The Psychotherapy Patient

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Assessing Religious Maturity

H. Newton Malony PhD

To cite this article: H. Newton Malony PhD (1985) Assessing Religious Maturity, The
Psychotherapy Patient, 1:3, 25-33, DOI: 10.1300/J358v01n03_03

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 Assessing Religious Maturity
H. Newton Malony

I sometimes laughingly say, "I spent 4 years of my life in mental hos-

pitals.'' And that is the truth. For 2 years I was a mental hospital chaplain
and for 2 years I was a mental hospital psychologist.
In the hospital where I was chaplain I use to attend staff meetings and
sit in a chair outside the "big table" around which sat the social workers,
the psychiatrists, the psychologists and the psychiatric nurses. They were
considered to be the REAL mental health professionals. The chaplain was
not included in their deliberations and the most that was ever made of re-
ligion was when one of the psychiatrists would report, "I had the patient
repeat 'Methodist Episcopal' "-as a gross index of brain damage in the
mental-status examination. Occasionally a social worker would report
that the patient was a "Baptist housewife" in giving the social history.
But this was as much concern as was ever expressed about religion. The
chaplain was never asked, "What is your religious diagnosis of the pa-
tient? ' '
Interestingly enough, things were different in the hospital where I was
a psychologist. Here the chaplain sat around the table with the rest of us.
In this hospital the chaplain was asked to make a report. The chaplain was
part of the deliberations. The chief of chaplains at this hospital had con-
structed a rating scale for the chaplains to use in making their assess-
ments. The scale helped the chaplains make judgments about how patients
related to God, to themselves, and to others. In using the rating scale, the
chaplain would ask patients questions about their religious faith and rate
the answers as to whether they reflected a "defensive" or a "coping" use
of religion.
Defensive religion was thought to be that which may have made pa-
tients feel better but which perpetuated their illness. It relieved symptoms
but kept patients from self-awareness and indulged their dependency on
their symptoms.
Coping religion was that which made patients feel good at the same
time that it facilitated their getting well. It made patients self-aware, in-

H . Newton Malony received his PhD in clinical psychology from George Peabody College in
1964. He is in the private practice of psychotherapy and is on the faculty of the Graduate School of
Psychology at Fuller Theological Seminary in Pasadena, California.
@ 1985 by The Haworth Press. Inc. All rights reserved. 25
26 Psychotherapy and the Religiously Committed Patient

terdependent with God, stronger in their desire to get well, and less con-
tent to rely on their symptoms for adjustment.
Although this rating scale was helpful to the chaplains in making their
reports, it was a crude instrument that served as a rough guide at best.
There were no standard questions to ask nor were there clear guidelines
upon which to base judgments.
Charles Hall, the senior chaplain of Topeka State Hospital who had
constructed this rating scale, knew its weakness and asked psychologist
Paul Pruyser of the nearby Menninger Foundation to assist him in refin-
ing the instrument. It was out of his collaboration with Chaplain Hall and
his interest in these matters that Pruyser (1976) later wrote R e Minister
As Diagnostician. This volume reasserted the importance of making "re-
ligious" assessments in both diagnosis and in treatment. He emphasized
the centrality of beliefs and suggested a number of dimensions in terms of
which evaluations could be made.
Pruyser's book became the basis for the construction of Nelson-
Malony Religious Status Interview (1982)-a I-hour interview schedule,
which is intended to provide mental health professionals a means for
assessing religious maturity with a rationale and accuracy similar to that
with which they assess intelligence and personality. A survey of note-
worthy pastoral theologians and psychologists of religion evidenced no
extant scale for such evaluation. The interview's light dimensions, 31
subscales and 43 questions, were also submitted to these scholars for their
critique.

