have noted the relevance of examining religious and spiritual issues as approached by the profession of psychology and, in particular, in respect to the practice of psychotherapy. This attention to religious and spiritual issues is based on an appreciation of the influential role religious beliefs, traditions and experiences serve in the lives of persons. Religious and spiritual dimensions are posited to be significant constituents of human experience and as such fall within the legitimate

We return in this closing chapter to the central question posed in the introduction: What is the influence of religion as a variable in mental health and psychological treatment? Broadly stated, the issue concerns the inclusion of religious issues in the clinical practice of psychology. Consideration of "inclusion" is crucial to this discussion because it defines the relationship between the science and profession of psychology and the domain of human experience referred to as religion. Furthermore, such a determination regarding inclusion establishes the parameters of treatment and standards of care, delimits the scope of legitimate psychological research and scholarship, and dictates the course of education and clinical training. It is our view that religious issues should be included within the clinical practice of psychology. We believe that this inclusion is justified in light of four interrelated factors: the professional ideal of cultural inclusion; the substantial evidence of religion as a cultural fact; the developing body of theoretical, clinical, and empirical research literature concerning religion as a variable in mental health; and the appreciation of psychological treatment as a value-based form of intervention. We conclude our discussion with an appraisal of current education and training respective of religious issues and suggest a model for training and future research.In positing that religion be included as a variable in psychological treatment, we are not issuing a universal statement regarding the positive 561

The results of the study suggest that religious activities and beliefs may be particularly compelling for persons who are experiencing more severe symptoms, and increased religious activity may be associated with reduced symptoms. Religion may serve as a pervasive and potentially effective method of coping for persons with mental illness, thus warranting its integration into psychiatric and psychological practice.

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Christian prayer is a central religious practice which has received scant attention in psychological research. The two major types of prayer are verbal and contemplative prayer. A review of the empirical studies of prayer suggests that the work done in this area can be divided into four categories: (a) developmental studies of conceptions of prayer; (b) research on motivations for praying; (c) studies of the effects of verbal prayer; and (d) studies of the effects of contemplative prayer. The studies on the development of the concept of prayer generally have found patterns consistent with Piaget's stages of moral and cognitive development. Regarding motives for prayer, Welford (1947) supported the hypothesis that prayer is not just a neurotic flight from anxiety. Elkins et al. (1979) found verbal prayer to be generally ineffective in anxiety reduction. Parker and St. Johns (1957) demonstrated that a program of spiritual development that includes verbal prayer can be effective as a therapeutic intervention. The findings of Sacks (1979) suggest that contemplative prayer may facilitate ego development. Opportunities for further research on prayer are discussed.