Issues and Challenges of Integrating Religion and Spirituality into Counselling: An exploration of Counsellors' Experience

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Twelve counsellors were interviewed using a semi-structured interview and focus group discussion. Thematic analysis was performed and identified five main themes: 1) Knowledge and readiness to integrate religion and spirituality, 2) Being a role model, 3) Client's religious knowledge, 4) Awareness to refer to experts, and 5) Lack of understanding of the client's religious diversity. religion spirituality collectivist phenomenology Asia Introduction Religious and spiritual issues are prevalent in the lives of many individuals, including those seeking therapy and counselling sessions (Gladding & Crockett, 2019 ; Cashwell & Young, 2011 ; Johnson, 2013 ). This is because the element has a positive effect and is a source of support and inspiration for the client (Pargament, 2014 ). According to Christopher et al. ( 2015 ), the counselling frame may be affected by a lack of focus on religious and spiritual issues if counsellors commit mistakes in understanding problems, which in turn leads to misconceptualization of problems and inappropriate treatment plans for clients (Christopher et al., 2015 ; O'Connor & Vandenberg, 2005 ). Culbertson (2001) noted that neglecting clients' religion and spirituality leaves them as less than a whole. In other words, the clients are not perceived holistically. She further added that denying these two aspects means overlooking the crucial resources that clients may use to maintain health. Counsellors' refusal to address clients' religion and spirituality may lead them to impose their values on clients Burke et al. ( 1999 ), be culturally insensitive (Frankl, 2005 ), and expose them to high countertransference (Passalacqua & Cervantes, 2008 ). In line with the past studies that support religion and spirituality integration with counselling (Gladding & Crockett, 2019 ), the American Counseling Association (ACA) has issued guidelines called The Competencies for Addressing Spiritual and Religious Issues in Counseling (ASERVIC) (ACA, 2009). The guidelines help practitioners address issues related to religion and spirituality in session. The guide is to be used with other empirical counselling approaches. This shows that counsellors are responsible for religious and spiritual issues brought on by clients. The Council for the Accreditation of Counseling and Related Educational Programs (CACREP) has also adjusted its standards by expanding social and cultural diversity to include religious and spiritual orientation (CACREP, 2015). The standard clearly shows the need for a program to prepare potential counsellors to understand the impact of religious beliefs and spiritual traditions on clients and counsellors. Anxiety related to religious and spiritual issues has also been added as a Code V diagnostic category (code V62.89) in The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) (American Psychiatric Association (APA), 2013). Richards and Bergin ( 2000 ) noted that lack of exposure and competency is one of the issues counsellors face. Another issue identified is that counsellors are uncomfortable discussing religious matters and spirituality in counselling (Adams, 2012 ; Mohd Dagang, 2013 ). Counsellors may avoid dealing with religious and spiritual issues because they feel unprepared regarding knowledge and experience that touch those elements (Delaney et al., 2007 ). According to Hall et al. ( 2004 ), counsellors also tend not to involve themselves in discussing religious and spiritual elements in counselling because some may consider it a small issue and not an essential aspect of cultural diversity. Previous studies have identified several barriers that prevent counsellors from incorporating religion and spirituality into their practice. These include insufficient training for addressing clients' religious and spiritual issues (Bowsera et al., 2020 ; Mohd Dagang, 2013 ), clients' reluctance to engage in discussions on these topics, and a general lack of understanding and appreciation of their own religious beliefs (Bowsera et al., 2020 ; Hamja, 2016). Additional factors are the principle of separating church and state (Richard, 2001 ), the perception that religion and spirituality are highly personal and sensitive matters (Joan, 2012 ; Sumari & Baharuddin, 2016 ), and a lack of personal interest among counsellors, who may not recognize the significance of these aspects in the therapeutic context (Koenig, 2009 ; Christopher et al., 2015 ; Adams, 2012 ). Lack of certainty about balancing the scientific approach with religious and spiritual practices and the belief that religious and spiritual issues should be addressed by religious authorities instead of counsellors (Passalacqua & Cervantes, 2008 ; Hamjah, 2016 ) may also lead to avoidance of integration. Most previous studies were conducted in Western culture, where counselling and psychotherapy are rooted in evidence-based practice. In a collectivist religious culture, neglecting clients' religious and spiritual beliefs leaves them less than whole. Thus, this study attempts to understand the issues and challenges counsellors face in the collectivist society of Malaya in their effort to incorporate religion and spirituality in counselling. The Malaysian context A literature review on religion, spirituality, and counselling published in 2013–2023 using the Google Scholar engine indicated that limited studies were conducted in Malaysia. The studies that were done tend to focus on barriers to the effectiveness of the religious integration approach in family and marriage counselling (Mohamed Sidik et al., 2020 ), the experience of students in an Islamic-based counselling course (Sumari & Baharudin, 2016), integration of religion in counselling (Mohd Dagang et al., 2013), the Islamic approach in counselling (Hamjah & Mat Akhir, 2014) and the use of resources related to religion by Malaysian Chinese counsellors (Sing & Lai, 2012 ). Mohamed Sidik et al. ( 2020 ) explore the obstacles to the effectiveness of religious integration in family and marriage counselling. Six counsellors were interviewed. The findings show that counsellors' lack of confidence is the main barrier to integration. Thus, the study suggested integrating religion and spirituality in counsellors' training. Research by Sumari and Baharudin (2016) interviewed final-year students to understand their class experiences in an Islamic-based counselling course. The students reported that the class helped them increase their understanding of counselling and professional competence and improve their self-understanding and relation to God. The findings show that exposure to religion in some courses may positively impact counsellors' understanding of themselves. Meanwhile, Mohd Dagang ( 2013 ), who studied the level of spiritual and religious competence among 240 counsellors, found that the level is moderate. The study also found a relationship between spiritual competence and cross-cultural counselling. Another survey by Hamjah and Mat Akhir (2014) studied the Islamic religious approach applied by counsellors working at one Religious Council Counseling Center in Malaysia. The study's findings indicated three aspects of the Islamic approach: faith, worship, and moral conduct. Sing and Lai ( 2012 ) were interested in studying religious integration in psychotherapy among Chinese people from three different religions, Christianity, Taoism, and Buddhism, in Malaysia. The results show that by integrating religion and spirituality in the treatment process, the physical and somatic aspects of mental illness are addressed. Despite these studies, there is still a lack of qualitative studies that touch on counsellors' experience integrating religion and spirituality. This study is necessary, given that the Malaysian population is multiracial and multireligious (Malaysian Department of Statistics, 2023). One Pillar of Malaysia is Belief in God (Malaysian Department of Information, 2017). Malaysia National Education Philosophy also emphasizes the importance of religion and spirituality in education. The aim is to produce students with a balanced intellectual, spiritual, emotional, and physical personality based on faith and reverence for God (Ministry of Education Malaysia, 2021). According to Article 3(1) of the Federal Constitution, Islam is considered an official religion, but other religions may be practised in peace and harmony in any part of the Federation. In Malaysia, religion and spirituality are terms used interchangeably. In terms of population composition, Malay Muslims comprise the majority (63.1%), followed by Chinese, who are mostly Buddhist (19.8%) or Christian (9.2%). Most Indians are Hindu (6.3%). Less than 1% (0.7%) of Malaysians identify as atheists. It can be inferred that most Malaysians have a religious identity and can practice their religions freely (Malaysian Department of Statistics, 2023). Thus, clients may raise religious and spiritual issues during sessions. Unfortunately, the counselling curriculum in Malaysian higher education institutions relies heavily on Western standards. This lack of training may make some counsellors uncomfortable integrating religion and spirituality into practice. According to Mohamed ( 2017 ), the deficiencies found in the previous classification of the counselling theory approach require a classification that can integrate religion and spirituality into a more comprehensive dimensional pattern of the counselling theory approach by combining humans' physical and spiritual elements. According to Deraman et al. ( 2018 ), who conducted a study to analyze the needs of the Malaysian community for spiritual counselling services for 100 participants, showed a high need for spiritual counselling services among the respondents, which is 91 per cent (91 people). Based on this research gap, the current study aims to explore and understand the issues and challenges experienced by Malaysian counsellors in integrating religion and spirituality in counselling. Methodology Research design This research aims to explore and understand counsellors' experiences on how they integrated religion and spirituality into their counselling regime. A qualitative phenomenological research design was employed to collect the data to achieve this objective. A qualitative methodology was chosen because the design emphasizes understanding and interpreting participants' socio-cultures and experiences in a specific context and time (Blomberg & Volpe, 2008 ). The method focuses more on revealing research problems by exploring problems and phenomena that only a few know and understand (Creswell, 2007 ; Johnson & Christensen, 2008 ). Furthermore, the phenomenological method helps reveal the interpretation of an experience from participants' points of view (Denzin & Lincoln, 2003 ; Merriam, 1998 ). Data Collection Procedure After getting ethics approval from the Research Committee Ethics in March 2023, the researchers identified the potential participants using purposive and snowball sampling. Purposive sampling allowed the researchers to intentionally select participants based on specific characteristics and criteria pertinent to the study, ensuring that the sample is directly relevant and can provide rich, detailed, and highly relevant data. This method is particularly useful when