Why Spirituality Belongs in Modern Therapy
The following post, adapted from an academic paper, explores the complex history and modern necessity of integrating spiritual and religious beliefs into therapeutic practice.
For centuries, mental health and spirituality had a positive working relationship, with religious institutions often caring for those with mental health issues. However, this relationship soured during the 17th and 18th centuries, with major psychological theorists like Freud portraying religion as an expression of neuroses and distress. While the fields are making strides to reconnect, spiritual and religious interventions are still rarely utilized in many therapeutic settings today.
Given that a vast majority of the general population—and an even higher percentage of those receiving psychotherapy—hold spiritual or religious beliefs, it is essential for clinicians to know how to provide these integrated services. This post will explore the importance of integrating a client's faith and spirituality into therapy to support their mental health and holistic well-being.
The Spectrum of Belief: Religion vs. Spirituality
While many use the terms interchangeably, religion and spirituality are two distinct constructs that can overlap or operate on their own.
Religion is defined as an "affiliation with an organization guided by shared beliefs and practices". It is something that is taught and can be physically read.
Spirituality is defined as "the journey people take to discover and realize their essential selves". It is an internal exploration to find connection, meaning, and transcendence.
A 2017 Pew Research Center survey highlights this diversity: 48% of U.S. adults identify as both religious and spiritual, 27% as spiritual but not religious, 6% as religious but not spiritual, and 18% as neither. Among mental health recipients, the numbers are even higher, with nearly 90% identifying with some form of spiritual or religious belief and practice (SRBP). In one study, over 80% of participants agreed that spirituality was important to their mental health.
The Importance of Spiritual Integration in Therapy
The American Psychiatric Association encourages clinicians to consider a patient's cultural and religious/spiritual ideas when making treatment decisions. Integrating SRBPs is crucial because they often form the foundation of a person's core values, influencing their lifestyle choices and behavior.
Research shows that religious youth are more likely to engage in manners that enhance their health and less likely to engage in maladaptive behaviors like substance use. As one researcher states, "A cure is the removal of symptoms. Healing is the healing of the whole person". Traditional Western psychotherapy tends to focus on external symptoms, but integrating a client's spiritual framework allows a therapist to address the whole person, conceptualizing symptoms through a different lens.
How Spiritual Interventions Work in Practice
When a client expresses a desire to incorporate their faith into treatment, a clinician can use a bio-psycho-social-spiritual model to assess their needs. Interventions can then be tailored to the client's specific beliefs.
Emotion Regulation: A person's SRBPs often influence how they regulate emotions. For example, Christians may be taught to control negative emotions, while Buddhists are taught to allow them to pass without judgment. A study found that clients who used emotion regulation strategies congruent with their Buddhist beliefs experienced a decrease in depressive symptoms.
Depression: At one spiritually integrated inpatient program, a study found that religious coping significantly decreased depressive symptoms from intake to discharge. 65% of participants said their spirituality helped them cope through practices, community, forgiveness, and belief.
Conduct Disorder: In a randomized controlled trial, spiritual psychotherapy was used to help adolescents with conduct disorder develop a secure attachment to God. The results found that the intervention significantly reduced the avoidant attachment styles often correlated with the disorder.
Nature-Based Spirituality: Experiencing spirituality through nature can lead to intense therapeutic outcomes. Nature-based therapy can help a client expand their perspective, feel a sense of universal belonging, and engage in quiet introspection.
Conclusion: My Own Experience
I received weekly spiritual psychotherapy for two and a half years. Through that experience, I not only addressed external symptoms like sadness and low self-worth but also gained wisdom, insight, and a deeper sense of connection with all beings. It was through that spiritual healing that I was able to create positive, sustainable changes in my life. While spiritual psychotherapy will not benefit every client, these concepts are extremely prevalent and should not be discouraged or minimized within clinical settings.
References
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American Psychological Association Committee on Religion, Spirituality and Psychiatry. (2006). Resource document on religious/spiritual commitments and psychiatric practice. American Psychological Association.
Dein, S. (2010). Religion, spirituality, and mental health. Psychiatric Times.
Idler, E. (2008). The psychological benefits of spiritual/religious practices. Spirituality in Higher Education Newsletter, 4(2).
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Lipka, M. & Gecewicz, C. (2017). More americans now say they're spiritual but not religious. Pew Research Center.
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Rothman, A. & Coyle, A. (2020). Conceptualizing an islamic psychotherapy: A grounded theory study. Spirituality in Clinical Practice.
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Yamada, A., Lukoff, D., Lim, C.F., & Mancuso, L.L. (2020). Integrating spirituality and mental health: Perspectives of adults receiving public mental health services in California. Psychology of Religion and Spirituality, 12(3), 276-287.
