Treatment Alliance: A Bridge over the Religiosity Gap?

Many mental health care patients, regardless of their religious beliefs, prefer a similar outlook on life with their professional caregivers. Patients experience greater openness to discuss religion and spirituality (R/S), mutual understanding, less fear of disapproval and report a higher treatment alliance. The question is whether the core problem of a so-called ‘religiosity gap’ (RG) lies in (a) an objective difference in outlook on life, (b) a perceived difference in outlook on life or (c) in unmet R/S care needs. We explored this by matching data of 55 patients with their respective caregivers for a quantitative analysis. An actual (objective) RG, when patients were religious and caregivers not, was not associated with a lower treatment alliance but a difference in intrinsic religiosity, especially when caregivers scored higher than patients, was related to a lower treatment alliance. A subjective RG, perceived by patients, and a higher level of unmet R/S care needs were also significantly associated with a lower treatment alliance as rated by patients. These results emphasize that sensitivity, respect and openness regarding R/S and secular views are essential elements in treatment and might benefit the treatment relationship.