The Ethics Corner is a regular publication of the ABPP Ethics Committee, featuring clinical vignettes, ethical situations and dilemmas, and coverage of relevant ethical issues which arise in clinical and forensic settings. The ABPP Ethics Committee provides consultation services to ABPP specialists and constituents focused on responding to inquiries related to ethical standards, principles, and guidelines governing the practice of psychology. Contact them by submitting a Consultation Request Form and learn more on their website.
Professional psychology, along with so many other health care disciplines as well as society in general, have become increasingly attentive and sensitive to issues of cultural diversity in recent years. We are likely all well aware of diversity, equity, and inclusion (DEI) efforts within our professional organizations and institutions and the importance of becoming more culturally competent and humble in our various professional roles. Most of these efforts have focused on issues related to race, ethnicity, gender identity, sexual orientation, and various marginalized or historically oppressed groups. The American Psychological Association among many other organizations have offered numerous training opportunities, articles, books, webinars, and other materials to assist psychologists and other mental health professionals learn more about these important topics and incorporate them into their professional activities.
Our Code of Ethics makes it very clear that we need to be sure that we are well trained and competent to provide evidence based best practices that are culturally competent as well as culturally humble. In order to do so we have much to learn and keep abreast of when it comes to diversity, equity, and inclusion. Principle E: Respect for People’s Rights and Dignity of our Code of Ethics is especially relevant as it states:
“Psychologists respect the dignity and worth of all people, and the rights of individuals to privacy, confidentiality, and self-determination. Psychologists are aware that special safeguards may be necessary to protect the rights and welfare of persons or communities whose vulnerabilities impair autonomous decision-making. Psychologists are aware of and respect cultural, individual, and role differences, including those based on age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, and socioeconomic status, and consider these factors when working with members of such groups. Psychologists try to eliminate the effect on their work of biases based on those factors, and they do not knowingly participate in or condone activities of others based upon such prejudices.”
Additionally, our Code of Ethics also states in section 2.01b, Boundaries of Competence:
“Where scientific or professional knowledge in the discipline of psychology establishes that an understanding of factors associated with age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, or socioeconomic status is essential for effective implementation of their services or research, psychologists have or obtain the training, experience, consultation, or supervision necessary to ensure the competence of their services, or they make appropriate referrals…”
Although far from perfect, our profession has made great strides in becoming more aware and respectful of diversity when it comes to race, ethnicity, gender, gender identity, sexual orientation, and so forth. However, we have been remarkably less attentive to diversity based on religion and spirituality. Most psychologists have little if any training with religious diversity and tend to ignore this important part of their client’s identities (Vieten & Lukoff, 2022). In fact, some surveys have found that psychologists often feel more comfortable discussing the details of their client’s sexual lives rather than anything that might have to do with religion and spirituality (Knox et al., 2005). This state of affairs needs to be addressed, as religion and spirituality are certainly a large part of many people’s lives, identities, and speak to intersectionality since religion and spirituality is often associated with race, ethnicity, culture, and so forth. Additionally, religion and spirituality are common ways that people receive much needed social support, moral guidance, and cope with the various challenges and stressors in their lives. Ignoring or denying the role that religion and spirituality plays in the lives of our clients is not reasonable, appropriate, or ethically sound.
Since most psychologists tend to be secular with only a minority being actively engaged in a religious tradition themselves, many may feel at a loss as to how to rectify their lack of knowledge, training, and interest in religious influences in their client’s lives (Shafranske & Cummings, 2013). Sadly, too many psychologists may dismiss the role of religion in the lives of their clients or only see the role of religion as a negative influence. Too many psychologists may hold biases and prejudices about certain religious traditions, beliefs, practices, and identities that they are unfamiliar with or those that receive negative press attention. Personally, I have often experienced these biases as a recent APA Council member representing Division 36 (The Society for the Psychology of Religion and Spirituality) of APA.
So, how can psychologists ensure that they are more informed and trained on the role and impact of religion and spirituality among their clients and how can they best incorporate these issues into their professional roles consistent with our Code of Ethics? First, they might consider reviewing continuing education opportunities in these and related topics. They might review the resources that are available from Division 36 of APA as well. They may wish to read articles from the APA journal, Spirituality in Clinical Practice (in full disclosure, I am currently the editor-in-chief of this journal). Second, they might consider consulting with colleagues who specialize in this integration. Again, APA Division 36 might be helpful to find appropriate consultants as well contacting state psychological association referral networks as well. Consulting with experts including clerics is always a good idea as well. Perhaps the most important take home message is to treat religion and spirituality as you would any other type of cultural difference by acknowledging it, welcoming it, and respecting it within your professional work in a way that is open to understanding and engagement.
Further Learning
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.
Pargament, K. I., Mahoney, A., & Shafranske, E. P (Eds.) (2013). APA handbook of psychology, religion, and spirituality (Vol. 2): An applied psychology of religion and spirituality. American Psychological Association.
Plante, T. G. (2024). Spiritually Informed Therapy (SIT): Spiritually Informed Therapy: Wisdom and Evidence Based Strategies that Work, San Diego, CA: Cognella.
Society for the Psychology of Religion and Spirituality (APA Division 36)
References
American Psychological Association. (2017). Ethical principles of psychologists and code of conduct (2002, amended effective June 1, 2010, and January 1, 2017). https://www.apa.org/ethics/code/
Knox, S., Catlin, L., Casper, M., & Schlosser, L. Z. (2005). Addressing religion and spirituality in psychotherapy: Clients’ perspectives. Psychotherapy research, 15(3), 287-303.
Shafranske, E. P., & Cummings, J. P. (2013). Religious and spiritual beliefs, affiliations, and practices of psychologists. In K. I. Pargament, A. Mahoney, & E. P. Shafranske (Eds.), APA handbook of psychology, religion, and spirituality (Vol. 2): An applied psychology of religion and spirituality (pp. 23–41). American Psychological Association.
Vieten, C., & Lukoff, D. (2022). Spiritual and religious competencies in psychology. American Psychologist, 77(1), 26-38.
Thomas Plante, PhD, ABPP
Board Certified in Clinical Psychology
Correspondence: tplante@scu.edu