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Working With the Sacred: Four Approaches to Religious

and Spiritual Issues in Counseling

Brian J. Zinnbauer and Kenneth I. Pargament

This article examines the advantages and disadvantages of 4 helping orientations of the counselor to religious and spiritual
issues in psychotherapy: rejectionism, exclusivism, constructivism, and pluralism. The constructivist and pluralist approaches are
advocated as those orientations best suited to work with diverse clients and religious beliefs, and flexible enough to deal respect-
fully, ethically, and effectively with a variety of religious and spiritual issues in counseling.

It is inevitable that the therapist be . . . a moral agent. The danger
is in ignoring the reality that we do this, for then the patient, thera-
pist, and community neither agree on goals nor efficiently work
toward them. A correlated danger is that therapists, as secular
moralists, may promote changes not valued by the client or the
community, and in this sense . . . therapists may be unethical or
subversive. (Bergin, 1980a, p. 97)
Everything to do with religion, everything it is and asserts, touches
the human soul so closely that psychology least of all can afford to
overlook it. (Jung, 1978, p. 337)
laden (e.g., Bergin, 1980a; T. A. Kelly, 1990, Kovel, 1982;
Lovinger, 1984; Schwehn & Schau, 1990), but counselors
do not remain value-free in counseling despite their inten-
tions to do so (Bergin, 1980a; Beutler, 1979; T. A. Kelly,
1990). Specifically, several studies have found evidence that
clients adopt the values of their counselors (T. A. Kelly,
1990; Schwehn & Schau, 1990) and that client and counselor
value convergence is associated with counselors’ ratings of
improvement but not necessarily with clients’ ratings or with
standardized measures of symptomatology (T. A. Kelly,

I
n the twentieth century, contact between the worlds
of religion and counseling has frequently been marked
by antagonism and conflict. From the writings of Freud
and his view of religion as illusory wish fulfillment
(Freud, 1927/1961a) to contemporary views that re-
ligious belief is associated with emotional disturbance, ir-
rational thinking, inflexibility, and intolerance (Ellis, 1980),
many practitioners have been indifferent if not hostile to
religion and the religious beliefs of their clients.
Such antipathy toward religion would not necessarily be
problematic if counseling were a value-free enterprise, as
was widely believed in the 1960s (Miranti & Burke, 1992).
A counselor doing “value-free” therapy would not need to
worry that his or her values might enter and influence the
therapeutic process but could instead rely on the methods
and techniques of a therapeutic approach to ensure effec-
tive results. One could be a “blank slate” analyzer, a stimu-
lus-response behavior modifier, or a client-centered posi-
tive regarder without worrying that value conflicts might
arise with clients.
Such a simple view of values and counseling is alluring,
but a wealth of literature produced in the last 30 years sug-
gests that this conception of counseling as value-free is
mistaken. Not only has counseling been found to be value-
1990; T. A. Kelly & Strupp, 1992).
In addition to these empirical results, several authors have
contended that counselors’ personal and professional val-
ues influence other aspects of the therapeutic process. To
offer distressed individuals more than simple empathy or
medication, it is necessary for counselors to base their work
on theoretical orienting systems (Pargament, 1997). These
orienting systems incorporate heavily value-laden assump-
tions about people, the world, and the process of helping.
Moreover, they serve as road maps for helpers in their work
with distressed people. Values have several functions: They
underlie the counselor’s choice of therapeutic techniques
(Patterson, 1989); they are the bases for decisions regard-
ing the goals for treatment, the ways in which successful
treatment is measured, and the regulation of the structure
and content of therapeutic sessions (Bergin 1980a); and they
are central to what is defined as suffering, what is treated
in counseling, and even the choice to help another person
at all (Kovel, 1982).
Therefore, conflict may arise in counseling when clients
and counselors differ widely in their values and when cli-
ents are concerned that their values will be challenged or
changed. This is clearly the case with religious values. There
is a well-documented difference between clients and coun-

Brian J. Zinnbauer is currently a staff psychologist with the Cincinnati Veterans Affairs Medical Center in Cincinnati, Ohio. Kenneth I. Pargament is a professor
of psychology and the director of clinical training at Bowling Green State University, Bowling Green, Ohio. Correspondence regarding this article should be sent to
Brian J. Zinnbauer or Kenneth I. Pargament, Department of Psychology, Bowling Green State University, Bowling Green, OH 43403 (e-mail: bzinnba@choice.net).

162 JOURNAL OF COUNSELING & DEVELOPMENT • SPRING 2000 • VOLUME 78

 Four Approaches to Religious and Spiritual Issues in Counseling
selors regarding religion and religious values. Counselors
are less involved in traditional religious practices than their
clients (Bergin, 1991; Ragan, Malony, & Beit-Hallahmi,
1980; Worthington, 1986) and view the inclusion of religious
material in counseling as less important than do clients (Bergin
& Jensen, 1990; Quackenbos, Privette, & Klentz, 1985). These
differences have led some to warn that counselors may
knowingly or unknowingly convert their clients to a more
secular value system (Tjelveit, 1986). It is interesting that,
when surveyed, religious clients often report fears that their
values will be undermined by secular counseling
(Worthington & Scott, 1983).
Despite these value differences, many counselors have not
received training on how to recognize and manage value
differences in counseling (Vachon & Agresti, 1992; Wick,
1985), to deal with religious or spiritual issues in counseling
(Bergin & Jensen, 1990; E. W. Kelly, 1994; Shafranske &
Malony, 1990), or to recognize the potential impact of their
own religious beliefs on the process of counseling (Pargament,
1997). Therefore, there is a need for counselors to be sensi-
tive to religious issues and able to manage them in their
work. The purpose of this article is to examine how counse-
lors view religion and spirituality and how they approach
these issues in their work with clients. Specifically, four cur-
rent orientations to religious and spiritual issues in counsel-
ing are presented and discussed, and the potential limits to
each orientation are considered. Finally, we advocate for the
use of two conceptual frameworks that address religious is-
sues in counseling effectively and respectfully.
