Spirituality and Religiosity in Psychotherapy Practice. A National Survey of Psychological Psychotherapists
In the past two decades, a growing theoretical discussion and empirical exploration of clinically relevant issues related to spirituality and religiosity can be observed within academic psychology. Of special interest are the questions of the appropriate ways of dealing with spiritual and religious issues in a psychotherapeutic context as well as the clinical value of including spiritual and religious factors in psychotherapeutic practice and diagnostics. Up to now, empirical studies about this subject however mostly originate in the USA.
In the context of the project a national survey of psychological psychotherapists in private practice was conducted. The goal of the research project was to explore the attitudes and experiences of mental health professionals concerning the issues of spirituality and religiosity. Furthermore an understanding was to be gained of to which extent and in which form religiosity and spirituality play a role in contemporary psychotherapeutic practice. The research project was composed of three parts:
- In the course of a first survey a short questionnaire was employed which explored some of the central issues that were discussed at the time. This was sent to a sample of 1700 psychotherapists. The main goals of this short survey were to conduct intergroup comparisons of psychotherapists with different theoretical orientations as well as a survey which is as representative as possible.
- In an intermediate phase a questionnaire was developed for the assessment of the attitudes towards the relationship between spirituality/religion and psychotherapy. This questionnaire was empirically validated on the basis of a sample of 230 psychotherapists in the context of a diploma thesis. On the basis of the analysis of items and dimensions, an economic instrument with satisfactory to very good psycho-metric properties was composed for application in the second survey of the main study.
- In the second survey of the main study a more differentiated and extensive questionnaire was employed. It was sent to a partial sample of psychotherapists who had agreed in the course of the short survey to participate in a further in-depth-survey. The primary goal here was the differentiated exploration of certain central issues which could not be considered in the first survey for the sake of representativeness.
Selected results of the short questionnaire:The response rate was 57% with an N of 909. In addition, 55% of the participating psychotherapists (N=498) agreed to participate in a more detailed survey. The major psychotherapeutic schools - cognitive-behavioral-therapy, psychoanalytic / depth psychology approaches and client-centred psychotherapy - were approximately equally represented. Furthermore the non-respondent survey showed that the respondent sample was only slightly biased towards those who are more likely to find this topic of interest, namely psychotherapists with a humanistic or an integrative orientation. Alltogether the data can be considered as being approximately representative.
It became apparent that the subject areas of religiosity and spirituality are also a current and relevant topic for psychotherapists in the Federal Republic of Germany. The participants proved to be very open minded and interested as regards such issues. The psychotherapists estimated that an average of 22% of their clients address matters and problems related to spirituality and religiosity in the course of therapy. Comparable with Us-american surveys the survey data suggest that clinically relevant issues related to religiosity and spirituality receive only limited consideration in psychotherapy training. 81% of the psychotherapists reported that such issues were rarely or never included. A great portion of the psychotherapists advocated a greater consideration of this special subject in the context of academic education and psychotherapy training. 67% were of the opinion that it should play a greater part in the graduate education of psychologists and more than half of them estimated the possible benefit of further training concerning such issues for their own psychotherapeutic practice as moderately to very high.
Most notably the psychotherapists were found to have a sizeable personal investment in spirituality and religion. Asked for the relevance of spirituality / religiosity in their personal lives all in all 65% of the participants described those as of moderate importance (27%), or as fairly (22%) or very important (16%). A further remarkable finding of this study is, that spirituality and religiosity do also play an important role as influencing factor on the part of the psychotherapists. A total of 56% endorsed the assertion that their own spiritual/religious orientation influences their practice of psychotherapy at a moderately (27%), fairly (21%) or very strong level (8%).
By using analysis of variance procedures, the differences between the individual groups of theoretical orientation yielded significant results for nearly all of the dependent variables (confirmed by non-parametric procedures, Kruskal-Wallis). The course of the mean values within the dependent variables presented itself consistently as follows: The lowest levels were found for psychotherapists who self-classified their theoretical orientation as cognitive-behavioral, followed by psychodynamic / psychoanalytic and eclectic psychotherapists. The highest mean-values were shown by psychotherapists with a humanistic orientation. Altogether however the influence of the theoretical orientation with regard to the attitude towards and the experiences with the subject areas religiosity and spirituality proved to be comparatively small.
A multiple regression was performed to examine which factors on the part of the psychotherapists are predicting the discussion of religious / spiritual issues and problems in the course of psychotherapy. All together 26% of the variance could be explained by this analysis. It showed that personal characteristics, such as personal dealings with these subject areas, the relevance of religiosity or spirituality for one’s own life or the psychotherapists own belief in a higher transcendent reality, are more important than structural factors, such as professional status or psychotherapeutic orientation.
All in all the data do suggest that the issues of spirituality and religiosity are of considerable relevance for psychotherapeutic practitioners in the Federal Republic of Germany. The findings imply, that spiritual and religious factors should be given greater consideration in the context of academic education, postgraduate psychotherapeutic training as well as scientific research.
The systematic analysis of the findings of the third part of the project is still pending.
Project leader: Prof. Dr. Dr. Harald Walach
Cooperation Partner: Prof. Franz Caspar
Performance Part 1 and 3: Dr. Liane Hofmann
Performance Part 2: Dr. Liane Hofmann and Dipl.-Psych. Britta Möckelmann
Publications:
Hofmann, Liane (2011). Zur Relevanz von spirituellen Themen für psychotherapeutische Praktiker – Ergebnisse einer bundesweiten Studie. Bewusstseinswissenschaften – Transpersonale Psychologie und Psychotherapie. 17(2), S. 56–69. [Relevance of spiritual issues for psychotherapeutic practitioners - results of a national survey]
Hofmann Liane & Walach, Harald (2011). Spirituality and religiosity in psychotherapy - A representative survey among German psychotherapists. Psychotherapy Research, 21(02), pp. 179-192.
Hofmann, Liane (2011). Spirituelle oder religiöse Orientierung und deren Auswirkung auf die psychotherapeutische Tätigkeit. In A. Büssing & N.B. Kohls (Hrsg.), Spiritualität transdisziplinär. Wissenschaftliche Grundlagen im Zusammenhang mit Gesundheit und Krankheit. Heidelberg: Springer, S. 173-192. [The effects of psychotherapists' spiritual or religious orientation on their practice of psychotherapy]
Hofmann, Liane (2009) Spiritualität und Religiosität in der psychotherapeutischen Praxis. Eine bundesweite Befragung von Psychologischen Psychotherapeuten. Dissertation. Carl von Ossietzky Universität Oldenburg. [Spirituality and Religiosity in Psychotherapy Practice. A National Survey of Psychological Psychotherapists]
Hofmann, Liane, Britta Möckelmann und Harald Walach (2003): Entwicklung und empirische Validierung einer Skala zur Erfassung der Einstellung von Psychotherapeuten zum Verhältnis von Psychotherapie und Spiritualität/Religiosität. In: W. Belschner, L. Hofmann und H. Walach (Hg.): Auf dem Weg zu einer Psychologie des Bewusstseins. Oldenburg: BIS, S. 113-154. [Development and empirical validation of a scale for the assessment of psychotherapist attitudes towards the relationship between psychotherapy and spirituality/religiosity]
