Many individuals with psychosis identify as religious or spiritual and report using religion as a means of coping with symptoms. However, clinicians often feel uncertain about addressing this topic in therapy. A systematic review examined the role of spirituality and religiosity in the maintenance and recovery of psychosis. Positive Religious Coping improved wellbeing, treatment expectancy, and medication adherence, while Negative Religious Coping increased suicidality, symptom severity, and illness duration. Religious/spiritual explanatory models were associated with delayed recovery, whereas bio-psychosocial models supported it. Integrating religiosity/spirituality into Cognitive Behavioural Therapy for Psychosis (CBTp) may enhance assessment, formulation, and interventions, thereby improving engagement with culturally diverse clients in Early Intervention Services.
Dr Anna Georgiades (PhD, DClinPsy, BABCP) Lecturer in Early intervention in psychosis, IoPPN, and Senior Clinical Psychologist (NHS)
18 July 2025
New review explores how religion and spirituality may impact individuals with psychosis
This systematic review examined evidence of religiosity and spirituality in the maintenance and recovery of people with psychosis.
Many individuals with psychosis consider themselves religious or spiritual and report using religion as a means of coping with their illness. However, research exploring the impact of religiosity and spirituality on the experience of psychosis is sparse, with most studies focusing on delusions or hallucinations with religious content. A systematic review, now published in Early intervention in psychiatry examined the evidence regarding the role of religiosity/spirituality in the maintenance and recovery of psychosis.
A total of thirty-five studies were eligible for inclusion in the review, finding that religiosity and spirituality were associated with positive symptoms of psychosis. Individualised religious practice was associated with more severe delusions, while high intrinsic religiosity was associated with an increased severity of auditory and visual hallucinations.
When looking at recovery, Positive Religious Coping (PRC) was found to improve wellbeing, quality of life, treatment expectancy, and medication adherence, while Negative Religious Coping (NRC) increased suicidality, positive symptom severity, and illness duration, and reduced social functioning. Holding religious/spiritual explanatory models was correlated with increased psychosis symptom severity and delayed recovery, while holding a bio-psychosocial explanatory model assisted with recovery.
Religiosity/spirituality appears to play a significant role in the maintenance and recovery of positive symptoms of psychosis. Cognitive Behavioural Therapy for Psychosis (CBTp) could be enhanced by integrating religiosity and spirituality into assessment, formulation, and the development of targeted interventions. By doing this, CBTp could offer more cultural adaptations, and therefore potentially improve engagement with clients from diverse cultural backgrounds in Early Intervention services.
Westhead, M., & Georgiades, A. (2025). The Role of Spirituality and Religiosity in the Maintenance and Recovery of Psychosis: A Systematic Review. Early intervention in psychiatry, 19(7), e70061. https://doi.org/10.1111/eip.70061
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Lecturer in Early Intervention in Psychosis, Deputy Director, MSc Early Intervention in Psychosis