A National Survey of Client Preferences and Perceived Relevance for Integrating Religion/Spirituality into Mental Health Treatment

Background and Purpose: Among adults in the United States, 83% indicate religion is at least somewhat important in their lives, and 89% believe in God(Pew Research Center,2015). These beliefs often weave into mental health treatment through clients’ various religious/spiritual positive and negative coping strategies. However, previous studies to understand client preferences for integrating their religion/spirituality into treatment have been limited by small samples and specific faith traditions or clinical issues(Harris, Randolph, & Gordon,2016). There has not yet been a large, national survey of current mental health clients’ preferences for integrating religion/spirituality into treatment, let alone the degree to which clients perceive these two dimensions of their lives as relevant to one another.

Thus, this study explored: 1)what are current mental health clients’ views regarding the integration of RS into treatment, and 2)do clients view their RS and mental health as being relevant to one another?

Methods: Qualtrics’ crowdsourcing services were contracted to recruit approximately 1,000 adults who saw a mental health care provider within the last month. The online survey included a variety of demographic items, the Religious/Spiritually Integrated Practice Assessment Scale–Client Attitudes(RSIPAS-CA), and a new, 27-item instrument to measure clients’ perceived relevance of religion/spirituality and mental health.

Results: A total of 1,018 met screening criteria (saw a mental health therapist in the last month), and the sample was representative of US adults, including demographics, region, and religious affiliation.

Regarding the first question, the RSIPAS-CA had high reliability(alpha=.91). Descriptive statistics indicated 58% agreed “it is important for my therapist to know how to discuss my RS in mental health therapy”(21% disagreed) and more clients preferred the therapist ask about their RS rather than the client bring it up. Further, 68% are “open to working with a therapist who has a different RS than [the client],” 75% agree “a good therapist is sensitive to clients’ RS beliefs,” and 71% “would be open to discussing [their] RS beliefs in therapy.”

Regarding the second question,the instrument measuring perceived relevance of RS and mental health initially had high reliability(alpha=.96). Among respondents,65% agreed “engaging in my RS practices improves my mental health,” 62% agreed “my RS beliefs motivate me to seek ways to become mentally healthy,” and 63% “consider my RS to be relevant to my mental health.” An exploratory factor analysis was done in SPSS on 40% of the sample(n=408), reducing the instrument to two scales (X²=9782.05,df=351,p<.001):Relevance of RS and mental health(eight items) & Relevance of RS struggles and mental health problems(four items). The remaining 60%(n=610) were used for a confirmatory factor analysis in Mplus, and the fit was adequate(Kline, 2005) with both scales reliable (alphas=.96 and .85,respectively) and valid.

Conclusions and Implications: As social work research explores the relationship between clients’ religion/spirituality and mental health, considering client preferences and whether these two areas of their lives are relevant to one another is critical. In addition to this first national effort to capture current clients’ views on this topic, this innovative, reliable and valid instrument may contribute to future studies.