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   RELIGIOUS PRACTICE IN MARITAL INTERVENTIONS

INCORPORATING RELIGIOUS

PRACTICE IN MARITAL INTERVENTIONS:

TO PRAY OR NOT TO PRAY?

Although couples seeking guidance frequently seek out a religious or spiritual

counselor, empirically–based marital interventions seldom acknowledge religious

and spiritual beliefs. Beach et al. have proposed that, at least for some couples, religious

practice is an appropriate element of marital therapy and a potential agent for

strengthening and improving marriages. In this commentary, we welcome the development

of marital interventions that are sensitive to the beliefs and values of specific

populations. At the same time, the suggestion that therapists intervene directly

and participate in religious practices with their clients raises serious questions.

Given religious doctrines that may not promote healthy relationships, how are therapists

to decide which religious teachings to include and which to ignore? How

much should therapists adopt the role of religious ministers? For which couples is

prayer an appropriate means of marital intervention? How can a behavior as entrenched

as prayer be altered? Addressing these questions is crucial for advancing

marital interventions that recognize the centrality of religious practice in the lives of

many couples.

Whether they are engaged and preparing for marriage, or distressed

and looking for treatment, when couples look for help, one place

they typically turn to is a religious or spiritual counselor. Yet, as

Beach, Finchm, Hurt, McNair, & Stanley (2008) point out, most empirically–based

interventions for improving and strengthening cou- 670

Journal of Social and Clinical Psychology, Vol. 27, No. 7, 2008, pp. 670–677

Correspondence concerning this article should be addressed to Kieran T. Sullivan, Department

of Psychology, Santa Clara University, 500 El Camino Real, Santa Clara, CA

95053. E-mail: ksullivan@scu.edu.

ple relationships do not acknowledge spirituality or religious beliefs

directly. To address this oversight and bridge the gap between couples

and the treatments available to serve them, Beach et al. have proposed

a framework for integrating religion and spirituality within

empirically–based marital interventions.

We welcome this proposal for two reasons. First, many couples

participate in premarital counseling offered through religious organizations

and some marital therapists adopt an explicitly religious

perspective in their marketing and practicing of marital counseling

(e.g, Christian counseling). To date, counseling in this vein has developed

separately from empirical research on marriage and marital interventions.

Thus, it is long past time for an explicit theoretical

framework to acknowledge this trend directly and guide empirical

work toward this area. Second, although many have paid lip service

to the idea of culturally sensitive interventions for couples, few have

developed models for doing it. The framework proposed here is an

important step in the right direction, as it is designed to connect to a

specific population (i.e., couples whose religious beliefs are an important

part of their lives) using language and imagery familiar to

that population. We are aware of few other frameworks for marital

interventions that reflect as explicit an awareness of the unique

needs of specific populations.

At the same time, we share with the authors a sense that their proposal

is preliminary and that crucial questions about the role of religion

and spirituality in marital interventions remain unanswered. In

these brief comments, we highlight several unanswered questions

and suggest priorities for further developing this perspective.

INCORPORATING RELIGIOUS TEACHINGS:

ALL TEACHINGS, OR JUST A SELECT FEW?

Marital interventions are presumably designed to promote the

well–being of couples and their relationships. Often, that goal coincides

with the goals of religious and spiritual teachings, but not always.

Religious traditions may include teachings or texts that, when

applied to a specific relationship, are not in the couple’s best interests,

and might be detrimental to wives in particular. Although some

counselors may choose to adhere to all elements of a particular religious

tradition, therapists offering non–denominational therapies

RELIGIOUS PRACTICE IN MARITAL INTERVENTIONS 671

may be required to select elements of a religious tradition that fit

with some independent, non–religious world view and avoid elements

that appear counterproductive or even harmful. This creates

tensions that seem inevitable whenever an empirically–based intervention

is linked to religious teachings: How much should the therapist

adhere to a religious tradition, and which teachings should the

therapist include in the intervention?

These questions arise whenever we imagine implementing some

of the specific recommendations proposed by Beach et al. (2008, this

issue). For example, the authors suggest, as one technique for implementing

religious practice in marital therapy, encouraging couples

to meditate on sacred texts. It is not hard to find elements

within sacred texts that are consistent with empirically–based couple

interventions. However, it is also fairly easy to find texts that

contain advice or injunctions that may not promote successful functioning

within marriages. When working with couples on forgiveness

following an affair, for example, what would be the impact of

meditating on “Give honor to marriage, and remain faithful to one

another in marriage. God will surely judge people who are immoral

and those who commit adultery” (Hebrews 14:4)? When working

with couples who value egalitarian relationships, what would be

the impact of meditating on “Wives, submit yourselves unto your

own husbands, as unto the Lord. For the husband is the head of the

wife, even as Christ is the head of the church” (Ephesians 5:22–23)?

