Psychological Reports, 1990, 66, 3-9.
@ Psychological Reports 1990
PSYCHOTHERAPISTS' RELIGIOUS BELIEFS A N D T H E I R PERCEPTION O F THE PSYCHOTHERAPY PROCESS WILLIAM C. GIBSON' AND WILLIAM G . HERRON St. John's University Summary.-In a comparison of religious and nonreligious psychotherapists' perceprions of a portion of a psychotherapeutic session no significant differences were found on the Vanderbilt Psychotherapy Process Scale for four groups of therapists des~gnaredaccording to their scores on three religious questionnaires. Whlle the results suggcsr attitudes toward religion are not reflected in therapists' practice of psychotherapy, bmitations of the study indicate the need for more rigorous testing of this possibility.
There has been controversy about the possible role played by therapists' religious beliefs in their practice of psychbtherapy. he broad conteit for this is the view that therapists' values inevitably enter into therapy (Kessel & McBrearty, 1967; London, 1986; Patterson, 1958; Williamson, 1958). The specific role of religious values has generated considerable discussion (Bergin, 1980a, 1980b; Curry, 1986; Ellis, 1980; Walls, 1980). Surveys of therapists' religious beliefs (Ragan, Malony, & Beit-Hallahmi, 1980; Shafranske & Gorsuch, 1984; Shafranske & Malony, 1985) indicated many therapists saw religion as potentially helpful in coping with life, but compared to the general public, therapists were less overtly religious. Studies of how religious and nonreligious therapists practice therapy have not been definitive. Some have observed no differences in cbnical judgment or diagnosis (Lewis & Lewis, 1985; Wadsworth & Checketcs, 1980), while others found differences in patients' perception of therapists who varied in religiosity (Hdowe, 1985; Worthington & Scott, 1983). The present study addressed one aspect of the issue not previously considered, the possibility of differences between religious and nonreligious therapists in their perception of the therapeutic process.
Subjects
The original groups sampled were 150 psychologists who were members of both Divisions 29 (Psychotherapy) and 36 (Psychologists Interested in Religious Issues) of the American Psychological Association and 150 psychologists who were members of Division 29 but not of Division 36. The first group was conceptualized as having face validity as "religious" therapists, the
'Requests for reprints should be sent to William C. Gibson, 306 B East Essex Avenue, Lansdowne, PA 19050.
4
W. C. GIBSON & W. G. HERRON
second as "nonreligious." Of the total of 300, 103 provided usable responses. They were then divided into four groups based on their responses on three religious beliefs questionnaires. Group 1 (n = 34) was made up of subjects scoring high on the Associational Involvement Scale and high on the Religious Beliefs Scale. They may have scored high or low on the Scale of Nondoctrinal Religion. They frequently attend services and other activities and ascribe to traditional religious beliefs. Group 2 (n = 33) was made up of subjects who scored low on the Associational Involvement Scale, high on the Scale of Nondoctrinal Religion, and either high or low on the Religious Belief Scale. These subjects may represent the "typical" religious position of spiritually inclined psychologists as described by Shafranske and Gorsuch (1984) and Shafranske and Malony (1984). These psychologists do not attend religious activities and may or may not ascribe to traditional beliefs, but do hold the more liberal nondoctrinal beliefs. Group 3 (n = 19) scored low on all three scales. This may correspond to an atheistic or agnostic position. Finally, Group 4 (n = 9) scored high on the Associational Involvement Scale but low on the Religious Beliefs Scale (their scores may have been high or low on the Scale of Nondoctrinal Religion). This group may represent those who attend religious activities for social reasons or out of habit but do not subscribe to traditional beliefs and may or may not subscribe to more liberal nondoctrinal beliefs. Over 83% of the subjects were between the ages of 3 1 and 60 yr. The respondents were predominantly white (95%). About 80% had been practicing from 6 to 25 yr., 90% saw patients individually, and 43% considered their theoretical orientation to be "eclectic." Over 60% indicated affiliation with one of three major religious groups (Catholic, Protestant, or Jewish), while over 13% considered themselves to be atheist or agnostic. Instruments All subjects received the Associational Involvement Scale (Lenski, 1963), a three-item scale measuring involvement in church and synagogue activities; the Religious Beliefs Scale (Brown & Ferguson, 1968), an eight-item scale assessing traditional theistic beliefs such as belief in God and humans' responsibility to God; and the Scale of Nondoctrinal Religion (Yinger, 1969), a seven-item scale assessing the respondents' perceptions of the value of religion in dealing with the human situation, the value of suffering, and the perception of order and pattern in the universe. Subjects also received the Vanderbilt Psychotherapy Process Scale (O'Mdey, Suh, & Strupp, 1983), an 80-item scale which quantifies characteristics of patients, therapists, and the patient-therapist relationshp from the point of view of an observer of a therapy session. This scale has been divided into eight subscales using principal components factor analysis (O'Malley, et al., 1983). These subscales are Patient Dependency, Patient Exploration, Patient Hostility, Patient Participa-
PSYCHOTHERAPISTS' RELIGIOUS BELIEFS
5
tion, Patient Psychic Distress, Negative Therapist Attitude, Therapist Exploration, Therapist Warmth, and Friendliness. These same scales were used in the data analysis and were derived by summing the scores on the constituent items for that scale.
