Let’s Talk About It: Discussing Politics and Religion in Therapy
According to a 2024 Pew Research Center survey, many US adults (36%) don’t talk to close friends or family about religion, and a survey by the same group in 2016, revealed that 50% of US adults never or seldom bring up that subject with those outside their families. In that same 2024 survey, 23% reported they also don’t discuss politics with family or friends, which is not surprising, given that a 2022 survey showed that 88% of adults believe that there are strong or very strong conflicts between people of opposing political parties.
Given the sensitive nature of issues surrounding strongly held belief systems like religion and politics, it’s no wonder that many psychotherapy clients worry about raising them in their mental health counseling sessions. Additionally, early psychotherapy theorists like Sigmund Freud and B.F. Skinner dismissed religious paradigms as frivolous and unrelated to mental health, leading to generations of psychotherapists who received little, if any, guidance on how to assess client’s belief systems and the impact of these worldviews on client wellness. With lack of training came a worry, shared by many therapists, that they would not know how to respond in appropriate ways when clients brought up these topics, especially if they were unfamiliar with the belief system or personally disagreed with it.
However, going back as early as the 1940s and 50s, a growing number of psychotherapists have taken actions to bring awareness to the importance of belief systems on mental health and train providers to incorporate these discussions into secular mental health settings. A 2012 Duke University meta-study showed that there were over 3000 peer-reviewed studies linking religion, spirituality, and mental health, and this number has only grown in the intervening years. The advent of technology like functional MRIs have shown that practices like prayer, meditation, vigils, and other rituals can have strong positive impacts on the brain, particularly emotional regulation, stress management, and executive functioning. Other elements related to political and religious belief systems, like interaction with people who are perceived to have similar values and enacting associated values-driven actions have also been shown to have immense impacts on emotional resilience.
Conversations About Religion & Spirituality
The possible uses of religious and spiritual themes in mental health settings are limitless. However, authors such as Craig S. Cashwell & J. Scott Young and Tracy E. Robert & Virginia A. Kelly. have identified a number of specific instances where belief systems may assist in psychotherapeutic practice. They include:
Identifying client values and worldviews
Identifying strengths and sources of resiliency
Mindfulness and prayer in stress management
Transitioning into life phases such as adulthood, parenthood, and retirement.
Grief and loss
Forgiving oneself and others
Existential questions around life changing events such as illness and accidents.
Decisions around marriage, sex, family planning, and child-rearing.
Supporting transitions like job losses/changes and geographic moves
Addiction
Disasters and other adverse events
Empowerment when encountering racism, sexism, and other forms of oppression
Today groups like the Association for Spiritual, Ethics, and Religious Values in Counseling and the Society for the Psychology of Religion and Spirituality are active members of their respective parent groups, the American Counseling Association and American Psychological Association. They regularly hold professional development conferences, publish research journals, and advocate for public policy that reflects their values. Most importantly, they have published document such as the Competencies for Addressing Spiritual and Religious Issues in Counseling as a guide to both providers and clients on what constitutes ethical and culturally-sensitive use of these themes.
Conversations about Politics and World Events
Media representations of mental health issues often focus on factors that are internal to clients (thoughts and feelings) and ways they interact with clients’ immediate circumstances such as work, school, families, and friendships. However, there is growing research and anecdotal evidence that larger systemic issues may play a larger role in client wellness and the impacts may mirror symptoms associated with trauma. This was perhaps most obviously demonstrated in Spring of 2020 when the global COVID-19 pandemic and associated social, health, financial, and institutional declines led to increases in depression, anxiety, substance misuse, and symptoms that mirrored complex trauma across all demographics. However, the impacts of systemic factors such as increased economic disparities, discrimination based on visible and invisible identities, decrease of quality social interactions, and increased threats to the natural environment are among those named as most impactful to client wellness. Increased reliance on the 24-hour news cycle and social media alone have led to significant rates of anxiety, depression, family distress, and issues with attention and motivation. Meanwhile, there is a trove of research suggesting that discrimination based on race, sex, gender presentation, and sexual orientation can increase both mental and physical health risks.
