Ethical issues in considering 'religious impairment' in diagnosis

There are several ethical implications of clinician assessment of clinically significant religious impairment (CSRI). This paper draws upon the American Psychological Association's (APA's) Code of Ethics (1992) to review relevant ethical principles and standards. It then presents a continuum of responses to the relationship between psychology and religion: (1) religion as harmful, (2) benign neglect of religion, (3) formal: problem-focused, (4) formal: domain-focused, and (5) religion as paradigmatic alternative. This continuum is followed by a discussion of three clinical vignettes and an examination of the potential ethical tensions for each model. The conclusions drawn from this review are that the formal: domain-focused model presents a rationale for inclusion of CSRI in assessment and is the most promising among alternative models for avoiding professional obsolescence, expanding alternatives for clients and clinicians, and enhancing ethical practice and professionalism.