The “Why” & “What” of Project #2: 

This project focuses on client’s views, preferences, and experiences when it comes to the integration of faith and practice. Emerging evidence indicates that many clients prefer to have RS issues integrated into treatment for their mental health concerns. Prior to this project, no study has examined the views, preferences, and experiences of a national sample of diverse mental health clients with respect to the integration of their RS into treatment. With compelling evidence demonstrating positive mental health outcomes for clients whose RS are addressed in treatment (Koenig et al., 2001; 2012; Koenig et al., 2015), and a majority of US adults indicating religion is important to them (Pew Research Center, 2015), it is critical to elucidate the views, preferences, and experiences among mental health care clients on a national-level.

Project Activities: 

We conducted a national survey of clients who are currently receiving mental health treatment on their views, preferences, and experiences with respect to the integration of RS into their mental health care. Through this study, the goal was to capture whether and the degree to which the mental health clients’ needs are being met regarding this area of their lives. There were five domains considered when surveying these clients:

  1. Views of whether RS is relevant, as well as helpful or harmful to their mental health;
    • An instrument was developed to measure clients’ personal views regarding RS and mental health (e.g. “I consider my RS to be relevant to my mental health treatment,” and “Engaging in RS practices improves my mental health”).
  2. Attitudes toward and preferences for integrating RS into mental health treatment;
    • Client Attitudes Toward Spirituality in Therapy (CAST; Rose, Westefeld, & Ansley, 2001) and Client Attitudes Toward Religious/Spirituality Integrated Practice (Oxhandler, in progress) measures were used.
  3. RS characteristics, including RS affiliation, views of God, religious coping, and intrinsic/extrinsic religiosity, and how each are related to client preferences for integrating RS into treatment;
    • Survey included measures of several client RS characteristics – the Brief Religious Coping Measure (Brief RCOPE; Pargament, Feuille, & Burdzy, 2011), Froese and Bader’s (2010) Views of God survey, the Duke University Religion Index (DUREL; Koenig & Büssing, 2010) to measure intrinsic and extrinsic religiosity, and three items from the Pew Research Center to assess RS affiliation and the client’s perceived level of RS.
  4. Experiences with what has been helpful or harmful regarding practitioners integrating RS (or not) in treatment;
    • Two open-ended probes were included to better understand clients’ perceptions of therapists’ approaches to RS in treatment, including what has been helpful and harmful.
  5. Clients’ perceptions of the importance of each of the 16 competencies in their work with mental health providers.
    • Participants were to rank their importance of each competency and the extent to which they found each manifested by their treating professionals.

Moreover, a number a demographic items were included to describe the sample and assess whether certain variables predicted preferences for RS integration. They included participants’ basic information (e.g. age, race/ethnicity, region, education, religious/spiritual upbringing). We also assessed how long participants have been in therapy, their mental health diagnoses, type of therapist, and type of treatment (if known).

Desired Changes:

Our expectation was that the findings gleaned from the survey of mental health clients would buttress the findings that came from the survey of mental health professionals. Our assumption was that the survey of mental health clients would demonstrate that many clients:

  • View RS as relevant to their mental health and treatment;
  • Feel that their RS is not addressed adequately in treatment;
  • Would like their mental health professionals to demonstrate RS competencies;
  • May have had negative experiences with respect to RS issues in treatment.

We anticipated that some clients would prefer not to have their RS addressed in mental health treatment and that variations in preferences would depend in part on their levels of religiousness and spirituality. Overall, we expected that the results from this survey will point to the need for training of mental health professionals in RS competencies.

Similar to the survey of mental health professionals, this survey of mental health clients should lead to several outputs and outcomes, including:

  • A revised set of RS competencies relevant to the range of mental health disciplines;
  • Presentations and publications documenting the need for training in RS competencies in mental health care;
  • Successful efforts to foster wider adoption of training in RS competencies;
  • Improvements in the quality of mental health care by fostering RS competencies in the training of mental health professionals.

What We Found:

  • Preliminary findings have demonstrated the lack of training received by providers in this domain and the desire among consumers for skills and sensitivity toward RS issues in treatment.