Helpful and Harmful Approaches to Integrating Religion and Spirituality into Mental Health Care: A National Survey of Current Clients' Experiences in the United States.

This article describes a national sample of 989 current mental health clients' views regarding whether and how their mental health care providers integrated the client's religion/spirituality (RS) into treatment. Within the online Qualtrics survey, two open-ended items asked respondents what (if anything) the client perceived their therapist having done regarding the client's RS that was (1) helpful/supportive or (2) hurtful/harmful. Participants also reported various ways therapists included the topic of RS in practice, if any. Nearly half freely described helpful ways their providers integrated the client's RS, and half indicated it was not discussed or applicable. Although 9.6% described hurtful experiences, most indicated their provider had not done anything harmful related to integrating RS. Implications for practice and training across mental health disciplines are discussed.

Mental health professionals' perspectives on the relevance of religion and spirituality to mental health care.

BACKGROUND: A large body of evidence indicates that spiritual and religious backgrounds, beliefs, and practices (SRBBPs) are related to better psychological health. Spirituality and religion (R/S) are also important aspects of multicultural diversity. There is evidence that clients would like to talk about their spirituality, and that including it in assessment and treatment planning can be beneficial. However, the extent to which practicing mental health professionals view SRBBPs as relevant to mental health and clinical practice is unclear. METHODS: A survey examining several aspects of addressing SRBBPs in clinical practice was distributed to 894 professionals across mental health disciplines, including psychiatry, psychology, social work, marriage family therapy, licensed professional counselors, certified chemical dependency counselors, and psychiatric mental health nurses. RESULTS: 89% of mental health professionals agreed that clinicians should receive training in R/S competencies. There were no differences between mental health disciplines in ratings of importance of such training. Younger individuals and those who identify as more spiritual were more likely to consider R/S training as important. Although 47.1% of professionals had not received much R/S training, many perceived themselves to be highly competent in R/S clinical integration practices (57.8% considered themselves able to display them very much or completely). In addition, respondents with more R/S training evaluated themselves as more proficient in R/S clinical integration. Nearly two-thirds (65.2%) of respondents reported encountering few to no barriers to engaging in R/S competent mental health care. CONCLUSIONS: There is a growing consensus among mental health care professionals that mental health professionals should be trained in R/S competencies. Strong agreement exists that basic R/S competencies include respect, empathy, examination of bias, and routine assessment of R/S in mental health care. Four in five of those surveyed agree that more active competencies, such as identifying and addressing religious and spiritual struggles and problems and helping clients explore and access R/S strengths and resources should be included, whereas one in five report less comfort with these competencies.

Enhancing competencies for the ethical integration of religion and spirituality in psychological services.

Advancement of Spiritual and religious competencies aligns with increasing attention to the pivotal role of multiculturalism and intersectionality, as well as shifts in organizational values and strategies, that shape the delivery of psychological services (e.g., evidence-based practice). A growing evidence base also attests to ethical integration of peoples' religious faith and/or spirituality (R/S) in their mental care as enhancing the utilization and efficacy of psychological services. When considering the essential attitudes, knowledge, and skills for addressing religious and spiritual aspects of clients' lives, lack of R/S competencies among psychologists and other mental health professionals impedes ethical and effective practice. The purpose of this article is to discuss the following: (a) skills for negotiating ethical challenges with spiritually integrated care; and (b) strategies for assessing a client's R/S. We also describe systemic barriers to ethical integration of R/S in mental health professions and briefly introduce our Spiritual and Religious Competencies project. Looking ahead, a strategic, interdisciplinary, and comprehensive approach is needed to transform the practice of mental health care in a manner that more fully aligns with the values, principles, and expectations across our disciplines' professional ethical codes and accreditation standards. We propose that explicit training across mental health professions is necessary to more fully honor R/S diversity and the importance of this layer of identity and intersectionality in many peoples' lives. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Licensed Master of Social Workers' Engagement in the Process of Evidence-Based Practice: Barriers and Facilitators.

