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Traditionally, the word spirituality has been used for concepts and experiences that either are religious or are analogous to it. More recently, there has been controversy concerning the meaning and application of the term spirituality as it is differentiated from religion and religiosity. Inasmuch as the largest body of research relevant to issues in counseling and religion has concentrated on what can be defined as “religion and mental health,” this entry begins in that context and then addresses other understandings of spirituality.

The relation between religion and mental health can be divided into two separate, but related issues: the influence of religion on mental health and the place of religion in the counseling session.

The Influence of Religion on Mental Health

For centuries, some of the most brilliant minds in the world's cultures pondered the nature of the human condition in the context of religion. In general, these individuals took religion as a given, and presumed that the best life was that which conformed to the dictates of the religion with which the individual identified. Religion was generally presumed to be required for the good ordering of society, its function being to promote virtue and condemn vice, at least for the masses. When psychology began to emerge as a distinct discipline at the midpoint of the 19th century and sever its ties with philosophy, there was a general reconsideration of religion and its relation to human welfare. This process continued into the twentieth century, and a number of the founding fathers of the fledgling field of psychology essentially rejected religion out of hand (e.g., Sigmund Freud, John B. Watson, B. F Skinner) as a remnant of unsophisticated and superstitious thinking.

As the specialties of clinical and counseling psychology developed after World War II and were influenced by behavioral and psychoanalytic theories, psychology continued with the presumption that religion was the vestige of an earlier, irrational mentality, and that it was detrimental to optimal functioning. Items with religious content were included in the first edition of the Minnesota Multiphasic Personality Inventory (MMPI) because therapists had heard such phrases from their clients, and associated them with their clients' disorders. Positive correlations between the Marlowe-Crown Social Desirability scale and measures of religiousness were taken as evidence that religious individuals had a strong “approval motive” and thus their answers on other measures were suspect. Albert Ellis, one of the most prominent therapists of the second half of the 20th century, promoted rational-emotive therapy (RET), which took for granted that religion was irrational and thus a detriment to mental health.

Over time, evidence grew that the presumption of a general negative impact of religion on mental health was untenable. A large-scale factor analysis of the MMPI discovered that its religion-related items loaded on a factor orthogonal to those measuring disorders. These items were removed from the MMPI-2. Other research found that religious and nonreligious individuals differed in their response patterns to certain items on the Social Desirability Scale. When these items were removed, there was no correlation between the remaining items on the Social Desirability Scale and measures of religiosity.

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