Spiritual Struggles, Psychological Distress, and Growth during Religious Transitions

Background and Purpose

Major life transitions that disrupt identity and meaning systems are often associated with psychological distress. Religious and spiritual transitions represent a common but understudied form of identity disruption. Given that a substantial proportion of individuals in the United States orient their lives around religious or spiritual frameworks, these transitions—and the struggles they involve—are highly relevant for social work research and practice. Prior research consistently links spiritual struggles to poorer mental health, including distress and suicidality. At the same time, theory suggests that these struggles may also facilitate growth. This mixed-method study examines this tension by investigating spiritual struggles as predictors of both distress and perceived spiritual growth during religious transitions.

Methods

Data were drawn from the RESTARTS study (Relational Experiences, Spiritual Transformations, Attachments, Religious Transitions, and Sanctifications), a sample of U.S. adults who reported a religious or spiritual transition (N = 1,069) in the past 20 years. Participants reported on six domains of spiritual struggle (doubt, meaning, moral, interpersonal, divine, and demonic) during the year before their religious change as well as distress and perceived spiritual growth. Analyses included descriptive statistics, ANOVA tests, and multivariate regression models estimating associations between overall and domain-specific struggles and both distress and growth. Qualitative questions asking 152 participants what led to growth were coded.

Results

Spiritual struggles were common and were associated with elevated distress across mental health indicators. Meaning-related struggles were particularly strongly associated with distress, including suicidality. Among participants reporting at least some level of struggle, over 90% also reported experiencing some degree of spiritual growth, with nearly 70% reporting moderate to extreme growth. Overall levels of struggle were positively associated with growth (β = .28, p < .001). However, associations varied by domain. Doubt (β = .18, p < .001), interpersonal (β = .14, p < .001), and demonic struggles (β = .13, p < .001) were positively associated with growth, whereas divine struggles were negatively associated (β = −.21, p < .001). Moral and meaning struggles showed weaker, marginal associations. Six themes were found in qualitative coding outlining pathways to growth from spiritual struggles.

Conclusions and Implications

This study highlights religious transitions as an important context in which distress and growth co-occur. For social work practice, findings underscore the need for attention to assessment of clients’ spiritual and meaning-making frameworks, particularly during periods of identity disruption. Distinguishing between types of spiritual struggle may help practitioners identify when distress reflects adaptive meaning-making versus heightened clinical risk.

Meaning-related struggles may warrant particular attention given their strong association with distress and suicidality, while struggles involving questioning or interpersonal processes may support growth. Integrating spiritual assessment into biopsychosocial approaches, and supporting clients in exploring meaning and identity without imposing or dismissing spiritual frameworks, may enhance both risk detection and opportunities for growth. These findings reinforce the importance of attending to spiritual contexts as part of clinically effective, culturally responsive social work practice.