UNDERLYZNG ASSUMPTIONS

Several assumptions underlie the Religious Status Interview. They are

as follows:
The first assumption is that "religion" refers to substantive social rcal-
ity rather than dynamic subjective motivation. This preference for assess-
ing a person's adherence to religion as it is seen objectively in cultural
realities, for example, in the Christian faith, as opposed to assessing a
person's individual feelings or urges about a transcendent dimension to
life, follows the distinction made by Berger (1974) between religion as it
appears in society and religion as it is inferred in subjective experience.
The Nelson-Malony interview evaluates religious answers to life's ques-
tions (i.e., substantive religion) as opposed to the asking of religious
questions (i.e., dynamic religion).
Secondly, it is an interview schedule which evaluates the Christian
religion, not religion in general. In his book, Pruyser notcd that it was
time for psychologists to begin to pay attention to the content of peoples'
religion in addition to its style. By this he meant that we should consider
 H. Newron Mulony 27

what people believe, not just how they believe. Therefore the Nelson-
Malony interview intends to assess maturity in Chrisiian faith rather than
faith in general. It deals with matters of creation, redemption, justifica-
tion forgiveness, and salvation-all essential categories of the Christian
religion. It does not attempt to measure the religious status of Hindus,
Buddhists, Muslims, or humanists. It leaves to practitioners of those
faiths the task of constructing their own measurement tools. It limits itself
to a single religion because of the conviction that there is no such thing as
religion-in-general; this assumption was stated previously. The content of
beliefs is important; and the authors, being Christian, felt best equipped
to make judgments about that which they knew best.
However, in the third place, the interview schedule attempts to assess
the way these beliefs function in the life of the person being evaluated.
The authors attempt to combine "functional" with "substantive" re-
ligion. Although this procedure focuses on what people believe (i.e., sub-
stance), it, nevertheless, is primarily concerned with how these beliefs
are used or incorporated into daily life (i.e., their function). For example,
belief in God's grace is less important than whether and how God's grace
is experienced in daily living.
The fourth assumption underlying the Nelson-Malony interview is that
what people say about their religion is the sine qua non or essence of their
faith. This places a priority on the ability to talk about one's faith, and this
bias is intentional. Thus, the evaluation is confounded with verbal ability;
however, it is not unlike the assumption on which intelligence and per-
sonality tests have been constructed. On the Wechsler tests of intelligence
one is as smart as one's ability to answer questions and define words. On
the Rorschach Ink Blot and the Thematic Apperception tests of person-
ality, persons are judged on the basis of their ability to report perceptions
verbally or to tell meaningful stories. Although many may seem hesitant
to equate mature religion with verbal ability, the authors were convinced
that being able to give religious rationales and interpretations for life
events was the best estimate of this characteristic. Further, they assumed
that thoughts precede action and that facility in verbal expressiveness is a
central component of functional religion. It would seem that the Christian
faith is primarily a unique interpretation of life that the believer under-
stands or does not understand; and one's ability to explicitly apply that
understanding and to self-consciously report it should be the optimal in-
dex of its presence or lack of it. Persons are no more religious, in this
sense, than their ability to rationally relate the belief and their behavior.
The fifth assumption follows from the fourth. Here is it assumed that
the ability to talk about religion should be spontaneous. Therefore, inter-
viewers are encouraged to ask direct questions and to wait for the
answers. While clarification of the question is appropriate, it is assumed
that little effort should be put into trying to help persons express them-
28 Psychotherapy and the Religiously Committed Patient

selves or in pressuring them to speak when they seem hesitant. The ra-
tionale underlying this approach is that functional religion is that religion
which functions automatically rather than that which functions under op-
timal or pressured conditions. It is thought that this is best measured by
judging what people say when asked such questions as, "What does God
mean to you?" without attempting to help them put their answers into
more or better words. The habit or trait of being religious is, thus, more
important to assess than the capacity to be religious.
Sixth, the interview is assumed to be both reliable and valid. At present
these assumptions have been only partially supported. Studies, based on
small samples, have found that it is possible for the same people to be in-
terviewed by different inte~iewersand obtain similar responses. Fur-
ther, it has been found that judges can independently score the same inter-
views similarly. Moreover, it has been concluded that persons will give
similar responses to the questions when they are interviewed again 2
weeks later. Finally, when pastors were asked to nominate very mature,
mature, and immature persons from their churches, their interview scores
tended to correlate with designations by their pastor.