understanding complex phenomena such as religion and spirituality in counselling among professional counsellors in Malaysia. Snowball sampling, on the other hand, was utilized to leverage the initial participants' networks, facilitating access to other potential subjects who fit the study's criteria but might have been difficult to reach through conventional means. This method is especially effective in reaching populations that are hard to locate or hesitant to participate, allowing the research to tap into a wider, yet still relevant, participant base. Data were collected from the population sample through individual interviews and focus group discussions (FGD). The interview is one of the methods in qualitative inquiry that allows the researcher, the main instrument, to gain an in-depth understanding of participants from their subjective point of view. In-depth interviews were conducted with participants until the data reached saturation. For data triangulation, a Focus Group Discussion was conducted with the participants twice, in April and June 2023, through a video conference. Like individual interviews, the FGD also aims to gain insight into the experiences of research participants. The group dynamic allows participants to share based on one another's responses and generate ideas they never thought of in an individual interview. Interview transcription was checked repeatedly to ensure no mistakes in writing the transcripts. The researchers also made a self-reflection in a special notebook after each interview to make explicit and take note of any researcher subjectivity that may inadvertently bias during data collection and analysis. Participants Identified research participants were contacted via electronic mail messenger (e-mail). The identified participants were asked to respond to two questions: (1) how long have you been providing counselling services to the community? Furthermore, (2) Have you ever integrated religion and spirituality into counselling? Initially, researchers contacted 43 counsellors. Of that number, only 23 counsellors responded to the e-mails and provided the answers to the two screening questions. The researchers then conducted preliminary interviews with the 23 participants. The final screening found that only 12 participants fulfilled the criteria. The criteria are that the counsellors must be registered with the Malaysian Board of Counsellors with a valid Certificate of Practice and have more than five years of practical experience, particularly in using religion and spirituality in counselling sessions. The 12 participants volunteered and signed informed consent to participate in the study. The participants' demographic background is shown in Table 1 . To protect the privacy and confidentiality of the participants, they are identified as R1 to R12. Table 1 Participants' Profile Respondents Age Race Religion Gender Level of education Years of Practice R1 43 Malay Islam Male Master of Guidance and Counseling 22 R2 60 India Hindus Male Master of Guidance and Counseling 23 R3 57 China Christian Female PhD in Counseling 30 R4 61 China Buddhist Male Master of Counseling 22 R5 52 Malay Islam Female Master of Guidance and Counseling 13 R6 61 Malay Islam Male Master of Counseling 21 R7 48 Kadazan Christian Female Master of Counseling Psychology 10 R8 37 Malay Islam Female Bachelor of Counseling 11 R9 63 Malay Islam Male Master of Counseling Psychology 20 R10 58 India Hindus Female Master of Counseling 15 R11 45 Malay Islam Female PhD in Counseling 10 R12 36 Malay Islam Male Master of Counseling 12 Data Analysis The researcher used the eight-analysis approach of Moustakas ( 1994 ) to analyze the data. The analysis involves listing relevant experience, reduction, thematic clustering, comparison of data sources, creating and constructing textual description, constructing composite structural description, and finally synthesizing textural and structural description into an expression. Validity and Reliability Lincoln and Guba ( 1985 ) used "trustworthiness" to describe the validity of qualitative research. The validity of this study is achieved by ensuring the validity of research questions in answering the desired outcome and the appropriateness of methodology and design, sampling, and data analysis: triangulation, member checking, and process audit trail enhanced validity. The researcher used the triangulation suggested by Guinon ( 2002 ), which is the triangulation of data sources. In the triangulation process, the researcher collected and analyzed data sources from transcribing individual interviews and focus group discussions (FGD). Reliability is enhanced and improved by ensuring the durability and dependability of responses to multi-codes of the data set. Results The results of the thematic analysis using eight methods introduced by Moustakas ( 1994 ) produced five main themes related to issues and challenges experienced by counsellors in using religion and spirituality in counselling, namely i) Knowledge and readiness to integrate religion and spirituality, ii) Being a role model, iii) Client's religious knowledge iv) Awareness to refer to experts and v) Lack of understanding of the client's religious diversity. The five themes are discussed in the following section. Knowledge and readiness to integrate religion and spirituality Most respondents think counsellors need to improve their knowledge and practices of using religious and spiritual elements. R4 sees that by enhancing knowledge and training, counsellors can avoid misunderstandings and conflicts during sessions. At the same time, R7 believes that knowledge alone is not enough. Still, counsellors also need to be experienced as clients of counsellors who use religious and spiritual elements in counselling to understand better and apply. "..first of all, the most important thing is that he (the counsellor) has to understand his religion first and also other religions so that there are no problems, conflicts, there may be wrong perceptions about our religion and our clients". (R4/IV01) Another counsellor shares his perspective: "..the first thing he is here is to work on ourselves first. Like me, I also go to a lot of counselling sessions for my issues or part of training. I once went to a paid session, at the hospital, so I have my issue, and I found the answer. So when I experienced it myself, then I believed, so then I could do it. Before this, I couldn't do it, so when I experienced and experienced myself, I could accept and use this approach, one of them has the challenge of being a counsellor or a practitioner, he needs experience, that is, having accepted as a client with this technique. Yes, knowledge is one thing, if there is no knowledge it is difficult to connect and experience is also important and if we use this approach, God will help us with the way we pray - let the session be led by God.." (R7/IV02) Even R5, R6, and R9 think counsellors can help clients more effectively by improving knowledge and practice. "Knowledge in religion needs to be expanded, through reading or attending religious classes with parties who have expertise, because sometimes through reading is a bit limited. It is possible, one is in terms of attending classes and the third is through discussions with religious experts. Sister Ida feels that it is really necessary for us to tidy up again in terms of religious and spiritual counseling. So when we have that knowledge, it is easy for us to help our clients deal with the problems they face. They are open". (R5/IV01) Another counsellor supports this: ".. his challenge is to us, how far we understand Islam is up to the teacher. We have to accept this client as it is. We cannot expect too much from this client. Indeed, the client is in a state of imbalance. So for teachers, who always need upskilling, reskilling is the counsellor himself....... It means that knowledge is important.". (R6/IV01) "Because we cover a lot of Western theories, then in the field it is not enough for us to implement to integrate religion and spirituality, it is not enough, that's why you have to learn other techniques or skills and must combine... then you can solve the problem. If you only depend on you having expertise in terms of Western theories only, now it's difficult to help clients.. the more knowledge the better.." (R9/IV01) Being a role model Being a role model for clients and the community is also an issue and challenge experienced by counsellors who use religious and spiritual elements in counselling. Therefore, counsellors should always be prepared to increase their knowledge and practice and express themselves through an attitude that can be a good follow-up model. R1 illustrates this. "..in terms of trying to control ourselves, because this client looks at us, he might make us his role models, so even as human beings we cannot run away from each other's mistakes and weaknesses. Try not to show it in front of the public. It's not that we're hypocrites, it's just that here we don't have bad intentions towards people, but we don't want people to see it and it can be a bigger slander. So take care of ourselves..." (R1/IV01) Another counsellor agrees with this: "Sometimes when we bring this religious and spiritual approach, most clients and society think we are perfect and never make mistakes, so expectations from others also become a challenge for us as counsellors. It's as if we are like angels who can do no wrong. We will be looked at askance…" (R12/IV01) According to Rogers ( 1961 ), in the human-centred approach, the counsellor is an agent of change by providing a suitable and therapeutic atmosphere that allows the client to become an individual who develops and functions well. Counsellors' qualities, such as unconditional acceptance, authenticity, and understanding, greatly influence changes in the client compared to the techniques used (Corey, 2017). Therefore, being a role model is challenging because counsellors need to be prepared to improve knowledge and practice and show attitudes that can be good role models for clients and society. The client's religious knowledge Counsellors also need to assess the client's level of religious knowledge early so that the approach used in integrating religion and spirituality in counselling will be easier and more effective. This is shared by R2 as stated below: "If you want to add. We need to know to what extent his client understands the concept of religion. If I Hindukan, to what extent does my client know about religion so that it is easy for me to tell him in a simple and abstract way? If he knows about religion, I will use an abstract method, if he does not understand religion, I have to use a simple method and this is an easy method when we are with the client. So we have to know about our clients. To what extent is our client's knowledge so that the approach will be easier". (R2/IV01) This statement is supported by another participant who shared her experience: "The clients who come with us are various, some are ok and some are not ok. I think among the clients, they don't want to comment too much about religion, because they think I've been scolded. When he talks about religion, he feels that he has to be lectured or scolded.. so the important thing is that the counsellor has to assess the level of the client's religious knowledge first, lest the client think that he will be punished". (R11/IV01) Worthington & Sandage ( 2001 ) suggest