Psychotherapy Volume 27/Spring 1990/Number 1

RELIGIOSITY OF PSYCHOTHERAPISTS:A NATIONAL SURVEY

ALLEN E. BERGIN AND JAY P. JENSENBrigham Young University

A brief review of previous results onstudies of therapist religious values isprovided and compared with a newnational survey of clinicalpsychologists, marriage and familytherapists, social workers andpsychiatrists. The results confirm otherfindings in that psychologists show lowrates of conventional religiousaffiliation and participation; but wealso discovered a substantial amount ofreligious participation and spiritualinvolvement among all groups oftherapists beyond or in addition totraditional conventions. There may be areservoir of spiritual interests amongtherapists that is often unexpressed dueto the secular framework ofprofessional education and practice.This phenomenon, which we termed"spiritual humanism," could providethe basis for new dimensions ofpractice that might bridge the culturalgap between a secular profession and amore religious public. A large number

Portions of this article were presented at the annual conventionof the Society for Psychotherapy Research, Santa Fe, NewMexico, June 16, 1988. Parts of this presentation are basedon a doctoral dissertation by Jay Jensen (1986). We are gratefulto David Greaves for helpful suggestions; and we also gratefullyacknowledge financial support from an intramural researchgrant funded by the College of Family, Home and SocialSciences, Brigham Young University.

Correspondence regarding this article should be addressedto Allen E. Bergin, Brigham Young University, Dept. ofPsychology, 285 TLRB, Provo, UT 84602.

of distressed persons appear to desirehelp that is consistent with theirspiritual frames of reference.

Religious Orientation of the TherapistWhen discussing religion and psychotherapy,

it is helpful to recall the axiom that "every thera-peutic relationship is a cross-cultural experience."Bridging the perceptions and experiences of clientand therapist is comparable to gaining facilitywith another culture (Pedersen, Draguns, Lonner,& Trimble, 1981). Such is the case, on a collectivelevel, as our secular field addresses in a newlyrigorous way the world of the religious client.This cross-cultural gap begs to be bridged, for intheir deepest moments of self-comprehension andchange, many clients see, feel, and act in spiritualterms (Bergin, 1980a; 19806; 1986).

Previous FindingsData from previous surveys indicated that ther-

apists were less committed to traditional values,beliefs, and religious affiliations than the normalpopulation at large (Bergin, 1980a; Beit-Hallahmi,1977; Henry et al., 1971). Although there are lessdata concerning clients (rather than the generalpopulation), the existing findings support thosefound for nonclients. There has been some dis-cussion of whether these differences are simplydue to the fact that therapists' demographics aredifferent from those of the average client. Althoughsome degree of the variance in therapist valueorientations may be attributable to higher levelsof education, income, and family class background,it has been noted that psychologists and therapists(as a group) are particularly set apart by standardsthat are informed by a scientific Weltanschauung,a humanistic orientation, and a liberal politicaloutlook (Lovinger, 1984).

A study in Australia by Khan and Cross (1983),of more than 400 therapists and more than 400

A. E. Bergin & J. P. Jensen

clients, showed the therapists to emphasize valuesconcerning freer life styles, especially in the sexualarea, than clients. They also endorsed a flexible,growth-oriented philosophy more than the clients,who endorsed more strongly items having to dowith self-control and obedience. Similarly, ther-apists were found to be less religious in the tra-ditional sense.

Some have argued that such differences are duein part to the fact that therapist values are moreadvanced by virtue of education and experience(Walls, 1980), and that the therapeutic changeprocess is in part one of learning new values thatare healthier. Research does show in some studiesthat client values change in the direction of thetherapist's values (Beutler, 1981). The questionis whether this reflects an improvement in mentalhealth or is merely a matter of verbal reconditioningthat is coincidental to the change process.

A National Survey

In order to examine these matters further, theopinions of four groups of mental health profes-sionals in the United States were surveyed (Jensen,1986). The survey was conducted in 1985 andinvolved replies by 425 therapists representing59% of a national sampling of clinical psychol-ogists, psychiatrists, clinical social workers andmarriage and family therapists. Comparisonsshowed our sample to be demographically andgeographically comparable to national statisticson these groups. They were an experienced pop-ulation with half having had 16 or more years ofprofessional experience. It was found that thetherapists endorsed a set of values about whichthere was a high degree of professional consensusto the effect that they lead in the direction ofpositive mental health (Jensen & Bergin, 1988).To provide context for the reader we have sum-marized the previously published portion of theresults as follows:

These values concern one's sense of being a free agent; havinga sense of identity and feelings of worth; being skilled ininterpersonal communication, sensitivity, and nurturance; beinggenuine and honest; having self-control and personal respon-sibility; being committed in marriage, family, and other re-lationships; having orienting values and meaningful purposes;having deepened self-awareness and motivation for growth;having adaptive coping strategies for managing stresses andcrises; finding fulfillment in work; and practicing good habitsof physical health. These findings are consistent with otherassessments of practitioners' values (Cross & Khan, 1983)and of mental health values (Tyler et al., 1983).