How does a therapist working with couples that report domestic violence

respond to “If you (husbands) experience rebellion from the

women, you shall first talk to them, then desert them in bed, then

you may beat them” (Quran 4:34)? Should therapists choose to

avoid problematic sections of sacred texts on marriage, it is possible

that inclusion of more acceptable sections of the same text will serve

to implicitly endorse all teachings regarding marriage from that

source.

These illustrations highlight the complexities of incorporating religious

practice into a therapeutic process. Efforts to incorporate religious

practice, especially prayer and meditation on sacred texts, will

have to proceed carefully and justify including some religious teachings

and leaving out others. Making these choices may be beyond the

training of marital therapists, which leads directly to our next point.

672 SULLIVAN ET AL.

THE PROBLEM OF DUAL RELATIONSHIPS:

PROFESSIONAL COUNSELOR OR RELIGIOUS MINISTER?

Beach et al. (2008, this issue) raise the possibility that therapists may

construct prayers for their clients, routinely pray with their clients,

suggest particular sacred texts upon which to meditate, and/or become

involved in the interpretation of those texts. Given this level of

involvement by the therapist, it seems possible, or even likely, that a

couple will begin to view the therapist in a ministerial role, in addition

to her or his role as therapist. The possibility of creating a dual relationship

with clients deserves serious consideration, in light of the

American Psychological Association’s ethical principal concerning

multiple relationships between psychologists and their clients (APA,

2002), and caution regarding multiple relationships may be especially

warranted in the case of marital therapy. We can identify three

immediate potential problems with this particular dual role. First, as

Beach et al. point out, therapists are not typically trained to act in a

ministerial role. Just as therapists may feel uncomfortable with couples

receiving psychologically–based marital interventions from

priests, ministers, and rabbis who are not trained therapists, we

should not expect that therapists will necessarily perform competently

when selecting, interpreting, and incorporating religious practices.

Even attempting to do so may require additional training

beyond what therapists typically receive. Second, even when therapists

use “the couples’ own language system” as suggested by Beach

et al., religious beliefs are often held very strongly and very idiosyncratically.

If the therapist prays, or speaks about religious beliefs or

practices in a way that differs from couples’ deeply held beliefs and

practices, this might have a negative impact on the therapeutic relationship

and the intervention. Finally, if the couples perceive the

therapist in a ministerial role, they may turn to the therapist for guidance

on moral decisions (e.g., is divorce wrong?). Jacobson and

Christensen (1996) warn against this in their ground–breaking book

on couple therapy, Integrative Couple Therapy. As they write, “We are

not secular priests, ministers, or rabbis. Unfortunately, we cannot

count on our clients to recognize that. Therefore, it is our job to make

sure we do not obfuscate what is already a complicated relationship

by playing the role of moral arbiter” (p. 16). In sum, incorporating

religion and spirituality into marital therapies may lead couples to

RELIGIOUS PRACTICE IN MARITAL INTERVENTIONS 673

expect therapists to take on responsibilities that may fall outside

their scope of practice and training.

COMMUNITY CONTEXT:

HOW CAN IT HELP AND HOW CAN IT HURT?

A strength of Beach et al.’s (2008, this issue) framework is that it

builds marital interventions on the foundation of practices already

acceptable and familiar to the communities being targeted. The advantage

of this approach is that the therapist is not imposing something

entirely new, but rather attempting to shape existing behavior.

This may be an effective route to change. The danger, however, is

that these behaviors, because they are bound to community and culture,

are laced with existing meanings that may be hard to change.

We concur with Beach et al.’s caution that prayer “may also have the

potential to harm relationships” and Maloney, Pargament,

Tarakeshwar, and Swank’s (2001) argument that it is “critically important

to recognize religion’s potential to function adaptively or

maladaptively for couples and parents, depending on the nature of

religious beliefs and practices” (p. 585). To develop this concern further,

among couples who are already engaging in prayer prior to the

intervention, the role of prayer probably varies quite a bit. For some

couples, prayer may be working well and already enhancing relationship

functioning. The proposed approach would work well for

these couples, calling attention to an existing and effective strategy

for maintaining intimacy and resolving conflict. For other couples,

however, prayer may be working poorly or even harming relationship

functioning (e.g., praying for the other person to change), and

these behaviors may be supported by the community and thus

resistant to interventions.

CHOOSING THE RIGHT APPROACH FOR EACH CLIENT:

HOW TO DECIDE?

Beach et al. (2008, this issue) are very careful to remind readers that

prayer is not an appropriate element of marital interventions for all

couples. This is a crucial point worthy of further elaboration. How

might a therapist decide when to incorporate prayer for a specific

couple? We cannot assume that prayer is an appropriate element of

674 SULLIVAN ET AL.

marital interventions, even for couples who pray. There is evidence,

for example, that the impact of religiosity on marital satisfaction is

moderated by personality factors. Sullivan (2001) found that religiosity

had a positive effect on marital satisfaction when husbands

were low in neuroticism and a negative effect on marital satisfaction

when husbands were high in neuroticism.

