Ethical implications1

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Feb 20, 2024

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Ethical Implications of Implementing Religion or Spirituality into Therapy Grand Canyon University PSY-510: Contemporary and Ethical Issues in Psychology Katie Wick February 7, 2024 1

Ethical Implications of Implementing Religion or Spirituality into Therapy For many clients who attend psychotherapy, incorporating their religion and spirituality into their therapy is important to them and their progress. On the other hand, some clients do not want religion or spirituality incorporated into their treatment. The implementation of religion or spirituality into therapy raises some ethical considerations that need to be considered to not harm the client. The four areas that we will be exploring are competence, multiple relationships, imposing religious values in therapy, and informed consent. Competence The APA ethical principles and code of conduct 2.01 states that psychologists are to provide services within the boundaries of their competence based on education, training, supervised experience, consultation, study, or professional experience (American Psychological Association, 2017) . Clients who want to have their religion incorporated into their therapy will need to find a therapist who has the appropriate training and is competent in the spiritual aspect of therapy. For clients seeking to include religion and spirituality, finding a therapist who is knowledgeable of the role and potential impact of religion and spirituality on health, mental health, and emotional well-being (Barnett & Johnson, 2011) , is going to be pivotal in accomplishing their goal in treatment. Some ways that a competent therapist can incorporate religion or spirituality into therapy is by praying, meditation, and reading scripture as part of the process. Therapists who do not have the proper education or training can inadvertently push their religious beliefs onto their clients. Clients who do not want spirituality in their treatment may feel coerced into believing the beliefs of the therapist and they may shy away from treatment in the future. The Christian worldview in regards to competence and making ethical decisions focuses on cultural humility and being genuinely curious and comfortable with 2

discussing a client's faith and having the willingness to say, “I don’t understand, but I’m willing to learn alongside of you (Abrams, 2023) ” Multiple Relationships Another ethical challenge concerning religion or spirituality is multiple relationships. Multiple relationships occur when a clinician is in a professional relationship, such as a therapist and another personal or professional relationship in a different context or a relationship with someone close to the close (Currier, Fox, Vieten, Pearce, & Oxhandler, 2023) . Examples of multiple relationships would be a therapist who is also the client's religious leader or a therapist who is also the client's teacher. There are some cases where it may be hard not to have a multiple relationship like living in a very small town where there is a lack of services. In these cases, the therapist would need to find another therapist for the client to see. If one is not available then boundaries will have to be set before treatment that would sever the other relationship. In cases of the therapist also being a religious leader the client may look more to the clergy member as a spiritual leader than a therapist. These skewed views can limit the responsiveness to the treatment the client accomplishes. Defining the therapeutic boundary will be vital for the client to receive appropriate care. The Christian worldview guides ethical decisions with multiple relationships by allowing clear and effective boundaries to be established that are essential for a clients well being. Imposing Religious Values in Therapy The role of bias with religious issues explicitly intersects with Principle E of the Code of Ethics. Psychologists should be intentional and diligent in preventing bias from affecting religious or spiritual issues in treatment (Hathaway, 2011) . In therapy, religion or spirituality has a place for most individuals, for some, it has no place. As a therapist we are not to impose or 3

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force our beliefs onto our clients, we should leave our personal preferences at the door and treat each client according to their beliefs and culture. Imposing religious values can lead to an inappropriate diagnosis of a patient such as being delusional. Such as the case with the new atheism. In the new atheism, it has become common to declare either theistic or atheistic beliefs to be a delusion (Hathaway, 2011) . Both of these ideas are true but just because someone, possibly the therapist, believes that one of these ideas is false, does not make it a delusional thought. As a therapist, one needs to be aware of their biases and avoid imposing them onto a client. Each client is entitled to treatment that does not violate their autonomy in their beliefs and that does not cause any harm. In order for therapists to provide respectful, competent treatment that involves religion or spirituality, the therapist will need education, consultation from peers, and continued training to ensure they are providing the non-biased, non-judgemental, and appropriate treatment that the client deserves. The Christian worldview helps guide ethical decisions in imposing religious values by guiding the therapist to leave their biases at the door, have compassion and consideration of others and their beliefs, and provide only the treatment options that the client wants to have integrated into their therapy. Informed Consent Informed consent is seen by many as the primary means of protecting the self-governing and privacy rights of those with whom psychologists work (Fisher, 2022) . Psychologists also shall not try any experimental procedures in lieu of standard psychotherapies without clear warrant and informed consent as implied by Principle A of nonmaleficence (Hathaway, 2011) When integrating religion and spirituality into therapy clinicians should inform patients as early as possible about their willingness to discuss religions and spirituality in a respectful, 4

