Client Perspectives on Spirituality in the Therapeutic Relationship

There has been increasing interest in the integration of spirituality into psychotherapy in the last 10 years, yet we have very little in-depth information about clients' perspectives on spirituality in the counseling relationship to help guide this integration. Using a narrative methodology to explore the counseling experiences of 12 spiritually-committed clients in detail, this study suggests that clients who may not identify as traditionally religious may still view the entire process of psychotherapy through a spiritual lens. Furthermore, their spirituality may guide their interpretation of therapy, their expectations of the therapist, and their choice to engage in or terminate treatment in complex ways. By exploring the experiences of this growing breed of spiritually-committed clients, the results shed new light on the dimensions that deserve consideration as we think about how to respond to a client's spiritual needs in psychotherapy.     

When 2–3% really matters: The (un)importance of religiosity in psychotherapy

Previous research suggests that clients’ religious beliefs are commonly excluded from therapeutic practice. Often, this exclusion is attributed to practitioners’ lack of knowledge or appropriate skills. Such analyses, however, have little regard for the interactional aspects of the therapist/client encounter. Drawing upon work within discursive social psychology, we argue that the exclusion of religious beliefs does not reflect therapists’ lack of knowledge or awareness but can more usefully be seen as the discursive accomplishment of marginalizing clients’ beliefs. Six practising psychotherapists were interviewed about religious beliefs within the therapeutic process. Participants construct religious beliefs as important but relevant only to restricted categories of clients. They rework religious beliefs as compatible with accepted practice, or construct particular groups of clients as incompatible with the process. Training and other requirements are reformulated in terms of spiritual beliefs rather than religious beliefs. These constructions display awareness of religious beliefs while marginalizing their relevance in practice. Inclusion of clients’ religious beliefs to best effect will require more psychotherapy to engage more constructively with religion than it does at present.     

Research and Theory Religion and Spirituality in Coping With Stress

Relations among and between religion, spirituality, and the ability to cope with stress were examined using a sample of 115 graduate students in counseling. Religion and spirituality positively correlated with coping with stress. Counseling students who expressed spirituality through religious beliefs had greater spiritual health and immunity to stressful situations than counseling students who identified themselves as spiritual but not religious. Counseling students with a religious/spiritual affiliation indicated more discomfort counseling clients hostile to religion compared with counseling students with a spiritual‐only affiliation. The results have implications for preparing counseling students to work with clients with religious/spiritual issues.     

Working With the Sacred: Four Approaches to Religious and Spiritual Issues in Counseling

This article examines the advantages and disadvantages of 4 helping orientations of the counselor to religious and spiritual issues in psychotherapy: rejectionism, exclusivism, constructivism, and pluralism. The constructivist and pluralist approaches are advocated as those orientations best suited to work with diverse clients and religious beliefs, and flexible enough to deal respectfully, ethically, and effectively with a variety of religious and spiritual issues in counseling.     

Addressing Spiritual Issues in Secular Counseling and Psychotherapy: Response to Helminiak's (2001) Views

D. A. Helminiak (2001) suggests that counselors who work within the framework of a client's chosen religious or spiritual perspective are illegitimately responding to spiritual issues in counseling. In contrast to this position, this article affirms that spiritually sensitive counselors who work within the religious or spiritual framework of clients can practice both ethically and effectively and can generate useful research examining the relationship between spirituality and successful therapeutic outcomes.     

“Out on the edge of my comfort”: Trainee counsellor/psychotherapists' experiences of spirituality in therapy—A qualitative exploration

The integration of spirituality into counselling and psychotherapy poses complex challenges. Personal spirituality, professional competency and ethical considerations may impact on trainees' experiences of integrating spirituality into therapy. This study adopted an inductive, qualitative approach to explore trainee counsellor/psychotherapists' experiences and perceptions of integrating spirituality into therapy. Six trainee counsellors and psychotherapists were recruited using purposive sampling from a professional counsellor and psychotherapist training institution in the UK. In‐depth, semi‐structured interviews were conducted, audio‐recorded and transcribed verbatim. Thematic analysis of the interviews revealed two overarching themes: spirituality provides support but needs a warning; and spirituality is relevant but undervalued. These themes encompass a wide range of trainee concerns associated with integrating spirituality into therapy. Participants reported that they felt unprepared to work therapeutically with clients' spiritual beliefs. However, the value of spirituality in providing support to both the trainee and their clients was highlighted by several participants. Some participants described integrating clients' spirituality as having a positive impact on the therapeutic relationship, but often felt threatening to the trainee. This research has implications that are important for counselling and psychotherapy training and developing enhanced consideration of client spirituality and the interpersonal environment in which therapy is delivered.     