that assessing the domain of religion and spirituality can help counsellors determine how spirituality may be related to the problems presented by the client. By using various forms of assessment, counsellors may be able to determine the extent to which the client's religious and spiritual beliefs contribute to or maintain their problems. Awareness to refer to experts Awareness of the need to refer to experts is also seen as an issue and challenge for counsellors when using religious and spiritual elements in counselling. R1 and R2 share this theme. "If we need to consult, we refer to people who are more knowledgeable about the issues brought by the client himself. Because sometimes the client leads to a discussion about the law such as marriage. If it is related to divorce, what is all that, even though I have studied about that knowledge, we are told that we are not Kadi or Sharia court. So don't make it easy for us to classify what that person's condition is like" (R1/IV01) Meanwhile, R2 shared her perspective: "..because in the Hindu religion itself, there are several groups with different opinions. So if this group is in that category. He desperately won't listen to what I have to say. Have certain concepts that have different beliefs. Although the same, this person is Hindu but holds a different religious concept, so sometimes when we talk about Magavan Kitab, he does not accept it. He may have a hold of other books of knowledge if this kind of case needs to be referred to someone who is more expert in understanding the client himself". (R2/IV01) In most cases, the counsellor may consult a religious authority regarding issues related to religious and spiritual doctrines, beliefs, or practices raised by the client. This is necessary to help counsellors understand the problems presented by their clients and can detect when clients may misunderstand or misinterpret an important tenet in their religious or spiritual system. Sometimes, clients present problems with losing purpose and direction due to losing their religious beliefs (Lukoff,1998). This situation also requires consultation or referral to a religious authority. Lack of understanding of the client's religious diversity According to R3 and R4, understanding the diversity of religions, especially in Malaysia, is important for counsellors because Malaysia is made up of various religions and cultures. "So it is important as a counsellor, we understand beliefs from different religions, especially important beliefs such as Christianity also believe in one God, if he is not Buddhist, he believes in everything, everything needs to be worked on. If Christians believe that all sins have been atoned for, if the Chinese have Christians there are Buddhists, so I want to help this client integrate all the beliefs so that he can be helped fully... Meaning, we accept that diversity. It means that if we want to do integration, it is not based on one religion but depends on the religion of the client itself.. because, in Malaysia, we have assets like this, because we have different nations, so we have to get along, learn, and adapt. In terms of cross-culture, Malaysia is the best and should learn and understand the importance of Cross-Cultural" (R3/IV01) Another counsellor shared her perspective: "In Malaysia we have cross-cultural, so the first thing that is more important is that he (counsellor) has to understand his religion first and also other religions so that there is no problem, there is a conflict, there may be a perception that is all wrong in terms of your perception. The important thing is that he does not cause problems for clients and counsellors, especially those of a different religion." (R4/IV01) R8 and R11 think that understanding the diversity of the client's religion can also build a sense of respect among counsellors and clients who may have different religions and beliefs. "It means, if we can find out his religion, whether it's Buddhism, or Hinduism, his behavior in his religions, even the basics are ok. From there we see, we understand his way of life, we respect his religion, how do we want him to respect Islam" (R8/IV01) "inclusive of all religions. We should not condemn other religions, and be very respectful. If you don't know, ask. I will also ask "What is the opinion of the Hindu religion about transgender ".. don't condemn other religion and always ask what does the religion and always ask, what does religion permit you to do. In this kind of situation that all I did" (R11/IV01) Discussion The study found that issues and challenges in integrating religion and spirituality in counselling are related to counsellors' knowledge, preparation, skills, and attitudes of counsellors. The sharing of experiences by counsellors shows that the level of expertise and readiness of counsellors become among the main issues and challenges. The level of knowledge and readiness of counsellors is seen as the main issue and challenge because participants indicated that lack of clinical training causes many counsellors to avoid integration. Counsellors may become more confident in integrating religion and spirituality in counselling if they have basic training in religious study or attend short-term courses related to the field. The lack of exercise may result in counsellors feeling incompetent in dealing with religion and spiritual issues. As found in a study by Bowsera et al. ( 2020 lack of training is seen to have a direct impact on the counsellor's ability to effectively deal with religious and spiritual issues in counselling, especially when dealing with clients who come from various cultures and religions. Lack of training also causes counsellors to blur with competence and professional ethics (Pargament & Saunders, 2005). According to Morrison et al. ( 2009 ), ethical concerns are also a factor in counsellors trying to avoid integrating religion and spirituality in counselling. These include dual-role relationships between counsellors or preachers, violation of professional boundaries by placing value on the client, risking exceeding the limits of professional competence, entanglement with elements of mysticism, superstition, and superstition, as well as being exposed to the issue of underestimating the client's beliefs, which is considered holy or sacred (Morrison et al., 2009 ; Christopher et al., 2015 ). According to the ACA code of ethics (2005), counsellors can be considered unethical if they practice counselling services outside their competency area under the professional responsibility section (c.2.a). The code of ethics for Malaysian counsellors (Counsellor Code of Ethics Malaysia, 2023) also states that counsellors should provide services according to their areas of expertise and not exceed the limits of expertise based on their education, training, and supervised experience. The failure to train counsellors on religious and spiritual issues not only ignores the counsellor's commitment to understanding the client holistically but also has led to the belief in counsellors that they do not have the competence to integrate religion and spirituality in counselling (Cashwell & Young, 2005). Counsellors are also said to be unwilling to integrate religion and spirituality into counselling because they have not received sufficient formal training in those elements (Mohd Dagang, 2013 ; Oxhandler & Pargament, 2018 ). Counsellors need to understand the client's various cultures, ethnicities, and religions because the client's personality, attitude, and behaviour are formed from cultural and religious values (Barnett & Johnson, 2011 ). Religious and spiritual elements need to be integrated into counselling because they guide one to understand the value of the client's life (Miranti 1998). Religion and spirituality are the main influences in forming the client's cultural identity (Worthington & Sandage, 2001 ). Religion and spirituality are the components of various cultures (Pargament, 2005 ), and religion and spirituality help in exploration and problem-solving in counselling (Burke et al., 2005 ). Religion and spirituality are also seen as the main components that affect the client's physical, social, emotional, and intellectual (Witmer & Sweeney, 1992 ). Therefore, religion and spirituality need to be integrated as one of the components discussed in the counselling process, as well as other aspects such as the client's physical, social, emotional, and intellectual aspects. Dickson and Jepsen ( 2007 ) assert that counsellors must accept that religious and spiritual elements heavily influence part of the client's cultural development. If those elements are not given special attention, the counsellor has removed a great potential from forming the client's identity and general view (Corey, 2017). Therefore, religious and spiritual elements must be included as one of the components assessed in the counselling process, as are other aspects such as the client's physical, social, emotional, and intellectual aspects. Implications The secular concept that separates religious life from life is suitable in a social science situation. The opinion that integrating religion and spirituality is unprofessional is inappropriate. Religion and spirituality are not only knowledge related to the personal angle and the afterlife but are also necessary for human life in some societies. This section discusses the study's implications for future research and practice. Implications for Future Research This qualitative research uses a phenomenological approach, where researchers explore and understand counsellors' experiences using religious and spiritual elements in counselling. The findings of this study have contributed to the field of research methodology. For example, while going through the data collection process, the researchers learn a lot about new experiences that they have never had before. Each shared experience gives its meaning to the study participants. The expertise of counsellors integrating religion and spirituality in counselling is valuable and should be highlighted in the findings of this research. Therefore, this approach is seen as one of the most effective and appropriate ways to understand the phenomenon experienced by counsellors who integrate religion and spirituality into counselling. However, due to the limitation of this current research that focuses on issues and challenges experienced by counsellors, it is recommended that future studies consider examining or exploring the clients' experience. Future researchers may also consider the mixed method and quantitative approach, which involves a large scale of participants, to understand the issue. Implications for Counseling Practice and Training Based on the situation and counselling trend in Malaysia, several strategies need to be taken so that the counselling approach in Malaysia fits with various cultural and religious backgrounds by providing training to counsellors who are competent to help clients from diverse backgrounds overcome the various problems encountered (Litterell et al., 1989 ) The approach of integrating religion and spirituality that suits the culture and religion of the community needs to be worked on without setting aside Western theories that do not conflict with the culture and religion of the Malaysian community (Mohammad & Harun, 2006 ; Ab. Rahman, 2008 ). The Malaysian Board of Counsellors may consider incorporating religion and spirituality in the training of counsellors to equip them with the skills necessary to help clients with religious and spiritual issues. Training providers that organize continuous professional development for counsellors may also consider offering courses related to integrating religion and spirituality into counselling. Declarations Declaration of Interest The authors declare that there is no conflict of interest Author Contribution Mr.Abu Shahim prepared the draft of the manuscript. He is the main researcher. Mr Radhi identified the potential participants and scheduled the interview sessions. Dr Sumari as a supervisor of this research project oversees the project to ensure it meets the ethical and research procedure. Dr Sumari polished the final copy of the manuscript.Dr A. Razak as a qualitative expert ensures all the methodological procedures of qualitative research are followed. She also helped Dr Sumari polish this articleDr Md Shah and Dr Mohd Dagang were involved in data transcription and ensured that the data reached saturation Acknowledgement The authors would like to thank Dr Marcus Griffin from American Proofreading Center for his professional assistance in proofreading this article References Ab. Rahman, A. (2008). Perkhidmatan kaunseling pendekatan dalam hikmah berdakwah . Utusan Publications & Distributors Sdn. Bhd. ACA Code of Ethics (2014). Retrieved 5 Mei 2021 from www.counseling.org. Adams, J. R. (2012). Spiritual issues in counseling: what do students perceive they are being taught? Counseling and Values , 57 (1), 66–80. 