The Spiritual Therapist: Navigating Boundaries, Collaboration, and Access

Can a therapist also be a spiritual guide? This is a question I wrestle with often.

In the mental health field, we are trained to stay in our lane. We collaborate with doctors for physical health and probation officers for legal issues. But until recently, I hadn't given enough thought to collaborating with clergy members and spiritual teachers.

If we view a client holistically, these spiritual leaders are just as vital to the treatment team as a psychiatrist. They can ensure the client receives the best outcome by addressing the soul in ways a standard clinician cannot.

The Ethics of "Spiritual Therapy"

I have a vision for my future practice: I want to provide Spiritual Therapy, helping clients find psychological healing while simultaneously ascending in their spiritual journey.

However, reading the ethical guidelines initially discouraged me. Vieten & Scammell (2015) state that unless you are a trained clergy member, you must operate within your professional boundaries. I felt a moment of panic—is my dream practice unethical?

But there is a caveat: You can practice this way if you are specifically trained and openly advertise your services as spiritually oriented. Transparency is key. This was a relief for my private practice plans, but it raised a troubling systemic question.

The Access Gap

If spiritual therapy relies on "openly advertising" as a niche service, what happens to low-income families?

Clients at community mental health clinics rarely get to choose a "spiritually oriented" therapist. Agencies don't typically operate in that fashion. This suggests a significant gap in care: wealthy clients can pay for holistic, spiritual integration, while low-income clients may be left with a strictly secular model that ignores a massive part of their identity.

A Look at the Data

Curious about how other professionals feel, I looked at the 2015 APA Survey of Psychology Health Service Providers.

I anticipated that competency regarding religious clients would be low. Surprisingly, psychologists rated themselves as more competent with religious clients than with military or rural populations. This is promising, but it leaves me wondering: Are they truly competent in spiritual integration, or just comfortable with the topic of religion?