open, and sensitive way (Currier, Fox, Vieten, Pearce, & Oxhandler, 2023) . At the beginning of establishing a treatment plan with a client, a therapist should ask the client about his or her beliefs and if they want their faith to be a part of treatment. If the client does not want faith-based therapy then the therapist should not use religion or spirituality in the treatment. If a therapist has different beliefs of religion and spirituality than the client they make the client aware of these conflicts of interest before proceeding with treatment. It is also important for the therapist to acknowledge that the integration of religion or spirituality is appropriate for every client. The client's autonomy and cultural background need to be respected in these regards. Ensuring that clients are fully aware of the risks and benefits of integrating religion or spirituality and obtaining informed consent the therapist will uphold the ethical principles and the client will receive the effective treatment that they are seeking. The Christian worldview guides ethical decision-making with informed consent in that it respects the client's rights and dignity to make informed decisions about their treatment. Informed consent grants the client autonomy in their treatment and ensures that they have all the information needed to make an informed decision. Conclusion The Christian worldview offers valuable insight into making ethical decisions about integrating religion or spirituality into a client's therapy. The Christian worldview offers hope of restoration, not only for individuals, but also for families, communities, and societies in which individuals live, work, and serve one another (Grand Canyon University, 2023) . By applying the Christian worldview and following the Code of Ethics and other guidelines in the field of psychology, clients can feel comfortable that they are receiving competent treatment from a therapist who has the proper education and training in the specific domain of therapy they are receiving, does not create multiple relationships that can alter the success of treatment, does not 5

hold biases or tries to impose their values of religion and spirituality onto the client, and provides all the valuable information and treatment options available so that the client can make an informed decision and give consent for treatment that will enable successful treatment. 6

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References Abrams, Z. (2023). Can religion and spirituality have a place in therapy? Experts say yes. Monitor on Psychology, 54 (8), 67. Retrieved from American Psychological Association: https://www.apa.org/monitor/2023/11/incorporating-religion-spirituality-therapy American Psychological Association. (2017). Ethical principles of psychologists and code of conduct . Retrieved from American Psychological Association: https://www.apa.org/ethics/code Barnett, J. E., & Johnson, W. B. (2011). Integrating spirituality and religion into psychotherapy: Persistent dilemmas, ethical issues, and a proposed decision-making process. Ethics & Behavior, 21 (2), 147-164. doi:https://doi-org.lopes.idm.oclc.org/10.1080/10508422.2011.551471 Currier, J. M., Fox, J., Vieten, C., Pearce, M., & Oxhandler, H. K. (2023). Enhancing competencies for the ethical integration of religion and spirituality in psychological services. Psychological Services, 20 (1), 40-50. doi:https://eds-p-ebscohost- com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=15&sid=68db8a62-0f17-49cd- aaed-1b8da44eee45%40redis Fisher, C. (2022). Decoding the ethics code: A practical guide for psychologists (5th ed.). Sage Publications. Grand Canyon University. (2023). One Foundation at GCU. Retrieved from Grand Canyon University: https://students.gcu.edu/one-foundation-grand-canyon-university 7

Hathaway, W. L. (2011). Ethical guidelines for using spiritually oriented interventions. In J. D. Aten, M. R. McMinn, & J. E. Worthington, Spiritually Oriented Interventions for Counseling and Psychotherapy (pp. 65-81). doi:http://dx.doi.org/10.1037/12313-003 8

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