Culturally and Faith-Responsive Clinical Practice in Action
This article draws on recent PhD research by the Cairnmillar Institute PhD candidate, Aysegul Sertel, under the supervision of RoseAnne Misajon (Associate Professor & Research Supervisor) and Joanne Brooker (Senior Lecturer & Research Supervisor) exploring how culture and faith shape mental health experiences across diverse communities in Australia. As this edition coincides with Ramadan, an important period of reflection for many in our community, these insights offer timely guidance for clinicians seeking to enhance culturally safe and faith responsive practice.
Understanding Culture and Faith in Mental Health Practice
Cultural diversity is recognised as a core element of ethical, competent, and safe psychological practice. Rather than being treated as a specialist area that some psychologists choose to work in and others do not, considerations of cultural, linguistic, religious, and spiritual diversity should be embedded across all areas of psychological work, including respect, safety, competence, non-discrimination, and reflective practice (Psychology Board of Australia Code of Conduct, 2025).
How Cultural and Spiritual Worldviews Shape Client Experiences
Psychological practice is grounded in respect for persons and peoples, with an understanding that clients’ experiences of mental well-being, distress, help-seeking, and family roles are shaped by their cultural and social contexts. Attending to personal values and assumptions, and remaining responsive to clients’ worldviews, supports culturally responsive practice. As Ramadan approaches, this offers a timely opportunity to pause and reflect on cultural competence in practice.
Insights from Muslim Mental Health Professionals
For many Muslims, religiosity is not an optional add-on but the worldview through which distress, coping and hope are understood. My PhD examines the role of religiosity and culture in understanding mental health and in shaping therapy for Muslim clients. I interviewed Muslim mental health professionals in Australia, including psychologists, counsellors, social workers, mental-health nurses and occupational therapists, working across school, hospital, primary-care and community settings. Across the board, Muslim mental-health professionals emphasised that faith-responsive care strengthens therapeutic fit, trust and follow-through, which are key predictors of engagement, retention and outcomes.
Faith as a Psychological Resource
Muslim mental-health practitioners consistently described Islam as a faith rich in psychological resources. They noted that religious teachings offer practical guidance, emotional structure and a coherent moral compass that helps clients make sense of distress and persevere through hardship. Daily prayer, fasting and remembrance were viewed as grounding rituals that foster emotional regulation and a sense of stability. Participants observed that clients who remain connected to their faith often display greater resilience, discipline and optimism when navigating adversity. Religion, in their accounts, operates not merely as comfort but as an active coping strategy and a framework for meaning-making that can be integrated into evidence-based therapy.
Working Within Clients’ Meaning Systems
These voices reflect what multicultural best practice already urges: clinicians should work within clients’ intersecting identities, including religion and spirituality, because this is often the client’s core meaning system (APA, 2017). When therapy speaks the client’s language of meaning, alliance strengthens, strategies shared in therapy are more valued and clients keep showing up long enough for change to take place.
Two Core Principles for Faith Responsive Practice
Muslim mental-health professionals in my study identified two broad principles for incorporating religion into therapeutic practice. The first is to ask early and follow the client’s lead. Rather than assuming religiosity, clinicians were encouraged to explore clients’ spiritual orientation and the relevance of faith to their wellbeing. Several practitioners described beginning intake assessments by gently inquiring about religious background and level of connection, while remaining careful not to impose assumptions. They emphasised curiosity, sensitivity and ongoing consent when weaving spiritual themes into sessions.
The second principle is to use faith-congruent skills, not slogans and translate therapeutic strategies into faith-congruent language. Practitioners described aligning behavioural activation or cognitive restructuring with familiar Islamic values, such as sabr (patience), tawakkul (trust in God) and shukr (gratitude). This integration, they noted, makes interventions more relatable and meaningful to clients. In their experience, when therapy aligns with the client’s moral and spiritual framework, it enhances rapport, deepens engagement and promotes longer-term adherence. Faith was also viewed as a protective factor: even minimal spiritual connection could motivate clients to persevere and make constructive choices during psychological distress.