(Jensen & Bergin, 1988, p. 295)

Despite this consensus on the value themes thatshould guide psychotherapy goals, there was con-siderable difference of opinion on the mental healthimplications of various religious and sexual lifestyles. A factor analysis helped to clarify thesefindings. The consensus values, described above,loaded heavily on the main, first factor, whichwe termed, Positive Mental Health. Opinions onreligion and sex were closely linked in a secondfactor we called Traditional Morality. To get abetter picture of the morality factor, we subse-quently explored the therapists' religiosity; andthese previously unreported findings are presentedherewith.

Table 1 shows the therapists' religious pref-erences. A large proportion (80%) claim sometype of religious preference, with Protestants beingthe most common group at 38%. It is interestingthat the second largest group consists of agnostic,atheist, humanist or none (20%). In Table 2 itshould be noted, however, that attendance at re-ligious services (a better measure of religiouscommitment than preference) is much lower than80%. Regular attenders account for 41%, whileoccasional attenders and non-attenders total 59%.This is closer to other estimates that showed slightlyless than 50% of psychologists to be believers intraditional religion (Ragan et al., 1980).

Another way we assessed the therapists' reli-giousness was via the classic Religious OrientationScale (ROS) developed by Allport and Ross (1967).This 21-item scale provides two subscale scores:The Intrinsic score reflects a kind of religiositymarked by inner conviction, spiritual experienceand resistance to social pressures contrary to one'sbeliefs; the Extrinsic score reflects a dependencyupon religion for emotional support and for socialapproval and social influence. Based on this mea-sure, 100 respondents were classified as intrinsicallyreligious, 28 as extrinsically religious, 102 as pro-religious (high in both intrinsic and extrinsic) and89 were nonreligious (low in both intrinsic andextrinsic), with 106 not responding to these items.Assuming that the non-responders did not like thetraditionally religous content of the items (a goodassumption), they may be classified with the non-religious, thereby bringing the total non-religiousto 195 (89 plus 106). Then, the ROS shows that230 of the 425 respondents can be classified inreligious terms, or 54%, which is consistent withour other findings and those of previous investi-gators.

For comparison purposes, we have inserted in

Religiosity of Therapists

TABLE 1. Religious Preference of Professional Groups vs. Public at Large (Percentages)

Variable

Religious PreferenceProtestantJewishCatholicAgnosticAtheistNoneLatter-day SaintUnitarianEastern (Asian)OtherHumanistGreek Orthodox

Totals

Marriage & FamilyTherapists

N = 118

49121452642212

—100

Clinical SocialWorkers

N = 106

40222063

—2422

——100

Psychiatrists

N = 71

30142113833

—41

—3

100

ClinicalPsychologists

N = 119

32249

1711222

—11

—100

Total

N = 414

381815106332211

—100

1984Gallup Poll"

N = 29,216

572

28

9

4

100

"Gallup Poll (Religion in America, 1985) included only five categories comparable to ours.

Tables 1 and 2 results on similar measures froma recent Gallup poll of the public at large (Religionin America, 1985). In Table 1, 91% of the publicshow a religious preference, which is somewhathigher than our professional sample (80%); butin Table 2 professionals are shown to have levelsof religious attendance and life-style commitment

that are surprisingly similar to the lay public'sprofile. In our survey, 41% of therapists attendservices regularly compared with 40% of the laypublic. Also, 77% of therapists try to live accordingto their religious beliefs compared with 84% ofthe public. This is discrepant from previous findingsand suggests that (a) those findings were misleading

TABLE 2. Religious Involvement of Professional Groups vs. Public at Large (Percentages)

Religious Service Attendance

RegularLow or never

I try hard to live my lifeaccording to my religiousbeliefsStrong agree/agreeUncertain/disagree/strong

disagreeMy whole approach to life is

based on my religionStrong agree/agreeUncertain/disagree/strong

disagree

Marriage &Family

Therapists

(N = 118)

5050

85

15

62

38

ClinicalSocial

Workers

(N = 106)

4456

83

17

46

54

Psychiatrists

(N = 71)

3268

74

26

39

61

ClinicalPsychologists

(N = 119)

3367

65

35

33

67

Total

(N = 414)

4159

77

23

46

54

1984Gallup Poll

(N = 1500)

40°60

84*

16

72r

28

"Gallup Poll (Religion in America, 1985) asked whether the respondent had attended a church or synagogue service withinthe previous 7 days. Forty percent said "yes."

*The Gallup item was: "I tried hard to put my religious beliefs into practice in my relations with all people. . . ."The Gallup item was: "My religious faith is the most important influence in my life."