MATURITY DEFINED

Next, a definition of maturity was assumed. Based not only on

Pruyser's i'he Minister As Diagnostician (1976), but also on Gordon All-
port's me Individual and His Religion (1 95O/l96l), Marie Jahoda's Cur-
rent Concepts of Positive Mental Health (1958), and David Duncornbe's
fie Shape of the Christian Life (1969), an understanding of mature Chris-
tian religion was divined. A statement of this understanding follows:

Mature Christians are those who have identity, integrity, and in-
spiration. They "identify" in that their self-understanding is as chil-
dren of God-created by Him and destined by Him to live according
to a divine plan. They have "integrity" in that their daily life is lived
in the awareness that they have been saved by God's grace from the
guilt of sin and that they can freely respond to God's will in the pres-
ent. They have "inspiration" in that they live with the sense that
God is available to sustain, comfort, encourage, and direct their
lives on a daily basis. These dimensions of maturity relate to belief
in God the Father, God the Son, and God the Holy Spirit. They per-
tain to the Christian doctrines of creation, redemption, and sanctifi-
cation. They provide the foundation for practical daily living.

Experientially, these beliefs result in a "freeing sense of security"

which pervades the life of the mature Christian (Duncombe, 1969). In
 H. Newton Malony 29

very practical and concrete ways Christian maturity results in very ob-
servable perceptions and very explicit behaviors. Duncombe's model is
instructive for assuming that the Nelson-Malony interview model of ma-
turity leads to optimal adjustment to life. It is shown in Table 1.
Here it can be seen that mature religion has effects which result in
mature personality. It helps the person adjust to life in an effective and
acceptable manner. The "freeing sense of security" which results in self-
awareness, accurate perception, adequate expressiveness, and realistic
interaction could be seen as an important and integral part of satisfying
adjustment for any and all persons in any and all circumstances. Of
course, like any state or trait in the person, this freeing sense of security
exists along a continuum ranging from less to more. It is the presumption
of the Nelson-Malony schedule that the more mature the religion, the
greater will be this freeing sense of security.
This leads logically to the last assumption underlying this measure of
religious maturity, namely, that the assessment of religious maturity can
have an important place in the diagnosis and treatment of emotional prob-
lems. As noted earlier, this was the presumption of the staff at Topeka
State Hospital when they included the chaplain in case conferences. Such
an assessment could and, perhaps, should be a part of such decisions in all
mental health facilities.
Religion is an important part of many, if not most, people's lives. This
is certainly true in the United States where the vast majority report be-
lieving in a God and where organized religion is an obvious part of public
life. Thus, religious faith is probably just as important to assess as ego
strength, interpersonal relations, self-concept, and emotional control.

TABLE I
THE RESULTS OF FAITH

'A FREEING SENSE OF SECURITY'

INTERNAL nesurrs EXTERNAL RESULTS

Y t
2ul 2 SELF ACCURATE
" l s
2 AWARENESS PERCEPTION

HONEST REALISTIC

EXPRESSION IMUIACTION
B
I I

IAdapted Frm 0. bncmbnbe The Sham of The t h r i r t f a n L j f e . I(n 'lork:

bblngdon P r e s s . 1969. p . 22)
 Psychotherapy and rhe Religiously Committed Patienr

