Date of Award

Summer 2013

Document Type


Degree Name

Doctor of Philosophy (PhD)




Clinical Psychology

First Advisor

Saunders, Stephen M.

Second Advisor

Torres, Lucas

Third Advisor

Wierzbicki, Michael


A growing number of studies have found that clients would prefer to discuss spiritual and religious (S/R) concerns in psychotherapy and, notably, see it as an appropriate place to discuss these concerns. Although clients report they would prefer to discuss S/R matters with their therapist, psychologists are reluctant to do so. Lack of training may be a factor in the reluctance of psychologist to discuss spirituality and religion with their clients. In addition to the research on spirituality/religion and psychotherapy, the therapeutic alliance has been proposed as a similar component among all forms of treatment and consistently shown to be predictive of psychotherapy outcome. While the therapeutic alliance is one of the most widely investigated components in psychotherapy, no studies to date have looked at the impact of S/R querying on ratings of the alliance. This study is a first attempt towards that goal. A measure of clinician competence, the Scale of Spiritually Conscious Care (SSCC) was constructed to assess clinician awareness, knowledge, comfort, competence, and skills in addressing spirituality and religion in psychotherapy. Following creation of this measure and initial reliability investigation, clinicians were trained to administer S/R queries to their clients. Finally, the impact of this training on clinician competence and client ratings of the alliance was investigated. Results indicated the SSCC demonstrates adequate test-retest reliability and strong internal consistency. Although clinicians reported increased comfort and competence after the training, in addition to increased incorporation of client spirituality and religion into psychotherapy; no significant differences were found between those who attended the training and those who did not. Additionally, no significant differences in ratings of the alliance between client who discussed spirituality and religion with their clinicians and those who did not were found. The lack of significant results may be related to the small sample and low power to detect genuine differences between groups. These results are taken to be a strong first step in investigating the effect of S/R querying on ratings of the alliance and worthy of further investigation.