Does Spirituality Have a Place in Therapy?

For a long time, I saw quite a clear division between spirituality and therapy.

I’ve always had a personal interest in spirituality, and I was certainly aware that I benefited from it mentally. At different points in my life, it has helped me gain a wider perspective on whatever I was going through and, perhaps most importantly, given me a sense of hope.

But that was personal. When it came to my work as a therapist, I was much less convinced that spirituality had a place.

I had no problem with practitioners who positioned themselves more specifically as spiritual therapists. That can cover a very wide spectrum, from therapists whose work is connected to a recognised religion or religious practice to those who work with approaches such as meditation, spiritual hypnosis or past life regression.

I just didn’t see that as what I did. I had my personal interest in spirituality on one side and my therapeutic work on the other.

I’m also a big fan of research. Again, on a personal level I didn’t need research to tell me that certain spiritual practices made me feel better. I knew they did. But when it came to my professional practice, if something couldn’t really be “proved”, I was far more cautious about giving it a place.

Over time, two realisations have shifted my thinking.

The first is that there doesn’t actually need to be such a hard and fast division. You don’t have to specialise in spiritual practices to allow spirituality into therapeutic work, and doing so doesn’t mean abandoning all the other psychological approaches you use.

Spirituality can simply be one part of someone’s life, alongside their relationships, physical health, work, family, past experiences, culture and everything else they bring into therapy.

The second realisation was that I was getting too caught up in the question of whether something was “true”.

If a client believes in God, reincarnation, an afterlife, a universal consciousness or some kind of connection that is difficult to put into words, I don’t think it’s particularly useful for me as a therapist to get into a debate about whether that belief can be proved.

A much more useful question is: does it help?

And when we start asking that question, there is actually research to draw on.

Does Spirituality Have a Place in Therapy? What Does the Research Tell Us?

Research into spirituality and psychotherapy has been growing for some time. Studies suggest that some clients actively want to be able to talk about religious and spiritual issues in therapy and that, when these areas are important to the client, incorporating them can be a useful addition to more conventional therapeutic approaches (Post & Wade, 2009).

More recent research has looked at what happens when psychological therapies actively incorporate a person’s existing religious or spiritual beliefs. Researchers brought together the findings of 23 controlled studies involving almost 1,500 people and found that, for people who already had a strong religious or spiritual affiliation, therapy that incorporated this part of their lives was associated with greater improvements in psychological symptoms and general functioning (Bouwhuis-Van Keulen et al., 2024).

Other researchers have looked at how spiritually integrated therapy is actually being used in everyday clinical practice. Looking across 35 studies, Captari et al. (2022) found spiritual approaches being incorporated into work involving trauma, eating disorders, general psychotherapy and existential concerns such as meaning and purpose.

None of this means that spirituality makes therapy better for everyone. It certainly doesn’t mean that therapists should introduce spiritual beliefs to clients who have no interest in them.

But it does suggest that spirituality can have a legitimate place in therapy when it is already meaningful to the person we are working with.

And I think that distinction is really important.

Why Might Spirituality Become More Important at Different Points in Life?

We don’t necessarily spend our whole lives thinking about why we are here.

There are periods when life itself takes up most of our attention. We might be establishing a career, bringing up children, managing relationships, paying bills, caring for other people and simply dealing with what needs to be done.

And then something changes.

It might be a bereavement, illness, trauma, menopause, children leaving home, the end of a relationship, retirement or simply becoming older. Sometimes there isn’t one obvious event at all. We just reach a stage where we begin looking at our lives differently.

And some of the questions that come up at those points are bigger ones.

What matters to me now?

What gives my life meaning?

What happens when I die?

What am I connected to?

What helps me make sense of being here?

Research suggests that spirituality can become particularly relevant around significant life changes. Research looking at people's experiences during major life events has found that spirituality can become part of how people make sense of what has happened to them and how they find meaning, hope and a way forward (Maley et al., 2016).

Bereavement is an obvious example. Research drawing together the experiences of people who had been bereaved found that spirituality could play a changing role throughout grief. It could offer meaning and connection, but people's spiritual beliefs could also change as a result of the loss itself (Martins et al., 2024).

Serious illness can bring similar questions to the surface. Balboni et al. (2022) looked at a very large body of research into spirituality, health and serious illness and concluded that spirituality was important enough to people's experiences that spiritual care should be recognised as part of person-centred care.

Ageing is interesting too. Research following people over many years suggests that there isn't one simple pattern in which everybody becomes more spiritual as they get older. Some people do, some don't. What does seem to happen is that the experiences that often accompany later life can lead us to think differently about meaning, relationships, mortality and what matters to us.

Perhaps, then, spirituality doesn't necessarily become more important because we reach a particular age. It may become more relevant because the questions we are asking have changed.