INTEGRATING COUNSELING WITH RELIGION AND SPIRITUALITY
Attempts at integrating counseling with religion and spiri-
tuality are not new. For example, Vande Kemp (1985)
pointed out that integrations of psychology with religion
and spirituality have existed ever since psychology estab-
lished itself as an independent discipline in the mid–nine-
teenth century. From the early Christian writings about
human nature (known as the “Christian Psychologies”) that
date from the 1840s, to modern popular efforts such as
Peck’s (1978) The Road Less Traveled, a notable minority
of writers have made many efforts to integrate these disci-
plines. Vande Kemp, in her review of these historical move-
ments, identified 37 institutions and 17 separate scholarly
journals devoted to just such an integration during this cen-
tury. Finally, articles have recently appeared in the Ameri-
can Counseling Association’s Journal of Counseling & De-
velopment that review historical and training issues related
to religion and spirituality as those issues specifically per-
tain to counseling care (see Maples & Maples, 1999; Miller,
1999).
One convenient route into the landscape of current treat-
ments of religious and spiritual issues in counseling is to
examine two polar opposite and extreme orientations to
religion in the therapy process. These orientations will pro-
vide a frame of reference for our consideration and critique
of four approaches to religion and spirituality. To do this,
JOURNAL OF COUNSELING & DEVELOPMENT • SPRING 2000 • VOLUME 78
we turn to the writings of two early and famous therapists:
Sigmund Freud and Carl Jung.
In his writings, Freud characterized religion and spirituality
as essentially products of wish fulfillment and fantasy. Chil-
dren seek relief from the “terrifying impression of helpless-
ness in childhood” (Freud, 1927/1961a, p. 30) and need a
figure in their lives to protect them. This role of protector
is initially provided by one’s own father, but as one grows
older and this sense of helplessness continues, the individual
needs a more powerful protector. This powerful protector
is sought by the individual through a belief in a divine Fa-
ther. Later on, religious experiences of transcendence and
spiritual experiences of oneness with God or the universe
are ways individuals consolidate this religiousness (Freud,
1930/1961b). These “oceanic” feelings are, however, merely
infantile regressions to a primitive state of “limitless narcis-
sism” (Freud, 1930/1961b, p. 19), which is experienced by
infants before they recognize distinctions between them-
selves and the world around them.
As an adaptation to feelings of helplessness and needs for
protection from suffering, Freud viewed religion and spiri-
tuality in distinctly negative terms. Freud concluded that
religion
consists in depressing the value of life and distorting the picture of
the real world in a delusional manner. . . . At this price, by forcibly
fixing [religious believers] in a state of psychical infantilism and by
drawing them into a mass-delusion, religion succeeds in sparing
many people an individual neurosis. But hardly anything more.
(Freud, 1930/1961b, pp. 31–32)
A contrast to this portrait is provided by a contemporary
of Freud, Carl Jung. For Jung,
Religions are psychotherapeutic systems in the truest sense of the
word, and on the grandest scale. They express the whole range of
the psychic problem in mighty images; they are the avowal and
recognition of the soul, and at the same time the revelation of the
soul’s nature. (Jung, 1978, p. 336)
That religious ideas and experiences are psychically real is
fundamental for Jung:
The ideas of the moral order and of God belong to the ineradicable
substrate of the human soul. That is why any honest psychology,
which is not blinded by the garish conceits of enlightenment, must
come to terms with these facts. They cannot be explained away or
killed with irony. In physics we can do without a God-image, but
in psychology it is a definite fact that has got to be reckoned with,
just as we have to reckon with “affect,” “instinct,” “mother,” etc.
(Jung, 1978, p. 339)
For Jung, psychological problems are essentially religious
problems:
A psychoneurosis must be understood, ultimately, as the suffering
of a soul which has not discovered its meaning. . . . the cause of the
suffering is spiritual stagnation, or psychic sterility. (Jung, 1978,
p. 252)
Jung thus painted a radically different picture of religion
and spirituality from that of Freud. In contrast to Freud’s
163
Zinnbauer and Pargament
view of religion and spirituality as illusory wish fulfillment,
Jung viewed them as realities that are psychotherapeutic
and reflective of the soul. Instead of Freud’s characteriza-
tion of religion and spirituality as delusional and distorting,
Jung presented them as fundamental to human experience
and psychic evolution. In contrast to Freud’s position that
religion and spirituality are very poor resolutions to suffer-
ing, Jung stated that
[m]an is never helped in his suffering by what he thinks of for
himself; only suprahuman, revealed truth lifts him out of his dis-
tress. (Jung, 1978, p. 253)
These two positions represent the extremes of the vari-
ous positions taken by others in their musings and writings
about religion and spirituality. They are also both equally
limited as viable conceptual schemes for counseling. As ar-
gued by Wilber (1995), Freud’s position represents a re-
ductionistic position, whereas Jung errs in the opposite di-
rection by taking an elevationist position. Freud’s error is
that he takes all religious phenomena and belief and re-
duces them all to lower prerational states. As stated by
Wilber, “genuine mystical or contemplative experiences . . .
are seen as a regression or throwback to infantile states of
narcissism, oceanic adualism, indissociation, and even primi-
tive autism” (p. 206). Starting from a position that denies
any legitimacy to religious and spiritual belief and experi-
ence, Freud can do nothing but explain them away as patho-
logical. And for Freud and those who have followed him,
having arrived at such an ontological verdict for religion
and spirituality, no amount of evidence or argument can
avoid reducing all aspects of religion to irrationality.
