Understanding Preferences for Addressing Spirituality Among Adults Seeking Outpatient Mental Health Care

Abstract

Focusing on 472 religiously heterogenous adult patients seeking psychotherapy at a university-based outpatient clinic, this brief report examined (1) these patients' preferences about clinicians appreciating their religion and/or spirituality (R/S) backgrounds (spiritually affirming) and addressing spiritual concerns in treatment (spiritually integrated) and (2) role of demographic factors and psychological functioning in predicting preferences for R/S integration. Analyses revealed that more than half of patients reported moderate or greater importance for spiritually affirming care and one-third hoped to address spiritual issues. Furthermore, these factors emerged as indicators of stronger preferences for R/S integration: female sex, racial minority status (African American, Native American), history of marriage (past and present), affiliation to organized religion (Christianity, Islam), and importance placed on R/S. In general, findings suggest that most patients seeking psychotherapy in a university-based clinic in southern Alabama might desire a spiritually affirming approach, and a smaller subset prefer an approach in which R/S is integrated into treatment.

A practice‐based evidence investigation of God representations in spiritually integrated psychotherapies

“…Drawing on a PBE design with clinicians practicing SIPs in a mid‐sized city on the US Gulf Coast, nearly twothirds of the client sample exceeded the clinical threshold for psychological distress on the CORE‐10 at the first session. Consistent with findings about clients' preferences for clinicians to tailor treatment activities according to their sacred beliefs, practices, and/or relationships (Currier et al, 2020; Rose et al, 2001; Rosmarin et al, 2015), nearly the entirety of the sample wished to discuss issues related to R/S and were willing to receive suggestions of a religious or spiritual nature from the clinicians. Furthermore, in keeping with the emotional burden of struggles with R/S, over onethird of clients reported religion had hurt them or contributed to some of the challenges in their lives at the first session.…”

“…Like other religions, Christian beliefs, practices, and/or relationships may shape understandings of sacredness in life as well as offer pathways to deepening a connection with transcendent reality in a manner that also influences preferences for mental health care (Pargament, 2013). Particularly when religious faith and/or spirituality (R/S) is highly valued, research suggests clients generally desire clinicians to respect and incorporate this cultural domain in psychotherapy (Currier et al, 2020; Rose et al, 2001; Rosmarin et al, 2015). Furthermore, evidence affirms that therapies addressing spiritual perspectives or content in a culturally congruent way (termed “spiritually integrated psychotherapies” [SIPs]) usually yield equivalent or better outcomes compared with nonintegrated approaches (for reviews, see Anderson et al, 2015; Captari et al, 2018; Gonçalves et al, 2015).…”

Enhancing competencies for the ethical integration of religion and spirituality in psychological services.

“…Instead, clinicians should clearly discuss ways of incorporating R/S in the treatment process and goals; having these conversations might strengthen the therapeutic alliance and set expectations for safety, trust, collaboration, and reciprocal feedback. In doing so, clinicians should not be surprised when religious patients do not wish to discuss the role of R/S in their suffering or recovery (Currier et al, 2020; Rosmarin et al, 2015). In such cases, the occurrence of emotionally painful symptoms can lead to struggles with R/S (Bockrath et al, 2021).…”

“…Spiritually integrated care has also become a vital aspect of effective practice within the evidence-based practice movement. Beyond the sheer prevalence of R/S among U.S. adults (Gallup, 2020; Pew Research Center, 2015), studies have consistently found most clients prefer clinicians to discuss R/S beliefs, practices, or relationships in mental health care (Abernethy et al, 2021; Currier et al, 2020; Oxhandler et al, 2021; Rosmarin et al, 2015). Further, longitudinal studies affirmed the role of communal (e.g., service attendance) and individual (e.g., prayer) aspects of R/S in preventing the onset of mental health disorders and supporting recovery and growth when they occur (Koenig et al, 2012).…”

Religiousness, meaning, and quality of life: Test of a mediational model among adults seeking a spiritually integrated inpatient program

“…Future research will also ideally illuminate best practice guidelines for addressing religious faith and/or spirituality at varying levels of mental healthcare in a manner that supports meaning making and QOL and applies to religiously and therapeutically diverse settings. Indeed, findings from other psychiatric inpatient programs (Rosmarin et al, 2015) as well as outpatient settings (Currier et al, 2020) indicate most individuals who seek mental health treatments are interested in tailoring their care according to sacred beliefs, values, and relationships in their lives. With the exception of the American Counseling Association (Association for Spiritual, Ethical, and Religious Values in Counseling, 2009), none of the major organizations for mental health professions in the U.S. have established competencies for addressing religion and/spirituality in clinical practice.…”