RELIGIOUS MATURITY AND TREATMENT

As with all assessments, the measurement of religious maturity has im-

port for three types of decisions: diagnosis, general mental status, and
treatment. Diagnostic decisions pertain to the question of causation. The
central issue is, "What caused the person to have the problem they
have?" In the case of religion, the issue is, "Whether and/or how does
the person's religious faith provoke the person to become disturbed or
emotionally upset?" General mental status refers to the person's basic
personality and intellectual structure on top of which they became dis-
turbed. The question here is, "What are the characteristics of the
person's premorbid functioning?" In regard to religion, the issue is, "Is
this person's religious faith a basic strength or an essential weakness of
his or her personhood quite apart from the problem being experienced?".
Treatment refers to the plan for effecting change. The question here is,
"What should be the components of the treatment plan?" In the case of
religion, the issue is, "Can this person's religious faith be used as a re-
source to call on in working with this person or will it be a weakness to be
overcome or ignored?"
In regard to diagnosis, it should be obvious that variations in level of
religious maturity might make religion more a cause of emotional dis-
turbance in certain situations. In regard to general mental status, having a
religious faith that was judged to be a personality strength might prove to
be an asset in preventing mental illness from becoming worse. Finally, in
regard to treatment, it is important to know whether one can utilize a per-
son's religious faith in the intervention process. Malung these judgments
about religious maturity is potentially valuable addenda to almost all
clinical decisions in the mental health professions.

DIMENSIONS ASSESSED

One would be hard pressed to find treatment goals more encompassing

than those mentioned by Duncombe (1969). His conviction that religion
can enhance or impede self-awareness, accurate perception, adequate ex-
pressiveness, and realistic interaction is fundamental to the Nelson-
Malony interview.
Turning to the content of the Nelson-Malony Religious Status Inter-
view, there are eight dimensions which are assessed. These are (1)
Awareness of God, (2) Acceptance of God's Grace and Steadfast Love,
(3) Being Repentant and Responsible, (4) Knowing God's Leadership and
Direction, (5) Involvement in Organized Religion, (6) Experiencing
Fellowship, (7) Being Ethical, and (8) Affirming Openness in Faith. A
 H.Newton Malony 31

person can be judged mature in one or more dimensions and thus be more
or less balanced in maturity or immaturity. However, the major interest is
in an overall or general measure of maturity across all dimensions.
Definitions of maturity in each of the eight dimensions are as follows:
Awareness of God. Matwe persons stand in awe before God as crea-
tures and are aware of their Creator. Mature persons express awareness
of their dependence upon the Creator, but also recognize their capa-
bilities. Mature persons show humility in the face of life's besetting prob-
lems and have a realistic awareness of their own creaturely limitations but
do not deny their own capacity for productive action. Mature persons
worship God as an expression of reverence and of love toward God.
Mature persons pray as a means of spiritual sustenance and communion
with God and as a way of honestly expressing concerns.
Acceptance of God's grace and steadfast love. Mature persons view
God as loving them unconditionally. Mature persons use God's love and
forgiveness as an impetus for new life and responsible action. Mature
persons appreciate God's love and manifest this through a sense of joy
and gratitude. Mature persons have the ability to find meaning in the
suffering and difficulties of life. This meaning is based on trust in God
and His goodness.
Being repentant and responsible. Mature persons accurately accept
personal responsibility without denying other factors, such as the en-
vironment, in personal difficulties and in sin. Mature persons' attitudes
toward repentance are based on constructive sorrow which leads to a con-
cern to correct the situation. Mature persons are aware of their inner irn-
pulses and accept them as a legitimate pan of ,their humanness. Mature
persons are able to request and to accept forgiveness from others without
feeling threatened or self-depreciating. Mature persons are forgiving of
others without experiencing continued resentment toward them.
Knowing God's leadership and direction. Mature persons express trust
in God's leadership for life yet also recognize their role in that process.
Mature persons express an optimistic, yet realistic, hope based on trust in
God. Without denying present problems, mature persons are confident
that God is in control of life. Mature persons have a positive sense of role
identity that provides meaning in relation to faith.
Involvement in organized religion. Mature persons experience regular
weekly involvement with others in religious worship, prayer, study, and
service. Mature persons evidence active involvement and commitment to
religious activities. Mature persons are involved in church or in a reli-
gious group as an index of their desire to grow in their faith.
Experiencing fellowship. Mature persons experience relationships at
various levels of intimacy including interdependent, growth-oriented re-
lationships with other believers. Mature persons identify positively with
32 Psychotherapy and the Religiously Committed Patient