Regardless of whether there is an identifiable impact, it is imperative that clients feel they can raise these topics in their counseling sessions. Mental health providers receive training that helps them: 1) learn knowledge about particular issues impacting their clients, 2) become aware of their own views of the issues, 3) learn skills to consider these issues in client conceptualizations and treatment goals, and 4) advocate for client wellness and the public at large at personal, institutional, and systems levels. Ethical mandates also require that mental health providers learn to set aside their personal views when engaging with clients, so they are able to objectively work toward client-defined goals and values – a practice known as values bracketing. ACA Divisions such as the Association for Multicultural Counseling and Development, Counselors for Social Justice, and Society for Sexual, Affectional, Intersex, and Gender Expansive Identities work to create this awareness for professional counselors. In parallel, the APA has many similar divisions, as well as divisions devoted to the Study of Social Issues; Environmental, Conservation, and Population Psychology; and Media and Technology.
Casting Nets and Testing the Waters: Starting These Conversations
As with many subjects that are discussed in counseling sessions, both providers and clients may be the party who initiates conversations. In the literature, the process by which providers let clients know they can and should bring up subjects is known as “casting nets”. The process by which clients may check to see if providers are open to certain subjects is known as “testing the waters.” Ideally, providers may “cast nets” with regard to any number of subjects, but here are some common ways that this process may apply to conversations around belief systems such as religion, spirituality, politics, or other systemic issues.
Provider Marketing: Providers will often directly and indirectly indicate subjects they are comfortable discussing on their websites and in other publicly available information. When researching a practice or specific provider, it may be useful to identify the agency’s mission statement or clinical scope, specific research or training associated with providers, or other specialty areas. It is important to note that differences of approach and training may exist among mental health counselors, those who provide counseling explicitly associated with a religious belief system, and clergy who occasionally provide counseling services. If you are unsure, you are always welcome to ask what the person’s primary professional identity is, what training they have received, and the scope of their license(s) and certifications.
Intake Paperwork: Once you have chosen a provider, there may be questions related to your culture or religious background on the questionnaires in your intake paperwork. Even if you don’t specifically identify with a nameable religion or culture, this is also a place you can record data related to specific values that were instrumental to your upbringing and your current worldview, social or political factors influencing your welfare, or other related data. There may be separate questions related to your education, socioeconomic status, or health in other areas of the paperwork, but you are welcome to restate them if you feel they apply to this area as well.
Meeting Your Provider: Regardless of what you choose to include in intake paperwork, your first meeting with your provider is a good time to let your provider know what is important to you. Your provider is likely to take some of your first meeting to ask for more detailed information about your background, your concerns, and your opinion of the things that influence you the most. Most will ask some standard questions asking for demographic information and the circumstances that make up your daily life as well as about values impacting your worldview and your goals for counseling. This is also a time for you to ask them questions.
First Session and Beyond: If you are not sure how your provider will react to discussions about your belief systems – whether part of a spiritual/religious framework or political philosophy – you have several options regarding how to bring these subjects up. Some clients will come right out and talk about these things, while others may “test the waters” by dropping subtle references to their belief system and see if the provider picks up on them. Regardless of how you choose to go about it, it is important to monitor how your provider responds. Do they make assumptions about what you might be talking about, or do they ask for more information? Does their behavior toward you change in any way? That said, providers are human and may not know everything there is to know, so what’s most important is that you feel comfortable clarifying and/or correcting them if they misunderstand something you are trying to express.
Utilization of Other Helpers: There may come a time in your counseling relationship when you recognize that discussion of how your belief system impacts your mental health is not best suited for a licensed psychotherapist. You may choose to also discuss interactions of your religious/spiritual beliefs with a religious counselor, pastoral counselor, clergy, religious healer, or other members of your congregation. Systemic oppressions and other civil rights issues may be better addressed by legal professionals such as lawyers, professional mediators, or case workers. If in doubt, be sure to ask your psychotherapist what is and is not in their scope of practice, and request referrals if necessary.
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Dr. Elisa Woodruff (she/they) has specific training in working with diverse populations, with a passion for helping clients navigate their social/cultural identities and utilizing values/beliefs to guide their work. They have taught specialized graduate courses and provided training to other mental health providers on techniques to ethically incorporate conversations about culture in general and religion/spirituality in particular into secular counseling conversations as well as ways to bracket biases and advocate for systemic change within institutions. Elisa is Past-President of the Illinois Society for Sexual Affectional Intersex and Gender Expansive Identities and member of the Illinois branch of Association for Spiritual Ethics and Religious Values in Counseling. Elisa is currently taking new clients. Call (630)-297-7559 to request an appointment today!!