Jung, on the other hand, elevates religious and spiritual
phenomena to the level of “transcendent glory” (Wilber,
1995). Taking as fundamental that human problems can be
viewed through a religious lens, Jung and others who have
also taken this position (e.g., Assagioli, as cited in Vande
Kemp 1985; Cox, 1973) are forced to lend transpersonal
TABLE 1
Four Approaches to Religious and Spiritual Issues in Counselinga
Item Rejectionist
Is there an absolute reality? Yes
Does God really exist? No
Is there a single best way to approach reality? Yes
Must the counselor share the individual’s
religious views? No
Is the counselor respectful of religion? No
Should religious issues be discussed in
counseling? No
Should counselors involve religious resources
and coping methods in counseling? No
a
See also Pargament, 1997.
164 JOURNAL OF COUNSELING & DEVELOPMENT • SPRING 2000 • VOLUME 78
and spiritual status to states that are merely dissociated,
unintegrated, and psychologically unhealthy. For the
elevationist, as stated by Wilber, “anything nonrational gets
swept up and indiscriminately glorified as a direct route to
the Divine” (1995, p. 207). Having elevated all human suf-
fering to the level of the sacred, there is no room to dis-
criminate healthy from unhealthy religion and spirituality
or to characterize some suffering as pathological.
Fortunately, these two extremes are not the only ap-
proaches available to counselors in their consideration of
religious and spiritual issues. Four approaches to religious
and spiritual issues were identified in the professional lit-
erature based on their differing ontological assumptions
and counselors’ views of the role of religion in counseling
(see Table 1). We have labeled these approaches the
rejectionist, the exclusivist, the constructivist and the plu-
ralist (see also Pargament, 1997). Each approach is pre-
sented and discussed in turn.
THE REJECTIONIST
The first and most notorious orientation lies close to Freud’s
antagonistic and reductionistic approach, and the “atheis-
tic” position identified by Quackenbos, Privette, and Klentz
(1986). Rejectionist elements can be found in numerous
theoretical systems of therapy including the psychoanalytic,
the behavioral, and the existential. Central to this approach
is the denial of those sacred realities, such as the existence
of God or heaven, that are fundamental to the beliefs of
religious and spiritual adherents. Examples from the psy-
choanalytic camp of rejectionism include descriptions of
religion as defensive primitive idealization and longing for
an omnipotent caregiver, and reductions of religious altruism
to defensive ways to “undo” past sins or failures (McWilliams,
1994). Examples from the behavioral camp include Ellis’s
equation of religious belief with irrational thinking, emo-
tional disturbance, and impaired emotional and mental
Approach
Exclusivist Constructivist Pluralist
Yes No Yes
Yes No Yes
Yes No No
Yes No No
Yes/No Yes Yes
Yes Yes Yes
Yes Yes Yes
 Four Approaches to Religious and Spiritual Issues in Counseling
functioning (Ellis, 1980) and Robb’s (1986) claim that reli-
gious “supernaturalism” and absolute thinking are the root
cause of affective and behavioral disturbance in humans. Fi-
nally, from the realm of existential psychotherapy are Yalom’s
(1980) characterizations of beliefs in immortality or a per-
sonal God as defenses against death anxiety, religious prescrip-
tions as ways to avoid decision making and responsibility, and
religious explanations as magical explanations.
Although each of these approaches takes a different stance
on religion, each also reduces religion to the level of psy-
chological defense or disturbance. None of these positions
necessarily deny the existence of an absolute reality, they
simply deny that absolute reality includes religious or spiri-
tual elements. From this point of view, expressions of reli-
giousness and spirituality cannot be taken at face value, but
are interpreted as signs of underlying psychopathology. The
counselor’s task when encountering such expressions is to
cut through the bulwark of religious defense and to en-
courage a more ego-oriented and rational approach to life
(Pargament, 1997).
Religious rejectionism has several serious disadvantages
as an orientation in counseling. First, the rejectionist’s hos-
tile approach toward all religious beliefs makes it more dif-
ficult to form a strong working relationship or therapeutic
alliance with the significant number of religiously commit-
ted clients who seek counseling (Shafranske & Malony,
1990). In addition, such approaches serve to make the reli-
giously committed more wary of mental health professionals
in general and reinforce their fears that their religious be-
liefs and values will be demeaned or changed in counseling
(Keating & Fretz, 1990; McLatchie & Draguns, 1984).
Second, rejectionists’ equation of religious belief with emo-
tional disturbance and impaired mental functioning (e.g., Ellis,
1980) is inconsistent with research findings. Reviews of re-
search on religion and mental health (e.g., Bergin, 1983; Levin
& Vanderpool, 1987; Pargament, 1997) have concluded that
religion has a mixed and weak relationship to mental health.
Pargament in particular has shown that religion can serve many
purposes in coping with life stress and has identified effective
and ineffective forms of religious coping.
A final problem with the rejectionist approach is a matter
of ethics. The Association for Spiritual, Ethical, and Reli-
gious Values in Counseling has emphasized the importance
and necessity of incorporating spirituality competencies into
CACREP standards (Miller, 1999). In addition, recent profes-
sional guidelines call for the respect for cultural and religious
diversity (e.g., American Psychiatric Association, 1990;
American Psychological Association, 1993).
