Integrating Clients’ Spiritual and Religious Experiences into Clinical Practice
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Many clients believe in religion, a higher power, or some form of spirituality. When facing mental health issues, clients may want to include religion and spirituality in their counseling sessions. The challenge for counseling professionals is that they often lack formal training in this type of counseling.
Some religious and spiritual practices can be healing to the individual, while others cause harm. If the counselor strives to treat the client as a whole person, religion and spirituality must be included in the therapeutic work.
How Religion and Spirituality Help Clients
Spiritual and religious counseling can be beneficial to a client’s well-being and mental health. Clients can find meaning, a sense of community, and healing. A special note: For healing to occur, clients must resonate with the religious or spiritual belief.
Communities help clients heal by reducing feelings of isolation. When people give and receive social support, they tend to develop a sense of belonging. This improves mental health.
Religion and spirituality involve healing practices. Forms of healing may be administered through prayer, rituals, and hands-on healing. In prayer, clients express their suffering and ask for guidance. Prayer can also be performed on behalf of others. When clients help others, it gives them a sense of meaning and direction. After a prayer session, clients may report receiving guidance or feel less anxious or depressed.
Prayer can be traditional or spiritual. Ask clients what types of prayer they prefer and what the significance of the prayer means to them. The counselor offers a safe space and can pray with the client in session or encourage the client to pray on their own. A client with spiritual beliefs may prefer to write their own prayer or sit in quiet meditation. If the client has written a prayer, invite them to read it in session or meditate briefly with the client. The counselor can extend support through keeping a client in their thoughts, reciting a specific prayer, or sending positive intentions.
Rituals act as a container for powerful and overwhelming emotions, such as grief and trauma. These practices provide structure and stability in uncertain times. Examples of rituals are singing, lighting candles, creating a healing altar, and certain forms of prayer.
Although hands-on healing is part of religious and spiritual practice, it is not recommended that counselors administer it in clinical sessions. Physical touch during the counseling session is not recommended. Many professionals in the field of counseling believe that touch, even when used in a healing manner, could be misinterpreted by the client. Instead, counselors can describe somatic or healing techniques or recommend a certified practitioner.
When using prayer, rituals, or healing as part of counseling, check in with the client to assess their mood and whether these practices are improving or worsening their mental health.
Spiritual and Religious Abuse
The community heals, but it can also cause harm. Some clients have experienced trauma from spiritual and religious practices. They may have depression, anxiety, post-traumatic stress disorder, or substance misuse. Look for feelings of guilt, shame, and self-harm.
Many have experienced abuse through control or coercion. It is not unusual for the client to suppress their emotions or self-expression. For this reason, some clients may have difficulty expressing themselves or not recognize that they have experienced abuse. When abuse is recognized, clients may face shame or denial about what happened to them.
Religious/spiritual trauma can be a particularly life-altering experience because religion and spirituality are often lenses through which people view the world. Religious/spiritual trauma can thus impact a person’s sense of identity, their core beliefs and values, and their perception of safety in the world. Moreover, it can deeply alter or damage an individual’s relationship and previous understanding of that which they consider to be sacred (Walsh & Koch 2023).
Many religious teachings do not support sexual and gender identity. These followers believe God or a Higher Power would punish them or reject them for who they are. This causes harm. Some religions are becoming more open, but those in the LGBTQ+ community still experience abuse. People are reporting trauma or rejection of their sexual/gender identity.
Cults are religious or spiritual organizations led by a charismatic and often abusive leader. Many leaders use manipulation and abuse to control their members. Abuse can be reported as financial, emotional, verbal, sexual, and/or physical.
Cults often prey on individuals undergoing significant life transitions, emotional distress, or social isolation, using psychological manipulation to create dependency and compliance. Key techniques include love bombing, isolation from external influences, repetitive reinforcement of ideology, and cognitive restructuring to reshape an individual’s worldview. These strategies exploit cognitive biases, such as confirmation bias and cognitive dissonance, to entrench members within the cult’s belief system. Furthermore, the use of fear, guilt, and punishment ensures obedience while discouraging dissent (Barnty 2024).
Treating Religious and Spiritual Abuse
The priority in counseling is to establish a sense of safety. Counselors want to normalize the client’s fear while also supporting them in developing assertiveness skills. One goal is to help clients feel more confident in questioning or disagreeing with others. This can be encouraged in counseling through role-playing.
