish spirituality, often in subtle, gradual ways—referred to by the researchers as “veiling and unveiling” their Jewish spiritual perspective. The therapists don’t simply choose between hiding and openly declaring their spiritual orientation. Instead, they move flexibly along a spectrum, revealing more or less of their Jewish spiritual framework depending on the client, the timing, and the strength of the therapeutic relationship.

The third main theme was that the therapists tended to have a flexible, universalistic view of identity and treatment. Most reject strict categories like secular, religious, spiritual, or ultra-Orthodox. Instead, they view Jewish identity as fluid, overlapping, and dialogical. This flexibility helps them work across religious differences. Nearly all believe their therapeutic approach could be useful for clients from many different Jewish backgrounds, and some think it could also help non-Jewish clients. Their position is that Jewish spiritual psychotherapy can be adapted sensitively for many kinds of people.

The study also offered insights into several types of spiritual interventions the therapists use. First, the therapists said they often use language purposefully. They select words, metaphors, and concepts that resonate with both religious and secular clients. Sometimes they employ terms with Jewish roots that are also used in the secular Israeli culture, allowing spiritual meanings to be conveyed without being too explicit. At other times, they tailor their language to match the client’s background, using more openly religious language with religious clients and more universal or psychologically-oriented language with secular clients.

Second, many of the therapists draw on Jewish texts, including biblical stories, rabbinic teachings, and midrashim (ancient legends and commentaries on the biblical text). These texts sometimes serve as direct therapeutic tools and sometimes function more implicitly in shaping the therapist’s thinking. In some cases, therapists tell stories from the Bible without highlighting that they are using “religious material,” making the intervention feel more universal and less doctrinal. Some therapists said they find that even clients they assume will not be receptive eventually respond positively to such material once trust has been established.

Third, many of the therapists use prayer, often in varied and discreet forms. Some pray privately before or during sessions without informing the client, seeking wisdom, guidance, or help to serve the client. Others invite clients to participate in prayer, but only when it appears clinically appropriate. Sometimes, this means using traditional Jewish prayer language; other times, it involves helping clients compose highly personal prayers or employing prayer in a more contemplative, symbolic, or open-ended spiritual way. Prayer thus ranges from explicitly religious to broadly spiritual, depending on the therapist and the client.

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Conclusions

The researchers concluded that the therapists’ cautious “veiling and unveiling” style represented not avoidance or inconsistency, but rather a form of cultural sensitivity. The therapists aim neither to deny their own spiritually-informed clinical perspective nor to impose it in ways that could harm the therapeutic alliance. This strategy allows them to stay authentic while pacing disclosure carefully, usually introducing more explicit spiritual material only after building enough rapport and only when it seems likely to benefit the client.

Previous research in the United States has shown that psychotherapists from other religious traditions are also careful to integrate spirituality into treatment in a culturally sensitive manner (e.g., Richards & Potts, 1995). Such culturally and spiritually sensitive approaches are consistent with best-practice recommendations (Berrett, Hardman, & Richards, 2023; Pargament, 2011; Richards & Bergin, 2005, 2014; Richards, Pargament, Exline, & Allen, 2023).

Psychotherapists seeking additional resources about integrating spirituality into treatment with Jewish clients may find the publications and organizations listed in the references helpful.

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