According to the Guidelines for Providers of Psychological
Services to Ethnic, Linguistic, and Culturally Diverse Popula-
tions published by the American Psychological Association
(1993): “Psychologists respect clients’ religious and/or spiri-
tual beliefs and values, including attributions and taboos,
since they affect world view, psychosocial functioning, and
expressions of distress” (p. 46). The American Psychiatric
Association (1990) guidelines also discourage the imposi-
tion of religious or antireligious belief systems on patients.
JOURNAL OF COUNSELING & DEVELOPMENT • SPRING 2000 • VOLUME 78
THE EXCLUSIVIST
A second approach in the current literature is the exclusivist
approach. This approach overlaps with what McDargh
(1993) called the “spiritual reality” perspective, what
Quackenbos et al. (1986) termed the “orthodox” religious
position, and what Benner (1989) described as “Christian
spirituality.” Just as religious rejectionism is scorned by reli-
gious believers, religious exclusivism is viewed suspiciously
by many mental health professionals. The central tenet of
this approach is a fundamental belief in the ontological re-
ality of a religious or spiritual dimension of existence. In-
cluded in this orientation are assertions such as God exists,
spiritual experiences influence human behavior, absolute
values exist and are grounded in scripture or religious texts,
and counselors must share the religious or spiritual
worldview of clients to be effective. Also associated with
this view is a belief that there is a single route to the reli-
gious or spiritual reality. Metaphorically, there is a single
path up the mountain of God.
Good examples of this approach can be seen in the con-
servative Christian writings of Jay Adams (1970) and Mar-
tin and Deidre Bobgan (1987). Central to their writings is
an affirmation of the existence of God and the ultimate
authority of biblical scripture to interpret every aspect of
human life. The “Word of God” in scripture offers the only
true conceptions of human nature, human behavior, how
to live one’s life, morality and issues of moral values, and
human problems. According to Bobgan and Bobgan, “prob-
lems in living are due to separation from God because of
the sinful condition of mankind and the presence of sin in
the world after the Fall” (p. 207). Similarly, Adams argued
that “apart from organically generated difficulties, the ‘men-
tally ill’ are really just people with unsolved personal prob-
lems” (p. 29) that are the direct result of “their unforgiven
and unaltered sinful behavior” (p. xvi).
The exclusivist is respectful of clients’ religious views, but
only within the limits of the exclusivist’s own understanding
of reality. Whereas the rejectionist rejects all religious
worldviews, the exclusivist insists that the counselor and cli-
ent both believe in the “one true” religious or spiritual
worldview. If the client does not initially believe in this spe-
cific religious world, it is the counselor’s job to bring the client
to it. Other value systems and approaches can only mislead
clients. For Bobgan and Bobgan (1987), “psychological sys-
tems of counseling may lead a person along the broad way
which leads to destruction” (p. 225); the biblical answer to
suffering and sin is Jesus, who is “the only means to reestablish
relationship between God and man” (p. 207). Adams (1970)
took this further to state that the only effective counseling is
done through the Holy Spirit. All true positive goals for growth
sought through counseling are the fruits of the Spirit, and
attempts to provide secular counseling or generate growth in
clients without the Spirit are not only misleading but are “at
bottom rebellion against God” (p. 20).
Other exclusivist Christian counselors may vary in the
degree to which they find secular counseling techniques and
165
Zinnbauer and Pargament
theories dangerous, but their adherence to certain exclusivist
principles remains a defining element of their approaches.
Notably, professionals such as Crabb (1988) and texts on
Christian psychology and counseling (e.g., Meier, Minirth,
Wichern, & Ratcliff, 1991) have been influential in explicat-
ing Christian views of health, pathology, relationships, emo-
tional disorders, and sin. At the core of each, however, lie
exclusivist assumptions about the nature of reality, the exist-
ence of a Judeo-Christian God, and biblically based prescrip-
tions for healthy thinking, feeling, and behaving.
The exclusivist account may seem to be an adequate
therapeutic approach at first glance, but closer examina-
tion reveals its problems. A primary problem has to do with
its restrictiveness. Counselors under this approach agree
with religious and spiritual clients on the existence of an
absolute religious reality, but they insist on a single route
to this reality. Such counselors also insist that they share
the same religious values as their clients. This means that
either they serve a restricted population with values quite
similar to their own, or they run the risk of overtly or co-
vertly converting clients to their own value systems. Fur-
thermore, with a narrow focus, this approach runs the risk
of being as intolerant of other religious believers as the
rejectionist. The Buddhist client who seeks therapy from
a Catholic exclusivist therapist runs the risk not only of a
clash in values but of being viewed as a member of a “false
religion.” Similar conflicts may arise among therapists and
clients from different denominations within the same tradi-
tion. Finally, empirical research on coping (e.g., Pargament,
1997) has shown that both religious and nonreligious forms
of coping contribute to well-being and successful adjust-
ment to negative life experiences. Counselors who insist
on the sole use of religious coping may hinder the coping
efforts of clients who use both religious and nonreligious
ways to deal with stress in life.
The exclusivist approach may work when clients and
counselors match closely on religious and spiritual values,
but it does not provide a very flexible approach to deal with
the diversity of religious and spiritual clients seeking the
assistance of mental health professionals. As discussed in
the section on the pluralist approach, when counselors and
clients are of the same religion or religious denomination, they
may over-estimate the amount of value similarity between
them. For the exclusivist, a client’s religious worldview and
use of religion in coping are appropriate only when they coin-
cide with the beliefs of the counselor.
