Religious/spiritual psychotherapy behaviors: Do we do what we believe to be important?

Professional psychologists have recently been encouraged to sensitively address religious/spiritual issues in psychotherapy. But how frequently do practitioners make religiously/spiritually informed interventions with their clients, and how important do they think it is to do so? Based on the existing literature, the authors identified 29 recommended religious/spiritual psychotherapy behaviors and surveyed 96 psychologists regarding perceived importance and use of these behaviors. The most and least frequently endorsed behaviors were identified. The greater the practitioners' religious/spiritual self-identification, the more likely they were to report using these behaviors in psychotherapy. However, overall, and for 90% of the individual items, clinicians engaged in these religious/spiritual psychotherapy behaviors less frequently than their importance ratings suggested they should. Practice implications and suggestions for educators are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religious commitment and expectations about psychotherapy among Christian clients.

To assist psychotherapists in understanding client religiousness, Richards and Bergin (2005) have suggested assessing clients' religiousness at a broad level initially, using ecumenical measures, followed by a more detailed assessment that uses measures particular to the client's religious affiliation. In this study, the utility of this approach was tested in predicting expectations about psychotherapy of Christian clients (N = 176). Their religious commitment was considered in comparison to religious beliefs, attitudes, values, and behaviors. Client religiousness was positively associated with ratings of therapist expertise and attractiveness, desire to discuss religious issues in psychotherapy, and desire to see a Christian therapist. This suggests that assessing religious commitment is important, and that measuring religious beliefs, attitudes, values, and behaviors add accuracy to assessment. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Foreword.

Two years ago, the editors reasoned that the diverse and fundamental character of religious experience would promote an equally varied special issue devoted to the topic of psychotherapy and religion. We have not been disappointed. The papers composing this issue vary greatly in terms of literary style, research methodology, theoretical persuasion, and religious topics. There remains a need to clarify the extent to which religious issues or material that emerge during therapy need to be dealt with via "new" techniques (involving major modifications of classical techniques and ideologies) or via the classical methodologies, informed, perhaps, by expanded insights and perspectives. This issue is meant to be both current and historically representative. These two goals have not always been in agreement. The day of monolithic theories, presumed to address all matters of religious and psychotherapeutic importance, has passed, but not without leaving trails along which the present studies follow. Contemporary religious pluralism is more closely matched with the varied beliefs and problems of those seeking psychotherapy. This change has entailed a growing refinement in the psychological study of therapy and religious practice; it also implies a more astute and psychologically informed understanding of both the healthy and pathological aspects of religious experience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosis or Faith? Clinicians' Assessment of Religious Beliefs.

This study investigated mental health professionals' assessment of the pathognomonic significance of religious beliefs. A total of 110 participants reviewed 3 vignettes depicting individuals possessing the religious beliefs associated with Catholicism, Mormonism, and Nation of Islam. The religious beliefs of the individuals in the vignettes were identified as either being integral to a religious tradition or not and also as either resulting in a threat to harm another or not. Identifying beliefs as religious resulted in lower ratings of pathology for 2 of the religions, and beliefs that did not involve a threat to harm also were rated lower for the same 2 religions. The results reveal a disjuncture between recommendations of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) and clinicians' judgments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethical responses when patients' religious beliefs appear to harm their well-being.

Although religious affiliation is generally associated with good mental health, at times patients may present with religious beliefs that appear to harm their well-being or social functioning. On the one hand, it would appear that respect for the patient's religious traditions requires psychologists to refrain from challenging those problematic religious beliefs. On the other hand, the goal of promoting patient welfare requires psychologists to challenge those beliefs that appear to inhibit patient well-being. This article analyzes this apparent dichotomy and suggests ethically based responses consistent with good clinical care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reconsidering the sauce: A comment on Floyd.