Procedure Each of the 300 individuals chosen for the original potential subject pool were sent a covering letter giving a rationale for the study ("a study of variables related to the psychotherapy process"), an instruction sheet for completing the materials, a consent form, a demographic information questionnaire, a transcript of a portion of a therapy session, the Vanderbilt Psychotherapy Process Scale, the three religious beliefs questionnaires, a brief statement of the true purpose of the study, and a prepaid return envelope. The therapy segment chosen was of about 10 min. in length and was characterized by discussion of issues which have religious or moral overtones (loneliness, guilt, anger) to enhance the likelihood that subjects' religious beliefs would come into play when the segment was evaluated. Patients' anonymity and confidentiality were respected. To control for subjects' expectancies, subjects were asked to read and sign the consent form, complete the demographic questionnaire, read the transcript, then complete the Vanderbilt Scale. Only after this did they complete the religious beliefs questionnaires. This procedure is similar to that used by Hilowe (1985). Subjects were requested to return the consent form, demographic questionnaire, the Vanderbilt Scale, and religious beliefs questionnaires using the prepaid return envelope.
Statistics f Treatment A chi-squared analysis was used to compare the four subject groups' responses to demographic questions. These four groups were also compared, using analysis of variance, on their subscale responses on the Vanderbilt Psychotherapy Process Scale. Finally, a discriminant function analysis, using the statistical software package SPSSX (1988), was performed to judge whether subjects could be reliably classified into religious or nonreligious groups based on Vanderbilt Scale scores.
RESULTSAND DISCUSSION A significant difference was found between the groups on the demographic variable of religious affiliation. Those designating themselves as liberal, atheist or agnostic, and no religious affhation tended to fall into Groups 2, 3, or 4, so the number of traditional religious subjects in the total sample was in the minority. I n regard to the Vanderbilt Psychotherapy Process Scales, one subscale, Therapist Exploration, could not be used because 59 of the 103 subjects did not complete all the items. No significant differences were found on the
6
W. C. GIBSON
& W.
G . HERRON
other seven subscales. The means and standard deviations of the four groups on these scales are shown in Table 1. The discriminant function analysis gave three functions, but none reliably discriminated subjects into religious and nonreligious groups ( p > .05). TABLE 1 MEANSA N D STANDARD DEVIATIONS OF GROUPS ON VANDERBILT SCALES Variable
Patient Exploration Therapist Exploration Patient Participation Patient Hostility Therapist Warmth, Friendliness Neg311veTherapist Attitude Pat~cntPsychic Distress Patient Dependency
Group 1, n = 34 M SD 21.60 4.78
Group 2 , n=33 M SD 22.27 4.35
M
SD
21.00
4.08
Group 4 , n =9 M SD 23.06 3.58
27.52 1440 28 88 7 44 20.68 14.36
27.36 15.20 27.77 7.33 21.63 14.23
28.82 14.00 29.47 7.53 22.18 14.06
3.13 2.94 6.33 2.32 3.15 3.51
27.43 15.71 28.29 7.57 22.86 16.43
3.75 3.62 6.25 2.35 3.68 3.43
3.60 3.79 6.36 1.92 3.61 3.59
Group 3 , n = 19
4.73 2.63 3.09 2.07 2.81 3.95
Religious and nonreligious therapists did not differ in their perception of the therapy process. However, the results have to be considered tentative for a number of reasons. First, it may be that they do differ but the rneasuring instruments used were not sensitive to the differences. I n this regard, the reliability of the Vanderbilt Psychotherapy Process Scale when using a written transcript has been questioned by O'Malley and Gomes-Schwartz (1983). Practical constraints resulted in the use of a written presentation in this study, but a different mode of presentation, and/or a more fine-grained analysis of a therapy session might show differences. Another potential problem with the current study was the use of a short written transcript which did not present specific religious material. Thus the stimulus for a "religious" response may not have been sufficient. Also, the composition of