Mary Whitehouse & Rick Hollings. 21st Century Psychology: A Reference Handbook. Editor: Stephen F Davis & William Buskist. Volume 2. Thousand Oaks, CA: Ssage Publications. 2008.
“No matter what the world thinks about religious experience, the one who has it possesses a great treasure, a thing that has become for him a source of life, meaning and beauty, and that has given a new splendor to the world and to mankind. Where is the criterion by which you could say that such a life is not legitimate, that such an experience is not valid?” ~ Carl Jung, Psychology and Religion
The relation between psychology and religion has been complex and variable since its inception in the early years of the 20th century. At best, the two have had a healthy respect for each other; at worst, condescending disdain. Yet the present state of affairs suggests a greater understanding and appreciation on the part of each for the other. The purpose of this chapter is to examine that relation from several different yet related perspectives. These include the history of the relation, definitional issues as they apply to an operational understanding of the terms religion and spirituality, issues involving research, and the implications of psychology and religion working together, as well as future directions.
Psychology and Religion’s Checkered History
The relation between American psychology and religion finds some of its earliest roots with one of its most recognized pioneers, William James. In his book Varieties of Religious Experience, written in 1902, he “distinguished between the ‘reality minded’ religious person who became integrated as a result of religious experience and the ‘sick soul’ who was full of self-mistrust and despair” (Cremins, 2002, p. 13). Other early psychologists also examined the psychological aspects of religiosity. Carl Jung considered religion as a way to wholeness (Kahle & Robbins, 2004), and his thinking suggests that he believed each person’s religious outlook had an impact upon his or her mental health (Kalhe & Robbins, 2004).
However, as the nascent field of psychology was defining itself, other voices focused on the negative aspects of religion. Sigmund Freud, in his work The Future of an Illusion, viewed religion as wish fulfillment, whereas John Watson implicitly dismissed it as something that could not be measured (Cremins, 2002) and, by implication, was not worthy of study.
During the 1920s the rift between psychology and religion grew wider as psychology continued toward self-definition. As psychology sought to establish itself as a legitimate discipline, it moved toward a scientific model, after the model provided by physics (Emmons & Paloutzian, 2003). This feature, along with American psychology’s embracement of behaviorism, led to and reinforced an empirical worldview, one antithetical to religion. In the course of increased differentiation, psychology programs separated from their “former home” in philosophy departments. In so doing, they shied away from topics too reminiscent of their “family of origin,” philosophy, and, by extension, theology (Emmons & Paloutzian, 2003).
While psychology was distancing itself from religion, religion was moving away from psychology. Paul Tillich’s The Religious Situation posited that “genuine religion was antithetical to the illusion that cultured values, even those of human health and well-being, were the values of God” (Neibuhr, 1932, as cited in Kurtz, 1999, p. 35), implying that health and well-being, the stuff of applied psychology, is not the domain of religion. More relevant to the growing distancing by persons of faith was the mistrust of “secular” health professionals, including psychologists. “Their suspicion may be rooted in an awareness that many psychologists … during the past century have endorsed naturalistic, mechanistic, hedonistic, relativistic and atheistic values and practices, which conflict with those of most traditional religious communities” (Bergin, Campbell, Jones, Richards, & Bergin, as cited in Richards & Bergin, 2005, p. 47). Another feature that added to the drift was the fact that although many religious traditions did not reject empiricism as one aspect of epistemology, they did reject the belief that empirical knowledge is the only source of truth or “that empiricism alone can lead to a completely accurate knowledge of the universe” (Richards & Bergin, 2005, p. 47).
From another angle, there was the question of the relevance of the teachings of psychology and religion in the lives of people. In some circles during the 1920s, religion was losing ground as mainline Protestantism became bogged down in “the Fundamentalist controversy,” which had been raised by the publication of The Fundamentals just after the turn of the century. As happens in such cases, the church (i.e., organized religion) became “increasingly irrelevant for a significant part of the American people” (Furniss, as cited in Kurtz, 1999, p. 34). Psychology provided Americans an alternate source of knowledge and wisdom for coping with everyday problems. In essence, psychology was becoming “an alternative faith” (Richards & Bergin, 2005, p. 37)
As the 20th century progressed, American psychology was further shaped by B. F. Skinner’s radical behaviorism. According to Skinner, “the environment controls behavior so that both good and evil, if each exist, reside there, not in the person” (Leahey, 1980). He was critical of religion, positing the notion that “traditional religions relied on fiction, negative reinforcement, and the threat of punishment” (Skinner, as cited in Kahle & Robbins, 2004, p. 61) In essence, what went on inside one’s brain, whether referred to as a mind, soul, or spirit, was unknowable because it could not be measured. Hence, the study of religion or spirituality was “understandably out of the question” (Cremins, 2002, p. 14).