A. E. Bergin & J. P. Jensen

or (b) that the professional population has changedin its orientation to religious issues in recent years,or (c) that earlier studies were over-representedby clinical psychologists, who are the least religioussubgroup.

Although the professionals' rates of conventionalreligious preference and involvement are lowerin some respects than for the public at large, theyshow an unexpected, sizeable personal investmentin religion by mental health professionals. Thisinvolvement is much greater than would be an-ticipated on the basis of published literature andconvention presentations in this field. There thusappears to be a significant degree of unrecognizedreligiousness among therapists. Some of this re-ligious interest is expressed in conventional ways,such as in affiliation and attendance, but a sizeableportion appers to be less conventional and morepersonal in form. This is shown especially in re-sponses to the questionnaire items listed in Table2 where 77% agreed with the item "I try hard tolive my life according to my religious beliefs"and where 46% agreed with the item "My wholeapproach to life is based on my religion." Otheritems in the survey, not shown in Table 2, alsoreflect this phenomenon clearly. In response tothe question: "Seek a spiritual understandingof the universe and one's place in it," 68% endorsethe item; while by contrast only 44% endorsehaving a "religious affiliation in which one activelyparticipates."

The patterns of preference, attendance and re-ligious orientation reflected in Tables 1 and 2 alsoshow differences across professions. Marriage andFamily Therapists consistently manifest the highestlevel of religiosity, followed closely by ClinicalSocial Workers, with Psychiatrists and, finally,Clinical Psychologists showing the least involve-ment. Tables 1 and 2 also reveal that the religiosityprofiles of Marriage and Family Therapists andClinical Social Workers are more similar to thoseof the public at large.

In light of a greater than expected involvementin religious issues by therapists, we were surprisedthat only 29% of them expressed a belief, in re-sponse to a survey item, that religous matters areimportant for treatment efforts with all or manyof their clients. The discrepancy between this resultand the amount of religious involvement by boththerapists and clients in their private lives maybe due to the fact that training, education andpractice currently provide little place for suchconsiderations. The clinical fields, in general, have

significantly addressed gender, ethnic and racialissues and, perhaps, the same consideration andemphasis need to be given to religious factors.

The lack of consensus among professionals re-garding the mental health implications of religiouspatterns of belief and conduct creates a dilemmain that laypersons generally endorse a religiousview of life. To the extent that therapists attemptto shape client change by influencing such sensitivethemes in people's lives, they are treading onrisky, and some would say, sacred territory. Thisis not to say that therapists should be inhibited orprevented from entering into any aspect of thepatient's life that is important for treatment; butit does suggest that empathic sensitivity to theissues of religiosity considered in this article wouldbe essential to avoiding harmful consequences.

For example, it is not uncommon to hear ofsecular therapists advising traditionally religiousclients to "give up" some aspect, or even all, oftheir religious commitment on the grounds thatone's beliefs and practices are inhibiting therapeuticprogress. It should be clear that such advice is athreat to some individuals' sense of identity andintegrity. While some changes in values may betherapeutic, an assault on the client's core valuesis most likely to be harmful (Bergin et al., 1988).

ConclusionGallup surveys (Religion in America, 1985)

continue to indicate that religious commitment isavowed by one-third of the American populationas being the most important dimension of theirlives. For another third, religion is consideredvery important but not the single most dominantfactor. For this two-thirds of the population, secularapproaches to psychotherapy may provide an alienvalues framework.

A majority of the population probably preferan orientation to counseling and psychotherapythat is sympathetic, or at least sensitive, to a spir-itual perspective. We need to better perceive andrespond to this public need (Bergin, 1988a; b).Indeed, it is still evident that most people whosuffer from emotional disorders prefer counselfrom clergy rather than mental health professionals(Veroff et al., 1981). Thus, while professionalopposition to a spiritual framework is still evident(Ellis, 1980; Seligman, 1988), it is hard to justify(Bergin, 1983).

The importance of religiosity for many clientsrequires a careful re-education of therapists whoseconceptual/clinical frameworks have room only

Religiosity of Therapists

for secular and naturalistic constructs. Bridgingthis cultural gap should prove rewarding, not onlyto the therapists who make the effort to enter intothis sphere of client experience, but also for thelarge number of clients who are hungry for helpthat is friendly and not foreign to their way ofthinking. They want someone who understandstheir perspective and who does not automaticallyinterpret their beliefs in pathological terms. It isperhaps because clients perceive the help offeredas foreign that so many decline to use it. It is alsopossible that the psychotherapy that does takeplace is hindered by an unspoken "religiosity gap."

The potential for a change in the direction ofgreater empathy for the religious client is under-scored by the surprisingly significant levels ofunexpressed religiosity that exists among mentalhealth professionals. There is apparently a blendof humanistic philosophy and spirituality that hasnot been well articulated. Perhaps this "spiritualhumanism" would add a valuable dimension tothe therapeutic repertoire if it were more clearlyexpressed and overtly translated into practice.

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