the sample was a problem. The "face-validityu groups had 57% as nonreligious, 43% as religious. In the subsequent refinement into four groups, if Group 1, the formal adherents of religious practice, are considered religious, and the other three groups as nonreligious, then the sample was predominantly nonreligious. The definition of religious and nonreligious is an issue here because, in contrast, if Groups 1 and 2 are considered religious, which could be argued, then the sample is predominantly religious. Viewed either way, the sample may have been too homogeneous to produce differences in perception of the stimulus. Finally, it can be hypothesized that these results may reflect the actual situation. That is, religious and nonreligious therapists may not, in fact, perceive the therapy process differently, at least as religious beliefs and the
PSYCHOTHERAPISTS' RELIGIOUS BELIEFS
7
therapy process are defined by the scales used here. This is consistent with some previous findings. Wadsworth and Checketts (1980) found no difference in diagnosis between "religious" and "nonreligious" therapists. However, their only religion variable was religious affiliation. Similarly, Hillowe (1985) found no difference in "religiousm and "nonreligious" therapists' judgement of patients, using the same religious beliefs scales used here. Those studies finding differences between "religious" and "nonreligious" therapists either used different therapist groups (Worthington & Scott, 1983), measured different aspects of psychotherapy (Hillowe, 1985; Lewis & Lewis, 1985) or varied the "patient" presentation so that there were "religious" and "nonreligious" patient conditions (Hillowe, 1985; Lewis & Lewis, 1985; Worthington & Scott, 1983). Worthington and Scott (1983) compared graduate-student and doctoral-level psychologists with graduatestudent and postgraduate-level pastoral counselors. They also presented a fictitious patient, "Mrs. R.," in various "religious" conditions. Also, Hillowe (1985) varied the "patient's" religious presentation and measured prognostic aspects of the therapy situation. Finally, Lewis and Lewis (1985) measured therapists' attraction and varied their "patient's" religious presentation but also only measured therapists' religious affiliation. The present results suggest that, while a majority of the therapists sampled held religious beliefs and had religious affiliations, a minority were "active" in their religion. Also, beliefs for or against religion may have been left at the door of the therapy room. This possibility was addressed by Strupp (1980) and Worthington (1988). Both of these authors drew a distinction between "therapeutic values" and "therapist values." Therapeutic values (or essential therapeutic values) include belief in the value of freedom, independence, and individuality, and in individuals' rights, privileges, and responsibilities (Strupp, 1980). These are inherent in the theory of therapy held by the therapist. By way of contrast, therapists' values (Strupp called them "idiosyncratic values") are those religious, philosophical, or other values that are held by the individual therapist, regardless of any theoretical orientation. Religious beliefs fall into this category. Worthington (1988) noted that there will probably be some overlap and perhaps even conflict between these two classes of values. The point here is that therapists' values may not significantly affect the conduct of therapy in the majority of cases, despite what many authors have said. Bergin (1980a, 1980b), Kessel and McBrearty (1967), Patterson (1958), and Williamson (1958) have all stated their beliefs that therapists' values must affect how therapists d o therapy. Specific examples of how individual Christian therapists see this occurring were provided by Malony (1978) and Vayhinger (1978). I n his qualitative study, Cohen (1987) found that h s subjects, when given a choice between religious beliefs and adherence to a psychoanalytic world view, frequently
8
W. C. GIBSON & W. G . HERRON
