What Behavioral Health Workers Need to Know About Spirituality

by Mary Peterson, PhD, ABPP

The integration of psychology and spirituality has been a topic of debate in the field of behavioral health. While some clinicians believe that religion and spirituality have no place in therapy, others argue that a client’s beliefs and practices can be important in their healing process.

In this article, we’ll explore the benefits and challenges of integrating spirituality into behavioral health work and offer practical tips for clinicians to navigate this sensitive topic.

Why is it important for behavioral health professionals to be able to discuss spirituality, faith and religion with their clients?

It’s simple: Most people consider matters of spirituality, faith and religion to be important, and that’s why behavioral health professionals such as counselors, social workers and psychologists need to be conversant with these topics. According to a 2017 survey by the Pew Research Center, 82% of Americans describe themselves as religious, spiritual or both.

For those who find comfort and affirmation in their spiritual practices, religion or spirituality can have a positive impact on their well-being.

It can be beneficial to participate in a faith community that supports their cultural identity and expresses their culture and faith through shared traditions and care for the community. Support from their faith community can also help people get through tough times. On the other hand, if a person’s religious or spiritual history has been hurtful or traumatizing, they may need to process that in therapy.

A behavioral health professional’s job is to identify how a faith community or spiritual practices either can be a source of strength and support or an area of pain or struggle that may need to be addressed.

In spite of this, many behavioral health workers are hesitant to talk about religion or spirituality with their clients, and they may not have training in this area, even though it can lead to improved mental health and overall health.

Why social workers aren’t discussing religion, spirituality with clients (2015)

What should behavioral health workers know about spirituality in order to be effective?

To start, it's important to recognize that spirituality is a significant aspect of many clients' lives, and it's therefore essential for behavioral health workers to be trained to address it. In George Fox University's counseling, social work and psychology programs, we teach students a few critical things to keep in mind when working with clients' spirituality.

First, while having some knowledge about various religions might be useful, it’s more important to maintain a respectful curiosity when clients share their religious and spiritual practices. Behavioral health practitioners understand that everyone is different. Staying curious allows your client to explain how they may be similar to or different from other people with a similar belief system. Instead of focusing only on the content of their beliefs, it's important to listen for how those beliefs affect their daily life.

Second, behavioral health workers should explore how important the client’s spiritual identity is in comparison to the other parts of their identity. For example, how important is it to them to adhere to the norms of their religious community? If living according to those norms and expectations is a priority, then it's likely to influence other important life decisions such as who they marry, their lifestyle, or even their choice of career.

As an example, a George Fox University student was working with a Japanese woman with a cultural-religious context of Shintoism, which emphasizes respect and reverence for ancestors and elders. The woman came to therapy due to a conflict with her partner, who didn’t understand her desire to have her mother move from Japan to live with them. The woman had previously been to therapy because of this issue, but she was counseled to work on “individuation and autonomy.” However, this approach only served to increase the woman’s internal conflict.

By understanding and learning more about her deeply held religious and cultural values, the student was able to help the client develop strategies to honor her mother and ancestors and also open up more to her partner about why it was essential for her to live in alignment with her beliefs.

Finally, it’s important for behavioral health providers to understand how spiritual and religious beliefs may have impacted their client’s sense of self. For instance, if a client was raised in a religious or spiritual culture that was shaming, they may experience excessive guilt or shame. On the other hand, if their spiritual community or practices emphasized forgiveness, self-compassion and grace, they may find it easier to forgive themselves or others.

How does a behavioral health worker's own religion or spirituality affect their work with clients?

When working with clients, your own religion or spirituality can affect how you approach this topic.

The first step is to assess your own comfort level in discussing your own religious or spiritual practices. Although you won't share your personal background with your clients, your comfort with your own religion or spirituality may parallel how comfortable you are with discussing your clients' spirituality. If you were raised to believe that talking about religion was taboo, then you may be tempted to overlook that aspect of your client’s life simply because it wasn’t something you thought was relevant or appropriate to explore.

Once you’ve determined how comfortable you are talking about your own beliefs, it’s important to recognize your own bias.

All of us have implicit biases that come from our culture and experiences. Bias can be positive or negative and can cause us to view religion and spirituality as either a protective factor or a risk factor. At George Fox University, we encourage students to consider what biases they have toward certain religious practices or groups.

For example, a number of religions have gender-role expectations. One student realized she thought some religious groups were patriarchal because they encouraged women to focus on the home and family instead of a career. By recognizing her own bias, the student was able to put it aside and focus on her female client's experience. In supervision, she was able to explore how those religious beliefs impacted her client and found that the client had a different perspective: She appreciated and felt supported by the norms of her religious community.

This example could have just as easily been the reverse – a female client seeking out a therapist because she doesn’t want to conform to the religious expectations of her community and wants to leave. In either case, it’s important for the psychologist, counselor or social worker to be comfortable talking about these matters and to check their biases. Being aware of our biases helps us avoid being hijacked by our worldview and allows us to focus on what's best for our clients.

As you continue to focus on your client, you'll start to see how their religious or spiritual practices may help them cope with challenging experiences. For example, if someone finds comfort in meditation, you might suggest it as a way to manage stress. On the other hand, if someone presents with depression and has withdrawn from other people, you may want to explore whether re-engaging with a former or new spiritual community may be helpful.

The ideas listed here are building blocks for understanding how to work with the spiritual or religious identities of clients. First, we have to be comfortable even exploring the topic with clients. Then, we need to be aware of our biases. Finally, we can consider if and how to include a client's beliefs or practices as part of an integrated treatment plan.

In Conclusion

Psychologists Megan Neff and Mark McMinn, in their piece “Embodying integration: A Fresh Look at Christianity in the Therapy Room” (2020), suggest that integrating psychology and faith opens the door for us to probe the depths of what it means to be human, from the experience of suffering to the experience of life’s joys. Being present for our client's deepest questions about life and understanding their spirituality enables us to walk alongside them as they navigate life’s challenges.