THE CONSTRUCTIVIST
A third counseling approach is the constructivist approach
that denies the existence of an absolute reality but recog-
nizes the ability of individuals to construct their own per-
sonal meanings and realities. Absolute reality does not ex-
ist “out there” to be found or discovered but is constructed
by humans in their interactions, interpretations, and strivings
to understand information, contexts, situations, and other
humans (Guba & Lincoln, 1989). These constructions are
166 JOURNAL OF COUNSELING & DEVELOPMENT • SPRING 2000 • VOLUME 78
rooted in the “experience, belief systems, values, fears, preju-
dices, hopes, disappointments, and achievements of the con-
structor” (Guba & Lincoln, 1989, p. 143) and of the social
context in which he or she exists.
Therefore, the constructivist position is not an essentially
religious position nor an atheistic one; both of these posi-
tions are themselves viewed as human constructions. This
position does not require the counselor to be religious to
work with religious people; both religious and secular
counselors can work effectively with religious clients. The
constructivist simply views all human belief systems as con-
structions—if one wants to construct a worldview that includes
God or spiritual realities, then fine. If one wants to con-
struct a worldview without God, that is fine as well. Coun-
seling within this approach focuses on the quality of the
client’s constructions rather than whether the constructions
correspond to those of the counselor (Neimeyer, 1995).
Quality in this sense refers to whether the client’s construc-
tions are internally consistent and coherent and allow the
client to adapt to his or her environment. When psycho-
logical symptoms appear, they are seen as indications that
one’s constructions have broken down, have come into con-
flict with one another, or are inadequate to allow one to
construct meaning out of experience (Neimeyer, 1995).
Therapeutic work is conducted within the client’s belief
system, and counseling techniques are used that incorpo-
rate elements of the client’s worldview.
An example of the constructivist approach to counseling
is provided by Bilu, Witztum, and Van der Hart (1990). In
their approach, the counselor enters the worldview of the
client and uses “myth-congruent metaphors” and meta-
phoric imagery work to effect therapeutic change. To ac-
complish this, the counselor must leave his or her own
mythic world and enter that of the client. Once accom-
plished, the client’s metaphors are symbolically manipu-
lated by the counselor to induce healing. It is important to
Bilu et al. that the counselor make this entrance into the
client’s belief system to ensure that both parties in the thera-
peutic context share the same symbolic universe. Other-
wise, the client’s metaphorical understanding of the prob-
lem may be hidden or rejected by the counselor, or the
counselor may not have sufficient leverage with his or her
therapeutic manipulation of client metaphors to create any
positive change in the client.
The case example provided by Bilu et al. (1990) described
the psychotherapeutic treatment of an orthodox Jewish man
in Israel by two secular European therapists. They began
with a description of the patient’s exposure to a terrorist
attack in Jerusalem and his subsequent posttraumatic stress
symptomatology. These symptoms included hallucinations
of a figure described by the patient as “the Black” who would
threaten to kill him. The therapists labeled this figure a
“demon” for the patient, and linked this hallucination to
the patient’s loss of his father in an automobile accident
when he was 8 years old. The treatment consisted of in-
structions to the patient to recite traditional incantations
to ward off the demon when he experienced the hallucina-
 Four Approaches to Religious and Spiritual Issues in Counseling
tions, and guided imagery in which the patient would imag-
ine himself traveling from the “desert” where he was at-
tacked toward a place of refuge where he could find shel-
ter, food, and company. Near the end of the treatment, the
guided imagery concluded with the patient’s arrival at this
place of shelter, whereupon he spontaneously imagined a
reunion with his father. This reunion was described by the
patient as a mystical experience, after which the patient
reported that all nightmares and persecutory hallucinations
had vanished. Therapy was thus concluded, and the pa-
tient later reported that he maintained his therapeutic gains
at a 1-year follow-up.
Bilu et al. (1990) chose their metaphors from Jewish
demonology and scripture. On the basis of the patient’s
descriptions, the persecutory figure was labeled a demon,
the movement from sickness to health was metaphorically
introduced as movement from the desert to the Garden of
Eden, and the use of ritual incantations to ward off the
demon was drawn from the ritual language of the Bible.
The willingness to enter different worldviews, to help
people understand their problems from the perspective of
their own constructions, and to find solutions to suffering
with the methods and metaphors of the client’s orienting
system are the keys to religious constructivism.
In a culture as religiously varied as that in the United
States, most counselors are likely to encounter people from
religious traditions outside their own. Religious constructivism
offers one approach that allows mental health practitioners
to assist a variety of religious devotees. Ethically, it offers
much greater appreciation for religious experiences and
religious diversity than the rejectionist or the exclusivist ap-
proaches, and seems much less likely to impose one par-
ticular brand of values on a given client. In taking a relativ-
istic view of the constructions of clients, the constructivist
allows clients maximal freedom in pursuing their own be-
liefs and values. Constructions are not problematic until they
produce symptoms of distress, and client’s constructions of
problems are afforded priority by the counselor.