gave up or drastically modified their religious beliefs. However, when it comes down to attempting to find statistically significant differences in measures from "religious" and "nonreligious" therapists, the results are far from conclusive and require further exploration. REFERENCES BERGM,A. E. (1980a) Psychotherapy and religious values. Jotrrnal of Consrrlting and Clinical Psychology, 48, 95-105. BERGIN, A. E. (1980b) Religious and humanistic values: a reply to Ellis and Walls. Journal of Constrlting and Clinical Psychology, 48, 642-645. L. (1968) Self-concept and religious belief. Psychological Reports, 22, BROWN, C., & FERGUSON, 266. COHEN,E. l? (1987) An exploratory study of religiously committed, psychoanalyticdy oriented clinicians. (Doctoral dissertation, City University of New York, 1986) Dissertation Abstracts International, 47, 3949B. CURRY, J. F. (1986) Beyond Ber in's theism: Christian humanism and psychotherapy. Paper presented at the meeting of the American Psychological Association, Washington, DC. ELLIS,A. (1980) Psychotherapy and atheistic values. Jorrrnal of Constrlting and Clinical Psychology, 48, 635-639. HILLOWE,B. V. (1985) The effect of religiosity of therapist and patient on clinical judgement. (Doctoral dissertation, Adelphi University, 1985) Dissertation Abstracts International, 46, 1687B. KESSEL,P., & MCBREARTY, J. P. (1967) Values and psychotherapy: a review of the literature. Percepttral and Motor Skills, 25, 669-690. LENSKI,G . (1963) The reLigiousjoctor. Garden City, NY: Doubleday (Anchor) LEWIS,K. N., & LEWIS, D. A. (1985) Im act of religious affharion on therapists' judgement of patients. Journal of Consulhng a n f ~ l i n i c aPl r y c h o L ~ 53, ~ ~ ,926-5132, LONDON,I? (1986) The modes and morals of psychotherapy. (2nd ed.) Washington, DC: Hemisphere. MALONY, H . N. (Ed.) (1978) Psychology and faith: the Christian experience of eighteen psychologists. Washington, DC: University Press of America. O'MALLEY,S. S., & GOMES-SCHWARTZ, B. (1983) The reliability of psychotherapy process ratings as a function of presentation mode. (Unpublished manuscript, Vanderbilt University, Nashville, TN) O'MALLEY,S. S., SUH,C. S., & STRUPP,H. H. (1983) The Vanderbilt Psychotherapy Process Scale: a report on the scale development and a process-outcome study. Journal of Consulting and Clinical Psychology, 5 1, 581-586. PATTERSON, C. H. (1958) The place of values in counseling and psychotherapy. Journal of Counseling Psychology, 5, 216-223. RAGAN, C., MALONY, H. N., & BEIT-HALLAHMI, B. (1980) Psychologists and religion: professional factors and personal belief. Revim of Religious Research, 21, 208-217. SHAFRANSKE, E. P., & G O R S U CR. ~ I ,L. (1984) Factors associated with the perception of spirituality in psychotherapy. Jorrrnal of Trnnspersonal Psychology, 16, 231-241. SHAFRANSKE, E. P., & MALONY, H. N. (1985) Psychologists' religious and spiritual orientations and their practice of psychotherapy. Paper presented at the meeting of the American Psychological Association, Los Angeles, CA. STATISTICALPACKAGE FOR ~ L SOCIAL E SCIENCES, INC. (1988) SPSS' user's guide. Chicago, IL: Author. STRUPP,H. H. (1980) Humanism and psychorherapy: a personal statement of the therapist's essential values. Psychotherapy: Theory, Research, and Practice, 17, 336-400. VAYHINGER, J. M. (1978) Science and religion reconsidered. In H . N. Malony (Ed.), Psychology and faith: the Christian experience o/ czghleen psychologists. Washington, DC: Univer. Press of America. Pp. 60-69. WADSWORTH, J. D., & CHECKET~S, K. T. (1980) Influence of religious affiliation on psychodiagnosis. Jorrrnal of Consulting and Clinical Psychology, 48, 234-240.
PSYCHOTHERAPISTS' RELIGIOUS BELIEFS
9
WALLS,G . B. (1980) Values and psychotherapy: a comment on "Psychotherapy and religious values." Journal of Consulting and Clinical Psychology, 48, 640-648. WLLI~AEUISON, E. G. (1958) Value orientation in counseling. Personnel and Guidance ]ournal, 36, 520-528. WORTHLUGTON, E. L., JR. (1988) Understanding the values of religious clients, a model and its application to counseling. Journal of Counseling, 35, 166-174. WORTHINGTON, E. L., JR., & SCOTT, G. G. (1983) Goal selection for counseling with potentially religious clients by rofessional and student counselors in explicitly Christian or secular settings. ]ournu1 o ~ y c h o l o g j land Theology, 11, 3 18-329. YINGER,J. M. (1969) A structutal examination of religion. Journal for the Scientific Study of Religion, 8, 86-99.