10.1002/j.2161-007X.2012.00009.x . American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Author. 10.1176/appi.books.9780890425596 . Association of Spiritual, Ethical, and Religious Values in Counseling (2009). Spiritual competencies. 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(2005). Man's search for meaning . Beacon Press. Freitas, H., Oliveira, M., Jenkins, M., & Popjoy, O. (1998). The focus group is a qualitative research method. Pakistan Journal of Social Sciences (PJSS) , 33 (1), 191–198. Gladding, S. T., & Crockett, J. E. (2019). Religious and spiritual issues in counseling and therapy: Overcoming clinical barriers. Journal Of Spirituality In Mental Health , 21 (2), 152–161. Guinon, L. A. (2002). Triangulation: Establishing the validity of qualitative study. Thousand Oaks . Sage Publishing. Hall, C. R., Dixon, W. A., & Mauzey, E. D. (2004). Spirituality and religion: implications for counsellor. Journal of Counseling and Development , 82 (4), 504–508. Hamjah, S. H. (2016). Pendekatan Kaunseling Spiritual Menurut Al-Ghazali . Dewan Bahasa dan Pustaka. Hamjah, S. H., & Akhir, M. (2014). N. S. Islamic Approach in Counseling. J Relig Health (2014) 53:279–289. 10.1007/s10943-013-9703-4 . Joan, S. D. (2012). Counsellor Perception Of Competence In Addressing Spirituality: Implications For Practice . PhD thesis. Texas A&M University-Commerce. Johnson, R. (2013). Spirituality in counseling and psychotherapy . John Wiley. Johnson, B., & Christensen, L. B. (2008). Educational research: Quantitative, qualitative, and mixed approaches . Sage. Koenig, H. G. (2009). Research on religion, spirituality, and mental health: A review. The Canadian Journal of Psychiatry , 54 (5), 283–291. Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry . Sage. Litterell, J. M., Aminah, H., & Scheiding, S. K. (1989). Malaysian student's preferences for counsellors: Effect of the sex and ethnic group of counsellors and student. International Journal for the Advancement of Counseling , 12 , 181–190. Lukoff, D. (1998). From spiritual emergency to spiritual problem: The transpersonal roots of the new DSM-IV category. Journal of Humanistic Psychology , 38 (2), 21–50. Malaysia National Archives (50 Fakta Rukun Negara. Retrieved 2021). April 25, from. https://malaysia.gov.my/portal/content . Mohammad, M., & Harun, L. M. (2006). Western-based Counselling Theories: Adopt or Adapt? Jurnal Persatuan Kaunseling Malaysia (PERKAMA) , 12 , 71–84. Mohamed, O. (2017). Psikologi Kognitif Ad Din Kaunseling Kesihatan Mental . Penerbit Universiti Putra Malaysia. Mohamed Sidik, M. S., Awang, A., Ishak, N. A., & Abdul Majid, N. (2020). Barriers To The Effectiveness Of Religious Integration Approach In Family And Marriage Counselling. Journal of Critical Reviews . 7, (8). Mohd Dagang, M. (2013). Faktor yang mempengaruhi integrasi kefahaman beragama dalam amalan kaunseling pelbagai budaya di Malaysia ( Factors affecting the integration of religious understanding in multicultural counseling practice in Malaysia). Unpublished PhD. thesis, Universiti Putra Malaysia. Morrison, J. Q., Clutter, S. M., Pritchett, E. M., & Demmitt, A. (2009). Perceptions of clients and counseling professionals regarding spirituality in counseling. Counseling and Values , 53 (3), 183–194. Merriam, S. B. (2002). Qualitative research in practice. Examples for discussion and analysis . Jossey-Bass. Merriam, S. B. (1998). Qualitative research and case study applications in education . Jossey-Bass. Merriam, S. B. (2009). Qualitative Research. A Guide to Design and Implementation . Jossey-Bass. Miles and Huberman. Ministry of Education Malaysia Retrieved April 15 2021. from https://www.moe.gov.my/ . Moustakas, C. (1994). Phenomenological Research Method . SAGE. O'Connor, S., & Vandenberg, B. (2005). Psychosis or Faith? Clinicians' Assessment of Religious Beliefs. Journal of Consulting and Clinical Psychology , 73 (4), 610–616. https://doi.org/10.1037/0022-006X.73.4.610 . Oxhandler, H. K., & Pargament, K. I. (2018). Measuring religious and spiritual competence across helping professions: Previous efforts and future directions. Spirituality in Clinical Practice , 5 (2), 120. Pargament, K. I. (2005). Spiritually integrated psychotherapy: Understanding and addressing the sacred . The Guilford Press. Pargament, K. I. (2014). Spiritually integrated psychotherapy . Guilford Press. Passalacqua, S., & Cervantes, J. M. (2008). Understanding gender and culture within the context of spirituality. Counseling and Values , 52 (3), 224–239. Punch, K. (2001). Developing effective research proposal . Sage. Richards, P. S., & Bergin, A. E. (2000). Handbook of psychotherapy and religious diversity . American Psychological Association. Richard, E. W. (2001). Addressing Spiritual Issues in Secular Counseling and Psychotherapy: Response to Helminiak's (2001) Views ., 45(3), 207–217. 10.1002/j.2161-007x.2001.tb00198.x . Rogers, C. R. (1961). On becoming a person . Houghton Mifflin. Rukun Negara (2021). Retrieved 25 April 2121 from https://malaysia.gov.my/portal/content . Sing, R. K. T., & Lai, A. O. N. (2012). Use of Religious Resources in Psychotherapy from a Tradition-Sensitive Approach: Cases from Chinese in Malaysia. Pastoral Psychol (2012) 61:941–957. 10.1007/s11089-011-0365-4 . Sridhar, S., & Phey, L. K. (2016). Singaporean Counsellors' Use of Spirituality in Counseling. Journal of Asia Pacific Counseling , 6 (2), 63–85. Sumari, M., & Baharuddin, D. F. (2016). Counseling Students' Experiences in an Islamic-Based Counseling Course. Int J Adv Counselling , 38 , 194–203. 10.1007/s10447-016-9267-6 . Witmer, J. M., & Sweeney, T. J. (1992). A holistic model for wellness and prevention over the life span. Journal of Counseling & Development , 71 (2), 140–148. Worthington, E. L. Jr., & Sandage, S. J. (2001). Religion and spirituality. Psychotherapy: Theory, Research, Practice, Training, 38(4), 473–478. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4698596","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":330995847,"identity":"133fb454-bc43-4732-8b92-d24bd1bc419f","order_by":0,"name":"Mohd Radhi Abu Shahim","email":"","orcid":"","institution":"Universiti Malaysia Terengganu","correspondingAuthor":false,"prefix":"","firstName":"Mohd","middleName":"Radhi Abu","lastName":"Shahim","suffix":""},{"id":330995848,"identity":"a66a38f6-d295-418a-abea-1a50e2024fb2","order_by":1,"name":"Melati Sumari","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAtklEQVRIiWNgGAWjYFAC5gYGBgMbMFOCSC2MDQwHDNJI1sJwmAQtuu2NjZ8/FJxPXNvAfPA2D8O2xAZCWszOHGyWOGBwO3HbAbZkax6G20RouZHYANXCYyZNnJb7D5t/HDA4B9TC/41ILTcY24C2HADZwkakljOJbRZnDJKNtx1mM7acY3DbmLCW44cP36j4Yye77XjzwxtvKm7LEtSCAMwgwoDBkQQtUGBPso5RMApGwSgY9gAAFUxE9q+N9osAAAAASUVORK5CYII=","orcid":"","institution":"University of Malaya","correspondingAuthor":true,"prefix":"","firstName":"Melati","middleName":"","lastName":"Sumari","suffix":""},{"id":330995849,"identity":"798bfe9b-884d-4577-adae-66c8852d25e5","order_by":2,"name":"Norsafatul A.Razak","email":"","orcid":"","institution":"University of Malaya","correspondingAuthor":false,"prefix":"","firstName":"Norsafatul","middleName":"","lastName":"A.Razak","suffix":""},{"id":330995850,"identity":"0e94d125-2279-4bdf-adba-6520ec107a3a","order_by":3,"name":"Kamarul Md Shah","email":"","orcid":"","institution":"Universiti Malaysia Terengganu","correspondingAuthor":false,"prefix":"","firstName":"Kamarul","middleName":"Md","lastName":"S","suffix":"Md"},{"id":330995851,"identity":"8eb46a69-74ba-42a0-ad6b-9cb2b49325c6","order_by":4,"name":"Mazidah Mohd Dagang","email":"","orcid":"","institution":"Universiti Malaysia Terengganu","correspondingAuthor":false,"prefix":"","firstName":"Mazidah","middleName":"Mohd","lastName":"Dagang","suffix":""}],"badges":[],"createdAt":"2024-07-07 03:23:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4698596/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4698596/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":85359603,"identity":"2d1e9c58-90c5-4c60-b849-65188b455f1d","added_by":"auto","created_at":"2025-06-25 05:46:52","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":767870,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4698596/v1/36cd5069-597f-41fb-81d9-0170ceac94c0.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Issues and Challenges of Integrating Religion and Spirituality into Counselling: An exploration of Counsellors' Experience","fulltext":[{"header":"Introduction","content":"\u003cp\u003eReligious and spiritual issues are prevalent in the lives of many individuals, including those seeking therapy and counselling sessions (Gladding \u0026amp; Crockett, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Cashwell \u0026amp; Young, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Johnson, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). This is because the element has a positive effect and is a source of support and inspiration for the client (Pargament, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). According to Christopher et al. (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2015\u003c/span\u003e), the counselling frame may be affected by a lack of focus on religious and spiritual issues if counsellors commit mistakes in understanding problems, which in turn leads to misconceptualization of problems and inappropriate treatment plans for clients (Christopher et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; O'Connor \u0026amp; Vandenberg, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2005\u003c/span\u003e). Culbertson (2001) noted that neglecting clients' religion and spirituality leaves them as less than a whole. In other words, the clients are not perceived holistically. She further added that denying these two aspects means overlooking the crucial resources that clients may use to maintain health. Counsellors' refusal to address clients' religion and spirituality may lead them to impose their values on clients Burke et al. (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e1999\u003c/span\u003e), be culturally insensitive (Frankl, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2005\u003c/span\u003e), and expose them to high countertransference (Passalacqua \u0026amp; Cervantes, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2008\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn line with the past studies that support religion and spirituality integration with counselling (Gladding \u0026amp; Crockett, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), the American Counseling Association (ACA) has issued guidelines called The Competencies for Addressing Spiritual and Religious Issues in Counseling (ASERVIC) (ACA, 2009). The guidelines help practitioners address issues related to religion and spirituality in session. The guide is to be used with other empirical counselling approaches. This shows that counsellors are responsible for religious and spiritual issues brought on by clients.