Spirituality and religion in psychotherapy

Twenty-seven clinicians in private practice were interviewed about how religion and spirituality interface with psychotherapy. Transcripts of unstructured interviews were subjected to a grounded theory analysis. Two categories emerged. The first category is the more problematic and contradictory one. It presents religion as a professional challenge. Therapists must respect client religion as a dimension of client identity, but also tackle clients' religious issues when needed. They must recognize when religious behavior is a source of distress and be able to understand the religious context of client problem behavior. And finally, they must be wary of how their own religious background may influence their attitudes in session. The second category presents the distinct contributions of religion and spirituality. It depicts religion as a clearing house for problem solving tools, providing cultural resources, healthy activities, wise teachings and social support. Spirituality provides a distanced perspective that allows seeing problems in a broader picture, which helps to access alternative meanings and solutions. Therapists saw client religion and spirituality both as daily life tools and as therapeutic aids. The clinicians' own spirituality also served as an asset in improving their interventions and coping with the emotional strains of their work with clients. Applied to practice, the model can help clinicians understand and come to grips with the complexity of religious cultural competence issues. It also helps separate the contributions of spirituality from those of religion and use their different potentials according to specific client needs.