Purpose:This article describes the qualitative responses from licensed masters-level social workers (LMSWs) regarding what they perceive as barriers and facilitators to consistently engaging in the process of evidence-based practice (EBP). Method:Two open-ended questions were posed to determine what helps social workers consistently use the EBP process and what inhibits them from regularly applying EBP to guide clinical decision-making. A total of 113 responses were recorded. Content analysis was used to identify emergent themes. Results:Facilitators to the consistent use of EBP included: the belief that EBP improves outcomes, research that was vetted and disseminated by trusted partners such as the National Association of Social Workers (NASW), and ethical mandates. Barriers included: time, lack of applicable research, client-specific factors, and cost. Factors identified as both facilitating and impeding the EBP process were lack of necessary technology, organizational context, provider beliefs, and research knowledge/training. Discussion and Conclusion: Providers identified a number of barriers and facilitators to engaging in the process of evidence-based practice, which guided the extent to which they consistently engaged in the process, and how difficult they perceived itto be.

The Relevance of Religion and Spirituality to Mental Health: A National Survey of Current Clients' Views.

Despite a growing interest in the relationship between religion and spirituality (RS) and mental health across helping professions, less is known about clients' perceived relevance of these areas. This article describes the development and validation of the Relevance of Religion and Spirituality to Mental Health (RRSMH) scale, and responses to the first national survey of clients' perceived relevance of RS to mental health. Specifically, a sample of 989 U.S. adults who saw a mental health care provider in the last month responded to an online survey that included 27 new items to measure clients' perceptions of the relevance of RS to mental health, both positive and negative. A confirmatory factor analysis revealed that the sample's data had an adequate fit to the final 12-item model, and the instrument's overall reliability was very good (α = .96). Descriptive analyses indicated that clients view RS as both supportive and relevant to their mental health. The RRSMH scale may be used in mental health research and practice settings. Authors recommend that RS be assessed and included in treatment planning, where appropriate, and addressed in training for mental health professionals.

Client Attitudes toward Integrating Religion and Spirituality in Mental Health Treatment: Scale Development and Client Responses.

This article describes the development, validation, and responses to the first administration of the Religious/Spiritually Integrated Practice Assessment Scale-Client Attitudes (RSIPAS-CA). A total of 1,047 U.S. adults responded to an online survey administered by Qualtrics, which included the RSIPAS-CA for secondary analysis. Of those, 245 indicated they were either current or former mental health clients and thus were asked to complete a 10-item instrument assessing clients' attitudes toward integrating religion and spirituality (RS) in mental health treatment. A confirmatory factor analysis showed the current sample's data approached an adequate fit, and the instrument's reliability was considered very good (α = .89). Descriptive analyses indicated that clients have mixed views regarding who should initiate the discussion of RS, but a majority responded favorably toward integrating RS in practice. The article ends with a general comparison between client responses to the current survey and clinical social workers' responses to the practitioners' RSIPAS. It also discusses implications for research based on the scale development and implications for practice and education, based on client preferences.

Integrating clients' religion/spirituality in clinical practice: A comparison among social workers, psychologists, counselors, marriage and family therapists, and nurses.

OBJECTIVE: This study was designed to describe and compare five helping professions' views and behaviors regarding the integration of clients' religion/spirituality (RS) in clinical practice. METHOD: A cross-sectional design was used to survey 3,500 licensed clinical psychologists, nurses, marriage and family therapists (LMFTs), clinical social workers, and professional counselors across Texas. A total of 550 responded to this online survey, which included the Religious/Spiritually Integrated Practice Assessment Scale and background questions. RESULTS: Attitudes concerning the integration of clients' RS did not differ by profession and were fairly positive. However, differences emerged regarding self-efficacy, perceived feasibility, and behaviors, with LMFTs reporting the highest scores for these subscales. CONCLUSION: This is the first comparison of these five professions' attitudes, behaviors, perceived feasibility, and self-efficacy regarding integrating clients' RS. These encouraging results not only indicate helping professionals' openness to integrating clients' RS, but also highlight key differences in training, self-efficacy, views of feasibility, and implementation.