\u003c/p\u003e \u003cp\u003eThe Council for the Accreditation of Counseling and Related Educational Programs (CACREP) has also adjusted its standards by expanding social and cultural diversity to include religious and spiritual orientation (CACREP, 2015). The standard clearly shows the need for a program to prepare potential counsellors to understand the impact of religious beliefs and spiritual traditions on clients and counsellors. Anxiety related to religious and spiritual issues has also been added as a Code V diagnostic category (code V62.89) in The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) (American Psychiatric Association (APA), 2013).\u003c/p\u003e \u003cp\u003eRichards and Bergin (\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2000\u003c/span\u003e) noted that lack of exposure and competency is one of the issues counsellors face. Another issue identified is that counsellors are uncomfortable discussing religious matters and spirituality in counselling (Adams, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Mohd Dagang, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Counsellors may avoid dealing with religious and spiritual issues because they feel unprepared regarding knowledge and experience that touch those elements (Delaney et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). According to Hall et al. (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2004\u003c/span\u003e), counsellors also tend not to involve themselves in discussing religious and spiritual elements in counselling because some may consider it a small issue and not an essential aspect of cultural diversity.\u003c/p\u003e \u003cp\u003ePrevious studies have identified several barriers that prevent counsellors from incorporating religion and spirituality into their practice. These include insufficient training for addressing clients' religious and spiritual issues (Bowsera et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Mohd Dagang, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2013\u003c/span\u003e), clients' reluctance to engage in discussions on these topics, and a general lack of understanding and appreciation of their own religious beliefs (Bowsera et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Hamja, 2016). Additional factors are the principle of separating church and state (Richard, \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2001\u003c/span\u003e), the perception that religion and spirituality are highly personal and sensitive matters (Joan, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Sumari \u0026amp; Baharuddin, \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), and a lack of personal interest among counsellors, who may not recognize the significance of these aspects in the therapeutic context (Koenig, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2009\u003c/span\u003e; Christopher et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Adams, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Lack of certainty about balancing the scientific approach with religious and spiritual practices and the belief that religious and spiritual issues should be addressed by religious authorities instead of counsellors (Passalacqua \u0026amp; Cervantes, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2008\u003c/span\u003e; Hamjah, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) may also lead to avoidance of integration. Most previous studies were conducted in Western culture, where counselling and psychotherapy are rooted in evidence-based practice. In a collectivist religious culture, neglecting clients' religious and spiritual beliefs leaves them less than whole. Thus, this study attempts to understand the issues and challenges counsellors face in the collectivist society of Malaya in their effort to incorporate religion and spirituality in counselling.\u003c/p\u003e\n\u003ch3\u003eThe Malaysian context\u003c/h3\u003e\n\u003cp\u003e A literature review on religion, spirituality, and counselling published in 2013\u0026ndash;2023 using the Google Scholar engine indicated that limited studies were conducted in Malaysia. The studies that were done tend to focus on barriers to the effectiveness of the religious integration approach in family and marriage counselling (Mohamed Sidik et al., \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), the experience of students in an Islamic-based counselling course (Sumari \u0026amp; Baharudin, 2016), integration of religion in counselling (Mohd Dagang et al., 2013), the Islamic approach in counselling (Hamjah \u0026amp; Mat Akhir, 2014) and the use of resources related to religion by Malaysian Chinese counsellors (Sing \u0026amp; Lai, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2012\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMohamed Sidik et al. (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) explore the obstacles to the effectiveness of religious integration in family and marriage counselling. Six counsellors were interviewed. The findings show that counsellors' lack of confidence is the main barrier to integration. Thus, the study suggested integrating religion and spirituality in counsellors' training.\u003c/p\u003e \u003cp\u003eResearch by Sumari and Baharudin (2016) interviewed final-year students to understand their class experiences in an Islamic-based counselling course. The students reported that the class helped them increase their understanding of counselling and professional competence and improve their self-understanding and relation to God. The findings show that exposure to religion in some courses may positively impact counsellors' understanding of themselves.\u003c/p\u003e \u003cp\u003eMeanwhile, Mohd Dagang (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2013\u003c/span\u003e), who studied the level of spiritual and religious competence among 240 counsellors, found that the level is moderate. The study also found a relationship between spiritual competence and cross-cultural counselling. Another survey by Hamjah and Mat Akhir (2014) studied the Islamic religious approach applied by counsellors working at one Religious Council Counseling Center in Malaysia. The study's findings indicated three aspects of the Islamic approach: faith, worship, and moral conduct.\u003c/p\u003e \u003cp\u003eSing and Lai (\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2012\u003c/span\u003e) were interested in studying religious integration in psychotherapy among Chinese people from three different religions, Christianity, Taoism, and Buddhism, in Malaysia. The results show that by integrating religion and spirituality in the treatment process, the physical and somatic aspects of mental illness are addressed.\u003c/p\u003e \u003cp\u003eDespite these studies, there is still a lack of qualitative studies that touch on counsellors' experience integrating religion and spirituality. This study is necessary, given that the Malaysian population is multiracial and multireligious (Malaysian Department of Statistics, 2023). One Pillar of Malaysia is Belief in God (Malaysian Department of Information, 2017). Malaysia National Education Philosophy also emphasizes the importance of religion and spirituality in education. The aim is to produce students with a balanced intellectual, spiritual, emotional, and physical personality based on faith and reverence for God (Ministry of Education Malaysia, 2021). According to Article 3(1) of the Federal Constitution, Islam is considered an official religion, but other religions may be practised in peace and harmony in any part of the Federation.\u003c/p\u003e \u003cp\u003eIn Malaysia, religion and spirituality are terms used interchangeably. In terms of population composition, Malay Muslims comprise the majority (63.1%), followed by Chinese, who are mostly Buddhist (19.8%) or Christian (9.2%). Most Indians are Hindu (6.3%). Less than 1% (0.7%) of Malaysians identify as atheists. It can be inferred that most Malaysians have a religious identity and can practice their religions freely (Malaysian Department of Statistics, 2023). Thus, clients may raise religious and spiritual issues during sessions. Unfortunately, the counselling curriculum in Malaysian higher education institutions relies heavily on Western standards. This lack of training may make some counsellors uncomfortable integrating religion and spirituality into practice.\u003c/p\u003e \u003cp\u003eAccording to Mohamed (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), the deficiencies found in the previous classification of the counselling theory approach require a classification that can integrate religion and spirituality into a more comprehensive dimensional pattern of the counselling theory approach by combining humans' physical and spiritual elements. According to Deraman et al. (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), who conducted a study to analyze the needs of the Malaysian community for spiritual counselling services for 100 participants, showed a high need for spiritual counselling services among the respondents, which is 91 per cent (91 people). Based on this research gap, the current study aims to explore and understand the issues and challenges experienced by Malaysian counsellors in integrating religion and spirituality in counselling.