The appropriateness of prayer as an element of couple interventions

is also complicated by the fact that each partner within a couple

may have different degrees of involvement in religion, different levels

of spirituality, and different beliefs and practices. Indeed, religion

or religious practices are actually a source of conflict for some couples.

Without directly acknowledging the potential diversity within

the couple, the therapist who advises particular religious practices

risks becoming an advocate for one partner over the other, and thus a

participant in the couple’s conflict. In sum, an explicit assessment of

the role and impact of religion and religious practices for each couple

may be warranted before incorporating religious practices into

psychological interventions.

Assessing the appropriateness and the effect of prayer and other

religious interventions is likely to be a complex process and it is not

yet clear whether any finite set of guidelines will suffice. The authors

do provide some initial thoughts, however, on therapist “dos and

don’ts.” Therapists may also want to consider one additional do and

one additional don’t.

Do. To avoid difficulties stemming from the therapist appearing to

impose prayer or prayer content, the therapist might begin by asking

more generally about all of the things couples do to find peace and

comfort. Using prayer as a self–soothing technique may be especially

promising when prayer is already part of the self–soothing repertoire

of both spouses. For couples who spontaneously mention

prayer as a source of solace, therapists might then explore further the

type of prayer that seems to work and whether the couple might

want to use this technique more deliberately and mindfully when

engaged in conflict. This approach also has the advantage of allowing

the therapist to assess the content of the prayer and whether that

content is likely to facilitate or detract from conflict resolution.

Don’t. It is important that therapists not let a desire to incorporate

prayer (or any other aspect of a therapeutic protocol) distract attention

from the real challenges that couples may face and that may

RELIGIOUS PRACTICE IN MARITAL INTERVENTIONS 675

have little to do with dyadic interactions. Beach et al. (2008, this issue)

describe prayer primarily as a means of facilitating more effective

dyadic interactions. That is likely to be a good thing in many

cases, but couples come to interventions with different problems and

different needs, some of which cannot be resolved solely through effective

communication (e.g., drug or alcohol dependence, violence,

financial or health difficulties, etc.). When there are significant personal

problems that pose a danger to either spouse or their children,

therapists must be cautious about promoting tolerance and

forgiveness through prayer.

CONCLUSION: TO PRAY OR NOT TO PRAY?

Marriage is central to and interdependent with couples’ lives. For

couples who are religious or spiritual, the effectiveness of marital interventions

may be limited if they do not address religion or spirituality

in some way. For some couples, religious teachings and prayer

will be, as Beach et al. (2008, this issue) suggest, a means of rising

above specific concerns and directing attention toward higher goals,

which presumably include sustaining a loving and long marriage.

Yet accepting this premise does not by itself answer exactly how involved

the therapist should be with a couple’s spiritual life and how

to ensure that therapists are incorporating religious practices appropriately.

Beach et al. have made an important first step in proposing a

framework for how to think about and evaluate the effect of incorporating

religious practices into therapy with couples. In response to

this proposal, we are prompted to consider some important questions:

How involved should therapists be in the religious and spiritual

lives of their clients? How can we resolve the inevitable tensions

between therapists’ goals and religious goals? How can therapists

shape the content and the meaning of prayer for couples, given how

entrenched and culture–bound these behaviors are likely to be? How

might we think cautiously about the potential for developing dual

relationships with couples and what is the potential impact of this

type of dual relationship on treatment? And how will we identify

couples for whom this approach would be appropriate? Beach et al.

have opened a door that needs to be opened. Now it is up to

therapists and researchers to deliberate on these questions and

determine where this road will ultimately lead.

676 SULLIVAN ET AL.

REFERENCES

Beach, S.R.H., Fincham, F.D., Hurt, T.R., McNair, L.M., & Stanley, S.M. (2008).

Prayer and marital interaction: A conceptual framework. Journal of Social

and Clinical Psychology, 27(7), 641–649.

Jacobson, N.S., & Christensen, A. (1996). Integrative couple therapy: Promoting acceptance

and change. New York: W.W. Norton.

Mahoney, A., Pargament, K.I., Tarakeshwar, N., & Swank, A.B. (2001). Religion

in the home in the 1980s and 1990s: A meta–analytic review and conceptual

analysis of links between religion, marriage, and parenting. Journal of

Family Psychology, 15, 559–596.

Sullivan, K.T. (2001). Understanding the relationship between religiosity and

marriage: An investigation of the immediate and longitudinal effect of religiosity

on newlywed couples. Journal of Family Psychology, 15, 610–626.

RELIGIOUS PRACTICE IN MARITAL INTERVENTIONS 677