Along with the increasingly influential theories of radical behaviorism, other views of psychology developed that were either implicitly or explicitly antithetical to the basic tenets of religion. For example, Alfred Adler developed the theory of individual psychology. He broke with Freud’s theories, taking a more pragmatic psychosocial view of personhood. He was optimistic about the nature of man, stressing man’s social nature. Like the behaviorists, Adler believed that environmental influences shaped behavior. His concept of the creative self is compared to the “conception of the theological soul” (Lundin, 1972, p. 269) and had many of the latter’s features.
Albert Ellis was at least initially much more outspoken against religion. His theory of rational emotive therapy espoused a totally rational approach to living. He wrote, “conventional religion is, on many counts, directly opposed to the main goals of emotional health—since it basically consists of masochism, other-directedness, intolerance, refusal to accept ambiguity and uncertainty, unscientific thinking, needless inhibition and self-abasement” (Ellis, 1970, as cited in Cremins, 2002, p. 14).
The confluence of psychology and religion was at least in part shaped by world events—namely, the Great Depression, with its equally great sense of despair and hopelessness, and World War II, which included the Holocaust and the advent of the nuclear age. In the wake of these events came the existential thinking of Viktor Frankl (1992), an awareness of the human proclivity for evil and a fear of total annihilation. Even so, there was the hope for something better. To cope with these circumstances, individuals appeared to have followed one of two general courses. One group, “finding both classic spirituality and classic Freudian insight ‘too dark and gloomy’ … united in rediscovering the ‘goodness’ of the self” (Kurtz, 1999, p. 37). This group sought relief and improvement through the human potential movement, which included “T-groups,” sensitivity training, and humanistic psychology, which was evident in the 1960s and 1970s.
At the same time, there was a relatively high percentage of Americans who claimed traditional religious values (apparently in spite of the upheaval and rise of Third Force Psychology). According to Cremins (2002), “the faith dimension or religious component of people’s lives remained consistent” (i.e., consistently high; p. 16) since the inception until the more sophisticated polls were developed. The 1990 Gallup poll on Religion in America reported 94 percent believe in God or a Universal Spirit, 84 percent believe in God as a Heavenly Father who can be reached by prayer, and the same number reported trying to practice what they believe (Cremins, 2002). In essence, the continued, consistently high percentage of persons believing in God was one factor that caused the field of psychology to rethink the significance of religion in human behavior and thought.
Another factor was the increased interest in and popularity of holistic medicine. As the practice of medicine has gained a better understanding and appreciation of the interaction of mind, body, and spirit, some researchers have been willing to explore the role of the spiritual dimension in the healing process (Cremins, 2002). A third factor that led to reevaluation of religion by the scientific community involved the high success rate of Alcoholics Anonymous, with its emphasis on the spiritual dimension as part of the healing process.
Cremins (2002) concluded by stating that spirituality has gained a new respect because of its efficacy. Put another way, the relation between religion and variables such as lower levels of depression, suicidality rates, recidivism rates among schizophrenics, and recovery rates for major psychiatric illnesses all but compelled psychology to reconsider its reality as a viable construct in the treatment of mental disorders.
The Confluence of Psychology and Religion
Because of the previously mentioned factors, a warming of relations between psychology and religion occurred during the last quarter of the 20th century. A number of pragmatic variables pointed to this change. Emmons and Paloutzian (2003) posit that the 1976 establishment of the American Psychological Association Division 36, Psychology of Religion, precipitated the change in relations. They also noted several other factors marking this change, including the number and frequency of textbooks published in the area, the increased frequency of psychology of religion material appearing in high-end journals, and the upsurge in the publication of specialized professional and postgraduate-level books relating religious aspects of applied psychology.
At a more practical level, there has also been an intentional effort to integrate psychology and religion by individuals such as M. Scott Peck, James Dobson, Gary Smalley, and John Trent (Kahle & Robbins, 2004). Another measure of change is the burgeoning number of recognized doctoral psychology programs, which expressly emphasize the integration of psychology and religion.
