Doctrinal dialogues: factors influencing client willingness to discuss religious beliefs

Abstract

Religious beliefs are an important part of daily life for many individuals; however, these beliefs are often not discussed in therapy settings. As a result, clients and clinicians may encounter barriers to treatment and be unable to harness potentially beneficial aspects of the religious belief system. The current study investigated factors influencing client willingness to discuss religious beliefs with a therapist, with the factors of interest being perceived clinician cultural humility (PCH), religious outlier status (ROS), and religious commitment (RC). Participants in the current study (N = 535) completed measures assessing RC and ROS and viewed a five-minute clip depicting a therapy session in which the clinician was either high or low in cultural humility. They then rated their perceptions of clinician cultural humility and their willingness to discuss religious beliefs with the therapist depicted in the clip. It was predicted that PCH, ROS, and RC would each separately predict willingness to discuss and would significantly contribute to a full three-factor regression model. PCH was expected to be the strongest predictor in the full model, and significant interactions were expected between PCH and ROS and between PCH and RC. Results demonstrated that PCH and ROS significantly predicted willingness to discuss when considered separately, while RC did not. In the full model, PCH was both the strongest predictor and the only significant predictor, accounting for 36% of the variance in willingness to discuss. These results emphasize the importance of clinician cultural humility in establishing an open therapeutic environment. Moreover, they suggest that clients are more willing to discuss their religious beliefs with a clinician who is high in cultural humility than one who is not, regardless of more stable client factors such as religious commitment and religious outlier status. These findings have implications for training and clinical practice, as they suggest that cultural CLIENT RELIGIOUS BELIEFS Judd, Katherine, 2017, UMSL, p.3 humility may be more important than cultural competence in some therapy situations, particularly when working with religious clients.

Cultural humility in psychotherapy and clinical supervision: A research review

“…Client-perceived therapist cultural humility was linked to positive working alliances, therapy continuance, expected treatment effectiveness (Hook et al, 2013), positive treatment outcomes (Kivlighan et al, 2019;Owen et al, 2014Owen et al, , 2016, higher psychotherapist competence ratings (DeBlaere et al, 2019), lower frequency and lower impact of racial microaggressions (Hook et al, 2016), lower colourblind racial attitudes (Haywood Stewart, 2019), greater prosocial justice advocacy attitudes (Chase, 2021) and willingness to disclose and discuss one's religious beliefs (Judd, 2017). Conversely, lack of participant-perceived therapist cultural humility was associated with weaker working alliances and more therapeutic ruptures (Davis et al, 2016).…”

Religious microaggressions in psychotherapy: A mixed methods examination of client perspectives.

“…Further, therapists could combat assumptions of religious homogeneity by acknowledging the variability within religious groups and exploring the connections between clients’ beliefs and presenting concerns in a curious, open manner. Indeed, therapist demonstrations of cultural humility, such as comments showing openness and acceptance, were associated with a lower frequency of microaggressions in psychotherapy (Hook et al, 2016) and led to greater client willingness to discuss religion (Judd, 2019), which could create opportunities to leverage their beliefs in treatment.…”

Integrating spirituality as a multicultural component into time-limited psychotherapy: Two case studies.

“…Third, the way the therapist delivered the intervention may have impacted the client’s perception of the therapist’s humility. Judd (2019) found clients only brought up R/S issues in psychotherapy if they perceived their therapists to be culturally humble. While we did not ask Emily or Rachel to rate Brad or Julie’s cultural humility, the fact that both clients engaged their therapists on R/S issues suggests that they found their therapists culturally humble; this is consistent with their overall high alliance and outcome scores by the end of treatment and prior findings suggesting an association between cultural humility related to R/S and client outcomes (Owen et al, 2014).…”

“…Namely, when clients saw their therapist as culturally humble in regard to their religious/spiritual identity, they also reported a stronger therapy alliance therapeutic alliance and better client outcomes (Owen et al, 2014). Judd (2019) found that participants reported being more likely to bring up R/S issues with a therapist if they perceived the therapist to be high on cultural humility, suggesting that a humble stance in session may lead to client-initiated cultural opportunities. Finally, a qualitative study investigating religious clients’ perceptions of secular therapy found that clients felt reassured about their treatment effectiveness when their therapist demonstrated an openness (i.e., comfort) to discuss R/S issues and felt more distressed when therapists ignored client prompts to discuss R/S issues (i.e., missed cultural opportunity; Mayers et al, 2007).…”