Spiritually Incorporating Couple Therapy in Practice: Christian-Accommodated Couple Therapy as an Illustration

Clinical Impact Statement Question: What is happening in spiritually integrated couple therapy sessions? Findings: Clinicians drew primarily from evidence-based treatments, and couples tended to improve over six sessions-especially those with less initial relational distress. Meaning: Client spirituality was more important in driving outcomes in spiritually incorporating couple therapy (SICT) than therapist spirituality. When therapists used specific spiritual techniques, they tended to discuss hope, forgiveness, and listening to the heart, silently prayed for the couple, and encouraged partners to pray. Next Steps: Highly distressed religious couples may be a special diversity population because they risk disengagement from treatment. Spiritually incorporating couple therapy (SICT)-couple therapy that incorporates spiritual interventions-has a growing research base. Information is limited on how spiritual interventions are used in practice; thus we studied treatment-as-usual (TAU). SICT is treatment that, at a couple's request, sometimes draws upon spiritual resources when addressing relational issues. We tracked 65 couples from 29 couple therapists (who advertised as spiritually incorporating therapists) over 402 sessions of SICT. Couple spirituality predicted use of spiritual interventions more than did therapist spirituality. The most used spiritual interventions included silent prayer for the couple, discussions of hope and forgiveness, and encouragement to consult their heart. In SICT, therapists used evidence-based couple therapy approaches. SICT should (a) treat highly religious couples in high distress as being at risk for early drop out; (b) follow couples' leads in using spiritual methods; and (c) draw on evidence-based couple and spiritual practices.