However, some questions can be raised about this orien-
tation. Some clinicians argue that it is not enough to accept
the client’s ontological beliefs about religion on a phenom-
enological level; ideally, the clinician should agree with the
client on the existence of religious or spiritual realities
(Spero, 1985b). The personal beliefs of the constructivist
may differ substantially from those of the client, and the
manipulation of the client’s sacred symbols and metaphors
to a secular end could come across as insincere and inau-
thentic. Authenticity is a particularly relevant concern for
the religious constructivist who seems to operate in a posi-
tion of pseudoreligious authority without the formal le-
gitimacy of a religious tradition (Pargament, 1997). As ar-
gued by Spero (1985b):
Well intentioned exhortations for psychotherapy and religion to
respect each other’s standards will not much help to preserve the
maximum values of psychotherapy for religious patients if thera-
pists cannot sincerely convey the impression that they accept the
patient’s reality. There is a quantum difference that therapists and
JOURNAL OF COUNSELING & DEVELOPMENT • SPRING 2000 • VOLUME 78
most non-psychotic patients perceive between accepting for the
sake of building rapport that, say, a patient’s fantasies have an “al-
most real” quality and the possibility that a “third party” (God) is
present in the relationship. Therapists who reject this distinction
eventually will convey this attitude to the patient, resulting in mis-
alliance. (p. 83)
Whether clients believe that constructivist counselors are
insincere and inauthentic and whether counseling is ad-
versely affected by a constructivist approach are questions
to be answered empirically. However, there is a paucity of
research investigating such questions. One exception is
Propst’s (1980) study, which found that nonreligious coun-
selors were more effective than were religious counselors
in providing a religious form of cognitive-behavioral therapy
to clinically depressed Christian clients. These results sug-
gest the efficacy of a constructivist approach in which the
counselor’s and client’s values differ and the counselor works
within the value system of the client.
A final criticism of this approach is of its relativistic ap-
proach to client constructions. With such a liberal defini-
tion of problems, the constructivist runs into the problem
of where to draw the line between health and pathology.
Certainly there are some religious beliefs that can be con-
sidered potentially harmful to self (client) or others (e.g.,
the client’s family) even if a client does not complain about
them. An example would be the religious client who be-
lieves that his religion requires him to beat his children as
discipline, or the father who views his daughter’s illness
as punishment from God and refuses to take her to a hospi-
tal. These discriminations are problems for other orienta-
tions as well, but the relativistic nature of the constructivist
approach makes them even more salient. Counselors in
these situations cannot rely solely on clients’ conceptions
but must decide whether to intercede based on personal,
ethical, and possibly legal grounds. Despite its relativistic
slant, constructivism is not value-free. Constuctivists must
be cognizant of their own values and beliefs about religion,
they have to be aware of their own profession’s ethical
positions on religious and spiritual issues, and they must
address the implications of these values for counseling.
THE PLURALIST
The final approach to religious issues in counseling is the
pluralist approach. Unlike the constructivist position, this
approach recognizes the existence of a religious or spiri-
tual absolute reality but allows for multiple interpretations
and paths toward it. In contrast to the exclusivist who main-
tains that there is a single path “up the mountain of God,”
the pluralist recognizes many paths as valid. Although both
the exclusivist and the pluralist may agree on the existence
of religious or spiritual reality, the pluralist recognizes that
this reality is expressed in different cultures and by differ-
ent people in different ways. Because humans are mortal
and limited, a single human religious system cannot en-
compass all of the religious or spiritual absolute reality. Each
different system, therefore, has a limited slant on the truth
167
Zinnbauer and Pargament
(Pargament, 1997). Thus, the pluralistic therapist can hold
personal religious beliefs while appreciating those of a cli-
ent with different religious beliefs. The pluralist recognizes
that religious value differences can and will exist between
counselors and clients without adversely affecting therapy.
One model for the use of this approach may be that of
cross-cultural therapy. When doing such therapy, counse-
lors must recognize that they and their clients enter the
therapeutic sessions with specific personal and cultural val-
ues, and ethnic–racial characteristics and beliefs (Tyler, Brome,
& Williams, 1991). It would be misleading and misguided to
assume that either party can become value neutral or to
assume that the counselor does not hold more power and
authority than the client in the therapeutic context. Once
these values and power imbalances have been recognized,
counseling is viewed as a process of resource collaborative
interchanges in which both counselor and client bring re-
sources and needs to the process, and both benefit from
the interchange (Tyler et al. 1991). The specialized skills of
the counselor and the life experiences of the client are rec-
ognized as resources to capitalize on in counseling. From
their initial session, both counselor and client begin a pro-
cess of negotiating the nature of the social reality in which
they will work and relate. They represent two distinct eth-
nic ecosystems, and they begin to define what they will
offer and expect from one another (Tyler et al., 1991). In
the process of this negotiation, both counselor and client
will decide on therapeutic goals and negotiate what will be
viewed as health for the client.
When the pluralistic counseling approach is used, the
counselor and client need to be cognizant of their own in-
dividual religious or spiritual histories, backgrounds, and
values. They negotiate their social reality under a shared
belief in a religious or spiritual absolute reality and work to
define the goals for therapy. In contrast to the constructivist
who works solely within the constructions of the client,
the pluralist brings his or her own “ecosystem” of beliefs,
experiences, and values into contact with that of the client,
and a new system is created. Unlike the exclusivist who
insists that the counselor and client must share the same
religious values and take the same route to the religious
absolute reality, the pluralist has more flexibility to work
with many religious and spiritual clients using various coun-
seling techniques. Within a cross-cultural framework, the
pluralist can respect the religious views of the client while
bringing his or her own religious views into the treatment.
In addition, rather than form judgments about clients’ reli-
gious beliefs based on their supposed inherent pathology
(rejectionist), their correspondence to a single system of
religious belief (exclusivist), or their production of symp-
tomatology (constructivist), the pluralist can use multiple
indices of health or pathology. Examples of such indices
include models of religious health and pathology (e.g.,
Pruyser, 1977; Spero, 1985a), the use of pragmatic out-
comes such as psychological adjustment and social func-
tioning as a basis for judgments of health (Pargament, 1997),
the adequacy of individuals’ religious goals and the efficacy
168 JOURNAL OF COUNSELING & DEVELOPMENT • SPRING 2000 • VOLUME 78
of attempts to achieve those goals (Pargament, 1997), and
specific religious warning signs of individuals coping with
life stress (see Pargament et al., 1998).
