The evaluation of religious and spirituality-based therapy compared to standard treatment in mental health care: A multi-level meta-analysis of randomized controlled trials

Objective: Psychotherapies are increasingly incorporating spiritual and religious systems of belief and practice, which aligns with recent developments toward person-centered treatments. The main objective of this meta-analysis was to compare the efficacy of a religion and spiritually-based (R/S) therapy to non-R/S treatments.

Method: A multi-level meta-analysis was conducted to compare randomized controlled studies of the efficacy between R/S-based and regular treatments in mental health care setting. Inclusion criteria were diagnosis, psychotherapeutic treatment, and explicitly religion/spirituality therapy. Outcome was assessed for symptoms and for functioning separately, and combined. We also examined several moderators, such as type of comparison, outcome domain, and diagnosis.

Results: Overall effect sizes obtained from 23 studies and 27 comparison groups indicated that a R/S treatment is moderately more efficacious compared to regular treatments at posttreatment (g =.52, p <.01) and at follow-up (g =.72, p <.01) (only available for symptoms). Results were similar for symptoms (g =.44, p <.01) and functioning (g =.62, p <.01).

Conclusion: In patients with a strong religious and spiritual affiliation, treatments with a focus on religious and spiritual issues are more efficacious than non-R/S-based therapy. Limitations as well as future directions are discussed.