Accepted January 3, 1990.
@ Psychological Reports 1990
PSYCHOTHERAPISTS' RELIGIOUS BELIEFS A N D T H E I R PERCEPTION O F THE PSYCHOTHERAPY PROCESS WILLIAM C. GIBSON' AND WILLIAM G . HERRON St. John's University Summary.-In a comparison of religious and nonreligious psychotherapists' perceprions of a portion of a psychotherapeutic session no significant differences were found on the Vanderbilt Psychotherapy Process Scale for four groups of therapists des~gnaredaccording to their scores on three religious questionnaires. Whlle the results suggcsr attitudes toward religion are not reflected in therapists' practice of psychotherapy, bmitations of the study indicate the need for more rigorous testing of this possibility.
There has been controversy about the possible role played by therapists' religious beliefs in their practice of psychbtherapy. he broad conteit for this is the view that therapists' values inevitably enter into therapy (Kessel & McBrearty, 1967; London, 1986; Patterson, 1958; Williamson, 1958). The specific role of religious values has generated considerable discussion (Bergin, 1980a, 1980b; Curry, 1986; Ellis, 1980; Walls, 1980). Surveys of therapists' religious beliefs (Ragan, Malony, & Beit-Hallahmi, 1980; Shafranske & Gorsuch, 1984; Shafranske & Malony, 1985) indicated many therapists saw religion as potentially helpful in coping with life, but compared to the general public, therapists were less overtly religious. Studies of how religious and nonreligious therapists practice therapy have not been definitive. Some have observed no differences in cbnical judgment or diagnosis (Lewis & Lewis, 1985; Wadsworth & Checketcs, 1980), while others found differences in patients' perception of therapists who varied in religiosity (Hdowe, 1985; Worthington & Scott, 1983). The present study addressed one aspect of the issue not previously considered, the possibility of differences between religious and nonreligious therapists in their perception of the therapeutic process.
Subjects
The original groups sampled were 150 psychologists who were members of both Divisions 29 (Psychotherapy) and 36 (Psychologists Interested in Religious Issues) of the American Psychological Association and 150 psychologists who were members of Division 29 but not of Division 36. The first group was conceptualized as having face validity as "religious" therapists, the
'Requests for reprints should be sent to William C. Gibson, 306 B East Essex Avenue, Lansdowne, PA 19050.
4
W. C. GIBSON & W. G. HERRON
second as "nonreligious." Of the total of 300, 103 provided usable responses. They were then divided into four groups based on their responses on three religious beliefs questionnaires. Group 1 (n = 34) was made up of subjects scoring high on the Associational Involvement Scale and high on the Religious Beliefs Scale. They may have scored high or low on the Scale of Nondoctrinal Religion. They frequently attend services and other activities and ascribe to traditional religious beliefs. Group 2 (n = 33) was made up of subjects who scored low on the Associational Involvement Scale, high on the Scale of Nondoctrinal Religion, and either high or low on the Religious Belief Scale. These subjects may represent the "typical" religious position of spiritually inclined psychologists as described by Shafranske and Gorsuch (1984) and Shafranske and Malony (1984). These psychologists do not attend religious activities and may or may not ascribe to traditional beliefs, but do hold the more liberal nondoctrinal beliefs. Group 3 (n = 19) scored low on all three scales. This may correspond to an atheistic or agnostic position. Finally, Group 4 (n = 9) scored high on the Associational Involvement Scale but low on the Religious Beliefs Scale (their scores may have been high or low on the Scale of Nondoctrinal Religion). This group may represent those who attend religious activities for social reasons or out of habit but do not subscribe to traditional beliefs and may or may not subscribe to more liberal nondoctrinal beliefs. Over 83% of the subjects were between the ages of 3 1 and 60 yr. The respondents were predominantly white (95%). About 80% had been practicing from 6 to 25 yr., 90% saw patients individually, and 43% considered their theoretical orientation to be "eclectic." Over 60% indicated affiliation with one of three major religious groups (Catholic, Protestant, or Jewish), while over 13% considered themselves to be atheist or agnostic. Instruments All subjects received the Associational Involvement Scale (Lenski, 1963), a three-item scale measuring involvement in church and synagogue activities; the Religious Beliefs Scale (Brown & Ferguson, 1968), an eight-item scale assessing traditional theistic beliefs such as belief in God and humans' responsibility to God; and the Scale of Nondoctrinal Religion (Yinger, 1969), a seven-item scale assessing the respondents' perceptions of the value of religion in dealing with the human situation, the value of suffering, and the perception of order and pattern in the universe. Subjects also received the Vanderbilt Psychotherapy Process Scale (O'Mdey, Suh, & Strupp, 1983), an 80-item scale which quantifies characteristics of patients, therapists, and the patient-therapist relationshp from the point of view of an observer of a therapy session. This scale has been divided into eight subscales using principal components factor analysis (O'Malley, et al., 1983). These subscales are Patient Dependency, Patient Exploration, Patient Hostility, Patient Participa-
PSYCHOTHERAPISTS' RELIGIOUS BELIEFS
5
tion, Patient Psychic Distress, Negative Therapist Attitude, Therapist Exploration, Therapist Warmth, and Friendliness. These same scales were used in the data analysis and were derived by summing the scores on the constituent items for that scale.