One example of such a pluralistic approach is Genia’s
(1990) proposal for what she terms the “interreligious en-
counter group.” This group therapy approach is specifically
geared toward encouraging spiritually troubled members
to find their own solutions to psychological, spiritual, and
existential concerns based on group and personal explora-
tion. It is presumed that a spiritual absolute reality exists,
and member’s religious and spiritual beliefs are accepted as
real. That the counselor and client both hold to basic spiri-
tual beliefs adds additional trust and rapport to the thera-
peutic relationship. However, just as important are the dif-
ferences between client and counselor. Such differences
provide the creative tension necessary for constructive
change and provide the source of creative solutions to prob-
lems. This diversity is prized by Genia: “The greater the
diversity of the group membership, the greater the poten-
tial for growth as each participant encounters within the
group the heritage, ideas, and wisdom of the great spiritual
traditions of our time” (p. 47).
The pluralist orientation offers a flexible and respectful
approach to religious and spiritual issues in counseling.
However, two cautions must also be mentioned. First, this
approach requires a good deal of self-knowledge on the
part of the counselor. To bring one’s own “ecosystem” or
worldview into the therapeutic context, a counselor must
be aware of his or her own beliefs, biases, values, and expe-
riences. Counselors must be continuously alert to the im-
pact of their beliefs and experiences on the process of
therapy to keep the atmosphere of respectful collaboration
from deteriorating into either religious indifference or co-
ercive missionary work.
A second caution is relevant not only to pluralists but
also to exclusivists who work with clients from religious
and spiritual backgrounds similar to their own. If a counselor
and client share a common belief in a religious or spiritual
absolute reality, it is possible for both parties to mistakenly
assume they share other common beliefs and values. Coun-
selors may prematurely close off discussion of issues they
presume they understand, and presume to know clients
better than they actually do. Likewise, clients may fail to
fully describe their problems or concerns in the course of
counseling because they assume counselors understand
them more than they do.
CATEGORIZING APPROACHES TO RELIGIOUS AND SPIRITUAL ISSUES
It is important to note with any categorical system that
some authors and approaches fall between the categories
or combine elements from more than one category. It is
our belief that few pure rejectionists or exclusivists cur-
rently practice psychotherapy (Pargament, 1997). For cli-
nicians, there may be differences between their theoretical
orientations and their actual practices in psychotherapy. For
example, Christian therapists who believe in the sole ve-
 Four Approaches to Religious and Spiritual Issues in Counseling
racity of the Christian faith may be able to take a respect-
ful attitude toward clients of other religions and work ef-
fectively with them in actual practice.
Researchers and theoreticians may also present approaches
that contain elements from more than one category. An ex-
ample of this is Allen Bergin whose “theistic realism” (Bergin
1980a, 1980b, 1988, 1991; Richards & Bergin, 1997) ap-
proach combines exclusivist and pluralistic elements. This
approach has several exclusivist features, including beliefs
that “God exists, that human beings are the creations of
God, and that there are unseen spiritual processes by which
the link between God and humanity is maintained” (Bergin,
1980a, p. 99). Bergin (1980a) has also argued that “there
are basic underlying human standards that are cross cul-
tural” (p. 99). His basic premise is that religious beliefs in
general should be attended to by practitioners and that a
“spiritual strategy” that includes a spiritual conception of
human nature, a universal moral frame of reference, and
specific techniques of change in an empirically valid, eclec-
tic, and ecumenical manner is the preferred clinical treat-
ment approach (Bergin & Payne, 1991; Richards & Bergin,
1997). However, the content in this approach is tailored to
the individual needs, language, and lifestyle of clients who
represent a wide range of religious beliefs. Thus, Bergin’s
attention to cross-cultural standards and universal morals
seems to draw from exclusivist assertions, whereas his pro-
posal for a flexible, ecumenical, and inclusive “spiritual strat-
egy” is more reminiscent of the pluralistic approach.
SUGGESTIONS FOR COUNSELORS WHO WORK WITH RELIGIOUS AND
SPIRITUAL ISSUES IN COUNSELING
The two positions advocated in this article are the constructivist
and the pluralist approaches. Both allow for a diversity of cli-
ents and religious beliefs and are flexible enough to deal re-
spectfully and effectively with a variety of religious and
spiritual issues in counseling. The central point that sepa-
rates them is the stance of each position on the ontological
status of an absolute religious or spiritual reality. The
constructivist denies this absolute reality and replaces it
with a relativistic account of personally constructed reali-
ties. The pluralist grants the existence of an absolute reli-
gious or spiritual reality but denies any one religious sys-
tem the ability to capture it fully and recognizes multiple
valid religious belief systems.
Both the pluralist and the constructivist approaches have
their positive and negative sides. Adhering to these two or
any of the four approaches previously presented is not so
much a matter of choice but of self-understanding and per-
sonal belief. Counselors need to look at themselves and their
values to determine which of the approaches fits their own
beliefs about the world. This article argues that counselors
who fall in the constructivist and pluralist camps may be in
a better position to deal with a wide range of religious and
spiritual issues in an effective and respectful way.
Rejectionists and some exclusivists may need to refer cli-
ents who present with religious or spiritual concerns. De-
JOURNAL OF COUNSELING & DEVELOPMENT • SPRING 2000 • VOLUME 78
ciding whether it is better to refer the client to a pluralist
or a constructivist is not presently clear. Further research
and comparison of the approaches is needed to help an-
swer this question. Both approaches, however, recognize
the validity of searches for significance in ways related to
the sacred. They simply differ over whether the object of
that sacred search is an absolute or a personally constructed
reality.
