In "Spiritual and Religious Competencies for Psychologists," Cassandra Vieten and her colleagues tackle a question that should embarrass the profession: why are most psychologists so poorly prepared to engage with the spiritual and religious dimensions of their clients' lives? This isn't a fringe concern. Research consistently shows that the vast majority of people worldwide consider spirituality or religion central to their identity, their coping strategies, and their understanding of suffering and healing. Yet most graduate training programs in psychology either ignore this dimension entirely or treat it as a potential source of pathology rather than resilience. Vieten's work represents a systematic attempt to close this gap by articulating exactly what competent, ethical engagement with clients' spiritual lives actually looks like in practice.

What makes this contribution particularly valuable is its precision. Rather than vaguely encouraging psychologists to "be more open" to spirituality, Vieten and her research team used a rigorous Delphi method—polling experts across multiple rounds to reach consensus—to identify sixteen specific competencies that psychologists need. These range from basic awareness (understanding your own spiritual attitudes and biases) to sophisticated clinical skills (knowing how to assess whether a spiritual experience is contributing to wellbeing or distress). The result is a practical framework that training programs can actually implement, supervisors can teach, and clinicians can use to evaluate their own readiness. For IMHU's community, this work matters because it represents the leading edge of institutional change—the slow but essential process of making mainstream psychology spacious enough to hold the full range of human experience, including the parts that don't fit neatly into materialist frameworks.

Here's a striking paradox at the heart of modern psychology: a profession dedicated to understanding the whole person systematically ignores one of the most important dimensions of most people's lives. Vieten's research documents how graduate programs in clinical and counseling psychology offer little to no training in spiritual and religious competence. Students learn to assess for depression, anxiety, trauma, substance use, and dozens of other clinical concerns, but they graduate without any structured preparation for engaging with the beliefs, practices, and experiences that many clients consider most fundamental to who they are.

The consequences play out in therapy rooms every day. Clinicians who feel unprepared to discuss spirituality tend to avoid the topic altogether, even when clients raise it. Others inadvertently pathologize religious experiences they don't understand, interpreting intense prayer as dissociation or mystical states as psychotic symptoms. Still others over-identify with clients' spiritual beliefs, losing clinical objectivity. Vieten argues that this competency gap isn't just an educational oversight—it's an ethical failure. Psychologists are bound by their ethical codes to practice within the boundaries of their competence and to respect client diversity. If spirituality and religion represent core aspects of diversity for most of the world's population, then failing to develop competence in this area violates the profession's own stated values. The gap between what psychologists say they value and what they're actually trained to do is wider than most want to admit.

The heart of Vieten's contribution is the set of sixteen empirically derived competencies organized into attitudes, knowledge, and skills. On the attitude side, psychologists need genuine self-awareness about their own spiritual and religious histories, including how those histories might create blind spots or biases in clinical work. Someone raised in a strict religious household who later rejected religion might unconsciously view all religious belief as constraining. A psychologist with a strong personal meditation practice might romanticize spiritual experiences and miss signs of distress.

The knowledge competencies require understanding the diversity of spiritual and religious traditions, knowing how spiritual issues intersect with clinical presentations, and being familiar with research on the relationship between spirituality and health outcomes. The skills are where things get most practically useful: conducting spiritually sensitive assessments, integrating spiritual resources into treatment when appropriate, knowing when to refer to spiritual directors or religious leaders, and—crucially—being able to distinguish between spiritual experiences that support wellbeing and those that indicate clinical concern. This last skill is particularly relevant to IMHU's mission. A psychologist who can competently assess whether someone's intense spiritual experience represents a spiritual emergency, a psychotic episode, or a meaningful developmental process is exactly the kind of clinician the field desperately needs more of.

Vieten draws an important distinction between mere tolerance of clients' spiritual beliefs and genuine therapeutic engagement with them. Tolerance is the baseline—not dismissing or pathologizing someone's faith—but it's not enough. A psychologist who simply avoids the topic of spirituality to prevent saying the wrong thing isn't practicing competently. They're practicing avoidantly. Genuine engagement means being willing and able to explore spiritual and religious dimensions of a client's experience with the same curiosity, skill, and clinical rigor brought to any other aspect of their life.

This matters because spiritual and religious concerns are often woven inseparably into the clinical issues people bring to therapy. Grief frequently involves questions about the afterlife, the meaning of suffering, or anger at God. Trauma recovery may be entangled with religious communities that failed to protect someone, or sustained by faith practices that provide genuine solace. Identity development for LGBTQ+ clients raised in conservative religious traditions involves navigating between spiritual belonging and authentic self-expression. Anxiety and depression can have spiritual roots—the dark night of the soul is a real phenomenon, not just a metaphor—and spiritual resources can be powerful factors in recovery. A psychologist who can't engage with these dimensions is working with an incomplete picture of their client, like trying to understand someone's health while ignoring their diet.

One of the most clinically demanding competencies Vieten identifies is the ability to assess when spiritual or religious experiences are contributing to health versus when they might indicate or exacerbate psychological distress. This is the question that keeps many clinicians up at night, and for good reason. The phenomenology of spiritual experience and psychotic experience can overlap significantly. Hearing a voice during prayer, feeling a profound sense of unity with all things during meditation, experiencing a sudden and overwhelming sense of divine presence—these can be markers of deepening spiritual life or symptoms of a clinical condition, and sometimes the distinction isn't immediately clear.

Vieten's framework doesn't offer simple decision trees for this assessment, because simple decision trees would be dishonest. Instead, it emphasizes the importance of context, function, and integration. Is the experience consistent with the person's spiritual tradition and developmental trajectory? Does it enhance or diminish their capacity to function in daily life and maintain relationships? Can they reflect on the experience with some degree of perspective, or are they completely absorbed in it? Are they distressed by the experience, and if so, is that distress about the experience itself or about not being understood? These questions don't yield algorithmic answers, but they give clinicians a structured way to think carefully about experiences that our current diagnostic categories handle poorly. This is exactly the kind of nuanced clinical reasoning that IMHU advocates for.

What gives Vieten's work its lasting significance is that it's designed not just to inform individual clinicians but to change institutions. By articulating competencies in clear, measurable terms, the framework gives training programs something concrete to build curricula around, accreditation bodies something specific to evaluate, and the profession as a whole a standard to aspire to. This is how systemic change actually happens in professional fields—not through inspirational calls for openness, but through the unglamorous work of defining competencies, developing training methods, and embedding expectations into institutional structures.

The progress has been real but slow. Some training programs have begun integrating spiritual competencies into their curricula. The American Psychological Association has increasingly acknowledged the importance of religious and spiritual diversity. Individual clinicians who encounter this framework often describe it as permission to bring their full selves and full curiosity into the therapy room. But the broader picture remains challenging. Most practicing psychologists still received no training in this area, and most training programs still treat it as optional rather than essential. Vieten's competencies represent what the field could become if it took its own values seriously—a psychology that genuinely engages with the full complexity of human experience rather than quietly editing out the parts that make materialist science uncomfortable. For anyone who has felt unseen or pathologized in a therapeutic relationship because of their spiritual experiences, this work offers both validation and hope that the profession is, however slowly, beginning to catch up.