As part of their everyday clinical practice mental health professionals are likely to encounter patients with religious beliefs or patients who have religious issues. Traditionally, psychiatrists and psychologists have underemphasised religious issues in their work (Larson, 1986; Lukoff & Turner, 1992; Sims, 1994; Crossley, 1995). Religion is often seen by mental health professionals in Western societies as irrational, outdated and dependencyforming, a view deriving from Freud (1907: p. 25), who saw it as a ‘universal obsessional neurosis’ (Box 23.1). For similar reasons the topic of religion plays little part in psychiatric training, which may be selected by people of a lower level of religiosity than the background population (Shafranske & Malony, 1990; Larson & Larson, 1991; Rubenstein, 1994). It is no wonder that the Danish theologian Hans Kung referred to religion as ‘psychiatry's last taboo’ (Kung, 1986).

Several studies highlight a ‘religiosity gap’: psychiatrists are often far less religious than their patients (Kroll & Sheehan, 1981; Neeleman & Lewis, 1994). Both the general public and psychiatric patients report themselves to be more religious and to attend church more regularly than mental health professionals (American Psychiatric Association Task Force, 1975). In fact, a Gallup poll in 1985 indicated that a third of the general population in the USA considered religion to be the most important dimension of their lives, and another third considered it to be very important (Gallup, 1986). Keating & Fretz (1990) report evidence that religious individuals are less satisfied with a non-religious clinician than with a religious one.