Coming to the Table: Integrating Psychology and Religion
Perhaps the earliest attempts at integration occurred in the pastoral counseling movement during the 1940s. However, it was not until the 1950s that a more formal attempt occurred with the establishment of the Christian Association for Psychological Studies (CAPS), a group consisting of conservative Christian mental health professionals, albeit mostly psychologists, with a stated purpose of integrating the principles of psychology and theology in the service of professional counseling and therapy (Beck, 2006). Beck noted in a review of the history of integration that one important feature that contributed to the process was the realization, perhaps better described as admission, that the previous assumption that psychotherapy was value free was incorrect. In fact, “[O]nce it was established that all clinical interventions are based upon some value system, the floodgates for inclusion of religion and religious themes in the psychotherapy process were opened” (p. 324). Beck also notes several important threads that are contributing to the momentum of integration to include the degree to which religion is “woven tightly into the fabric of American life” (Pargament & Maton, as cited in Beck, 2006, p. 324), “a desire among laity to become formally educated in both disciplines, and the interest among Christian mental health professionals in conducting their work with faithfulness to their understanding of Scripture and with congruency to the Christian worldview” (p. 324).
In another vein, if there is any truth to the proverb “the proof of the pudding is in the taste,” one must consider the issue of integration from the viewpoint of the consumer. Over the course of the 20th century, the use of mental health resources has increased markedly from its early days, when it was reserved for those who were wealthy, worried, but well. Over the years, especially during the last half of the 20th century, more and more individuals sought services for mental health problems as society made counseling more acceptable. For instance, statistical tables for the years between 1969 and 2002 reflect dramatic increases in the use of all forms of mental health services, with the singular exception of state and county mental hospitals (http://mentalhealth.samhsa.gov/publications/allpubs/sma06-4195/chp19table4.asp). Furthermore, there is a desire on the part of the counselees for religion to be part of the process. According to Kahle and Robbins (2004), a 1993 Gallup poll revealed that 66 percent of surveyed Americans stated a preference for a counselor who was religious. They also cited studies indicating that counselees believed that discussions of religious concerns were important in the counseling process and that the inclusion of spirituality and religion in a sensitive manner was both welcomed and appreciated. The degree of interest in having religion included in therapy is likely to vary widely, depending on a number of variables; however, the second author’s experience in 30 years of practice (in recent years, in a faith-based counseling center) has been that, in 2007, many counselees seeking help are very informed of their options and are intentionally seeking professional help from someone whose approach and interventions will not “‘conflict with biblical teachings'” (Richards & Bergin, 2000, p. 15).
In summary, at all levels, there has been a shift in thinking and attitudes about the mingling of psychology and religion. Depending upon the perspective one takes (e.g., top-down, bottom-up, or bidirectional), one finds change at all levels. Interestingly, even among some of the pioneers, a change in viewpoint has been noted.
As the second author was perusing book publisher catalogues to determine what materials involving psychology and religion are currently in print, he came across an item in the Albert Ellis Institute Catalogue. The reader will recall that in the 1960s, Ellis was outspoken in his view that religion was in direct opposition to mental health. However, in 2002, the Albert Ellis Institute (of which Ellis is still president) published a pamphlet titled “Incorporating Religion into REBT.” The description of the pamphlet reads as follows: “REBT principles of sound mental health are reinforced here by Christian teachings.”
Will the Real Definition Please Stand Up?
As previously noted, from the perspective of the developing discipline of psychology, part of the problem with the acceptance of religion was the difficulty in defining it. Clearly, without an operational definition of terms such as religion, religiousness, religiosity, and spirituality, it is difficult to measure, let alone understand, their role(s) in human behavior.
As yet, there is no agreed-upon definition of religion or spirituality. Attempts have been made to do so, but those efforts have been complicated by changes in cultural perceptions and definitions of the two terms.
The quest for spirituality emerged near the end of the 20th century, perhaps as a backlash against religiosity more so than religion, though it served as a reaction against the latter as well. The American Heritage Dictionary defines religiosity as “the quality of being religious” and “excessive or affected piety” (Pickett, Kleinedler, Pope, Schonthal, & Tamm, 2004, p. 1175). Americans as a group tend toward moderation in their theology, and their perception of such excessive piety may be one reason that so many people seek something outside institutional religion.