The counselor will validate any abuse the client has experienced. The healing process often includes the client sharing their story, whether in individual or group counseling sessions.
Support the client’s feelings of grief and loss. A trust has been broken within social relationships. Many lose their community, identity, and family relationships. Another aspect of treating religious and spiritual abuse is helping the client form new social supports. It can be difficult at the beginning of exiting an abusive religious group to form bonds with others. It may also take time for the client to build trust with the counselor.
Should Counselors Disclose Their Faith to Clients?
Counselors need to know their beliefs. This is done to raise their self-awareness and avoid imposing their beliefs upon others. Some counselors disclose their spiritual or religious beliefs on their website, social media, or advertisements. Clients who come to these counselors are aware of their basic beliefs.
When clients question a counselor’s religion or spiritual beliefs, it is key to explore why the answer is important to them. What would it mean to the client if their beliefs differed? As a counselor, you do not want to avoid answering a client’s questions, but rather dig deeper. Self-disclosure in therapy needs to be minimal and support the client’s therapeutic work. The focus of counseling is on the client, not the counselor.
Ethically Incorporating Religion and Spirituality into Counseling
Counselors must take responsibility for ethically integrating religion and spirituality into counseling, as formal training on this topic is often limited or lacking. The counselor ensures they do no harm and offer clients the best care possible.
These guidelines are a starting point for counselors who work with spiritual and religious practices:
1. Obtain Education
One way to increase the counselor’s worldview in religious and spiritual counseling is through education. Ask the client directly about their specific spiritual or religious beliefs. When a counselor is open to learning, this builds rapport and trust with the client. Counselor education involves ongoing professional development through training programs offered online or in-person.
Another type of educational experience is attending spiritual or religious gatherings. This activity requires the counselor to attend a gathering or meeting of a spiritual or religious group different from their own experience. Afterwards, the counselor can process their feelings, thoughts, and biases in supervision.
Counselors can reach out to a spiritual or religious leader in the community to learn more about their client’s beliefs. This person would not be a part of therapy but rather a consultant to the counselor. Counselors ask questions and learn information about the spiritual or religious practices in a confidential manner.
2. Maintain Religious and Spiritual Self-Awareness
When counselors work to increase their awareness of their own thoughts, feelings, and biases, this benefits the therapeutic relationship and helps prevent harm to the client. Counselors can bracket their assumptions and manage any internal reactions. Supervision is an essential part of this process.
This is stated in The American Counseling Association Code of Ethics (2014), A.4.b. Personal Values:
Counselors are aware of—and avoid imposing—their own values, attitudes, beliefs, and behaviors. Counselors respect the diversity of clients, trainees, and research participants and seek training in areas in which they are at risk of imposing their values onto clients, especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature.
3. Explore Your Cultural Heritage
A counselor increases their self-awareness by exploring their cultural roots. What religious or spiritual culture was the counselor raised in? How did this influence their beliefs? “To become culturally competent, counselors should begin by exploring their own cultural heritage and identifying how it shapes their perceptions of normality, abnormality, and the counseling process” (SAMHSA 2014).
4. Attend Regular Supervision Sessions
Supervisors are well-skilled in matters of transference and countertransference. For this reason, it is important to undergo regular supervision sessions to ensure the client receives the best care at all times. Counselors can hold biases and experience countertransference when their beliefs conflict with those of their clients. The more self-awareness the counselor develops, the less likely they are to act upon countertransference or transference reactions.
Lisa Hutchison, LMHC
Writer & Contributing ExpertLisa Hutchison, LMHC, is a licensed mental health counselor for the Commonwealth of Massachusetts. She works for professionals who want to treat and prevent compassion fatigue. With over 20 years of psychotherapy experience, she helps her clients assert themselves, set boundaries, and increase their coping skills. Her specialty is decreasing stress, anxiety, and depression while increasing realistic methods of self-care for those who help others. Ms. Hutchison’s psychological advice has been featured in Reader’s Digest and the Huffington Post. Her articles have been published in numerous magazines, including Grief Digest and Today’s Caregiver.
Lisa is the bestselling author of I Fill My Cup: A Journal for Compassionate Helpers and a faculty member writer for NetCE. Her latest continuing education unit publication is “Setting Ethical Limits for Caring and Competent Professionals.” She has taught creative writing in colleges and presented on boundaries for the compassionate helper; the use of expressive art to heal grief, anxiety, and depression; inspirational and motivational topics; and creative writing techniques.