Until recently, social workers have not acknowledged the relevance of these issues to the therapeutic process. A societal factor hindering the integration of religion and spirituality into social work practice is the common desire in American culture to keep secular endeavors separate from religious practice. This undoubtedly stems from a fear of an inappropriate overlap of church and state. Because most therapy takes place in a secular setting, social workers may feel that religion is out of place, and thus constrain themselves from raising religious issues or questions. Another factor that causes religion and spirituality to be left out of clinical social work is directly related to the clinicians themselves.
Social workers tend to be people whose own religious orientations are relatively irresolute.
Social workers may feel uncomfortable discussing religion with people whose beliefs differ from their own, fearing that such a conflict may result in a breach in the therapeutic alliance. Social workers may also be limited by their own prejudices from accepting and working within the client's own belief system. Similarly, social workers with highly developed religious orientations may fear a propensity to proselytize clients or judge them on their belief system or lack thereof, and so have chosen to avoid these potentially volatile issues. Because religious beliefs are so personal and charged with emotional affect, social workers may decide that the safest course is to steer clear of the whole issue. The therapeutic process, however, already tackles some of the most delicate and private of matters, including sex, drugs and money.