The Religiosity and Spiritual Beliefs and Practices of Clinical Social Workers: A National Survey.

This article describes the religious and spiritual beliefs and practices among a national sample of 426 licensed clinical social workers (LCSWs). Given the significant role LCSWs' intrinsic religiosity plays in whether or not they consider clients' religion and spirituality (RS) as it relates to practice, it is critical that the profession best understands current LCSWs' religious and spiritual beliefs, and in what ways these mirror or contrast those of the clients whom they serve. Findings from this secondary analysis of a recent national survey suggest that compared with the general U.S. population, fewer LCSWs self-identify as Protestant or Catholic, fewer engage in frequent prayer, and fewer self-identify as religious. However, more LCSWs engage in meditation and consider themselves to be spiritual. Although it appears that RS is an important area in both LCSWs' and clients' lives, the beliefs, practices, and degree of importance with either differ. This article addresses implications for practice and education, as identifying such differing views calls on the profession to strengthen its training surrounding LCSWs' self-awareness of their RS beliefs and recognizing that their clients may not hold similar beliefs or engage in similar practices.

Social Workers' Perceived Barriers to and Sources of Support for Integrating Clients' Religion and Spirituality in Practice.

This article describes the qualitative responses from a national sample of licensed clinical social workers (LCSWs) on their views regarding integrating clients' religion and spirituality (RS) in practice. Two open-ended questions were asked to assess what helps or assists LCSWs in assessing and integrating clients' RS in practice and what hinders or prevents LCSWs from considering this area of clients' lives. A total of 329 responded to either item, with 319 responses to the first item and 279 responses to the second. The authors used open-coding procedures, developed a codebook to analyze the data, and reached consensus on each response. Overarching themes that emerged from LCSWs' responses to what helps them consider this area included personal religiosity, education, and having an RS-sensitive practice. Regarding what hinders RS integration, LCSWs reported that nothing hinders such integration; that it was not relevant; or listed various barriers, including a lack of training, client discouraging the discussion, or experiencing fear or perceiving RS as a taboo topic. The article concludes with a discussion of the implications for social work education and practice.

The Integration of Clients' Religion and Spirituality in Social Work Practice: A National Survey.

This article describes the results of a cross-sectional study of licensed clinical social workers' (LCSWs') views and behaviors related to integrating clients' religion and spirituality in clinical practice. A total of 442 LCSWs from across the United States who advertised their services on the Internet provided anonymous responses to an online administration of the Religious/Spiritually Integrated Practice Assessment Scale. The results indicate that LCSWs have positive attitudes, high levels of self-efficacy, and perceive such integration as feasible, but report low levels of engagement in integrating clients' religious and spiritual beliefs into practice. Moreover, two variables emerged as significant predictors for LCSWs' overall orientation toward integrating clients' religion and spirituality in practice: practitioners' intrinsic religiosity and prior training (prior course work or continuing education). Implications and next steps for social work education and continuing training efforts are discussed.

Social work practitioners' integration of clients' religion and spirituality in practice: a literature review.

Emerging research on religion, spirituality, health, and mental health has begun to catch the attention of helping professionals. Some clients are expressing a desire for their health and mental health practitioners to initiate discussion of their religious or spiritual beliefs as they relate to their case. Social workers are the most represented group among personnel providing mental health services, so it is important to understand their attitudes, views, and behaviors regarding integrating clients' religion and spirituality (RS) into practice. Few studies have assessed such an integration; those that are available focus primarily on practitioner characteristics and use of specific helping activities to integrate clients' RS in treatment. This article discusses how RS have been integrated into social work practice and education and reviews instruments used to assess such practices. In addition, the findings from previous studies examining social workers' integration of clients' RS are compared with those of other helping professions. Finally, implications for education and practice are discussed.