Comments on the article Fundamentalism: Sauce for the goose by K. Floyd (see record 2007-09680-001). Floyd reminds us that the application of a little logic to the propositions we claim are true can sometimes show us that our beliefs are untenable, and that such a finding "could turn out to be very freeing indeed". In particular, he uses one of the arguments some of us struggled with the first time we met logic as a discipline: If P is true then Q is true. Q isn't true. Therefore, P isn't true. Floyd applies this principle to religious belief: If I believe that P is true and Q is true when in fact P implies that 0 is false then I am truly inconsistent! He also shows how easily we are willing to use such logic on the beliefs of others but not on our own beliefs. The current authors' attempt to demonstrate that Floyd makes several questionable steps in his reasoning, thereby calling into question the conclusions he draws. Floyd has sought to point out the lack of thought behind numerous religious beliefs. The current authors accept this general observation, but they believe it unfair to attribute this difficulty only to religious beliefs. The difficulty with religious beliefs is not that they are not concerned with truth vs. non-truth, but rather that for a number of reasons, the difference between these two poles is often not obvious. The question of the validity of religious beliefs is a philosophically spiny one that has been addressed, sometimes adequately and sometimes in very illogical, emotional and violent fashions, for thousands of years. It seems obvious to the authors that "three minutes thought" is not sufficient to untangle such an issue. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religiously integrated psychotherapy with Muslim clients: From research to practice.

In this paper, we attempt to translate empirical findings from a program of research that developed a Psychological Measure of Islamic Religiousness (PMIR) into practical clinical applications. The findings from this program of research are complemented and illuminated by findings from other empirical research and clinical work with Muslims. Our recommendations can be summarized as follows. First, clinicians should inquire directly about the place of religion in the lives of their Muslim clients. Second, mental health professionals should ask about what Islam means to their clients and educate themselves about basic Islamic beliefs and practices. Third, clinicians should help their Muslim clients draw on Islamic positive religious coping methods to deal with stressors. Fourth, we recommend that clinicians assess for religious struggles, normalize them, help clients find satisfying solutions to these struggles and, if appropriate, refer clients who struggle to a Muslim pastoral counselor or religious leader. Finally, in order to overcome stigma associated with mental health issues, mental health professionals should educate the Islamic public about psychology, psychopathology, and psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Finding meaning in religious practices: The relation between religious holiday rituals and marital satisfaction.

This study examined the relation between marital satisfaction and religious holiday ritual practices. 120 couples, married 9 years on average, completed measures of religious holiday practices (current family and family-of-origin) and marital satisfaction. Couples were interviewed about how important religion was to their family life. Marital satisfaction was related to religious holiday rituals beyond a global indication of religiousness. A different pattern was found for husbands and wives, with husbands' satisfaction more closely linked to ritual meaning and wives' satisfaction associated with routine practices. Family-of-origin rituals were connected across generations. Wives' marital satisfaction was related to husbands' report of religious holiday rituals but not the converse. Results are discussed in terms of how rituals affirm relationships, connect values and beliefs, and may have differential meaning for men and women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pentecostal perspectives on causes and cures of depression.

Religious beliefs about mental illness represent one potential influence on the choice to utilize or avoid professional help. For example, believing that devout spirituality assures mental health and/or that mental illness indicates spiritual failure may discourage religious individuals from seeking help. Such beliefs have traditionally been attributed to Pentecostals, but no research has assessed this assumption. This study examined Pentecostal perspectives on depression's causes and treatments. Contrary to the Pentecostal theological literature, participants endorsed a variety of causal factors. Regarding cures, however, faith was endorsed as the most effective option. Implications are provided and recommendations are offered to practitioners working with Pentecostals, including consultation and collaboration with clergy and religiously sensitive psychoeducational programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do we practice what we preach? An exploratory survey of multicultural psychotherapy competencies.

Practitioners are repeatedly encouraged to become multiculturally competent clinicians. But how frequently do professional psychologists intervene in multiculturally responsive ways, and how important do they think it is to do so? From the existing literature, the authors identified 52 recommended multicultural psychotherapy competencies and surveyed 149 professional psychologists regarding these practices and beliefs. Universal, infrequent, and not applicable practices were identified. Overall and for 86% of the individual items, participants did not practice what they preached. In addition, respondents reported that personal and professional experiences were most influential, and guidelines and codes least influential, in their development of multicultural competence. Five practice implications are offered, and suggestions for educators are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A postmodern reconstruction of psychotherapy: Orienteering, religion, and the healing of the soul.

