So many people turn to spirituality and religion for support. So it is worth considering how these practices can fit into the work you might do with a therapist.
Many people assume that spirituality and religion have to be kept out of a therapist's office. But more and more clinicians realize that it can be helpful for patients to talk about their spiritual and religious beliefs.
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Religion and Spirituality in America
Certainly, religion is an important part of American life. The Pew Forum on Religion and Public Life has reported that 87% of Americans consider themselves to be religious, while 57% attend some type of worship service on a regular basis.
Likewise, a Newsweek/Beliefnet poll found that 88% of Americans who responded described themselves as spiritual, religious or both.
There's no way to know how many respondents were struggling with their mental health, but many of them probably turned to their spiritual practices for comfort, particularly if they were working hard to manage severe and ongoing problems such as addiction, unusual stress or mental illness. Moreover, as a way to enhance psychotherapy, understanding a person's spirituality may provide helpful insights into his or her value system or relationships.
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Spirituality in Mental Health Treatment
Clinicians working in hospitals, mental health centers and other participating organizations are required by The Joint Commission — an independent organization that accredits and certifies more than 15,000 health care organizations and programs in the United States — to do a "spiritual assessment" of patients' spiritual beliefs and practices. The information is intended to improve treatment and services.
Critics of the regulation say that a spiritual assessment may not be as important in highly technical aspects of medical care — for example, cardiac surgery — as it is in primary care or mental health. Moreover clinicians in private practice don't have to adhere to The Joint Commission requirements.
Many patients receiving counseling may want their spiritual beliefs to be taken into account as part of their treatment. If this is important to you, it's helpful if the person treating you:
- Asks about your spiritual beliefs without judging them. Then your spiritual beliefs can become part of the treatment plan, according to The Joint Commission. A therapist doesn't have to come from the same religious community as you. What's more important is that the clinician is comfortable discussing these matters, takes your views seriously and can discuss them with you sympathetically.
- Is curious about your spiritual beliefs, is willing to learn about them, and — when it's helpful — to consult with clergy. If your therapist doesn't know very much about your particular religious practice, it's more difficult for him or her to know how best to help you. If the clergy or spiritual leader that you have a relationship with is willing, suggest to your therapist that he or she speak with that person.
- Is prepared to make spirituality part of the treatment plan. It's very helpful for the therapist to find a way to make spirituality part of your recovery plan along with support, medication and psychotherapy. For example, if you are a practicing Catholic who is struggling with an addiction, you may find it helpful to attend Mass on a daily basis rather than weekly.
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Starting the Discussion
If you're wondering how to get the conversation about spirituality going with your therapist or doctor, it may help to start by explaining your religious practices. Of course, it is up to your therapist or doctor to put you at ease so you can talk about these things. If religion is an important part of your life and your therapist is not interested in hearing about it, consider consulting someone else who is.
Here are some useful topics to talk about:
- How you express your spirituality
- How important prayer is to you
- Who, as a spiritual leader or clergy member, is particularly important to you and can be a resource if the therapist has questions
- How often you attend some type of religious service and how the practice of religion fits into your daily life
- How you find inner strength to deal with suffering and adversity; if you rely on a particular person, or follow a specific practice to gain strength
- Your specific spiritual goals
- How faith helps you cope with illness and suffering
- What type of spiritual support you want as part of your treatment plan
With a little planning, your religious practice does not have to compete with your mental health treatment. Instead, you and your therapist can find the best ways to use it as one more way to enhance your life.
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Michael Craig Miller, M.D. is Editor in Chief of the Harvard Mental Health Letter. He is also associate physician at Beth Israel Deaconess Medical Center and assistant professor at Harvard Medical School. He has been practicing psychiatry for more than 25 years and teaches in the Harvard Longwood Psychiatry Residency Program.