Religious and Non-religious Therapist Clinical Engagement as a Function of Selected Therapist and Client Variables

Religious clients represent a growing population of mental health consumers, and their problem presentations are complicated by their religious beliefs. Leading scholars assert that religious beliefs of clients are not only worthy of clinical exploration but essential for integration into treatment in order for these clients to make therapeutic gains. Yet, relative to the general population, a disproportionate number of psychologists identify as religious, a stable finding over the years and call into question of their capacity to effectively treat religious clients. Consistent with research on clinicians? value imposition, it is speculated that non-religious clinicians may demonstrate bias against religious clients. This study examined the effects of therapist religiousness (religious and non-religious), client problem presentation (religious and non-religious), and client ideation (healthy and unhealthy) on therapist clinical engagement in psychotherapy. The study employed a two-step methodology. First, an instrument was developed to measure therapist clinical engagement in psychotherapy. Second, using an analogue design, several hypotheses were tested regarding the above independent variables and therapist clinical engagement.

A national sample of psychologists (N = 154), ages 24 to 80, completed an online survey, consisting of a demographic questionnaire, and after viewing one of four video interview vignettes, also competed the Religious Commitment Inventory and the Clinical Engagement Scale. Using an established classification procedure, participants were separated into two groups: religious and non-religious. Exploratory Factor Analysis (EFA) yielded two factors on the Clinical Engagement Scale: Case Conceptualization and Alliance/Collaboration. Analysis of variance showed main effects for client problem presentation and client ideation but no main effect for therapist religiousness on Case Conceptualization. Post hoc analysis, however, revealed an interaction of therapist religiousness and client problem presentation on Case Conceptualization. Non-religious therapists engaged more with the non-religious client than the religious client. No main effects for therapist religiousness, client problem presentation, and client ideation were found on Alliance/Collaboration. Theoretical explanations of the findings and implications for psychological treatment, training, and further research were discussed.