Initially, spirituality was defined as “the body of spiritual or ecclesiastical persons” (Oxford English Dictionary, 1989, as cited in Rizzuto, 2005, p. 32). The more contemporary use of the term applies to the particular “pathways” used by individuals in their search for the sacred and/or for significance and meaning. Pargament (1999) defined spirituality as “a search for the sacred” and as being “the most central function of religion.” It deals “with however people think, feel, act, or interrelate in their efforts to find, conserve, and, if necessary, transform the sacred in their lives” (p. 12). In more common usage, spirituality deals with the “immaterial features of life” (Miller & Thoresen, 2003, p. 27) and tends to refer to a more individual approach in one’s search for the sacred.
Religion, as most people view it, is “an institutional phenomenon” (Miller & Thoresen, 2003, p. 27). Religiousness deals more with “the personal or communal search for the sacred that occurs within a traditional context or organized faith tradition” (Zinnbauer & Pargament, 2005, p. 35). Here the sacred is rooted in a particular tradition, culture, or institution (Zinnbauer & Pargament, 2005).
Unfortunately, “spirituality as a term tends to elude tight operational definition” (Miller & Thoresen, 2003, p. 27), and religion as a term does only marginally better. While there has been relatively low consensus on an operational definition of both terms, many will agree that the two are different but have a certain degree of overlap (Emmons & Paloutzian, 2003; Hill & Pargament, 2003; Miller & Thoresen, 2003; Zinnbauer & Pargament, 2005). It has been suggested that both religion and spirituality have, as their core aim, the search for the sacred (Zinnbauer & Pargament, 2005). For Zinnbauer, spirituality is a broader construct than religion. He defines both as “a personal or group search for the sacred,” the difference being that religion happens “within a traditional sacred context” (p. 35). The practice of spirituality is not necessarily confined within that context, though it does manifest itself within a context, be it cultural, familial, social, developmental, and so on (Zinnbauer & Pargament, 2005). Pargament does the reverse and defines religiousness as a broader construct than spirituality. For him, “spirituality is a search for the sacred. Religiousness refers to a search for significance in ways related to the sacred” (p. 36). The difference here is framing these two constructs in terms of “the means and ends of the searching process” (p. 36). Religiousness has spirituality at its core, but it is much broader than that, addressing a range of things that go beyond spirituality, such as “the material as well as the immaterial, the basic as well as the elevated, and the secular as well as the sacred” (p. 37). It is concerned with the full range of human experience, both the sacred and the profane (Zinnbauer & Pargament, 2005).
One of the more obvious—and dangerous—issues in defining these terms, especially in cultural contexts, is that of polarization. Over the course of the past 30 years, numerous forms of spirituality have gained increasing popularity (Zinnbauer & Pargament, 2005) whereas religion, in general, has seen a decline in the same. The term religion (with our culture implicitly referring to Christian religion of a conservative or fundamentalist nature) connotes more negative images. It is implicitly forceful, dogmatic, loud and obnoxious, legalistic, oppressive, excessively structured, heavily concerned with morality, and more recently steeped in politics. Religion is tied to an institution that, in the opinion of many, lacks relevance and is, according to some, ineffective. As of late, being “religious” is a bad thing.
Spirituality has found its home at the other end of the spectrum. It is open, free, concerned with the individual and one’s expression, permissive, liberating, good. Spirituality is moving, changing, laid-back, and free from the institution. Being “spiritual” is far more preferable to being “religious” these days.
The fact that this polarization between these two terms has taken place poses some potential issues for further inquiry into the relation between psychology and religion. To begin with, such polarity is restrictive. To divide religion and spirituality along institutional and individual lines reduces religion to “rigid entities that do not address the way religion works and evolves in the life of the individual” (Zinnbauer & Pargament, 2005, p. 27). It also causes us to “lose sight of the individual mission of the institution and the social context of the individual; we lose the opportunity to learn how people express their faiths within the context of their lives” (Pargament, 1999, p. 9).
