Attitudes and Preferences Regarding Mental Illness and Treatment Among Christian and Religious/Spiritual-Unaffiliated Individuals in the USA

Research regarding the role of a religious/spiritual (R/S) identity in psychotherapeutic processes and outcomes is limited. Consideration of client treatment preferences specifically has implications for treatment engagement and retention; however, research on the relationship between preferences and client R/S identification is mixed. The current project included two studies of R/S-unaffiliated (Study 1, n = 96; Study 2, n = 135) and Christian (Study 1, n = 90; Study 2, n = 132) participants in the USA. Study 1 investigated differences between these individuals with respect to attitudes toward mental health, preferences for therapist characteristics, and treatment preferences. Study 2 replicated Study 1 in a different community sample and considered how the degree of engagement in R/S services and activities may play a role in therapy-related variables. Results indicated that Christian individuals differed from R/S-unaffiliated individuals in regard to beliefs about the causes of mental illness; preferences for therapists of the same religion, race, and sexual orientation; and preferences for certain therapy tasks (e.g., homework, psychoeducation, learning skills) and types of therapy (e.g., group, family, couples). Results also indicated that preference for same-religion and heterosexual therapists increased as R/S engagement increased. Our findings highlight the importance of R/S in understanding mental health perceptions and treatment preferences and have implications for clinical practice.