Exploring religion and spirituality in psychosis: meaning-making and clinical psychologists' perspectives

Abstract

Section A
Background. Religious and spiritual (R/S) beliefs play a complex role in mental health recovery, yet their specific influence in the context of psychosis remains underexplored. This systematic review aimed to examine how individuals with psychosis use R/S to make sense of their experiences.

Methods. A systematic search of three databases (PsycINFO, CINAHL, and MEDLINE) identified 13 qualitative studies, which were appraised using the Critical Appraisal Skills Programme (CASP) checklist, and analysed using thematic synthesis.

Results. Three analytics themes were developed: 1) Constructing positive meaning through R/S, 2) Transforming struggle into spiritual understanding, and 3) Evolving explanations of unusual experiences.

Conclusion. This review highlights that mental health services must move beyond basic cultural awareness to actively support R/S meaning-making, creating flexible spaces where multiple explanatory frameworks (spiritual, cultural, and clinical) can safely coexist. Recognising and working with this complexity is crucial for supporting long-term recovery in psychosis.

Section B
Background. Religious and spiritual (R/S) beliefs can support meaning-making in psychosis but may also contribute to confusion or distress. Despite their importance to many service users (SUs), little is known about how clinical psychologists (CPs) engage with R/S content in practice. This study explored how CPs made sense of their own R/S beliefs and how these intersected with their work with SUs who also hold R/S beliefs in the context of psychosis.

Methods. Ten UK-based CPs with a range of R/S beliefs and practices participated in semi-structured interviews. Reflexive thematic analysis was used for data analysis.

Results. Four themes emerged: 1) personal R/S identity; 2) relational dynamics with SUs; 3) clinical complexity when working with R/S and psychosis; and 4) personal and professional development in building competence.

Conclusion. Findings highlight the need for clinical psychology training to move beyond policy recognition, embedding structured spaces for reflection on R/S.

Date of Award	2025
Original language	English