Zinnbauer and Pargament (2005) suggest that this polarization between the two words stems from “an errant choice of words” (p. 27). They propose four terms instead of two: religion, religiousness, spirit, and spirituality. Miller and Thoresen (2003) offer some explanation of these four terms. Religion is typically “an institutional … material phenomenon” whereas religiousness deals more with “some form of adherence to beliefs, practices, and/or precepts of religion” (Miller & Thoresen, 2003, pp. 27-28). In the same vein, “spirit as an external or internal animating force” is “differentiated from spirituality, a sacred human activity” (Miller & Thoresen, as cited in Zinnbauer & Pargament, 2005, p. 28). It seems more appropriate, then, to compare religion with spirit and religiousness with spirituality (Zinnbauer & Pargament, 2005).
Finally, the divergence between religion and spirituality as bad or good, respectively, brings up the issue of “evaluation … confounded with description” (Hood et al., 1996, as cited in Zinnbauer and Pargament, 2005, p. 28). The positive or negative effect of belief sets or practices is an issue for empirical research. Defining “constructs as inherently good or bad severely limits psychological inquiry and may reflect simple prejudice rather than informed analysis” (Zinnbauer & Pargament, 2005, p. 28). It is important to keep in mind that both religion and spirituality, like all of humankind, are inherently good with the capacity to do great harm. To deem one or the other good or bad at the outset limits the researcher’s capacity to evaluate the ways in which religion and spirituality have positive or negative outcomes.
The difficulty in even attempting to define these terms stems from the fact that there are so many different ideas, perceptions, and experiences concerning each. Those who have worked to develop an operational definition of religion and spirituality have sometimes found that those definitions are different from the mainstream usage of the terms (Miller & Thoresen, 2003). The meanings and connotations of religion, spirituality, and religiousness have evolved over the past century, and they continue to do so even now. As psychology continues to embrace the functions of religion and spirituality in the lives of individuals and groups, it will prove a worthy endeavor to develop clear operational definitions that are closely aligned with popular usage of the terms. It may also be, as some have suggested, that for purposes of conducting psychological research, terms such as spirituality are too global and that operationalizing the factors that constitute spirituality (e.g., mindfulness) may be more fruitful in the long run. Clearly, the definitional issue is a complex one that requires serious attention and clarification as psychology works with religion as a variable in human behavior.
Survey Says: Research Thus Far
Without a doubt, research has grown in the area of religion and psychology, especially as people have noticed a connection between religion and spirituality to physical and mental health. The field has made advances with regard to definitions of religion and spirituality and even more so in the area of measurement of these two (Hill & Pargament, 2003). As researchers have sought to further understand the religion-spirituality-health connection, they have done a remarkable job developing measures and scales in an attempt to concretize what they observed. Many of these researchers operated within a “measurement paradigm,” which relied heavily on the development and use of a variety of measures for research purposes, and with reasonable success. There are a number of measurements that are “reasonably effective” (Hill, 2005, p. 44). This also points to the field’s health and maturity. There are, however, several issues that arise out of the abundance of measures that we have at our disposal.
The measurement paradigm drives the need to constantly develop new measurements. This leads to greater interest in the measurements rather than in the objects of measurement themselves. Consequently, there is an overabundance of measurements that were developed, perhaps, without a clear need. As it is, “many existing measures have been underutilized” (Hill, 2005, p. 44). Also, it could be argued that researchers have developed a fair number of the measurements without the backing of theory-driven research (Hill, 2005).
Many of the measurements that have been developed thus far have typically relied on samples limited to White, middle class, American, Protestants—usually men. There is a gross underrepresentation of other races, religious groups, socioeconomic statuses, and cultural and ethnic groups (Hill, 2005; Hill & Pargament, 2003).
Another major issue in this area is the lack of sustained research programs that use standardized measures. This is partly due to the lack of a “clear, conceptual understanding of religion and spirituality” (Hill, 2005, p. 46), which makes it difficult to maintain a long-term research program. Funding for such research is virtually nonexistent and, as a result, research concerning religion and spirituality has been added on to other research instead of being the primary component. In other words, religion and spirituality have not been viable subjects of research due to the fact that measures have usually been inaccurate and very limited (Hill, 2005).
Finally, measures of religion and spirituality have relied heavily on self-report measures. Several relevant issues arise from the strict use of such measures: the inadequacy of responses due to closed-end questions, a social desirability bias, high levels of literacy required to answer questions, and the potential for response set bias. There is a significant need for the development and utilization of other methodologies (Hill, 2005).
Emmons and Paloutzian (2003) recommend a new concept to address such a need. They call it the multilevel interdisciplinary program because it “recognizes the value of data at multiple levels of analysis while making nonreductive assumptions concerning the value of spiritual and religious phenomena” (p. 395). In order for this paradigm to be effective, however, “those who study the psychology of religion and their counterparts in the rest of psychology and allied sciences” (p. 395) will need to work together.
