Addressing therapist concerns about religion in cognitive behavioural therapy: why, when, and how?

Despite religion being an important part of some patients' identity and value systems, therapists report finding it challenging to discuss religion in therapy. Avoiding religion for these patients can have detrimental effects on the therapeutic alliance, treatment outcomes, and parity of access for minoritised groups. Therefore, this clinical guidance paper aims to support therapists to bring religion into the therapy room by addressing six key concerns: (1) difficulties raising the topic, (2) 'getting it wrong' when discussing religion, (3) therapist and patient differences, (4) managing negative or ambivalent beliefs about religion, (5) perceptions of insufficient knowledge, and (6) a lack of time for meaningful discussions. These barriers are explored by drawing on empirical evidence, clinical experience, and illustrative case examples. The paper aims to provide suggestions and next steps for how therapists can reflect on and address these concerns, aiming to enhance confidence and competence in integrating religion into CBT.