In this article, psychotherapy is likened to conversational orienteering: helping others to understand the topography of meaning and goods "all around," and to find out where they are in the present, where they are going in the future, and directions for how to get there. Historically, religion has provided orienteering within a culture. The religious features of psychotherapy are discussed, and a case is made that modern psychotherapy is simply one form of religious orienteering that has been unusually successful in vying for therapeutic supremacy in 20th-century Western culture and, like modernism in general, unusually unaware of its religious function. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spiritually conscious psychological care.

There is increasing recognition of the importance of identifying and perhaps incorporating into psychological services the spiritual and religious beliefs and practices (SRBP) of patients. Research suggests that psychologists are reluctant to address the SRBP of their patients, because they are unsure how to do so without contravention of ethical standards. Moreover, numerous approaches have been published and promoted, and psychologists may feel overwhelmed by the profusion of advice. We organize the suggested approaches into four categories and place them on a continuum, and we discuss the ethical concerns related to each. At one end is spiritually avoidant care, which entails the attempt to avoid conversations with patients about their SRBP. Given the importance of these issues to psychological health and to understanding the patient, this approach is untenable. At the other end of the continuum, spiritually directive psychotherapy is characterized by an explicit attempt to maintain or change the SRBP of patients. Spiritually integrated psychotherapy entails utilizing SRBP to ameliorate patients' emotional distress. We suggest that psychologists should at least engage in spiritually conscious care, which we characterize as the explicit assessment of the general importance of SRBP to the patient, its influence on the presenting problem, and the potential of SRBP as a resource to help recovery. Specific suggestions are presented for how spiritually conscious care might be implemented. Finally, the need for better training in both basic and specific competencies needed to address patients' SRBP is reviewed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Levels of training to address religion in clincal practice.

Psychologists routinely work with clients who hold religious beliefs and values, yet there is often the question of whether psychologists are trained and competent to address religion as an aspect of diversity. How do training programs prepare psychologists to address this specific diversity issue? Do training programs equip psychologists to work effectively with religious clients? It is useful for psychologists to consider a 3-tier training system in religion and religious diversity that reflects a commitment to seeing religion as a meaningful expression of diversity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religious beliefs and political ideologies as predictors of psychotherapeutic orientations of clinical and counseling psychologists.

Examined the relations among religious beliefs, political ideologies, and psychotherapeutic orientations in 233 34-98 yr old clinical and counseling psychologists. A majority of the respondents affirmed having religious or spiritual beliefs and claimed that their religious beliefs influenced their practice of therapy. Most respondents labeled themselves as politically liberal, and almost half claimed that their political ideologies influenced their practice. The humanistic therapeutic orientation was positively related to Eastern and mystical beliefs, atheistic and agnostic beliefs, and political liberalism; the cognitive-behavioral orientation was positively related to conservative Christian beliefs; and the psychodynamic orientation was negatively related to Eastern and mystical beliefs and positively related to political liberalism. These findings are discussed in the contexts of the scientist practitioner model and postmodern, constructivist thought. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are religious beliefs relevant to mental health among Jews?

Although considerable evidence has linked religious beliefs to mental health among Protestant Christians, previous theory and research has emphasized that practices play a more important role than beliefs for Jews. Beliefs about God’s benevolence may be salient for Orthodox Jews, however, as such beliefs are central to traditional Jewish doctrine. Two studies were conducted to compare the extent to which religious beliefs predicted depression and anxiety for Orthodox Jews, non-Orthodox Jews, and Protestants. Results indicated that beliefs were salient for Orthodox Jews and Protestants, and less relevant for non-Orthodox Jews. Among Orthodox Jews, religious beliefs remained a significant predictor of anxiety and depression after controlling for religious practices. Implications for clinical treatment of Jewish individuals are explored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religion and spirituality.