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eResearch design\u003c/h2\u003e \u003cp\u003eThis research aims to explore and understand counsellors' experiences on how they integrated religion and spirituality into their counselling regime. A qualitative phenomenological research design was employed to collect the data to achieve this objective. A qualitative methodology was chosen because the design emphasizes understanding and interpreting participants' socio-cultures and experiences in a specific context and time (Blomberg \u0026amp; Volpe, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2008\u003c/span\u003e). The method focuses more on revealing research problems by exploring problems and phenomena that only a few know and understand (Creswell, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2007\u003c/span\u003e; Johnson \u0026amp; Christensen, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2008\u003c/span\u003e). Furthermore, the phenomenological method helps reveal the interpretation of an experience from participants' points of view (Denzin \u0026amp; Lincoln, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2003\u003c/span\u003e; Merriam, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e1998\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eData Collection Procedure\u003c/h2\u003e \u003cp\u003eAfter getting ethics approval from the Research Committee Ethics in March 2023, the researchers identified the potential participants using purposive and snowball sampling. Purposive sampling allowed the researchers to intentionally select participants based on specific characteristics and criteria pertinent to the study, ensuring that the sample is directly relevant and can provide rich, detailed, and highly relevant data. This method is particularly useful when understanding complex phenomena such as religion and spirituality in counselling among professional counsellors in Malaysia. Snowball sampling, on the other hand, was utilized to leverage the initial participants' networks, facilitating access to other potential subjects who fit the study's criteria but might have been difficult to reach through conventional means. This method is especially effective in reaching populations that are hard to locate or hesitant to participate, allowing the research to tap into a wider, yet still relevant, participant base.\u003c/p\u003e \u003cp\u003eData were collected from the population sample through individual interviews and focus group discussions (FGD). The interview is one of the methods in qualitative inquiry that allows the researcher, the main instrument, to gain an in-depth understanding of participants from their subjective point of view. In-depth interviews were conducted with participants until the data reached saturation. For data triangulation, a Focus Group Discussion was conducted with the participants twice, in April and June 2023, through a video conference. Like individual interviews, the FGD also aims to gain insight into the experiences of research participants. The group dynamic allows participants to share based on one another's responses and generate ideas they never thought of in an individual interview. Interview transcription was checked repeatedly to ensure no mistakes in writing the transcripts. The researchers also made a self-reflection in a special notebook after each interview to make explicit and take note of any researcher subjectivity that may inadvertently bias during data collection and analysis.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eIdentified research participants were contacted via electronic mail messenger (e-mail). The identified participants were asked to respond to two questions: (1) how long have you been providing counselling services to the community? Furthermore, (2) Have you ever integrated religion and spirituality into counselling? Initially, researchers contacted 43 counsellors. Of that number, only 23 counsellors responded to the e-mails and provided the answers to the two screening questions. The researchers then conducted preliminary interviews with the 23 participants. The final screening found that only 12 participants fulfilled the criteria. The criteria are that the counsellors must be registered with the Malaysian Board of Counsellors with a valid Certificate of Practice and have more than five years of practical experience, particularly in using religion and spirituality in counselling sessions. The 12 participants volunteered and signed informed consent to participate in the study. The participants' demographic background is shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. To protect the privacy and confidentiality of the participants, they are identified as R1 to R12.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParticipants' Profile\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRespondents\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRace\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eLevel of education\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eYears of Practice\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eR1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMalay\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIslam\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMaster of Guidance and Counseling\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eR2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIndia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHindus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMaster of Guidance and Counseling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eR3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eChina\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eChristian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePhD in Counseling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eR4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eChina\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBuddhist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMaster of Counseling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eR5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMalay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIslam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMaster of Guidance and Counseling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eR6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMalay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIslam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMaster of Counseling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eR7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKadazan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eChristian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMaster of Counseling Psychology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eR8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMalay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIslam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eBachelor of Counseling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eR9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMalay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIslam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMaster of Counseling Psychology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eR10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIndia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHindus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMaster of Counseling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eR11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMalay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIslam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePhD in Counseling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eR12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMalay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIslam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMaster of Counseling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eThe researcher used the eight-analysis approach of Moustakas (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e1994\u003c/span\u003e) to analyze the data. The analysis involves listing relevant experience, reduction, thematic clustering, comparison of data sources, creating and constructing textual description, constructing composite structural description, and finally synthesizing textural and structural description into an expression.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eValidity and Reliability\u003c/h2\u003e \u003cp\u003eLincoln and Guba (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e1985\u003c/span\u003e) used \"trustworthiness\" to describe the validity of qualitative research. The validity of this study is achieved by ensuring the validity of research questions in answering the desired outcome and the appropriateness of methodology and design, sampling, and data analysis: triangulation, member checking, and process audit trail enhanced validity. The researcher used the triangulation suggested by Guinon (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2002\u003c/span\u003e), which is the triangulation of data sources. In the triangulation process, the researcher collected and analyzed data sources from transcribing individual interviews and focus group discussions (FGD). Reliability is enhanced and improved by ensuring the durability and dependability of responses to multi-codes of the data set.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe results of the thematic analysis using eight methods introduced by Moustakas (\u003cspan class=\"CitationRef\"\u003e1994\u003c/span\u003e) produced five main themes related to issues and challenges experienced by counsellors in using religion and spirituality in counselling, namely i) Knowledge and readiness to integrate religion and spirituality, ii) Being a role model, iii) Client's religious knowledge iv) Awareness to refer to experts and v) Lack of understanding of the client's religious diversity. The five themes are discussed in the following section.\u003c/p\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\n\u003ch2\u003eKnowledge and readiness to integrate religion and spirituality\u003c/h2\u003e\n\u003cp\u003eMost respondents think counsellors need to improve their knowledge and practices of using religious and spiritual elements. R4 sees that by enhancing knowledge and training, counsellors can avoid misunderstandings and conflicts during sessions. At the same time, R7 believes that knowledge alone is not enough. Still, counsellors also need to be experienced as clients of counsellors who use religious and spiritual elements in counselling to understand better and apply.\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003e\u003cem\u003e\"..first of all, the most important thing is that he (the counsellor) has to understand his religion first and also other religions so that there are no problems, conflicts, there may be wrong perceptions about our religion and our clients\".\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n\u003cp\u003e(R4/IV01)\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003eAnother counsellor shares his perspective:\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\"..the first thing he is here is to work on ourselves first. Like me, I also go to a lot of counselling sessions for my issues or part of training. I once went to a paid session, at the hospital, so I have my issue, and I found the answer. So when I experienced it myself, then I believed, so then I could do it. Before this, I couldn't do it, so when I experienced and experienced myself, I could accept and use this approach, one of them has the challenge of being a counsellor or a practitioner, he needs experience, that is, having accepted as a client with this technique. Yes, knowledge is one thing, if there is no knowledge it is difficult to connect and experience is also important and if we use this approach, God will help us with the way we pray - let the session be led by God..\"\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n\u003cp\u003e(R7/IV02)\u003c/p\u003e\n\u003cp\u003eEven R5, R6, and R9 think counsellors can help clients more effectively by improving knowledge and practice.