Religion, Faith, and Spiritual Integration in Therapy

You may be wondering about the role of religion in therapy.

The reality is, religion, faith, and spirituality are essential sources of strength for many clients. A therapist’s sensitivity and willingness to integrate and acknowledge the client’s faith and religious beliefs into the therapeutic process helps clients to trust the therapist.

Stop for a moment and picture yourself at your office with a new client.

You’re finishing up your initial intake session. As you’re wrapping up, you ask the client if there is anything else you should know about them, and the client responds, “Yes.” 

The client says they are a conservative, evangelical Christian and that their faith is a very important part of their life. They tell you that they would like to engage in therapy with you in a way that’s not only welcoming of their belief system, but is also integrative of their holy scriptures and prayers. 

Sit with this scenario.

What does this bring up for you?

What’s your response, and how would you work with this client?

If you’re like many therapists, this can be an uncomfortable moment — even though the experience of this client, and their desire to integrate their beliefs into therapy, isn’t an unusual one. 

Understanding the Scope of Religion in America

In a Gallup poll from 2021, 76% of people polled in the United States believed in God or identified as religious. 

Additionally, in 2021 49% of all people in the United States surveyed identified religion as “very important” in their day-to-day life. 

These statistics are important in our role as therapists if we truly desire to work with the whole person.

What’s the ethical integration of faith and spirituality into therapy?

How do we keep our own biases and beliefs in check while integrating faith?

What does it look like to view faith and spiritual integration as a cultural competence or stance of humility? 

Faith and spirituality can be an important component for clients, but how can therapists interact and honor it well?

What Is Faith and Spiritual Integration, and What’s Not?

The integration of faith and spirituality, at its core, is the ability to humbly value the beliefs and perspectives of the person in front of us.

Many therapists are taught this is important in all aspects of a client’s life and that it’s an important “cultural competence.” And yet many are uncomfortable with implementing it within a client’s faith and spiritual beliefs. 

Some therapists, however, erroneously believe that in order to work effectively with a client’s faith or spirituality, they must subscribe to it as well, or be a religious leader.

Alas, faith and spiritual integration in professional therapy is not pastoral counseling, spiritual direction, or conversion therapy.

In your role as a psychotherapist you’re not giving theological or pastoral advice. 

Spiritual advice and direction can be the role of a minister, Imam, Rabbi, Shaman or other religious or spiritual leader — and these roles need to be distinguished from the role of psychotherapist.

If a therapist holds both titles, that needs to be clearly distinguished and delineated in material for the client.

How to Integrate Faith and Spirituality into Clinical Practice

 In our training we’re taught that therapists can effectively honor the worldview of their clients without subscribing to it, and faith and spiritual belief systems are no different. Here are a few ways you can go about integrating faith and spirituality into your clinical work. 

1. Don’t Make Assumptions

One of the biggest pitfalls a therapist can make when working to integrate someone’s beliefs is assuming they know what a client believes due to the title the client has identified with.

I’ve worked with clients who identified as conservative Christian and believed things that mainstream Christianity would balk at.

When we assume we know more about a client’s lived experience, including their lived experience in their faith, it can lead us to places with the client that can harm rather than help the client on their journey to health and wholeness.

EMDR consultant and trainer Mark Odland, LMFT, MDIV discusses the importance of “theological curiosity” in his training on Spiritual Trauma and EMDR Therapy. Staying curious for your client—and for yourself—is essential in effectively working together to do faith and spiritual integration. 

2. Have an Open Heart and Mind

We often talk about creating safe spaces for our clients, and yet faith and spirituality is often a place where clinicians struggle to be truly open-minded.

Ask questions, and when you’re given answers, let yourself have a stance of curiosity and non-judgment. When we make room for what a client embraces, even if we don’t agree or subscribe to it, we offer a protection and sacred connection that can be the difference in a client’s healing.

Clients need to be able to feel safe in their discussion of their faith and spiritual perspectives and beliefs—even as their beliefs might change over the course of their time in psychotherapy.

Oftentimes clients who come to the counseling center I run have told us stories of being judged for their belief system by previous therapists. The therapist thought their Native American spirituality was “woo woo” or their Christian theological perspectives were too “old fashioned,” or their Muslim faith traditions around modesty were too “conservative.”

These assumptions prevented the client from engaging in therapy in a meaningful way.