Procedure Each of the 300 individuals chosen for the original potential subject pool were sent a covering letter giving a rationale for the study ("a study of variables related to the psychotherapy process"), an instruction sheet for completing the materials, a consent form, a demographic information questionnaire, a transcript of a portion of a therapy session, the Vanderbilt Psychotherapy Process Scale, the three religious beliefs questionnaires, a brief statement of the true purpose of the study, and a prepaid return envelope. The therapy segment chosen was of about 10 min. in length and was characterized by discussion of issues which have religious or moral overtones (loneliness, guilt, anger) to enhance the likelihood that subjects' religious beliefs would come into play when the segment was evaluated. Patients' anonymity and confidentiality were respected. To control for subjects' expectancies, subjects were asked to read and sign the consent form, complete the demographic questionnaire, read the transcript, then complete the Vanderbilt Scale. Only after this did they complete the religious beliefs questionnaires. This procedure is similar to that used by Hilowe (1985). Subjects were requested to return the consent form, demographic questionnaire, the Vanderbilt Scale, and religious beliefs questionnaires using the prepaid return envelope.
Statistics f Treatment A chi-squared analysis was used to compare the four subject groups' responses to demographic questions. These four groups were also compared, using analysis of variance, on their subscale responses on the Vanderbilt Psychotherapy Process Scale. Finally, a discriminant function analysis, using the statistical software package SPSSX (1988), was performed to judge whether subjects could be reliably classified into religious or nonreligious groups based on Vanderbilt Scale scores.
RESULTSAND DISCUSSION A significant difference was found between the groups on the demographic variable of religious affiliation. Those designating themselves as liberal, atheist or agnostic, and no religious affhation tended to fall into Groups 2, 3, or 4, so the number of traditional religious subjects in the total sample was in the minority. I n regard to the Vanderbilt Psychotherapy Process Scales, one subscale, Therapist Exploration, could not be used because 59 of the 103 subjects did not complete all the items. No significant differences were found on the
6
W. C. GIBSON
& W.
G . HERRON
other seven subscales. The means and standard deviations of the four groups on these scales are shown in Table 1. The discriminant function analysis gave three functions, but none reliably discriminated subjects into religious and nonreligious groups ( p > .05). TABLE 1 MEANSA N D STANDARD DEVIATIONS OF GROUPS ON VANDERBILT SCALES Variable
Patient Exploration Therapist Exploration Patient Participation Patient Hostility Therapist Warmth, Friendliness Neg311veTherapist Attitude Pat~cntPsychic Distress Patient Dependency
Group 1, n = 34 M SD 21.60 4.78
Group 2 , n=33 M SD 22.27 4.35
M
SD
21.00
4.08
Group 4 , n =9 M SD 23.06 3.58
27.52 1440 28 88 7 44 20.68 14.36
27.36 15.20 27.77 7.33 21.63 14.23
28.82 14.00 29.47 7.53 22.18 14.06
3.13 2.94 6.33 2.32 3.15 3.51
27.43 15.71 28.29 7.57 22.86 16.43
3.75 3.62 6.25 2.35 3.68 3.43
3.60 3.79 6.36 1.92 3.61 3.59
Group 3 , n = 19
4.73 2.63 3.09 2.07 2.81 3.95
Religious and nonreligious therapists did not differ in their perception of the therapy process. However, the results have to be considered tentative for a number of reasons. First, it may be that they do differ but the rneasuring instruments used were not sensitive to the differences. I n this regard, the reliability of the Vanderbilt Psychotherapy Process Scale when using a written transcript has been questioned by O'Malley and Gomes-Schwartz (1983). Practical constraints resulted in the use of a written presentation in this study, but a different mode of presentation, and/or a more fine-grained analysis of a therapy session might show differences. Another potential problem with the current study was the use of a short written transcript which did not present specific religious material. Thus the stimulus for a "religious" response may not have been sufficient. Also, the composition of the sample was