\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003e\u003cem\u003e\"Knowledge in religion needs to be expanded, through reading or attending religious classes with parties who have expertise, because sometimes through reading is a bit limited. It is possible, one is in terms of attending classes and the third is through discussions with religious experts. Sister Ida feels that it is really necessary for us to tidy up again in terms of religious and spiritual counseling. So when we have that knowledge, it is easy for us to help our clients deal with the problems they face. They are open\".\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\n\u003cp\u003e(R5/IV01)\u003c/p\u003e\n\u003cp\u003eAnother counsellor supports this:\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003e\u003cem\u003e\".. his challenge is to us, how far we understand Islam is up to the teacher. We have to accept this client as it is. We cannot expect too much from this client. Indeed, the client is in a state of imbalance. So for teachers, who always need upskilling, reskilling is the counsellor himself....... It means that knowledge is important.\".\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\n\u003cp\u003e(R6/IV01)\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003e\u003cem\u003e\"Because we cover a lot of Western theories, then in the field it is not enough for us to implement to integrate religion and spirituality, it is not enough, that's why you have to learn other techniques or skills and must combine... then you can solve the problem. If you only depend on you having expertise in terms of Western theories only, now it's difficult to help clients.. the more knowledge the better..\"\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\n\u003cp\u003e(R9/IV01)\u003c/p\u003e\n\u003cdiv id=\"Sec16\" class=\"Section3\"\u003e\n\u003ch2\u003eBeing a role model\u003c/h2\u003e\n\u003cp\u003eBeing a role model for clients and the community is also an issue and challenge experienced by counsellors who use religious and spiritual elements in counselling. Therefore, counsellors should always be prepared to increase their knowledge and practice and express themselves through an attitude that can be a good follow-up model. R1 illustrates this.\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003e\u003cem\u003e\"..in terms of trying to control ourselves, because this client looks at us, he might make us his role models, so even as human beings we cannot run away from each other's mistakes and weaknesses. Try not to show it in front of the public. It's not that we're hypocrites, it's just that here we don't have bad intentions towards people, but we don't want people to see it and it can be a bigger slander. So take care of ourselves...\"\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\n\u003cp\u003e(R1/IV01)\u003c/p\u003e\n\u003cdiv id=\"Sec18\" class=\"Section3\"\u003e\n\u003ch2\u003eAnother counsellor agrees with this:\u003c/h2\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003e\u003cem\u003e\"Sometimes when we bring this religious and spiritual approach, most clients and society think we are perfect and never make mistakes, so expectations from others also become a challenge for us as counsellors. It's as if we are like angels who can do no wrong. We will be looked at askance\u0026hellip;\"\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\n\u003cp\u003e(R12/IV01)\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003eAccording to Rogers (\u003cspan class=\"CitationRef\"\u003e1961\u003c/span\u003e), in the human-centred approach, the counsellor is an agent of change by providing a suitable and therapeutic atmosphere that allows the client to become an individual who develops and functions well. Counsellors' qualities, such as unconditional acceptance, authenticity, and understanding, greatly influence changes in the client compared to the techniques used (Corey, 2017). Therefore, being a role model is challenging because counsellors need to be prepared to improve knowledge and practice and show attitudes that can be good role models for clients and society.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e\n\u003ch2\u003eThe client's religious knowledge\u003c/h2\u003e\n\u003cp\u003eCounsellors also need to assess the client's level of religious knowledge early so that the approach used in integrating religion and spirituality in counselling will be easier and more effective. This is shared by R2 as stated below:\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003e\u003cem\u003e\"If you want to add. We need to know to what extent his client understands the concept of religion. If I Hindukan, to what extent does my client know about religion so that it is easy for me to tell him in a simple and abstract way? If he knows about religion, I will use an abstract method, if he does not understand religion, I have to use a simple method and this is an easy method when we are with the client. So we have to know about our clients. To what extent is our client's knowledge so that the approach will be easier\".\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e\n\u003cp\u003e(R2/IV01)\u003c/p\u003e\n\u003cp\u003eThis statement is supported by another participant who shared her experience:\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003e\u003cem\u003e\"The clients who come with us are various, some are ok and some are not ok. I think among the clients, they don't want to comment too much about religion, because they think I've been scolded. When he talks about religion, he feels that he has to be lectured or scolded.. so the important thing is that the counsellor has to assess the level of the client's religious knowledge first, lest the client think that he will be punished\".\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec22\" class=\"Section2\"\u003e\n\u003cp\u003e(R11/IV01)\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003eWorthington \u0026amp; Sandage (\u003cspan class=\"CitationRef\"\u003e2001\u003c/span\u003e) suggest that assessing the domain of religion and spirituality can help counsellors determine how spirituality may be related to the problems presented by the client. By using various forms of assessment, counsellors may be able to determine the extent to which the client's religious and spiritual beliefs contribute to or maintain their problems.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec23\" class=\"Section3\"\u003e\n\u003ch2\u003eAwareness to refer to experts\u003c/h2\u003e\n\u003cp\u003eAwareness of the need to refer to experts is also seen as an issue and challenge for counsellors when using religious and spiritual elements in counselling. R1 and R2 share this theme.\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003e\u003cem\u003e\"If we need to consult, we refer to people who are more knowledgeable about the issues brought by the client himself. Because sometimes the client leads to a discussion about the law such as marriage. If it is related to divorce, what is all that, even though I have studied about that knowledge, we are told that we are not Kadi or Sharia court. So don't make it easy for us to classify what that person's condition is like\"\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec24\" class=\"Section2\"\u003e\n\u003cp\u003e(R1/IV01)\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003eMeanwhile, R2 shared her perspective:\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\"..because in the Hindu religion itself, there are several groups with different opinions. So if this group is in that category. He desperately won't listen to what I have to say. Have certain concepts that have different beliefs. Although the same, this person is Hindu but holds a different religious concept, so sometimes when we talk about Magavan Kitab, he does not accept it. He may have a hold of other books of knowledge if this kind of case needs to be referred to someone who is more expert in understanding the client himself\".\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec25\" class=\"Section3\"\u003e\n\u003cp\u003e(R2/IV01)\u003c/p\u003e\n\u003cp\u003eIn most cases, the counsellor may consult a religious authority regarding issues related to religious and spiritual doctrines, beliefs, or practices raised by the client. This is necessary to help counsellors understand the problems presented by their clients and can detect when clients may misunderstand or misinterpret an important tenet in their religious or spiritual system. Sometimes, clients present problems with losing purpose and direction due to losing their religious beliefs (Lukoff,1998). This situation also requires consultation or referral to a religious authority.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec26\" class=\"Section3\"\u003e\n\u003ch2\u003eLack of understanding of the client's religious diversity\u003c/h2\u003e\n\u003cp\u003eAccording to R3 and R4, understanding the diversity of religions, especially in Malaysia, is important for counsellors because Malaysia is made up of various religions and cultures.\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003e\u003cem\u003e\"So it is important as a counsellor, we understand beliefs from different religions, especially important beliefs such as Christianity also believe in one God, if he is not Buddhist, he believes in everything, everything needs to be worked on. If Christians believe that all sins have been atoned for, if the Chinese have Christians there are Buddhists, so I want to help this client integrate all the beliefs so that he can be helped fully... Meaning, we accept that diversity. It means that if we want to do integration, it is not based on one religion but depends on the religion of the client itself.. because, in Malaysia, we have assets like this, because we have different nations, so we have to get along, learn, and adapt. In terms of cross-culture, Malaysia is the best and should learn and understand the importance of Cross-Cultural\"\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec27\" class=\"Section3\"\u003e\n\u003cp\u003e(R3/IV01)\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003eAnother counsellor shared her perspective:\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\"In Malaysia we have cross-cultural, so the first thing that is more important is that he (counsellor) has to understand his religion first and also other religions so that there is no problem, there is a conflict, there may be a perception that is all wrong in terms of your perception. The important thing is that he does not cause problems for clients and counsellors, especially those of a different religion.\"\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec28\" class=\"Section2\"\u003e\n\u003cp\u003e(R4/IV01)\u003c/p\u003e\n\u003cp\u003eR8 and R11 think that understanding the diversity of the client's religion can also build a sense of respect among counsellors and clients who may have different religions and beliefs.