Spiritual and Religious Competencies in Psychology.

Vieten and Lukoff (2022) published “Spiritual and Religious Competencies in Psychology” in American Psychologist. They begin by observing that:

Religion and spirituality (R/S) are important aspects of human diversity that should be explicitly addressed in the field of psychology. The field has already included R/S in its definitions of multiculturalism, but while multicultural training is routinely included in doctoral level psychology course work and internship programs, it rarely includes specific training in R/S diversity. Polls of the American public indicate that religion and spirituality are important in most people’s lives, and hundreds of studies demonstrate empirical links between R/S and psychological health and well-being.

Spiritual and religious background, beliefs, and practices (SRBBPs) are an important aspect of most people’s psychological functioning, and a robust body of evidence indicates that SRBBPs play a role in psychological well-being. Religion and spirituality (R/S) are also meaningful aspects of cultural diversity, and like other forms of multicultural diversity, when not addressed can result in inadequate or insensitive care and increase barriers to care. Attending to the spiritual and religious aspects of people’s lives in the practice of psychology is a form of both clinical and cultural competence.

They emphasize the diversity within religions as well as the difference between perceiving oneself as religious or spiritual.

Spiritual and religious competence, similar to other forms of multicultural competence, includes basic attitudes, knowledge and skills—such as becoming aware of our own religious, spiritual, or nonreligious/nonspiritual views and how they might influence or bias our work as psychologists, inquiring about R/S in clinical and research settings, being able to effectively inquire about a client’s or research participant’s spiritual and religious background, beliefs, and practices, incorporating SRBBPs into overall assessment and treatment planning when indicated, or being willing to refer and collaborate with clergy if needed. Competence here refers to basic attitudes, knowledge and skills we propose all psychologists should possess, rather than advanced expertise.

While the words have historically often been used interchangeably, spirituality and religion are increasingly being viewed as distinct yet partially overlapping constructs. Religion most often refers to an organized belief system, guided by shared values, practices and understandings of the divine, and involvement in a religious community. Spirituality can be defined more broadly as an individual’s internal sense of connection to something beyond oneself, which could be perceived as a higher power or God, and/or a more general sense of the sacred, consciousness, or interconnectedness to all of nature and life (Mahoney & Shafranske, 2013).

Part of what I like about this article is its emphasis on the fact that religion and/or spirituality is important to more people in general than to psychologists as a group. They discuss research linking religion and spirituality “to an increased sense of meaning, purpose, resilience, satisfaction and happiness.” After reviewing participation in organized R/S, religious and spiritual coping, engagement in personal R/S, and R/S problems, they note that, while graduate students in clinical and counseling psychology programs believe that clients should be asked about R/S, they generally report no training in how to do so.

Vieten et al. (2013, 2015) developed a set of empirically based R/S core competencies for psychologists including attitudes, knowledge and skills in the domains of religion and spirituality. Table 1 in the article summarizes the competencies for psychologists, while Table 2 provides their proposed clinical assessment. I also like their findings that:

Studies have shown that those who received a spiritual assessment at intake responded positively and attended more of their subsequent mental health care appointments than clients in a randomly assigned group who did not receive a spiritual assessment (Huguelet et al., 2016). In simulated clinical interviews, Terepka and Hatfield (2020) reported that, "individuals asked about their religiosity during the interview experienced the interviewer as more empathetic, warm, understanding, experienced, trustworthy, and friendly. Participants reported being more willing to disclose personal information to the interviewer in the future when queried about their religiosity during initial interviews" (p. 3). 

Note that they propose asking a first question, “Do you have any beliefs or practices that help you cope with difficulties or stress?” If R/S isn’t directly mentioned, they ask “For some people religion or spirituality is a source of strength and comfort in dealing with life’s challenges. Is this true for you?”  If the answer to the second question is no, they ask a more general, “What are your sources of strength and support when you face life’s challenges?” It’s only if a client identifies R/S issues that they dive deeper. My hope is that more clinicians will at the very least ask the basic screening questions as part of their intake questions.