The extant research does suggest at least two very critical implications. The first is that there is an increasing desire on the part of the consumer to receive counseling that is faith-based. Secondly, it is evermore critical that clergy and mental health practitioners collaborate to better serve their counselees.
As previously mentioned, the majority of Americans seeking counseling prefer to see a counselor who is religious (Kahle & Robbins, 2004). Although most of those people surveyed are most likely looking for a Christian counselor, it is important to note the difference between “Christian counseling” and “faith-based counseling.” The former is limited to the Christian faith and tradition. Faith-based counseling is broader than one faith tradition. A faith-based counselor is, at best, competent about many different faith traditions and is open to helping persons of faith (whatever the sort) to utilize their faith as one of the resources in the counseling setting. The counselor may be from one faith tradition, whereas the counselee is from another. If more people are seeking faith-based counseling, it stands to reason, then, that mental health practitioners need to become more competent in the area of religion and spirituality in order to give their clients more holistic care.
It is noteworthy that research has shown that “clergy [italics added] are more likely than both psychologists and psychiatrists combined to be approached for help by a person who has a mental-health diagnosis” (Hohmann & Larson, 1993, as cited in Oppenheimer, 2004, p. 154). Some of the reasons cited for such reliance on clergy include their relative accessibility, the level of trust many people have in clergy, and their typically good, long-term relationship with the person seeking mental health services (Oppenheimer et al., 2004).
Research and Methodology
In order for research in the area of religion, spirituality, and mental health to progress, we first need to establish good operational definitions of religion and spirituality. Once those are established, we can move to establishing clearer instrumentation for measuring a population’s perception and personal experience of religion and spirituality. With clear definitions, we can also begin research that is targeted directly at religion and spirituality, instead of adding them to other projects as an afterthought.
More specifically, researchers agree that the most crucial need “is for more outcomes studies with actual clients on specific interventions and on spiritual-secular integrative approaches” (Richards & Bergin, 2005, p. 338). In addition, there is a pressing need for more research on culturally and religiously diverse groups. Richards and Bergin (2005) outline other areas for research consideration:
- Why does religion have positive and/or negative effects? What is it about religion that generates health or sickness?
- What are good, evidence-based spiritual interventions, and what population of people is comfortable with them? What are the therapeutic outcomes of such interventions?
- What are the effects of religion on inpatient treatment programs as well as group therapy approaches?
- How effective are clergy, chaplains, and lay religious leaders in the area of counseling? What are the effects of short-/long-term counseling with these individuals?
In general, “more research on religious clients, religious counselors, and religious and spiritual interventions is needed” (Richards & Bergin, 2005, p. 338).
In order for researchers to be successful in this arena, however, it is also beneficial to establish a clearer theoretical framework and basis for research in this field. At this point, there are multiple “distinct models of integration” (Beck, 2006, p. 328). Were researchers and theoreticians to establish an integrated, possibly meta-theory, the field should then be able “to work together with better cohesion and productivity” (p. 328), which spurs us to better, more systematic research. Without good theory, researchers are incapable of asking high-quality research questions that lead to such sound research programs (Corveleyn & Luyten, 2005).
Clearly there is no shortage of work to be done. Only through solid, intentional research will practitioners be more capable of continually decreasing the gap between religion, spirituality, and mental health and providing the best care to their clients.
It is clear that the main thrust for the future integration of psychology and religion is practical in nature: How can the two disciplines work together in the service of the individual in need of help, whether the presenting problem is spiritual with psychological features or psychological with spiritual aspects? The reality is, both disciplines are treating the whole person. Each aspect is nonetheless real and in need of attention in order to achieve meaningful change.
Although there is an interest in integrating the disciplines of psychology and theology, there will continue to be a need to find the means for achieving this goal. At a more systemic level, there is a need to develop empirically based treatment approaches that incorporate effective strategies from both disciplines (Beck, 2006). Over the last decade, psychology has begun to address this issue for itself (Chambless, 1996), although little if any research has been done incorporating proven elements from both disciplines.
