Most people who read my column realise that I write about spiritual issues on a regular basis. Actually, I write about issues that cross categories, including psychology, philosophy, psychotherapy, current events in Bermuda and the wider world, and so forth.I suspect that some people think what I do is Christian counselling. It would be misleading to think that I do. I can do that; I often did that when I was working as a pastor. Currently, though, I often work with religious people in a different fashion.There is a difference between a Christian counsellor and a counsellor who is a Christian. A Christian counsellor leads with the Bible, listening to the client to find touch points in which scripture and the details of the situation cross paths. Then, the Christian counsellor advises the client what to do in order to apply Biblical precepts that might make the situation better. A counsellor or psychotherapist who is a Christian might do that, but he or she might also utilise established approaches to psychotherapy that have evidence to warrant their use, and he or she would hopefully do so in a manner that is sensitive to the religious and spiritual beliefs and values of the specific client in question.Studies in North America have found that between 64 percent and 75 percent of the population believes spirituality is important to them, and a high number of people have spiritual issues that are part of their presenting problems. Further to that, about half the people a therapist will meet would welcome some kind of spiritual sensitivity, if not outright spiritual interventions, as part of their therapy. The numbers would vary for Bermuda, but they are likely to be similar (if not higher).Lately I have been reading about cultural competence in psychotherapy, with specific interest in what the various ethicists and psychology professionals say about psychotherapists with regards to spiritual and religious competence.It is widely believed that religious and spiritual issues fall under the category of multiculturalism. Increasingly, psychologists have called for colleagues to work in ways that are culturally sensitive. Ethical guidelines addressing such multiculturalism have been instituted by the American Psychological Association, the American Counselling Association, the US Surgeon General, the Canadian Psychological Association, and the Canadian Counselling Association (the ethical position of the psychologists in Bermuda closely follows that of professionals in the USA, Canada, and England). According to one influential scholar, responsible addressing of such multiculturalism must attend to multiple domains: age, developmental or acquired disabilities, religion and spiritual orientation, ethnicity, socioeconomic status, sexual orientation, indigenous heritage, national origin, and gender.One typical approach in the effort to become culturally sensitive is to study and memorise a list of characteristics descriptive of any given group. However, that is believed to be ultimately inadequate. With regards to spirituality, then, it would not be good enough to read books about the beliefs and practices of various religious groups (and it would certainly fall short to simply extrapolate from one’s own spiritual beliefs and experiences). There is just too much variation within groups to believe that someone’s description in a book or an article is going to really capture what is going on with the unique individual any given therapist might find sitting across from him or her in the consulting room. Rather, therapists need to attain accurate self-knowledge, knowledge of their specific client’s cultural and spiritual lives, and, as Brian Zinnbauer and John Barrett described it, “… an appropriate framework that balances attention to individual, group, and spiritual diversity”.Let’s expand on these things a bit.Therapists need accurate self-knowledge. What is that? A therapist needs to be comfortable and grounded in who he or she is in the current moment. If there is a lack of this kind of awareness in spiritual issues, then the therapist will likely avoid spirituality completely, ascribe his or her own spirituality to the client, or worse, pathologise any sign of spirituality at all.Therapists need to gain knowledge of their specific clients’ spiritual and religious lives. Basically, this means that a therapist has to be willing to ask questions about the client’s spiritual life and religious practices. Spirituality can be understood as a quest for the sacred, but how people define “sacred” varies. One person might find the quiet moment with all striving and desire gone, at one with the world, the universe, creation, and breathing in the mystery of life absolutely sacred. That is not necessarily the same as feeling a sacred moment in closeness to God. One person might find relationship with God sacred, but another might find the process of living sacred. One person might be strict in religious observance of holy days, dietary practice, prayer, and so forth, but another might be less so. Whatever the specific religious and spiritual conditions of the client, this is what the therapist needs to find out, and it is not good enough to read books about cultural backgrounds and religious practices of one religion or another and then to ascribe those to clients without talking to clients and finding out for oneself the specific and actual characteristics of an individual person.If a psychotherapist is uneasy going in this direction (as studies have shown that a majority of psychologists and psychotherapists either do not have a religious practice of their own), then they should seek to build up their competencies in that area.Psychotherapists need an appropriate framework that balances attention to individual, group, and spiritual diversity. This speaks to the method by which a therapist might ascertain the specifics of a case. The framework would include a cultural assessment (including age, generational influence, developmental or acquired disabilities, religion or spiritual orientation, ethnicity, socioeconomic status, sexual orientation, indigenous heritage, national origin, and gender), a list of problems, a list of strengths, and identified goals for the process of therapy.Most people have some kind of spiritual beliefs and religious practices, and frequently these would be identified as being very important to them. It is just common sense that such things should be included in the process of psychotherapy or counselling. There are often spiritual interventions that prove quite relevant to the process and outcomes involve.As I said at the beginning, most people know that I often write about spiritual issues; I do so as a culturally competent psychologist who just happens to also be an educated, trained, and ordained clergyman. It’s a great combination that serves my clients and me well.