a problem. The "face-validityu groups had 57% as nonreligious, 43% as religious. In the subsequent refinement into four groups, if Group 1, the formal adherents of religious practice, are considered religious, and the other three groups as nonreligious, then the sample was predominantly nonreligious. The definition of religious and nonreligious is an issue here because, in contrast, if Groups 1 and 2 are considered religious, which could be argued, then the sample is predominantly religious. Viewed either way, the sample may have been too homogeneous to produce differences in perception of the stimulus. Finally, it can be hypothesized that these results may reflect the actual situation. That is, religious and nonreligious therapists may not, in fact, perceive the therapy process differently, at least as religious beliefs and the
PSYCHOTHERAPISTS' RELIGIOUS BELIEFS
7
therapy process are defined by the scales used here. This is consistent with some previous findings. Wadsworth and Checketts (1980) found no difference in diagnosis between "religious" and "nonreligious" therapists. However, their only religion variable was religious affiliation. Similarly, Hillowe (1985) found no difference in "religiousm and "nonreligious" therapists' judgement of patients, using the same religious beliefs scales used here. Those studies finding differences between "religious" and "nonreligious" therapists either used different therapist groups (Worthington & Scott, 1983), measured different aspects of psychotherapy (Hillowe, 1985; Lewis & Lewis, 1985) or varied the "patient" presentation so that there were "religious" and "nonreligious" patient conditions (Hillowe, 1985; Lewis & Lewis, 1985; Worthington & Scott, 1983). Worthington and Scott (1983) compared graduate-student and doctoral-level psychologists with graduatestudent and postgraduate-level pastoral counselors. They also presented a fictitious patient, "Mrs. R.," in various "religious" conditions. Also, Hillowe (1985) varied the "patient's" religious presentation and measured prognostic aspects of the therapy situation. Finally, Lewis and Lewis (1985) measured therapists' attraction and varied their "patient's" religious presentation but also only measured therapists' religious affiliation. The present results suggest that, while a majority of the therapists sampled held religious beliefs and had religious affiliations, a minority were "active" in their religion. Also, beliefs for or against religion may have been left at the door of the therapy room. This possibility was addressed by Strupp (1980) and Worthington (1988). Both of these authors drew a distinction between "therapeutic values" and "therapist values." Therapeutic values (or essential therapeutic values) include belief in the value of freedom, independence, and individuality, and in individuals' rights, privileges, and responsibilities (Strupp, 1980). These are inherent in the theory of therapy held by the therapist. By way of contrast, therapists' values (Strupp called them "idiosyncratic values") are those religious, philosophical, or other values that are held by the individual therapist, regardless of any theoretical orientation. Religious beliefs fall into this category. Worthington (1988) noted that there will probably be some overlap and perhaps even conflict between these two classes of values. The point here is that therapists' values may not significantly affect the conduct of therapy in the majority of cases, despite what many authors have said. Bergin (1980a, 1980b), Kessel and McBrearty (1967), Patterson (1958), and Williamson (1958) have all stated their beliefs that therapists' values must affect how therapists d o therapy. Specific examples of how individual Christian therapists see this occurring were provided by Malony (1978) and Vayhinger (1978). I n his qualitative study, Cohen (1987) found that h s subjects, when given a choice between religious beliefs and adherence to a psychoanalytic world view, frequently
8
W. C. GIBSON & W. G . HERRON
