Does paying attention to religious themes in psychotherapy influence treatment outcome?

Cross-sectional studies show positive correlations between psychological
wellbeing and religiosity. Most religious patients prefer to discus religious
topics during their therapy. However, whether addressing religious issues in a
psychotherapy increases effectiveness of psychotherapy of religious patients is
virtually unknown, as are potential moderating and mediating mechanisms.

The main aim of the study is to investigate the influence of discussing
religious issues during therapy on treatment outcome, both 6 months after start
of treatment and 1,5 year after start of treatment. In addition, the study will
take possible mediating variables into account, such as cognitive schema*s,
image of God, and therapeutic alliance. Structural features of personality
pathology will be investigated as a moderator variable.

This study is a longitudinal experimental study, aimed at testing a theoretical
model (see appendix) of the association between the several variables. Four
groups will be formed, and subjects will be assessed at three moments in time.
Patients will be asked for their co-operation and will be asked the following
question: It is possible that religious topics are being discussed during your
treatment. Would you like that to happen? Patients can choose between: (1)
desirable and (2) not desirable. Subsequently, patients are ad random
allocated to: a) talking about religious issues in therapy; or b) not
discussing religious issues in therapy.
Patients in group a) discuss religious topics approximately 15 minutes per
session. Therapists record per session the time spend on religion. Patients in
group b) do not talk about religion.
At three times, all patients fill in questionnaires: (T0) before treatment;
(T1) 6 months after start of treatment; and (T3) 1,5 year after start of
treatment. (See for the questionnaires being used in the study the appendix.)

Two interventions take place: 1) filling in the questionnaires at three moments
in time; and 2) discussing religious issues during treatment yes or no.
Therapists receive a workbook describing different religious interventions that
can be applied in therapy.

Filling in the questionnaires can make some patients emotionally upset.
Clinical experience however shows that these emotional reactions do not
frequently occur or are of short duration.
Furthermore there is a risk of disappointment for patients depending on the
group they are assigned to. One group is allowed/have to talk about religious
topics and the other group is not allowed to speak about religion. Some
patients will be allocated to the group *not talking about religion* although
they desire discussing it. This may result in disappointment in the therapist
and of being discontent with the therapy.
Some patients will be allocated to the group *talking about religion* although
they do not want this. Subsequently, patients may feel not understood and
irritated. They might get unsatisfied with the therapist and therapy.