It is clear that counselors who work with religious or spiri-
tual clients need to include an appraisal of the client’s reli-
gion or spirituality in initial psychological assessments. Many
practitioners do not inquire about client’s religious beliefs
in the initial phases of counseling despite the possibility
that these values are central to clients’ views of themselves,
the world, and their problems. To this end, counselors should
be familiar with existing resources on religious assessment
that have been written for pastors (e.g., Fitchett, 1993;
Pruyser, 1976) and mental health professionals (Lovinger,
1984; Richards & Bergin, 1997).
Another issue concerns the competence of counselors to
understand the religious and spiritual worlds of their cli-
ents. The ethical principles of both the American Counsel-
ing Association (1995) and the American Psychological
Association (1992) require that counselors provide services
that reflect the boundaries of their competence. Those coun-
selors who intend to work with religious and spiritual cli-
ents should acquire adequate training, experience, and in-
formation about different religious and spiritual traditions
and beliefs (Lovinger, 1984). This may include gathering
information from clients themselves or learning about spe-
cific religious or spiritual beliefs through study of religious
texts and other materials. Gaining adequate experience with
specific groups of religious or spiritual clients may require
extensive exposure to such groups and proper supervision
from those familiar with such therapy.
A recent proposal by Richards and Bergin (1997) has
suggested an 8-point checklist of educational and training
standards for professionals who deal with religious and spiri-
tual issues in their work with clients. These suggestions in-
clude training in multicultural counseling, reading classic
works in the psychology of religion and on religious and
spiritual issues in counseling, reading current literature on
religion and spirituality published in mainstream mental
health journals, taking workshops devoted to religion and
mental health, studying world religions through reading
books or taking classes, acquiring specialized knowledge
about those specific religious traditions frequently encoun-
tered in therapy, and seeking appropriate supervision when
working with clients from traditions unfamiliar to the coun-
selor or when introducing specific religious and spiritual
interventions for the first time into treatment.
To manage value issues in therapy and avoid imposing
values on clients, therapists must also be aware of their
own value systems and beliefs. As argued by Beutler (as
cited in Vachon & Agresti, 1992) therapists should be sub-
jected to “detailed evaluation of their inner beliefs” (p. 510)
and know themselves at least as well as they attempt to
169
Zinnbauer and Pargament
know their clients. In addition to resolving their own reli-
gious or spiritual conflicts, counselors must identify what
they hold as models of psychological health and pathology,
and models of religious or spiritual health or pathology.
Similar to the aforementioned suggestions presented by
Richards and Bergin (1997), appropriate supervision or
consultation with counselors experienced with religious and
spiritual issues, cross-cultural counseling, or value conflicts
in counseling may help in this task. Discussions with reli-
gious leaders and clergy from counselors’ own religious or
spiritual traditions may help clarify their religious and spiri-
tual values. The possibility of counselors entering explor-
atory or insight-oriented counseling themselves may also
be appropriate. Finally, careful explication of one’s theo-
retical model of treatment and the assumptions that the
model makes about religion and spirituality should be con-
ducted during a counselor’s initial professional training and
then periodically as that counseling approach matures and
changes over time.
Once a counselor understands his or her personal values,
it becomes a matter of informed consent that the client is
made aware of the values and models held by the counse-
lor. When counseling enters areas of potential value con-
flict, counselors need to self-disclose the personal values or
religious and spiritual beliefs that guide their therapeutic
practice. If clients are to make a fully informed decision
about counseling, they need to understand what implicit
values will guide and shape the process.
Explicating one’s models of religious and spiritual
health and pathology may not be an easy process for
mental health professionals, but such explication is needed
(Miller, 1999). Models for psychopathology and mental health
are presented in the numerous psychotherapeutic systems,
but models of religious or spiritual health and pathology are
not so plentiful. Examples from the literature include those
by Hungelmann, Kenkel-Rossi, Klassen, and Stollenwerk
(1985), Pruyser (1977), Richards and Bergin, (1997), Spero
(1985a), and Vaughan (1991). Knowing one’s implicit mod-
els of health may be more relevant to the pluralist than to the
constructivist because of the constructivist’s relativistic ap-
proach. However, inasmuch as no counseling is value free, all
counselors need to recognize their own value systems and be-
liefs about health and pathology.
CONCLUSION
The worlds of religion, spirituality, and counseling are too
frequently at odds, but their inevitable collisions need not
prove injurious for the religious or spiritual client. There is
an abundance of research showing that therapy is value
laden and that counselors and clients often share different
value systems. This counselor–client value difference is
nowhere more apparent than in the realm of religious and
spiritual values. The clear need at present is for counseling
approaches that do not pathologize or elevate client reli-
gious and spiritual beliefs without clear empirical or clini-
cal justification. The fine line to be walked is between re-
170 JOURNAL OF COUNSELING & DEVELOPMENT • SPRING 2000 • VOLUME 78
spect for clients’ beliefs and the need to treat legitimate
psychopathology. Approaches that are hostile to all reli-
gious and spiritual beliefs and those that are too narrow to
treat the variety of clientele who seek mental health ser-
vices are not the answer to this need. The pluralist and
constructivist approaches are flexible enough and respect-
ful enough to treat religious clients effectively and ethi-
cally. Pluralist or constructivist counselors who are informed
by self-knowledge, an understanding of a variety of reli-
gious and spiritual beliefs, and a persistent awareness of
their own reactions to religious and spiritual issues in the
course of treatment are those best equipped to provide ef-
fective mental health services to religious and spiritual cli-
ents. Anything less, and counselors risk disregarding Bergin’s
warning and acting as unethical and subversive moral agents.
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