Integrating Spirituality Into Clinical Practice

Politics. Money. Religion. We are often discouraged to bring up these three topics in everyday conversation, as they are considered highly controversial issues in our society. Despite the fact that religion, faith, and/or spirituality are an important part of most Americans’ lives, religion has not always been viewed in a positive light within the field of psychology, and key figures in the field have expressed differing opinions about spirituality. Freud and Skinner, for example, questioned the value of religion or criticized it as harmful, while others like James and Jung held more positive, hopeful views. In recent decades, more contemporary psychologists have valued the role of religion in people’s lives, and the interest in the relationship between spirituality and psychotherapy has grown rapidly in the last 20 years. This shift is consistent with current research, which indicates a positive association between religious practice and mental health, recovery from mental and physical illness, subjective well being, and marital satisfaction.

Moreover, psychology professionals have begun to consider the ability to work with client’s religious and spiritual beliefs a form of cultural competency. Not only is it important to learn about client’s ethnicity, language, race, age, sexuality, and past history, it is equally valuable to understand an individual’s relationship with religion and how she/he experiences spirituality. Unfortunately, studies show a trend indicating that many clinicians are not comfortable exploring such areas while conducting therapy, since therapists receive no or minimal training, supervision, and coursework that present spirituality as an important element in therapy. Spirituality can manifest in people’s lives, and hence in the therapy room, in a variety of ways. Many people who seek help for physical, emotional/psychological, or interpersonal problems are also experiencing spiritual distress. In some cases, devastating events can bring one’s faith into question and even alienate some from their faith. In yet other instances, religious values can become too rigid, resulting in a punitive, harmful experience by the believer. However, spirituality can also be a source of incredible healing power form which individuals draw strength, inspiration, and meaning. As others in the field have suggested, most people across faiths consider their spiritual beliefs to bring them closer to loved ones, solve problems, respect themselves and others, refrain from doing undesirable things, help others in need, and find healing. Spirituality offers options for solutions to clients’ struggles. It also facilitates finding meaning in the human experience, as well as offers answers to often difficult conundrums. In addition, studies have asserted that spirituality provides motivation to remain committed to love in the face of a partner’s flaws; it gives purpose and significance to the passing of a loved one; and that spirituality offers a consistent morality that can serve as a stabilizing guide to those facing difficult circumstances.

Spiritual expression can be seen in many different forms, through religious as well as secular practices. Personal faith may involve belief in a higher power, a divine spirit dwelling in all things living, or an ultimate human connection for which we strive. While religious spirituality may involve attending a church/temple/sanctuary, praying, ceremonial milestones, rituals, etc., atheist/agnostic practices often include meditation, creative arts, chanting, a connection with nature, social activism, and interpersonal bonds.

While incorporating spirituality into clinical practice can enhance therapy, there are some precautions of which therapists who wish to do so must be aware, such as exploring our own spirituality and creating an open and safe space for spiritual discussions. Also, it is important to refer clients when appropriate, and to be careful about imposing one’s own beliefs and values or simply ignoring the client’s beliefs. In addition to respecting every client’s particular ethnic, cultural, and religious practices, we as therapists can expand our own knowledge by seeking training and doing further research. These steps will be key in assuring an adequate level of competence. It is critical not to make assumptions about clients’ spirituality, religious identification, upbringing, or community affiliation. Instead, we ought to strive to understand the individual experience of a client’s spirituality. In doing so, studies have suggested some guidelines: to respectfully inquire about the meaning of spiritual practices in clients’ lives, particularly as they relate to the presenting problem(s); explore religious/spiritual beliefs that may contribute to an individual’s suffering; facilitate understanding and mutual respect among families and couples facing spiritual conflicts; and identify different resources to increase resilience and facilitate healing.

Research demonstrates that secular, as well as religious counselors are integrating a spiritual element into therapy. The approaches can range form implicit to explicit integration. Implicit integration may occur when a counselor’s views and interventions are influenced by her own spiritual beliefs, yet they are not discussed with the client. A clinician may also engage in prayer and/or meditation prior to sessions. During explicit integration, on the other hand, the clinician may openly address a client’s spiritual beliefs, discuss spirituality as an element in the therapeutic process, or use overt spiritual tools such as prayer and meditation with her client.

Given the new trends, social changes, and increasing openness of both clients and therapists to integrate religious/spirituality elements into the therapeutic process, the field of mental health must continue to adapt and incorporate spiritual elements into both therapeutic interventions, as well as clinical training programs. While many clinicians recognize the need to delve into issues of spirituality and religion as part of clients’ presenting circumstances, we don’t always know how to do so in a way that is supportive and nonjudgmental. In light of widespread racism, faith intolerance, and mass discrimination inside and outside our country, it is imperative that we as clinicians equip ourselves with the tools and skills to engage in courageous conversations about such issues that affect all of us. Mental health professionals face an ongoing responsibility to make clinically appropriate decisions that serve our clients and enhance the therapeutic process. However, clinicians may struggle to balance our clinical judgment with newly emerging ethical, social, and moral responsibilities that arise as society continues to become segmented by ideological differences.

Karyn Maczka, MA, MFTI.
Registered Marriage and Family Therapist Intern #81717
[email protected] Ph: (858) 761-7121