We define religion and spirituality and discuss five scenarios in which they will probably emerge in psychotherapy. We review empirical research on religion and spirituality as they pertain to psychotherapy outcomes and relationships. Most research has been unsophisticated relative to the general status of psychotherapy research. Nonetheless, therapists are urged to assess for religion. and spirituality and, if possible, intervene in religiously and spiritually sensitive ways. Nine empirical studies of religiously accommodative Christian (n = 6) and Muslim (n = 3) psychotherapy have provided limited support for its efficacy, especially with depressed clients. Highly religious clients appear to desire therapy that respects (if not integrates) their religion, but research is unclear about the degree to which they can benefit from secular therapies, especially when they request religious therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Review of the Role of Religion and Spirituality in Chronic Pain Populations.

Objective: To review the current literature on the relation between religiosity-spirituality and health outcomes in chronic pain populations, to discuss the clinical implications of this research, and to provide suggestions for future studies. Conclusions: Additional religion-spirituality research and clinical intervention with chronic pain populations is warranted for several reasons. First, many persons with chronic pain use religious and spiritual beliefs and activities to cope with pain. Second, a relation between religion-spirituality and various health outcomes has been documented. Third, there is a lack of research on potential mediators of the relation between religion-spirituality and health in chronic pain populations. Fourth, well-designed spiritual or religious behavioral interventions for patients with chronic pain are sparse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religious ideology, a neglected variable.

Comments on an article by J. T. Jost (see record 2006-12925-001), which presented interesting data relating some personality dimensions to voting patterns in the last three U.S. presidential elections. R. K. Unger is surprised that in his extensive review of the role of ideology, Jost ignored the role of religious ideology in political attitudes and voting behavior. There is ample evidence that level of religious observance (sometimes labeled religiosity, hierarchical religious beliefs, or religious fundamentalism) played a role in 2004 and earlier presidential elections. The relationship between religious ideology and political attitudes is correlational, and one needs to look further for an explanation of their impact. A number of studies indicate relationships between religious fundamentalism and what Jost has termed "system-justifying ideologies." Unger suggests that religiosity has been largely ignored by psychologists interested in social and political behaviors. It is quite possible that religiosity is related to the various personality dimensions discussed by Jost. But we cannot learn more about these potential connections if we continue to ignore the importance of religious ideology as a psychological variable. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The use and abuse of religious beliefs in dividing and conquering between socially marginalized groups: The same-sex marriage debate.

This article discusses the use and abuse of religious beliefs and their role in divide-and-conquer strategies. Divide-and-conquer strategies are engaged to disrupt potential coalitions between and among marginalized group members, specifically sexual minority groups and people of color. Tensions between these groups have been exacerbated by the debate on same-sex marriage and comparisons between the discriminatory treatment of each group. A component of this discussion includes a brief exploration of one of the historical abuses of religious doctrine used to legitimize the marginalization of people of color and sexual minorities in the United States. For African Americans, one form of marginalization was reflected in criminalizing interracial marriage, and for members of sexual minority groups, a form of marginalization is denying group members the right to marry. The author also explores culturally competent and respectful disciplinary and clinical responses to religiously derived prejudice against sexual minority group members and people of color and discusses the implications for multicultural discourse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Can rational emotive behavior therapy (REBT) be effectively used with people who have devout beliefs in God and religion?

Several writers on religion and psychotherapy claim that people who follow a "loving God" model and who see God as a partner who works with them to resolve their problems are less emotionally disturbed and can benefit more from "rational" systems of therapy than religionists who have a more negative view of God. Some authors have specifically written that rational emotive behavior therapy (REBT) includes many religious philosophies and that the principles and practices of REBT are similar to those endorsed by certain kinds of devout religionists. In this article, the author describes the constructive philosophies of REBT and shows how they are similar to those of many religionists in regard to unconditional self-acceptance, high frustration tolerance, unconditional acceptance of others, the desire rather than the need for achievement and approval, and other mental health goals. It shows how REBT is compatible with some important religious views and can be used effectively with many clients who have absolutistic philosophies about God and religion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)