Date of Award

Spring 4-25-2008

Document Type


Degree Name

Doctor of Psychology (PsyD)


Graduate Department of Clinical Psychology

First Advisor

Clark D. Campbell, PhD

Second Advisor

Kathleen Gathercoal, PhD

Third Advisor

Mark R. McMinn, PhD


As mental health professionals become increasingly aware of the importance of religious values to clients there should be attempts not only to incorporate religion therapeutically but also to develop effective alliances with religious experts, in particular, members of the clergy. Since clergy are often on the frontlines of mental health issues, further research regarding referral patterns and collaboration is necessary. Clergy may be especially important in mental health care for rural communities where there is often a lack of adequate mental health resources and limited education surrounding mental health problems. The purpose of this study encompassed several different objectives. First, this study attempted to recognize attitudes that clergy possess about psychologists and other mental health professionals and explore how these attitudes influence referral patterns. Secondly, this research sought to understand how the nature of relationship between clergy members and mental health professionals affected referral patterns. Finally, this research aimed to analyze and compare attitudes and practices of clergy in rural and urban areas to determine specific similarities and differences. A questionnaire was developed by the author and committee members, based on a review of prior research in the area of psychologist-clergy collaboration. The questionnaire consisted of demographic information and Likert-style questions inquiring about attitudes and perceptions of clergy members relating to mental health professionals. Four-hundred randomly selected clergy members were invited to serve as participants. Clergy members were mailed a survey packet that included a cover letter explaining the purpose of the study, a questionnaire, a self-addressed stamped envelope, and a postcard that would enter participants in a drawing to win $50. Participants were also given an opportunity to complete the survey online and the URL was provided in the cover letter. A follow up postcard reminder was sent to participants three weeks after the original letter and survey. Seventy-one respondents returned the survey. The sample consisted of mainly highly educated, Caucasian males. 24% of urban respondents were female while 10% of rural respondents were female. The average age of participants was 52. Twenty-one different denominations were reported. 39% of respondents reported that they had received training in pastoral counseling, 30% had attended seminars in mental health counseling, 11 % reported no formal training, and 7% reported having a bachelors degree in psychology or a related field. No significant differences were found with regard to trust of Christian/non-Christian mental health professionals or cost of services. 19% of participants agreed that they trusted nonChristian mental health professionals to provide appropriate psychological services while 54% of participants agreed that they trusted Christian mental health professionals to provide these services. The study also aimed to asses whether clergy would be more willing to refer to mental health professionals based on variables such as: nature of relationship, similar belief systems, and level of trust within the relationship. Findings were consistent across rural and urban areas and no significant differences between areas were observed. Many respondents reported that they would refer if they believed the problem was of severe psychological nature. Several participants reported that they would refer because they do not have appropriate training in mental health issues. Reasons that pastors would not refer included lack of trust of mental health professionals. Also, many respondents reported that if the issue was spiritual rather than psychological in nature they would not refer. Recent research has identified various factors involved in enhancing or hindering collaboration between clergy in psychologists. However, research has not specifically addressed patterns of collaboration in rural versus urban areas. This study attempted to target these specific variables and add to the literature, thereby increasing awareness regarding these factors.