gave up or drastically modified their religious beliefs. However, when it comes down to attempting to find statistically significant differences in measures from "religious" and "nonreligious" therapists, the results are far from conclusive and require further exploration. REFERENCES BERGM,A. E. (1980a) Psychotherapy and religious values. Jotrrnal of Consrrlting and Clinical Psychology, 48, 95-105. BERGIN, A. E. (1980b) Religious and humanistic values: a reply to Ellis and Walls. Journal of Constrlting and Clinical Psychology, 48, 642-645. L. (1968) Self-concept and religious belief. Psychological Reports, 22, BROWN, C., & FERGUSON, 266. COHEN,E. l? (1987) An exploratory study of religiously committed, psychoanalyticdy oriented clinicians. (Doctoral dissertation, City University of New York, 1986) Dissertation Abstracts International, 47, 3949B. CURRY, J. F. (1986) Beyond Ber in's theism: Christian humanism and psychotherapy. Paper presented at the meeting of the American Psychological Association, Washington, DC. ELLIS,A. (1980) Psychotherapy and atheistic values. Jorrrnal of Constrlting and Clinical Psychology, 48, 635-639. HILLOWE,B. V. (1985) The effect of religiosity of therapist and patient on clinical judgement. (Doctoral dissertation, Adelphi University, 1985) Dissertation Abstracts International, 46, 1687B. KESSEL,P., & MCBREARTY, J. P. (1967) Values and psychotherapy: a review of the literature. Percepttral and Motor Skills, 25, 669-690. LENSKI,G . (1963) The reLigiousjoctor. Garden City, NY: Doubleday (Anchor) LEWIS,K. N., & LEWIS, D. A. (1985) Im act of religious affharion on therapists' judgement of patients. Journal of Consulhng a n f ~ l i n i c aPl r y c h o L ~ 53, ~ ~ ,926-5132, LONDON,I? (1986) The modes and morals of psychotherapy. (2nd ed.) Washington, DC: Hemisphere. MALONY, H . N. (Ed.) (1978) Psychology and faith: the Christian experience of eighteen psychologists. Washington, DC: University Press of America. O'MALLEY,S. S., & GOMES-SCHWARTZ, B. (1983) The reliability of psychotherapy process ratings as a function of presentation mode. (Unpublished manuscript, Vanderbilt University, Nashville, TN) O'MALLEY,S. S., SUH,C. S., & STRUPP,H. H. (1983) The Vanderbilt Psychotherapy Process Scale: a report on the scale development and a process-outcome study. Journal of Consulting and Clinical Psychology, 5 1, 581-586. PATTERSON, C. H. (1958) The place of values in counseling and psychotherapy. Journal of Counseling Psychology, 5, 216-223. RAGAN, C., MALONY, H. N., & BEIT-HALLAHMI, B. (1980) Psychologists and religion: professional factors and personal belief. Revim of Religious Research, 21, 208-217. SHAFRANSKE, E. P., & G O R S U CR. ~ I ,L. (1984) Factors associated with the perception of spirituality in psychotherapy. Jorrrnal of Trnnspersonal Psychology, 16, 231-241. SHAFRANSKE, E. P., & MALONY, H. N. (1985) Psychologists' religious and spiritual orientations and their practice of psychotherapy. Paper presented at the meeting of the American Psychological Association, Los Angeles, CA. STATISTICALPACKAGE FOR ~ L SOCIAL E SCIENCES, INC. (1988) SPSS' user's guide. Chicago, IL: Author. STRUPP,H. H. (1980) Humanism and psychorherapy: a personal statement of the therapist's essential values. Psychotherapy: Theory, Research, and Practice, 17, 336-400. VAYHINGER, J. M. (1978) Science and religion reconsidered. In H . N. Malony (Ed.), Psychology and faith: the Christian experience o/ czghleen psychologists. Washington, DC: Univer. Press of America. Pp. 60-69. WADSWORTH, J. D., & CHECKET~S, K. T. (1980) Influence of religious affiliation on psychodiagnosis. Jorrrnal of Consulting and Clinical Psychology, 48, 234-240.
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WALLS,G . B. (1980) Values and psychotherapy: a comment on "Psychotherapy and religious values." Journal of Consulting and Clinical Psychology, 48, 640-648. WLLI~AEUISON, E. G. (1958) Value orientation in counseling. Personnel and Guidance ]ournal, 36, 520-528. WORTHLUGTON, E. L., JR. (1988) Understanding the values of religious clients, a model and its application to counseling. Journal of Counseling, 35, 166-174. WORTHINGTON, E. L., JR., & SCOTT, G. G. (1983) Goal selection for counseling with potentially religious clients by rofessional and student counselors in explicitly Christian or secular settings. ]ournu1 o ~ y c h o l o g j land Theology, 11, 3 18-329. YINGER,J. M. (1969) A structutal examination of religion. Journal for the Scientific Study of Religion, 8, 86-99.
Accepted January 3, 1990.