Spirituality Doesn't Have to Mean Religion

One of the things that has changed for me is my understanding of how broad spirituality can be.

For some people, spirituality is very clearly connected to religion. For others it might involve meditation, nature, a belief in an afterlife, reincarnation, a feeling of connection with something larger than themselves, or simply a sense that life has meaning beyond whatever is happening today.

Some people might not even use the word “spiritual” to describe these experiences.

And perhaps that matters when we're thinking about spirituality in therapy. If we assume spirituality means religion, or that it involves a particular set of beliefs, we may miss the many other ways people experience meaning, connection and a sense of something beyond themselves.

This is also where my thinking about approaches such as past life regression has changed.

I used to feel that I needed to decide what I thought about past lives before I could consider using past life regression therapeutically. Now, I'm much more interested in what the experience means to the client and what they take from it.

Someone might understand a past life experience literally. Someone else might see it as metaphor, imagination, unconscious storytelling or symbolic processing. And someone else might have absolutely no idea what they think it is.

I don't think I need to decide for them.

That thinking is now central to the way I teach my Past Lives, Present Healing past life regression training. The course looks at spiritual, psychological, symbolic and archetypal ways of understanding regression rather than asking practitioners or clients to accept one explanation as the truth.

For me, the important part is what happens as a result of the experience. Does it help someone see an old problem differently? Does it give them a different perspective on a relationship? Does it help them access feelings that have been difficult to reach? Does it create hope, meaning or a sense of connection?

Those are therapeutic questions.

So, Does Spirituality Have a Place in Therapy?

I think the research gives us good reason to take spirituality seriously as one possible part of a person's therapeutic experience.

That isn't the same as saying that spirituality belongs in every therapy session or that it will be helpful for everyone. Spirituality can also be complicated. Religious or spiritual beliefs can be associated with guilt, fear, conflict and distress, and recent research has highlighted the importance of recognising these spiritual struggles rather than assuming spirituality is always protective (Currier et al., 2025).

For me, the biggest change has been letting go of the idea that spirituality and evidence-informed therapy have to sit on opposite sides of a divide.

I can still be interested in research. I can still question things. I can still be sceptical. And at the same time, I can recognise that spirituality, however a person defines it, may be an important source of meaning, hope or connection.

So, does spirituality have a place in therapy?

I think perhaps the most useful answer is that it can have a place when it has a place in the client's life.

As therapists, we don't have to provide the answers to the bigger questions.

Sometimes we simply need to make enough room for our clients to ask them.

References

Balboni, T. A., VanderWeele, T. J., Doan-Soares, S. D., Long, K. N. G., Ferrell, B. R., Fitchett, G., Koenig, H. G., Bain, P. A., Puchalski, C., Steinhauser, K. E., Sulmasy, D. P., & Koh, H. K. (2022). Spirituality in serious illness and health. JAMA, 328(2), 184–197. https://doi.org/10.1001/jama.2022.11086

Bouwhuis-Van Keulen, A. J., Koelen, J., Eurelings-Bontekoe, L., Hoekstra-Oomen, C., & Glas, G. (2024). The evaluation of religious and spirituality-based therapy compared to standard treatment in mental health care: A multi-level meta-analysis of randomized controlled trials. Psychotherapy Research, 34(3), 339–352. https://doi.org/10.1080/10503307.2023.2241626

Captari, L. E., Hook, J. N., Hoyt, W., Davis, D. E., McElroy-Heltzel, S. E., & Worthington, E. L., Jr. (2022). Spiritually integrated psychotherapies in real-world clinical practice: Synthesizing the literature to identify best practices and future research directions. Psychotherapy, 59(1), 85–98. https://doi.org/10.1037/pst0000407

Currier, J. M., McDermott, R. C., Sanders, P., & Richards, P. S. (2025). Spiritual struggles drive psychological distress in psychotherapy: Replication of findings using a practice-research network. Psychotherapy, 62(3), 424–431. https://doi.org/10.1037/pst0000581

Maley, C. M., Pagana, N. K., Velenger, C. A., & Humbert, T. K. (2016). Dealing with major life events and transitions: A systematic literature review on and occupational analysis of spirituality. American Journal of Occupational Therapy, 70(4), 7004260010p1–7004260010p6. https://doi.org/10.5014/ajot.2016.015537

Martins, H., Romeiro, J., Casaleiro, T., Vieira, M., & Caldeira, S. (2024). Insights on spirituality and bereavement: A systematic review of qualitative studies. Journal of Clinical Nursing, 33(5), 1593–1603. https://doi.org/10.1111/jocn.17052

Post, B. C., & Wade, N. G. (2009). Religion and spirituality in psychotherapy: A practice-friendly review of research. Journal of Clinical Psychology, 65(2), 131–146. https://doi.org/10.1002/jclp.20563