Addressing Spiritual and Religious Issues in Counseling African Americans: Implications for Counselor Training and Practice

Addressing spiritual and religious issues in the context of counseling relationships may be beneficial to many African American clients. The authors discuss various roles and functions of spirituality and religion in the lives of many African Americans, with particular attention to the impact of these issues on their mental health functioning and willingness to seek formal mental health services. The importance of academic training programs that prepare counselors to address potential spiritual and religious issues with their clients, is also highlighted.     

Law and grace in Saint Augustine: a fresh perspective on mindfulness and spirituality in behaviour therapy

The secular, acceptance-based philosophy of third wave behaviour therapy has easily absorbed the notion of mindfulness that originated in Eastern spirituality, entailing a secularised approach to transcendence. The present article seeks to connect mindfulness with existing efforts to integrate the Western client's spirituality into psychotherapy. For that purpose, we show how Christian grace theology and mindfulness theory overlap in the way they construe transcendence and self. Both approaches enhance openness to experience and deemphasise verbal control as a tool for personal progress. It is argued that awareness of this overlap can make it easier for the therapist to understand and appreciate the client's religious perspective. It can also help turn a client's spirituality into a relevant personal strength for therapy. Finally, explaining the overlap can enhance the credibility of mindfulness interventions with traditional Christian clients and make these interventions relevant to their spiritual concerns.     

Integrating counselling, psychotherapy and healing: An inquiry into counsellors and psychotherapists whose work includes healing

A qualitative study of 30 counsellors or psychotherapists whose work also includes healing was conducted using semi-structured interviews. Seven of the participants then joined the researcher in a human inquiry group. Participants in the research had been practitioners for a mean of over 10 years. The main themes that emerged were: the transition by the practitioner towards the use of healing; the taboo concerning talking about spiritual and healing experiences reported by the participants; the nature of healing as distinct from therapy; the supervision difficulties that arose when participants engaged in both counselling/psychotherapy and healing with their clients; and the concept of spiritual space. Some very experienced psychotherapists and counsellors are now including healing in their work. This raises a number of important issues, particularly relating to supervision.     

Marriage and Family Therapy Graduate Students’ Satisfaction with Training Regarding Religion and Spirituality

Marriage and family therapists are likely to encounter religious or spiritual clients in their career and thus are encouraged to be aware of their clients’ religious and spirituality. This awareness is often fostered within graduate training programs. This study aims to examine graduate students’ incorporation of religion and spirituality in therapy and their satisfaction with the quality and amount of training programs’ adherence to religion and spirituality. A sample of 135 graduate students from American Association for Marriage and Family Therapy accredited programs completed the survey. Findings showed that graduate students with greater levels of religiosity and spirituality were more likely to perceive it important to address religion/spirituality in therapy and to perceive there is a need for religious/spiritual education. When controlling for religious and spiritual orientations, overall regression results revealed that not having a course on religion and spirituality and perceiving a need for religious/spirituality in education predicted lower satisfaction with the amount and quality of current training surrounding these dimensions. Implications demonstrate the need to address religious/spiritual concepts in the curriculum, supervision, and in marriage and family therapy training.     

Therapists' Integration of Religion and Spirituality in Counseling: A Meta‐Analysis

The authors conducted a 26‐study meta‐analysis of 5,759 therapists and their integration of religion and spirituality in counseling. Most therapists consider spirituality relevant to their lives but rarely engage in spiritual practices or participate in organized religion. Marriage and family therapists consider spirituality more relevant and participate In organized religion to a greater degree than therapists from other professions. Across professions, most therapists surveyed (over 80%) rarely discuss spiritual or religious issues in training. In mixed samples of religious and secular therapists, therapists' religious faith was associated with using religious and spiritual techniques in counseling frequently, willingness to discuss religion in therapy, and theoretical orientation.     

Other than “the set pattern”: Developing one’s own thoughts about spirituality and religion

In qualitative research, psychoanalysts and psychoanalytic psychotherapists who had continued to have a personal interest in religion or spirituality reflected on their religious upbringing. The 25 participants interviewed often gave their responses in what can be identified as narrative form. These narratives articulated participants’ often poignant and distinctive, sometimes humorous, experiences. They relate how and why accepted teaching regarding religious and spiritual issues was challenged, usually in adolescence, but for several participants much earlier. Important aspects included differing responses of significant others to the participants’ independent thinking, the beginnings of subsequent religious and spiritual questing, and, for some, the decision to become a psychotherapist.     

Transitional Faith: A Developmental Step Toward Religious Maturity

Nonjudgmental exploration of religious concerns may be a vital component of psychotherapy with religiously oriented clients. This article summarizes a recent stage model of psycho-religious functioning that was developed to help psychotherapists work with religious material in clinical practice. Following this introduction a case study is presented that illustrates my clinical work with a young woman in the transitional stage of development. The presentation depicts the entanglement of her spiritual struggles with her emotional and interpersonal conflicts. Because transitional faith is a pivotal point in the developmental spectrum, counselors and therapists working with clients in this stage can play a key role in promoting clients' spiritual development.     