3. Get Comfortable With Being Uncomfortable

Those who do psychotherapy work well let their clients lead.

But, at the same time, letting our clients lead when it comes to faith can bring about uncomfortable moments and interactions. You may be asked to interact with belief systems that are foreign to your own experience.

If you do this work, things will get uncomfortable!

You may be asked to say a prayer with a client or read through texts or scriptures that go against your own belief system.

It’s important to remember that engaging with a client in their belief system isn’t the same as embracing it as your own faith or belief system.

Valuing something good for another person doesn’t mean that you necessarily have to value it for yourself. 

It’s also important to note that transference and countertransference can come up in these moments if we have our own history with a specific belief system.

I encourage you to get your own support around this.

In my consulting work and when I am supervising staff around faith and spiritual integration, these conversations can often create discomfort—even among friendly co-workers.

Having a stance of openness, leaving offense and judgment at the door, and remembering to check your own biases and beliefs will go a long way.

4. Use the Client’s Language

As helping professionals, it’s essential that we honor the client’s experience with their faith, spirituality, and beliefs and help walk with them to health and healing that holds the entirety of their encounter with the religious, spiritual, or divine. If a client refers to God as Allah, and their therapist turns around and refers to Allah as “the higher power or whatever you want to call it” this can be incredibly insensitive to the way in which a client is trying to engage. 

Moreso, it can feel offensive to clients, leading them to question whether or not their therapist can engage in the work they are doing.

As therapists, we don’t need to interpret or translate a client’s faith language or journey into one that makes sense to us.

We don’t need to automatically reframe their language back to them using our own. 

Tools for Assessing Faith and Religious Beliefs

Sometimes clients can value their faith system, but feel confused and uncertain about what it means to them or how it has changed over the years.

An assessment tool can be a helpful way for the therapist and client to engage.

It can be helpful to have tools to help clients make sense of their own belief system so they can utilize it more effectively for their healing, identifying what’s important to them and what’s not.

Using a Spiritual Assessment tool during intake can be a helpful place to start. Lynn Underwood’s Daily Spiritual Experiences assessment is framed from a Judeo-Christian belief system, but can be a good place to start when assessing the importance of faith in the lives of clients who identify within this worldview. (To email Lynn Underwood about the use of her scale go to her website.)

Sometimes an assessment tool can act as a sounding board for the client and the therapist. It can be a way to affirm who the client is and how their faith and spirituality can show up in their life and within therapy. 

Notes on Abuse and Trauma

When we engage in spiritual integration, it’s essential to remember that we may also come across spiritual and religious abuse.

As clinicians, we have to be mindful of how that affects our clients and our own navigation of integrative work.

Just because a therapist knows about a religion (or even participates in that religion) doesn’t mean that they know the experience of the client within their personal religious or spiritual context. 

Abuse of spiritual power is common across religions and spiritual practices, and clients may have abuse that’s part of their story and experience. Clinicians should be aware and prepared to address this—even as they are still honoring the parts of the client’s belief system that serve them well. 

As with all components of a client’s life, sometimes therapists can identify areas of harm for a client within their spiritual or religious belief system. If you as a therapist are identifying this, an important first step is asking yourself whether or not this is countertransference occurring, and if it’s a problem for the client or just a problem for you as the therapist. 

If there’s dysfunction and abuse of the client from a religious or spiritual context, look closely at the role of spiritual or religious trauma and help the client distinguish what is serving them well in their belief system and what is not.

When we work with clients from a cognitive behavioral perspective we do this all the time with other belief systems. When we do this with faith, if we come at it from a judgmental or tainted lens, the client will pick up on it and feel our own judgment or attempt to persuade them that their belief system is wrong. 

Faith Integration as a Mechanism of Healing

Faith integration doesn’t have to be taboo or overwhelming.

Remember to check your assumptions, your beliefs, and your own countertransference as you approach working with a client’s faith system.

When a client asks you to pray with them, or when they want to invite their god, spiritual guide, and holy texts or scriptures into the session for wisdom and direction, consider a response that allows honor and affirmation in place of confusion and fear. 

Doing faith integration work can be uncomfortable if a client’s practices differ from our own. That said, as someone who is passionate about this work, I can guarantee you that faith and spiritual integration is a powerful mechanism for healing. And for many clients, it can be the catalyst for creating client-centered change in therapy.