Spirituality and religiosity (S/R) have long been a complex and often controversial topic in the field of psychotherapy. Although many clients express interest in incorporating spiritual and religious elements into the therapeutic process, therapists often face challenges related to inadequate education and training, ethical issues, and historical tensions between science and religion. Religiosity and spirituality are usually an essential part of a person's identity, values, and worldview, and therefore potentially problematic to omit from therapy. However, their inclusion in practice is burdened by concerns about inappropriately influencing clients or misinterpreting their S/R values. Therefore, the team of authors from FSS MU decided to create a summary of findings from available qualitative studies dealing with how psychotherapists experience S/R in the process of psychotherapy.
The authors of the study, Katarína Heřmánková and Tomáš Řiháček from INPSY/Center for Psychotherapy Research, together with Veronika Gocieková from the Department of Psychology, Faculty of Psychology, MUNI, decided to summarize the findings from 52 qualitative studies focusing on therapists' experiences with the inclusion of S/R in psychotherapy. Using qualitative meta-analysis, they created an overview of themes that emerge from the combination of psychotherapy and S/R topics. The analysis included data from a variety of cultural and religious contexts, allowing for a comprehensive picture of the issues.
The authors identified 11 key themes, which were grouped under three main headings:
1. The relationship between S/R and therapist professional identity
Therapists reported that their own spiritual or religious values often influence their approach to clients. However, if therapists were able to reconcile their professional identity with their S/R beliefs, they perceived this as a great supportive factor. The authors point out that therapists often perceive their own spirituality as a source of support and inspiration that allows them to be more empathetic and more focused on the client's values and beliefs. However, therapists in the meta-analysis additionally mentioned a fear of unethicality as a result of imposing their own values on their clients.
2. Inclusion of S/R topics in the therapy session
The results of the study indicate that therapists use both implicit and explicit integration of S/R themes into the course of psychotherapy.
- The implicit approach is more covert and depends on the therapist's personal experience, beliefs, and practice. It may manifest itself, for example, as respect and recognition of the importance of the client's spiritual experience.
- On the other hand, in explicit integration, the therapist actively uses S/R interventions such as prayer or Bible reading. In general, however, the topic of integrating S/R into the therapeutic process is viewed by therapists as complex and its appropriateness depends on the context, the therapist's psychotherapeutic approach, and the client's preferences or order.
3. Lack of education, training and support in S/R topics
The study highlights that many therapists do not have adequate education and training on how to work with S/R topics. As a result, therapists reported that they did not feel competent and confident enough to address these topics in therapy.
Summary and recommendations for future research
This study shows that S/Rs play an important role in psychotherapy, both for clients and therapists. According to the results of the meta-analysis, therapists are advised to reflect on their S/R identity and become aware of the role it may play in the therapeutic process. Furthermore, according to the authors, it is advisable not to omit the topic of S/R from psychotherapy and to adapt the course of therapy accordingly. The authors also emphasize the importance of including the topic of S/R in training programs and recommend more support for therapists struggling with this topic in sessions. They also point to the need for further research to address the negative effects of S/R integration and to extend the findings to other cultural contexts. However, the results of the study offer valuable insight into ways to better tailor therapy to the individual needs of clients and thus contribute to their mental well-being.
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Recommended Citation:
Heřmánková, K., Řiháček, T., & Gocieková, V. (2024). Psychotherapists' experience with spirituality and religiousness in psychotherapy: A qualitative meta-analysis. Journal of Psychotherapy Integration. Advance online publication. https://doi.org/10.1037/int0000338