When Cultural and Faith Factors Are Overlooked
From my own clinical experience, I have seen the costs of neglecting this dimension. Some clients have ceased therapy with previous psychologists because of religious insensitivity, being told to move out of their parents’ home without regard for the cultural and Islamic significance of family bonds, or being advised to stop daily prayer when stressed, not recognising that prayer provides grounding, reflection and connection. For these clients, such guidance felt alienating and invalidating rather than empowering. When therapy fails to recognise that religiosity is intertwined with identity, belonging and coping, it risks rupturing the therapeutic alliance and invalidating the client’s lived reality.
Clinical Considerations During Ramadan
With Ramadan approaching, this is a fitting time for mental health professionals to consider faith-responsive training and reflection and introducing faith-responsive therapy in their practise. Fasting, night worship (taraweeh), altered sleep patterns and medication timing intersect with psychological wellbeing and daily functioning. Discussing fasting intentions, safety and sleep routines; adjusting therapy goals to align with Ramadan values of patience, compassion and moderation; and showing awareness of clients’ spiritual commitments are tangible ways to demonstrate respect and clinical attunement. Such adjustments communicate genuine understanding and improve adherence to both therapy and faith practices (APA, 2017; AIMA, 2025; NEPHU, 2025). Thus, integrating religiosity with Muslim clients is not “doing religion”, it is doing competent psychotherapy. As Ramadan begins, clinicians have an opportunity to align evidence-based techniques with clients’ spiritual worldviews, demonstrating both religious and cultural humility and clinical excellence, steps that strengthen engagement, retention and real therapeutic change.
Evidence from International Research
These findings echo international evidence showing that religiously integrated cognitive-behavioural therapy reduces depression among religious clients without compromising fidelity (Pearce et al., 2015). Similarly, culturally adapted behavioural activation models for Muslim service users have proven feasible and effective in improving engagement and outcomes (Mir et al., 2023; Mir et al., 2019). The American Psychological Association’s Multicultural Guidelines reinforce this direction: clinicians should work within clients’ intersecting identities, including religion and spirituality (APA, 2017).
Guidance and Key Considerations for Working with Culturally Diverse Communities:
This focus aligns with Cairnmillar’s commitment to culturally informed research and community centred practice. The following guidance supports clinicians and students who are developing their cultural and faith literacy in therapeutic settings.
- Treat cultural and religious diversity as a core ethical responsibility, not an optional skill
- Ask clients how culture, religion, or spirituality shape their understanding of mental well-being, distress and support, rather than making assumptions
- Adapt assessment, intervention, formulation and treatment when standard approaches may not be culturally appropriate
- Seek supervision or cultural consultation when cultural factors are central to the work
- Listen to our latest episode of How’s That Working for You?– ‘Race in the Therapy Room’ (Episode 6). The themes explored in the episode include culturally safe practice, collectivist versus individualist worldviews, the impact of identity on therapy, and the importance of understanding clients’ meaning systems.
About Aysegul Sertel: As a PhD candidate at The Cairnmillar Institute and co‑founder of Muslim Mental Health Professionals, Aysegul Sertel works to support practitioners engaging with Australian Muslim communities, whose mental health needs are shaped by faith, family, migration and community structures. Her work emphasises the importance of clinicians developing both cultural and religious literacy and maintaining reflective and inclusive practice to meet the needs of diverse communities.
About The Cairnmillar Institute: Established over 60 years ago, The Cairnmillar Institute is a not-for-profit organisation solely focused on advancing better mental health. We offer a range of high-quality psychology and counselling programmes that focus on evidence-informed treatments and education. We are committed to making a positive impact on the lives of individuals, families, and communities by providing innovative and accessible mental health care. If you or someone you know could benefit from extra support, our clinic also offers free counselling and low-cost assessments and has a variety of practitioners available for appointments across our 4 sites. Click here to request an appointment.