Spiritual Competencies for Psychotherapists: Research Findings and Training Opportunities

This article shares insights from “Improving Psychotherapists’ Spiritual and Religious Competencies: Evaluation of a Live Videoconferencing Training Program,”recently published in Psychotherapy (Richards et al., 2025). The study evaluated the effectiveness of a live videoconferencing training program in spiritually integrated psychotherapy (SIP) offered by ACPE: The Standard for Spiritual Care and Education (ACPE). Here, we summarize our findings and include qualitative comments from participants about their main takeaways.

ACPE’s SIP Training Program

ACPE is a professional association that includes (1) educators who prepare individuals for ministry through experiential education in hospitals, prisons, congregations, and other settings; (2) pastoral counselors; and (3) other psychotherapists (such as psychologists, professional counselors, licensed clinical social workers) who believe in the importance of attending to spirituality as part of psychotherapy. 

ACPE’s Level 1 and Level 2 SIP trainings are both 15-hour continuing education curricula. Level 1 includes courses in:

1. Foundations and ethics of spiritually integrated psychotherapy
2. What spiritual conversations sound like and how they begin
3. Spiritual assessment
4. Working with healthy spiritual resources
5. Working with spiritual struggles

The Level 2 training includes courses in:

1. Working with healthy spiritual resources
2. Working with spiritual injury
3. The spirituality of the therapist
4. Spiritually integrated case conceptualization

The Level 1 and Level 2 trainings follow standardized curricula designed to teach foundational knowledge, skills, and values. All ACPE SIP trainers use a common Trainer’s Manual, the same PowerPoint slides, and replicate the same small- and large-group exercises and discussion prompts. Most trainings have been conducted online via Zoom, though some have also been held in person.

ACPE’s SIP program also features a Level 3 20-hour consultation process that helps integrate foundational material into participants’ psychotherapy practices. The Level 3 training ends with certification. There is also a post-certification community of practice, consisting of four to eight members, that meets monthly with a SIP trainer for ongoing learning and support. ACPE believes that high-quality therapists develop over time, not through 15- or 30-hour trainings, but through experience with colleagues and mentors.

How We Measured the Effectiveness of the Training

Our research study focused solely on the online Level 1 and Level 2 trainings. We aimed to find out whether these trainings affected participants’ self-rated sense of competence in handling spiritual and religious issues in psychotherapy. 

We asked participants to complete two standardized questionnaires before and after training to evaluate its impact. The Religious/Spiritually Integrated Practice Assessment Scale (Oxhandler & Parrish, 2016) is a 5-point Likert-type measure designed to assess self-reported spiritual competencies and attitudes. We also used an adapted version of the Therapist Session Checklist (Sanders et al., 2015), which asks therapists to rate how often they use various spiritual practices and interventions during treatment.

Using a quasi-experimental one-group pretest-posttest design, we investigated whether participants’ spiritual/religious (S/R) competencies (i.e., self-efficacy, attitudes, and skills) improved and if their use of spiritual interventions increased after training. We also examined whether their perceptions of barriers to practicing spiritually integrated treatment in their setting changed following the training. The study involved 84 adult men and women from diverse spiritual backgrounds, mental health specialties, and geographic locations who completed the assessments both before and after the program. 

What We Learned in This Study

Our statistical analyses revealed that participants’ spiritual competence and use of spiritual interventions during treatment sessions significantly increased after the training program. Most changes were large or moderately large, indicating that the participants’ improvements were educationally and clinically meaningful. The training duration (15 hours vs 30 hours) did not heavily influence these gains. This suggests that the training program had a widespread positive effect, regardless of participants’ initial spiritual competencies or the level of training they received. Additional research is needed to more rigorously investigate the optimal number of training hours for promoting competency in basic and advanced S/R attitudes, knowledge, and skills. 

