Subtle Messages That Subvert the Safe Space: The Negative Relationship of Religious Microaggressions in Psychotherapy and Treatment Satisfaction Is Mediated by Poorer Working Alliance

Background The present study investigated religious microaggressions in psychotherapy and counselling. Aiming to conceptually replicate and extend previous findings of Trusty et al., we tested whether religious microaggressions adversely affect treatment satisfaction via poorer therapeutic alliance in a mediation model. Method In an observational online questionnaire study, N = 584 religious participants (53.18% identified as highly religious) in Germany were asked about their experiences in psychotherapy. We translated and extended the Religious Microaggressions in Counseling Scale (RMCS). In addition, treatment satisfaction and working alliance were reliably measured using established scales. Results Using structural equation modelling, we found a significant indirect effect of religious microaggressions on treatment satisfaction via therapeutic alliance. While these significant associations of religious microaggressions with therapeutic outcome variables are compelling, it has to be added that our cross‐sectional observational design does not allow for causal conclusions. Conclusion Our study replicated Trusty and colleagues' findings in another cultural context and extended them by using latent modelling, and more reliable measures in a larger sample including clients of different therapeutic institutions. Our findings provide further evidence for the relevance of religious microaggressions to central psychotherapeutic variables and extend the understanding of psychotherapeutic conditions and potentially harmful side effects for religious patients in psychotherapy.