Problems in the treatment of religious patients.

Members of religious groups are bound together by doctrine, ritual, and social organization. These factors also separate religious people from members of other groups or cultures. This division is apparent during interactions with other groups, and critical when members of religious groups are referred for help for psychiatric problems. In this paper we discuss four problems that therapists may encounter with strictly religious patients. Religious patients are often suspicious of secular therapists and therapy, and therapists too, may be influenced by their personal attitudes toward religion. Differentiating religious beliefs and rituals from delusions and compulsions is difficult for therapists ignorant of the basic tenets of that religion. Clinical examples of the four problems are presented from our work with patients from the ultra-orthodox Jewish community of North Jerusalem and we provide guidelines for their resolution. Therapists need a basic knowledge of the religion's doctrines and rituals, should assess patients using its terminology, and approach the patients through the social organization of their religious group. We consider that attention to these issues is vital for effective communication and assessment of strictly religious patients.