Therapists’ Responses to Religious/Spiritual Discussions with Trauma Versus Non-trauma Clients

This research explores therapists’ reactions to discussions of religion and spirituality in secular psychotherapy. We used a mixed method design including qualitative and quantitative components to examine data from 14 mental health professionals. Therapists acknowledged the importance of, and outlined reasons for, engaging in religious/spiritual discussions. They provided examples of the diverse ways in which their own views on religion/spirituality have an effect on their therapeutic work. Therapists view attention to religion/spirituality in trauma therapy as necessary. They see an emphasis on religion/spirituality within the treatment of traumatized clients as possessing distinctive qualities in comparison to their treatment of other populations.     

Religiosität und Spiritualität in der Psychotherapie

For many years religious and spiritual issues have been avoided in psychotherapy. In the face of social changes a more culturally sensitive psychotherapy is needed to professionally deal with religious backgrounds, spiritual needs and spiritual resources. A remarkable spiritual turn has recently been observed particularly in psychoanalysis, which was originally very antireligious. Health research studies are exploring the healing craft of religious virtues and values. It is important to discern between an empirically proven healing method and an ideologically founded promise of salvation. It is the task of the therapist to find out whether the patient's religiosity or spirituality is part of the problem or part of the solution.     

Psychotherapy and Religion: Rapprochement or Antithesis?

Religion and psychotherapy have long maintained separate directions, currently manifested in four viewpoints: orthodox, atheistic, neutralist, and moderate. Although each therapeutic viewpoint is distinct, each contains the seed for rapprochement. The need for a rapprochement that provides professional psychotherapy capable of addressing religious issues is clearly voiced by laypersons, who are clients or potential clients, and by members of the clergy and psychotherapeutic professions. Increasing numbers of ministers now receive professional preparation for pastoral counseling. It is timely for those in the counseling professions to consider seriously specialized education and certification in religious counseling for secular psychotherapists.     

Effects of Childhood Sexual Abuse on Client Spiritual Well‐Being

Forty‐three individuals receiving psychotherapy for childhood sexual abuse and 34 clients who sought psychotherapy for other reasons were compared on several aspects of spiritual functioning. The 2 groups did not differ significantly in spiritual well‐being. However, both groups scored lower than samples of medical outpatients and hospice workers. Most reported initiating and discussing spiritual issues during therapy, were satisfied and comfortable with these discussions, and rated spirituality as important to problem resolution. They also listed several obstacles to spiritual development. Possible research and practice implications are discussed.     

CHRISTIAN HUMANISM AND PSYCHOTHERAPY: A RESPONSE TO BERGIN'S ANTITHESES

Abstract. Secular and religious values of psychotherapists influence the process of psychotherapy. The psychologist Allen Bergin has pointed out several major antitheses between values of secular psychotherapists and their religiously oriented clients. The present essay is a response to Bergin's antitheses, on the one hand, and to humanistic psychology, on the other, from the point of view of a Christian humanism. Karl Rahner's theological anthropology is proposed as one possible foundation for an explicit articulation of the relationship between psychotherapy and religion, and as a means to address apparently divergent values of psychotherapists and religious believers.     

Spiritual,Religious, Nonspiritual,and Nonreligious Narratives in Marginalized Older Adults: A Typology of Coping Styles

SUMMARY

Narrative therapy is an important tool in the phenomenological framing of life events with older clients. Seventy-nine older adults who lived independently in four subsidized high-rise housing facilities in Chicago were interviewed in a research project about managing life challenges. Cases represent four types in a spiritual-religious typology: religious and spiritual, religious only, spiritual only, and neither religious nor spiritual (Zinnbauer, 1997). This article explores how older adults managed adversity and maintained a sense of self-efficacy. Findings indicate that older adults use many references to religion and spirituality in their narratives, either embracing these domains or defining themselves in contrast to them. Narrative therapy suggests that the implications of religious and spiritual resources addressed in client stories may reinforce coping capacity and promote aging well.     

Bridging the Divide

Abstract

Women who consider themselves traditional or conservative in the context of religious practice often experience tremendous conflicts regarding the integration of same-sex emotional and sexual feelings with their religion and spirituality. Current religious teachings about homosexuality make this combination difficult as only heterosexual sexuality within marriage is permitted in most orthodox faiths. Further, the way that spirituality and sexuality are conceptualized as opposing dichotomous categories (e.g., body vs. soul) presents women with a framework where integration does not seem possible. Observant women who come to psychotherapy often experience tremendous distress, guilt, depression, and even suicidality due to the conflict between their sexual feelings and religious doctrine. Relieving the distress, and resolving the conflicts while honoring the emotional complexity of sexual feelings, spirituality, and religious orthodoxy can present tremendous dilemmas for the practitioner as well as the client. Using the example of psychotherapy of an Orthodox Jewish woman who integrated same-sex desire into her life, this article describes psychotherapy process and alternative ways of viewing spirituality and sexuality that permit possible resolutions for clients.