Integrating religion and spirituality with psychotherapy in a religiously diverse nation—A mixed methods study on client attitudes and experiences in Singapore

<b>Objectives:</b> This study aimed to investigate clients' perspectives on the integration of religion/spirituality (R/S) with psychotherapy in Singapore, a religiously diverse nation. It was hypothesized that clients would report R/S integration to have a positive impact (H1), initiate R/S discussions (H2), and their R/S and perception of the religious context would be associated with their attitudes towards R/S integrated psychotherapy (H3). A cross-sectional mixed-methods design was employed. <b>Methods:</b> Participants were 275 Singapore psychotherapy clients (52.3% male, 46.9% female, 8% non-binary/third gender). Mean age was 34.93 years (<i>SD</i> = 9.95). Participants completed a questionnaire comprised of demographical items, psychotherapy experiences, various R/S-related measures and qualitative questions on considerations and opinions on R/S integrated psychotherapy. <b>Results:</b> Clients reported that R/S integrated psychotherapy (RSIP) had a positive impact and that they were the main initiator. Considering R/S as supportive during adversity and perceptions of the religious context were associated with attitudes towards integration. Unexpectedly, R/S diversity appeared to have a facilitatory effect on RSIP. Qualitative findings revealed client's experiences and perspectives, including their expectations towards therapists. <b>Conclusions:</b> These findings highlight the importance of therapists' R/S competency. In R/S diverse contexts, therapists may require greater sensitivity, openness, and the ability to work with clients holding diverse R/S beliefs.