Difficulties in integrating spirituality into psychotherapy.

The boundary between spiritual and psychotherapeutic issues is not well defined; indeed, the two may be interwoven. A patient's sense of a therapist may closely relate to the patient's assessment of the therapist's spirituality, and a therapist's recognition of the differences between psychopathological and spiritual beliefs may depend on a recognition of his or her own belief system. Changing the profession's approach to this issue is made difficult by 1) a traditional sense within many schools of psychotherapy that spirituality is outside the sphere of appropriate investigation and knowledge; 2) discomfort with personal spiritual issues in educators and trainees; 3) decreased emphasis on aspects of the therapist as important factors in patient outcome; and 4) decreased use of intensive supervision for psychotherapy in some training programs.