What We Learned Beyond This Study

Near the end of the Level 2 training, participants were asked to reflect on and share what they had learned. Here are some of the significant takeaways participants shared with us:

Spirituality is an add-in in psychotherapy, not an add-on

Spiritually integrated psychotherapy is not a collection of theories and strategies that replaces any of a therapist’s current models of psychotherapy. It is not a substitute for psychodynamic therapy, CBT, DBT, Sensorimotor Psychotherapy, or any other approach. Instead, spiritually integrated psychotherapy is like a fragrance or flavor that can be added to and blended with any of these models. 

Spirituality is more expansive than we’d previously considered

All participants arrived at the training with the ability to recognize explicit expressions of spirituality and religion. When their clients use words like “God,” “prayer,” “meditation,” “synagogue,” or “Scripture,” all therapists understand that their clients are saying something spiritual. What was new to many participants was the concept of implicit spirituality: experiences, practices, attitudes, and ways of being that reflect a deep sense of meaning, connection with something greater, and strong moral values, but are not explicitly labeled or formally acknowledged as “spiritual.” Implicit spirituality includes experiences of awe, compassion, gratitude, conscience, and many more. People have implicit spiritual experiences in nature, at concerts, with friends, and in various other settings. With this broader understanding of spirituality, participants would say things like, “I used to think my clients were never saying something spiritual. Now I realize they’re never not saying something spiritual.”

It all boils down to resources and struggles

The Level 1 curriculum includes a course on spiritual assessment, where participants learn to listen for (and if needed, ask about) nine specific items. They are then taught that these nine can be summarized into two categories: spiritual resources and spiritual struggles. Spiritual resources can be explicitly spiritual, such as scripture, prayer, music, an understanding of God, or a religious community that positively affects someone’s resilience and transformation. They can also be implicitly spiritual, like a park where someone walks daily, a pet they deeply connect with, a running group, or an art museum. Similarly, spiritual struggles can be explicitly spiritual, including feelings of abandonment by God, conflicts within a religious community, spiritual injuries experienced within a spiritual group, or tensions between a person’s sense of what’s right and what their religious tradition teaches. They can also be implicitly spiritual, such as feeling burdened by guilt, grappling with a moral decision, or experiencing despair and a sense of meaninglessness. Participants noted that it was helpful to have this simple understanding of what to be listening for, resources, and struggles, as well as to have learned strategies for then deepening and amplifying the positive benefits of resources and for engaging with struggles without giving advice or rushing people through their struggles prematurely. 

The two pillars of spiritually integrated psychotherapy are: (1) “move toward the spirituality of the client,” and (2) “draw upon but don’t impose your own.”

This two-part principle is introduced in the first course of the Level 1 training and repeated many times in both the Level 1 and Level 2 trainings. The first part, “move toward the spirituality of the client,” aligns with other trainings in spiritually integrated psychotherapy. Recognizing, expressing curiosity about, and working to strengthen clients’ healthy spiritual resources can significantly influence the course of treatment. Similarly, recognizing, expressing curiosity about, and engaging with spiritual struggles without trying to fix them are essential. The second part, “draw upon but don’t impose your own spirituality,” emphasizes the ethical guideline to work within the client’s worldview rather than persuading them to adopt the therapist’s views. Although therapists’ spiritual perspectives cannot be checked at the door any more than their gender, race, family background, sexual orientation, or other life experiences, it is vital to respect clients’ spiritual beliefs and agency. The ACPE training teaches therapists how to do this while using their own spirituality as motivation for therapy, as a source of resilience when the work becomes challenging, and to understand what causes hurt and how change occurs.

Conclusion

Mental health and pastoral professionals seeking to improve their skills in S/R aspects of diversity and treatment might find ACPE’s live video-conferencing SIP training program helpful. Further research is needed to determine the effectiveness of other SIP training programs (Richards et al., 2023). Studies are also needed to determine the number of training hours required to effectively develop competency in basic and advanced S/R attitudes, knowledge, and skills.