Spiritual direction vs. therapy

What is the difference between spiritual direction and therapy?

The short answer is purpose. Therapy, or psychotherapy, is a health service. Its aim is to relieve distress, improve functioning and help with problems such as depression, anxiety, grief, trauma and relationship conflict. It is provided by clinicians who are licensed by the state and accountable to a licensing board.

Spiritual direction has a different aim. Spiritual Directors International, an international association of spiritual directors, describes it as helping people experience the eternal and infinite aspects of their true nature through the wise, experienced and compassionate company of another person. The focus is your spiritual life: prayer, discernment, how you sense God or the sacred in ordinary days. It is not a treatment for anything.

How the two compare

The two overlap in method, since both rely on careful listening, but they differ in almost everything else.

• Focus: therapy looks at emotions, thoughts, behavior, relationships and symptoms; spiritual direction looks at your relationship with God, the divine or the sacred, and how it shows up in your life.
• Training: therapists complete graduate degrees and supervised clinical hours before licensure; spiritual directors usually complete a certificate program, often over a couple of years, with no state license.
• Regulation: therapists answer to a state licensing board and professional ethics codes; spiritual directors may follow voluntary guidelines, such as those published by Spiritual Directors International.
• Assessment: a therapist assesses mental health and risk, and may diagnose; a spiritual director does not.
• Rhythm: therapy is often weekly or every other week; spiritual direction is traditionally about once a month.
• Payment: therapy by a licensed clinician may be covered by health insurance; spiritual direction is not.

What spiritual directors say about their own limits

Good spiritual direction programs are clear about this boundary. The Haden Institute, based in North Carolina, trains spiritual directors in what it calls the Jungian mystical Christian tradition while welcoming people from many backgrounds. Its certification page says that its teachings often prove therapeutic for participants, but that it is not offering therapy and does not certify its graduates as therapists.

Spiritual Directors International also stresses that directors do not proselytize or try to convince, and that they honor each person's free will and discernment. It publishes Guidelines for Ethical Conduct for directors. None of this makes a spiritual director a mental health provider, and a responsible director will suggest therapy when what a person is carrying goes beyond spiritual companionship.

When do you need therapy rather than spiritual direction?

Spiritual questions and emotional pain often arrive together, which is why the line can blur. A few signs point toward therapy, whether or not you also want spiritual direction:

• Low mood, hopelessness, anxiety or panic that has lasted weeks and is affecting sleep, work or relationships.
• Trauma, including painful experiences within a religious community, that keeps intruding on daily life.
• A relationship in crisis, such as an affair, constant conflict or a marriage that feels close to ending.
• Grief that is not easing, or that has become tangled with guilt or despair.
• Using alcohol, drugs or other behaviors to cope.
• Any thoughts of harming yourself or ending your life.

When might spiritual direction be the better fit?

If you are functioning reasonably well and your questions are mainly about prayer, discernment, meaning or your sense of God, spiritual direction may be exactly what you want. People seek it when they feel spiritually dry, when they are discerning a vocation or a major decision, when their old ways of praying no longer fit, or simply because they want company in paying attention to their spiritual life.

Some people see a therapist and a spiritual director at the same time, for different things. That can work well as long as each knows their role. Therapy can address the anxiety, grief or relationship strain; spiritual direction can hold the questions about God and meaning that sit alongside them. A crisis of faith can be addressed in either setting, and spiritual crisis and the dark night describes how to tell a spiritual crisis from depression.

How Laura Bass keeps the two separate

Laura Bass is a psychotherapist in Charlotte. She also studied Spiritual Direction at the Haden Institute and is an Ordained Minister through the Alliance of Divine Love. Because she has training on both sides of this line, she keeps them as separate pathways, and clients choose what to include.

Her psychotherapy practice is the clinical pathway, for individual and couples concerns. Her spiritual and complementary work is described separately on the spiritual healing page, which states plainly that it is not psychotherapy, not medical treatment and not crisis care. There is also a page on spiritual direction in Charlotte.

If you are unsure which you need, ask Laura. For more on faith inside therapy itself, see what faith-integrated counseling is and how to choose a faith-sensitive therapist, or go back to the faith and therapy guide.

Common questions