At another level, there is a need to develop ways of integrating spiritual perspectives and practices into treatment. Richards and Bergin (as cited in Shafranske, 2005)
identified 19 examples of religious and spiritual interventions that could be applied within explicit integration, including therapist prayer, teaching scriptural concepts, reference to Scripture, spiritual self-disclosure, spiritual confrontation, spiritual assessment, religious relaxation or imagery, therapist and client prayer, blessing by therapist, encouragement for forgiveness, use of religious community, client prayer, encouragement of client confession, referral for blessing, religious journal writing, spiritual meditation, religious bibliotherapy, Scripture memorization and dream interpretation. (p. 204)
Other strategies used by the authors of this chapter include use of scripture as metaphor, involvement in experiential activities outside the therapist’s office (e.g., visiting the cemetery), use of religious rituals, and encouragement of spiritual practices in daily routines (e.g., yoga, meditation, prayer labyrinth, mandala).
In a related vein, Richards, Rector, and Tjeltveit (1999) suggest that therapists can encourage the integration of spirituality into the treatment process by asking counselees how they think spiritual beliefs and values might enhance their coping.
Collaboration and Consultation
Shafranske (2005) noted that even though consultation and collaboration between psychologists and religious professionals makes sense, rarely do psychologists consider clergy as potential collaborators. Beck (2006) observed that a weakness in the integration process is the failure to more actively involve individuals with biblical and theological expertise, by implication at either the theoretical or grassroots level, resulting in psychologists not being taken seriously by their religious counterparts.
Yet, with a growing population of people seeking faith-based mental health services, it would make sense, then, for psychologists and clergy to collaborate at a much greater level. There are several important aspects to this collaborative effort. To begin with, both clergy and practitioners, as individuals, need to have more integration between their personal theology and practice. Both need to be aware of their strengths and limitations in the healing process of individuals. One of the obstacles to collaboration cited was that of education. Clergy typically “obtain little if any psychological education in their training” (Oppenheimer et al., 2004, p. 159), whereas psychologists “may lack an awareness of spiritual issues” (p. 159). Both groups need to be more aware of and sensitive to those limitations, and to be willing to take advantage of opportunities to learn more about psychology or religion/spirituality.
If clergy are functionally the front line for mental health services, but are not equipped to appropriately work with an individual’s or family’s situation, they need to be aware of that, and they need to be able to refer the individual or family to a competent mental health practitioner. If there is an established relationship between clergy and psychologists or psychiatrists, there is more likely to be a strong referral base and a greater chance that the counselee(s) will get the help they need. For those people who are hesitant about seeking help from a mental health professional because of the faith issue, a clergy referral can help assuage any anxiety they might have. At the same time, mental health practitioners need to be willing to refer to clergy (Oppenheimer et al., 2004). Ultimately, ongoing interaction between the two provides a wealth of resources that are otherwise unavailable.
Education and Training
The ethics of addressing religious issues have become more apparent as psychologists have become increasingly aware of this dimension as part of the treatment process. Yarhouse and VanOrman (1999) discuss this matter in a very cogent manner, concluding their discussion with a number of recommendations similar to the ones previously noted. As one might expect, their first recommendation involved pursuing continuing education to enable clinicians to gain an understanding of similarities and differences among various religious traditions. Continuing education is a large umbrella encompassing a number of means for achieving this end. For persons entering the field of psychology, there are numerous programs that are designed with an express intent of integrating the two disciplines. Other programs, such as Fuller Theological Seminary, require their doctoral psychology students to earn a Master of Divinity degree as part of their training. Still other formal means include the pursuit of psychology and divinity degrees separately. For most professionals already practicing in the field of psychology, however, other options are more realistic. These would include in-service education, ongoing supervision, reading, and consultation. Another example in a group practice setting is regular case conference meetings in which the group might devote one meeting each month to spirituality. The process typically involves renewing a particular case from a spiritual dimension while exploring how that dimension relates to the clients presenting problems and mental health needs.
For persons living at the beginning of the 21st century, the world contains many opportunities as well as challenges. In Western cultures, people are living longer with the potential for a healthy life. For many, the quality of life is also good. At the same time, there are many factors that may potentially lead to a host of mental health problems, such as stress, anxiety, and depression, to name a few. Among those factors that enhance coping is a healthy religious faith. During the last century, psychologists became increasingly more aware of healthy religious healing benefits. During the 21st century, it will be important for psychology to work in conjunction with religion in order to help counselees who choose to use this resource in order to facilitate healthy adjustment.