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Religion: The Elephant In The Room

The Elephant

Religion/spirituality is “the elephant in the room,” when it comes to mental health treatment, says Baylor University researcher Holly Oxhandler, Ph.D.

“It’s “critical” that mental health providers be equipped to assess clients’ religion/spirituality.”

“Researchers examined data from 55 young adults (ages 18-25) with serious mental illness who had used crisis emergency services. Of the 55 young adults interviewed, 34 “mentioned religion or spirituality in the context of talking about their mental health symptoms and service use with little-to-no prompting,” researchers wrote.”

“The sample for the study was racially diverse and gender-balanced. Not all of those interviewed considered themselves religious, as 41 percent answered “other,” “I don’t know” or “none” when asked their religious preference. However, researchers found that religion and spirituality emerged as a unique way in which this sample was able to make sense of their difficult life situations and mental health struggles.” (source: Baylor University Media)

Not all associations were positive ones, but the ability and even the permission to speak about religion and spirituality is one that needs to be more often present in mental health treatment. Psychotherapists and counselors should be able to treat their patients’ belief systems with respect in most cases, and allow their patients to speak about them, or otherwise refer them to a therapist who can.

In the field of behavioral health, which focuses on addiction as well as mental health, there is often greater leeway and a greater sense of freedom to discuss religion, perhaps because of the acceptance of 12-Step programs. They used to speak about God, but today often more politically correct terms such as “higher power” are used. This gives tacit permission for people who aren’t sure whether or not they believe in the Creator (or are sure that they don’t) to express their belief that they themselves are spiritual beings.

In some cases, coming from a particular religious background may make therapists more sensitive and respectful of their patient’s explorations of spirituality even if different than their own; in others, it may not. And for many patients, they themselves do best when working with a counselor of their own faith-background. Therapists who don’t believe that psycho-spirituality is essential to whole-person development, especially if that spirituality looks different than their own, must work on developing an understanding of “where” their patient is “holding,” religiously/spiritually speaking.

The Elephant’s Suitcase

Elephants don’t necessarily travel light.


Prayer is one aspect of spirituality that may be central to a patient’s healing process as well as help them cope with symptoms of mental illness. There are some studies which suggest that various aspects of prayer can be helpful. From experience with thousands of patients, we have seen that at the very least prayer can provide a sense of calm and comfort, and sometimes, much more.


Another aspect of religion is connecting through community. Belonging to a religious group and attending religious services may provide those with mental illness with friends and a sense of connection, something that can be hard to come by. Isolation and loneliness can make anyone feel depressed, and interacting with others, having a sense of connection, can be a source of much needed joy.


One of the challenges of someone with any disability might have is feeling a sense of purpose, a sense that they matter. Religious groups offer volunteer opportunities of all kinds. Recently, I was in a corner grocery store and there was an older teen whose job it was to greet people and help anyone, especially older shoppers, find and carry the items they needed.

It turns out that the owner of the store was from the same religious community, and learned that this teen had depression and some slight cognitive disability and was not able to find a suitable summer job. He reached out to the boy’s family and asked him if he’d like a part-time volunteer job. Within a week he was paying the boy because the volunteer work he was doing turned out to be incredibly valuable. Shoppers were stopping in just to say hello.

I spoke to him and asked him how he was enjoying his summer and he said that helping others has changed his life–and that this was the best summer he ever had. Anyone who reads Therapy Soup regularly knows we often recommend that volunteering bean essential part of a treatment plan.







Religion: The Elephant In The Room

Richard Zwolinski, LMHC, CASAC & C.R. Zwolinski

Richard Zwolinski, LMHC, CASAC is the author of Therapy Revolution: Find Help, Get Better, and Move On Without Wasting Time or Money and is licensed in addiction and psychotherapy with over 25 years experience as well as a consultant to organizations and companies in the fields of mental health and addiction. He is the executive director of an outpatient behavioral health program. Learn more about Richard here.

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APA Reference
& C.R. Zwolinski, R. (2018). Religion: The Elephant In The Room. Psych Central. Retrieved on July 13, 2020, from


Last updated: 31 Jul 2018
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