\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003e\u003cem\u003e\"It means, if we can find out his religion, whether it's Buddhism, or Hinduism, his behavior in his religions, even the basics are ok. From there we see, we understand his way of life, we respect his religion, how do we want him to respect Islam\"\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec29\" class=\"Section2\"\u003e\n\u003cp\u003e(R8/IV01)\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n\u003cp\u003e\u003cem\u003e\"inclusive of all religions. We should not condemn other religions, and be very respectful. If you don't know, ask. I will also ask \"What is the opinion of the Hindu religion about transgender \".. don't condemn other religion and always ask what does the religion and always ask, what does religion permit you to do. In this kind of situation that all I did\"\u003c/em\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cp\u003e(R11/IV01)\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study found that issues and challenges in integrating religion and spirituality in counselling are related to counsellors' knowledge, preparation, skills, and attitudes of counsellors. The sharing of experiences by counsellors shows that the level of expertise and readiness of counsellors become among the main issues and challenges. The level of knowledge and readiness of counsellors is seen as the main issue and challenge because participants indicated that lack of clinical training causes many counsellors to avoid integration. Counsellors may become more confident in integrating religion and spirituality in counselling if they have basic training in religious study or attend short-term courses related to the field. The lack of exercise may result in counsellors feeling incompetent in dealing with religion and spiritual issues. As found in a study by Bowsera et al. (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2020\u003c/span\u003e lack of training is seen to have a direct impact on the counsellor's ability to effectively deal with religious and spiritual issues in counselling, especially when dealing with clients who come from various cultures and religions.\u003c/p\u003e \u003cp\u003eLack of training also causes counsellors to blur with competence and professional ethics (Pargament \u0026amp; Saunders, 2005). According to Morrison et al. (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2009\u003c/span\u003e), ethical concerns are also a factor in counsellors trying to avoid integrating religion and spirituality in counselling. These include dual-role relationships between counsellors or preachers, violation of professional boundaries by placing value on the client, risking exceeding the limits of professional competence, entanglement with elements of mysticism, superstition, and superstition, as well as being exposed to the issue of underestimating the client's beliefs, which is considered holy or sacred (Morrison et al., \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2009\u003c/span\u003e; Christopher et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). According to the ACA code of ethics (2005), counsellors can be considered unethical if they practice counselling services outside their competency area under the professional responsibility section (c.2.a). The code of ethics for Malaysian counsellors (Counsellor Code of Ethics Malaysia, 2023) also states that counsellors should provide services according to their areas of expertise and not exceed the limits of expertise based on their education, training, and supervised experience.\u003c/p\u003e \u003cp\u003eThe failure to train counsellors on religious and spiritual issues not only ignores the counsellor's commitment to understanding the client holistically but also has led to the belief in counsellors that they do not have the competence to integrate religion and spirituality in counselling (Cashwell \u0026amp; Young, 2005). Counsellors are also said to be unwilling to integrate religion and spirituality into counselling because they have not received sufficient formal training in those elements (Mohd Dagang, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Oxhandler \u0026amp; Pargament, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCounsellors need to understand the client's various cultures, ethnicities, and religions because the client's personality, attitude, and behaviour are formed from cultural and religious values (Barnett \u0026amp; Johnson, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). Religious and spiritual elements need to be integrated into counselling because they guide one to understand the value of the client's life (Miranti 1998). Religion and spirituality are the main influences in forming the client's cultural identity (Worthington \u0026amp; Sandage, \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e2001\u003c/span\u003e). Religion and spirituality are the components of various cultures (Pargament, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2005\u003c/span\u003e), and religion and spirituality help in exploration and problem-solving in counselling (Burke et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2005\u003c/span\u003e). Religion and spirituality are also seen as the main components that affect the client's physical, social, emotional, and intellectual (Witmer \u0026amp; Sweeney, \u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e1992\u003c/span\u003e). Therefore, religion and spirituality need to be integrated as one of the components discussed in the counselling process, as well as other aspects such as the client's physical, social, emotional, and intellectual aspects.\u003c/p\u003e \u003cp\u003eDickson and Jepsen (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2007\u003c/span\u003e) assert that counsellors must accept that religious and spiritual elements heavily influence part of the client's cultural development. If those elements are not given special attention, the counsellor has removed a great potential from forming the client's identity and general view (Corey, 2017). Therefore, religious and spiritual elements must be included as one of the components assessed in the counselling process, as are other aspects such as the client's physical, social, emotional, and intellectual aspects.\u003c/p\u003e \u003cdiv id=\"Sec32\" class=\"Section2\"\u003e \u003ch2\u003eImplications\u003c/h2\u003e \u003cp\u003eThe secular concept that separates religious life from life is suitable in a social science situation. The opinion that integrating religion and spirituality is unprofessional is inappropriate. Religion and spirituality are not only knowledge related to the personal angle and the afterlife but are also necessary for human life in some societies. This section discusses the study's implications for future research and practice.\u003c/p\u003e \u003cdiv id=\"Sec33\" class=\"Section3\"\u003e \u003ch2\u003eImplications for Future Research\u003c/h2\u003e \u003cp\u003eThis qualitative research uses a phenomenological approach, where researchers explore and understand counsellors' experiences using religious and spiritual elements in counselling. The findings of this study have contributed to the field of research methodology. For example, while going through the data collection process, the researchers learn a lot about new experiences that they have never had before. Each shared experience gives its meaning to the study participants. The expertise of counsellors integrating religion and spirituality in counselling is valuable and should be highlighted in the findings of this research. Therefore, this approach is seen as one of the most effective and appropriate ways to understand the phenomenon experienced by counsellors who integrate religion and spirituality into counselling. However, due to the limitation of this current research that focuses on issues and challenges experienced by counsellors, it is recommended that future studies consider examining or exploring the clients' experience. Future researchers may also consider the mixed method and quantitative approach, which involves a large scale of participants, to understand the issue.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec34\" class=\"Section3\"\u003e \u003ch2\u003eImplications for Counseling Practice and Training\u003c/h2\u003e \u003cp\u003eBased on the situation and counselling trend in Malaysia, several strategies need to be taken so that the counselling approach in Malaysia fits with various cultural and religious backgrounds by providing training to counsellors who are competent to help clients from diverse backgrounds overcome the various problems encountered (Litterell et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e1989\u003c/span\u003e) The approach of integrating religion and spirituality that suits the culture and religion of the community needs to be worked on without setting aside Western theories that do not conflict with the culture and religion of the Malaysian community (Mohammad \u0026amp; Harun, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2006\u003c/span\u003e; Ab. Rahman, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2008\u003c/span\u003e). The Malaysian Board of Counsellors may consider incorporating religion and spirituality in the training of counsellors to equip them with the skills necessary to help clients with religious and spiritual issues. Training providers that organize continuous professional development for counsellors may also consider offering courses related to integrating religion and spirituality into counselling.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eDeclaration of Interest\u003c/h2\u003e \u003cp\u003eThe authors declare that there is no conflict of interest\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eMr.Abu Shahim prepared the draft of the manuscript. He is the main researcher. Mr Radhi identified the potential participants and scheduled the interview sessions. Dr Sumari as a supervisor of this research project oversees the project to ensure it meets the ethical and research procedure. Dr Sumari polished the final copy of the manuscript.Dr A. Razak as a qualitative expert ensures all the methodological procedures of qualitative research are followed. She also helped Dr Sumari polish this articleDr Md Shah and Dr Mohd Dagang were involved in data transcription and ensured that the data reached saturation\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe authors would like to thank Dr Marcus Griffin from American Proofreading Center for his professional assistance in proofreading this article\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAb. Rahman, A. (2008). \u003cem\u003ePerkhidmatan kaunseling pendekatan dalam hikmah berdakwah\u003c/em\u003e. Utusan Publications \u0026amp; Distributors Sdn. 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Twelve counsellors were interviewed using a semi-structured interview and focus group discussion. Thematic analysis was performed and identified five main themes: 1) Knowledge and readiness to integrate religion and spirituality, 2) Being a role model, 3) Client's religious knowledge, 4) Awareness to refer to experts, and 5) Lack of understanding of the client's religious diversity.\u003c/p\u003e","manuscriptTitle":"Issues and Challenges of Integrating Religion and Spirituality into Counselling: An exploration of Counsellors' Experience","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-01 12:28:28","doi":"10.21203/rs.3.rs-4698596/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1d6f49de-5846-45a5-8243-a6d009687967","owner":[],"postedDate":"August 1st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-06-25T05:38:41+00:00","versionOfRecord":[],"versionCreatedAt":"2024-08-01 12:28:28","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4698596","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4698596","identity":"rs-4698596","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}