The significance of taking a spiritual history: A randomized controlled study in a sample of German psychotherapists

Abstract Background: In the past, psychotherapists have neglected religious and spiritual issues compared to other themes like sexuality or somatic experiences. Objective: We aim to determine if psychotherapists view taking a spiritual history as less important than taking a sexual or somatic history when patients report a spiritual crisis vs. a sexual crisis vs. a somatic crisis as causes for their depressive states. Method: Using a randomized controlled 3-group-between-subjects design, 117 psychotherapists were randomly assigned to one of three groups and presented with a fictional case vignette of a depressed patient, who reported either a spiritual vs. sexual, vs. somatic crisis as a cause for depression. As dependent variables, we assessed the importance that each group attached to taking a spiritual history, a sexual, or somatic history. Results: Psychotherapists in the spiritual-crisis condition considered taking a spiritual history significantly less important than psychotherapists in the sexual-crisis condition placed on taking a sexual history ( d = 0.47) and psychotherapists in the somatic-crisis condition placed on taking a somatic history ( d = 0.57). Discussion: Our findings show a bias against taking a spiritual history compared to a sexual and a somatic history. This bias could be addressed in the psychotherapy training as the process of taking a spiritual history constitutes a significant component of psychotherapy, one that is particularly sensitive to cultural and religious diversity.