Addressing spiritual concerns in psychotherapy might be challenging in secular societies. An additional obstacle may be a possible religiosity gap between psychotherapists and their patients. To explore levels of religiosity and spiritual care competence, the Spiritual Care Competence Questionnaire was given to professionals in Norwegian mental health clinics. 262 staff participated, 92 of them psychologists. Results indicated first, that psychologists were significantly less religious than other professionals. Second, competence scores varied in the lower range for all participants, regardless of profession. Third, psychologists were open toward spiritual topics in principle, but hesitant to address them actively.

Importance: Shared decision-making is a widely promoted approach, yet clinicians, typically supportive in principle, find it difficult to implement because of concerns and barriers they commonly encounter in practice. Objective: To generate a primer that describes shared decision-making from the perspective of clinicians. Methods: We collaborated with clinicians, patient representatives, and health service researchers. We invited members of the International Society of Shared Decision Making to co-produce a primer for clinicians using a series of jointly edited online documents. We shared drafts with other clinicians and patients. Finally, we integrated the contributions until we had arrived at a consensus. Findings: Twenty-five people from 13 countries contributed; 9 had medical qualifications, 4 had nursing qualifications, and 12 others had a range of backgrounds. A total of 30 patients and clinicians provided further comments. The description differs from previous versions because it addresses the barriers that clinicians frequently mention. It describes how to overcome common challenges by emphasizing the importance of a clear invitation at initiation; it suggests how to manage patients’ resistance to shouldering decisional responsibility; reinforces the need to allow time for deliberation, especially with other stakeholders; and reassures clinicians that consensus, albeit welcome, need not be the goal of shared decision-making. Conclusions and Relevance: This primer portrays a reflective clinician who is aware of power asymmetry, patient vulnerability, risk communication, health literacy, agenda setting, and goal clarification. It envisages a clinician who is curious about personal perspectives and who can offer collaborative, iterative, and deliberative steps.

Professional sensitivity to diversity has been part of psychotherapy guidelines for decades. Religion and spirituality are facets of diversity alongside social, cultural, ethnic or gender diversity, and the demand for diversity-sensitive psychotherapy is ...

This article explores the significance of religious/spiritual approaches to existential issues in psychotherapy in Norway, with its secular, Western-European society. A content analysis of eight semi-structured interviews with psychologists who are experienced in the intersection of psychotherapy and religion/spirituality confirms the perceived therapeutic benefit of addressing religion/spirituality. Participants reported “sacred moments” in therapy and the significance of religion/spirituality for their therapeutic identities. Religious/spiritual self-disclosure and ethical borders emerged as challenging topics. As core competencies, the interviewees named existential sensitivity, self-reflection, and self-disclosure management. The article discusses what is needed to create safe spaces for existential/religious/existential issues in secular psychotherapy.

Mental health care that is open to patients’ existential needs requires well-trained professionals who work in teams and use an open conceptualization of spirituality, religion and other meaning-making domains. Using a mixed methods approach, this article explores how professionals (n = 262) in secular Norway perceive obstacles and opportunities in existential care. The results show correlations between age group, personal religiosity, terminology and perceived expertise. Commitment is high, but collaboration with chaplains and team training are neglected.