Degree In Sight

A recent Gallup poll found that 84 percent of Americans say religion or spirituality is an important part of their lives. And, when it comes to working with a therapist, people with strong spiritual or religious beliefs prefer to work with someone who will integrate their beliefs and values in therapy, according to a recent study in APA's Professional Psychology: Research and Practice (Vol. 37, No. 3, pages 303-310).

But if your program is like most psychology programs, it hasn't taught you much about addressing religion in therapy. According to a 2002 study in Professional Psychology: Research and Practice (Vol. 33, No. 2, pages 203-206), only 13 percent of a representative sample of graduate programs included coursework addressing religion and psychology.

That's a significant problem, says Bowling Green State University professor Kenneth Pargament, PhD, because, "for many people, religion is one of the biggest ways they cope." Indeed, 50 percent of respondents in a 2004 survey by the National Opinion Research Center said that their religion or spirituality provided them comfort at least once a day. Meanwhile, only about 11 percent said they find comfort "once in awhile" and about 10 percent said "never or almost never."

In his private practice, Pargament has found that reminding religious clients of the resources that have helped them previously--whether they be a formal observance such as going to a church, synagogue or other place of worship, or informal methods such as meditation--can help enhance their progress.

In fact, not understanding a client's religious background can lead to misunderstandings, such as asking a person to do something that is against his or her beliefs, says William Hathaway, PhD, head of an APA Div. 36 (Psychology of Religion) working group that is developing practice guidelines for religion.

Some practices may even seem strange or troubling out of the context of a client's faith, Hathaway adds. To help psychologists with that context, Hathaway and the group started working on the guidelines-which are modeled after APA's diversity guidelines--in 2003 and hope to get them to APA's Council of Representatives for consideration in 2009.

So--regardless of whether you consider yourself religious--how can you prepare for treating religiously diverse clients? A few tips:

  • Overcome "religious myopia." Pargament says that a frequent mistake practitioners make is to misattribute religious problems-such as a crisis of faith or guilt over not following religious values-to other causes such as family or work. For example, marital conflicts about other issues are often rooted in religious differences, he adds. It's also important to understand how a client's religion or spirituality affects his or her daily life, says Edward Shafranske, PhD, a psychology professor at Pepperdine University who has studied religion and psychology. Is it a positive or negative force? Does it give them hope? Or are they weighed down by sense of guilt? Discussing a client's religious beliefs may also bring negative coping skills to light, says Pargament. Sometimes clients may pray for a miracle when they really need human intervention-such as a woman who finds a lump in her breast and prays for it to go away instead of praying and going to the doctor, he explains.

  • Teach yourself. Seek out information on your own, whether through extra classes such as a basic introduction to religion, workshops or just talking to psychologists who have worked with religious clients or study religion and psychology, says Patrick Bennett, PhD, a social psychologist who does research on religion at Indiana State University. Pargament suggests visiting churches, synagogues and mosques to talk to congregants and get an idea of what the services are like. APA also offers resources: Div. 36 publishes articles in its quarterly newsletter Psychology of Religion and sponsors APA convention presentations and occasional research conferences, says Shafranske. For more, see the division's Web site at www.apa.org/divisions/div36. There are also videos and books for psycyhologists, he adds (see box).

  • Break through bias. You may have more in common with your religious client than you think. "Whether we are explicitly religious or not, each of us is trying to make sense of our world and asking ourselves ontological questions such as 'What is the meaning of life?'" argues Shafranske. His research has found that statistics indicating that psychologists are less religious than the general population don't tell the whole story. Although psychologists are less likely to participate in organized religion than the general public, many find spirituality to be personally relevant, he found in a 2000 study published in Psychiatric Annals (Vol. 30, No. 8, pages 525-532).

  • Recognize when you need help. You are not your client's religious adviser, emphasizes Shafranske. If you feel like you need an additional perspective, try consulting someone--without breaking confidentiality--who is more familiar with your client's religious practices, he adds. With your client's permission, you may also want to work with his or her priest, rabbi, pastor or imam to address religious issues, says Bennett. After all, the patient's religious community is often an important source of social support, adds Hathaway. For example, enlisting the help of the religious community could help a bereaved client having trouble going on with his or her life reengage, he notes.

And like any other personal issue or set of beliefs, if you honestly cannot remain objective with your religious client, refer him or her to another practitioner, agree experts.

Further resources

  • APA Psychotherapy Videotape Series—Spirituality

  • Richards, P.S., & Bergin, A.E., (Eds.). (1999). Handbook of psychotherapy and religious diversity. Washington, DC: American Psychological Association.

  • Richards, P.S., & Bergin, A.E., (Eds.). (2003). Casebook for a spiritual strategy in counseling and psychotherapy. Washington, DC: American Psychological Association.

  • Richards, P.S., & Bergin, A.E. (2005). A spiritual strategy in counseling and psychotherapy. (2nd ed.). Washington, DC: American Psychological Association.

  • Spilka, B., Jr., Hood, R.W., Hunsberger, B., & Gorsuch, R. (2003). The psychology of religion: An empirical approach. (3rd ed.). New York, NY: Guilford Press.