The Role of Religion in Counseling
As counseling psychologists we are expected to consider our clients from a holistic point of view. This essentially means that we need to distant yourselves from taking the reductionistic orientation of most medical thinking. Instead we ought to work on the assumption that starting from a particular initial condition different factors interact with each other thereby producing properties that are highly dependent on the individual person involved (Borrell-Carrió, Suchman, & Epstein, 2004). This perspective is referred to as the biopsychosocial model. Its founder, George Engel, described this approach to (mental) health as interactional and dynamic in nature (Engel, 1980).
Counseling based on a biopsychosocial formulation requires a complex assessment in which the psychologist needs to examine biological, psychological, and social factors influencing the client’s problem. See the article ‘A Method for Developing a Biopsychosocial Formulation’ by David Ross if you are looking for detailed suggestions on how to develop a sound biopsychosocial formulation.
When thinking about the biopsychosocial model and religion you might agree that religion can be a vital aspect of the client’s social and psychological identity that notably shapes his values, beliefs, and behaviors. Moreover, religion satisfies the instinctive human need for the meaning of experiences (i.e. the experience of health or illness) and the general purpose of life (Cook, Powell, & Sims, 2009; Park 2010).
Reasons for Integrating Religious Elements into Counseling
That said, recent scientific studies suggest that religious-accommodating approaches yield equal (Paukert et al., 2011) if not improved outcomes to counseling that places no focus to the religious identity of the client (Ripley et al., 2014). Frankly, those results are no surprise as by integrating religious elements, the counselor shows acceptance and respect for the religious client, which in return is likely to increase trust and elevate the therapeutic alliance.
Research also clearly demonstrates that religion can be an invaluable factor in the process of instilling and facilitating positive coping, psychological well-being, and resilience in religious clients (Brewer-Smyth, & Koenig, 2014; Faigin & Pargament, 2011; Blando, 2006; Koenig, 2001). Encouraging the client to conduct prayers, to engage in religious events, or to increase visits to the place of worship are all examples of religious elements that can be integrated into counseling to drive these processes.
Pitfalls of Integrating Religious Elements into Counseling
Regardless of the growing evidence supporting the integration of religious elements into counseling; it is no secret that the majority of psychotherapeutic schools of thoughts had been conceptualized by Western scholars (Basit & Hamid, 2010). As a consequence most approaches focus on the mainstream, white, Christian, Euro-American clientele (Beshai, Clark, & Dobson, 2013). Only a few counselors are, therefore, trained to work with religiously divergent clients. In addition to the lack of training there is a lack of knowledge. Competent religiously-sensitive counseling would require the counselor to get an in-depth understanding of the client’s religion and to respect the relevant religious concepts. Understanding and acceptance are key elements. Consider the following example:
A Muslim client sees a secular therapist as he wishes to become ‘normal’ and to no longer experience homosexual urges.
Knowledge about Islam allows the counselor to understand that homosexuality is forbidden in Islam. But if the secular counselor fails to respects the client’s view that homosexuality is a sin (consider that in most Western countries homosexuality is seen an accepted sexual orientation) and that homosexuality is a mental problem (consider homosexuality was no longer listed as a mental disorder as of the ICD-10; the APA removed homosexuality from the DSM even earlier in 1973) bias and tensions will arise and an ethical practice is no longer guaranteed.
Hence, caution must be paid as it is not clear how the constellation between religious client and conservative therapist, or vice versa impacts therapeutic results (Norcross, 2002). Moreover, not each and every client, who identifies himself as religious, wishes to incorporate or discuss religious elements within the context of counseling.
The recent study by Dr. Jennifer Ruff “Psychologist Bias in Implicit Responding to Religiously Divergent Nonpatient Targets and Explicit Responding to Religiously Divergent Patients” is a worthy read for all counseling psychologists who would like to provide competent culturally- and religiously sensitive therapy.
Applied Recommendations
Religion can help in facilitating positive change during the counseling process. But in order to ethically and competently apply religiously sensitive counseling, psychologists must display the proper knowledge and respect. This also involves a certain degree of critical self-reflection on how our very own religion and culture influences our behaviors and assumptions.
Then, in line with contemporary research findings counseling psychologists should discuss religion and the significance it holds to the client at an early point in the counseling process in order to set the proper course of treatment and to evaluate the possible involvement of religious elements.
References
- Basit, A., & Hamid, M. (2010). Mental health issues of Muslim Americans. The Journal Of IMA / Islamic Medical Association Of North America, 42(3), 106-110. doi:10.5915/42-3-5507
- Beshai, S., Clark, C., & Dobson, K. (2013). Conceptual and Pragmatic Considerations in the Use of Cognitive-Behavioral Therapy with Muslim Clients. Cognitive Therapy And Research, 37(1), 197-206.
- Blando, J. (2006). Spirituality, religion, and counseling. Counseling and Human Development, 39(2), 1.
- Borrell-Carrió, F., Suchman, A. L., & Epstein, R. M. (2004). The Biopsychosocial Model 25 Years Later: Principles, Practice, and Scientific Inquiry. Annals of Family Medicine, 2(6), 576–582. doi:10.1370/afm.245
- Brewer-Smyth, K., & Koenig, H. G. (2014). Could Spirituality and Religion Promote Stress Resilience in Survivors of Childhood Trauma? Issues In Mental Health Nursing, 35(4), 251-256. doi:10.3109/01612840.2013.873101
- Cook, C., Powell, A., & Sims, A. (2009). Spirituality and Psychiatry. London: Gaskell.
- Engel, G. (1980). The clinical application of the biopsychosocial model. Am J Psychiatry, (137), 535–544.
- Faigin, C., & Pargament, K. I. (2011). Strengthened by the Spirit: Religion, Spirituality, and Resilience Through Adulthood and Aging. Resilience In Aging, 163. doi:10.1007/978-1-4419-0232-0_11
- Koeing, H. G. (2001). Religion and medicine II: Religion, mental health, and related behaviors. International Journal of Psychiatry in Medicine, 31, 97–109. doi:10.2190/BK1B-18TR-X1NN-36GG.
- Norcross, J. C. (2002). Psychotherapy relationships that work [electronic book]: therapist contributions and responsiveness to patients / edited by John C. Norcross. New York: Oxford University Press, c2002.
- Park, C. L. (2010). Making sense of the meaning literature: An integrative review of meaning making and its effects on adjustment to stressful life events. Psychological Bulletin, 136(2): 257–301.
- Paukert, A. L., Phillips, L. L., Cully, J. A., Romero, C., & Stanley, M. A. (2011). Systematic review of the effects of religion-accommodative psychotherapy for depression and anxiety.Journal Of Contemporary Psychotherapy, 41(2), 99-108. doi:10.1007/s10879-010-9154-0
- Ripley, J. S., Leon, C., Worthington, E. r., Berry, J. W., Davis, E. B., Smith, A., & ... Sierra, T. (2014). Efficacy of religion-accommodative strategic hope-focused theory applied to couples therapy.Couple And Family Psychology: Research And Practice, 3(2), 83-98. doi:10.1037/cfp0000019
Sabrina Korsinek
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