the family of God and have a sense of community with other believing
persons as well as with people everywhere. Mature persons have a sense
of commonality with all of God's creatures and with God's creation.
Being ethical. Mature persons follow their ethical principles in a flexi-
ble but committed manner. Mature persons' religious faith strongly
underlies and guides their ethical behavior. Mature persons show a con-
cern for personal and social ethics. Their acts evidence that they have a
concern for both and are concerned about individual responsibility and
social justice. Mature persons have a sense that they are serving others
through their work or vocation.
Aflnning openness in faith. Mature persons' faith provides a directive
for life as a whole. Mature persons spend a significant time reading about
their faith and discussing it with others as an expression of a desire to
grow in faith. While expressing confidence in their own view, mature
persons show a tolerance for other viewpoints and evidence a willingness
to examine others' beliefs in an honest manner. Mature persons' faith is
differentiated and is composed of a relatively large number of categories
and elements.
Taken together, it is the conviction of the authors that these dimensions
are an adequate measure of religious maturity from the viewpoint of the
JewishIChristian faith. They are indices of how mature faith can function
in life to assure accurate self and other perceptions coupled with adequate
expression and action.

CONCLUSION

This essay has described a relatively new systematic attempt to assess

religious maturity. It is not the first or only such attempt. As early as
1965, Draper, Meyer, Parzen, and Samuelson reported an attempt to
assess the diagnostic value of religious ideation in response to a Group for
the Advancement of Psychiatry report calling for such investigation.
However, Draper and his colleagues seemed more preoccupied with us-
ing religious ideas to categorize patients' types of emotional disturbance
than with assessing mature faith. The Nelson-Malony Religious Status In-
terview (1982), described herein, is an attempt to remedy this lack of at-
tention to mature religion.
It is felt that the Nelson-Malony Religious Status Interview provides a
means whereby mental health professionals may make valid and reliable
judgments about the degree to which the functional Christian faith of their
clientslpatients is contributing to their disturbance, their mental state, and
their potential response to treatment.
It is felt that the underlying assumptions accord with Feinsilver's
(1960) 3-R test for religious maturity in spite of the fact that the Nelson-
 H. Newton Malony 33

Malony assumptions pertain explicitly to the Christian faith and not to

religion in general. The Christianity of the Religious Status Interview,
discussed herein, is indeed reasonable (it comes to terms with modern
thought); responsible (it generates social concern); and related (it con-
nects persons to others and to the physical world).
Furthermore, the underlying assumptions also accord well with Orlo
Stntnk's 15 questions about mature religion in his 1965 book.
Thus, there is now available a means for assessing religious maturity
through the interview medium. Only the future will tell how valuable such
an evaluation can be. Although unaccustomed to making such judgments,
mental health professionals may come to agree with Anton Boisen, the
founder of clinical pastoral education, who reportedly said that knowing
about a person's religion was the most important knowledge a counselor
could have.

REFERENCES
Allpon, G. (1961). 7he individual and his religion. New York: Macmillan. (Originally published
1950.)
Berger, P.L. (1974). Second thoughts on defining religion. The Journal for the Scientific Study of
Religion, 13, 125-133.
Draper, E.. Meyer. G.G., Parzen, Z.. & Sarnuelson. G. (1965). On the diagnostic value of religious
ideation. Archives of General Psychiatry. 13. 202-207.
Duncornbe, D.C. (1969). The stages of rhe Chris~ianlife. New York: Abingdon Press.
Feinsilver. M. (1960). h search of religious marurity. Yellow Springs, OH: Antioch Press.
lahoda, M. (1958). Current concepts ofposirive mental health. New York: Basic Books.
Nelson. D.O. & Malony, H.N. (1982). 7he religious status interview. Unpublished document,
Fuller Theological Seminary, Pasadena. CA.
P ~ y s e r P.
, (1976). 7he minister as diagnostician. Philadelphia, PA: Westminster Press.
SlNnk. 0. (1965). Mature religion: A psychological study. New York: Abingdon Press.