Mark Baker, Director of La Vie [Christian] Counseling Center in Santa Monica and Pasadena, Calif., has experienced what he calls a "clash of cultures" up close. Early in his career, Baker, a Ph.D. in clinical psychology and a M.Div. in theology, had his application to a psychoanalytic institute for training rejected. A colleague later told him that the institute rejected his application partly out of fear that he would "substitute one form of fundamentalism for another."

On the other hand, Baker recounts a conversation he once had with a church member, who dismissed mental health as something "that might be great for Tuesday afternoons in the library [but] doesn't belong in the House of God."

The differences are more than philosophical. As Hodge points out in his journal article, cultural differences can lead to misunderstandings in marital therapy, where liberal therapists' preference for "egalitarian marriage"--in which the partners share the power and decision-making often runs headlong into the conservatives' support for "complementary marriage"--in which the partner's roles are different but are understood to have equal worth. Evangelicals end up feeling threaten by the therapist instead of helped.

For their part, many conservative Christians view marital therapy as a "marriage breaker"--a process intent on breaking up the household. What evangelical couples don't understand, says Vande Kemp, is breaking up a marriage is not considered a therapeutic task. She points out that the couple's relationship is usually a mess by the time they ask for help, and they sometimes have little more connection between them than a belief in the sanctity of marriage.

An irony of the religious-secular clash is that social work has deep roots in religion. Radical Catholic Dorothy Day, founder of "houses of hospitality" and the Jewish Educational Alliance, or "Edgies," were involved in charitable work and social services in the late 19th and early 20th centuries.

The integration of religious work and social work, however, was not without its abuses. The Orphan Train Movement, begun after the Civil War and lasting up until the 1920s transferred more than 30,000 immigrant children--many of them Catholic--to seemingly more wholesome Protestant families in the Midwest. Later, the Indian nations saw their children taken from reservations and placed in schools where they were not allowed to speak their native language or practice their religion. More recently, Bible study classes have been made mandatory in some shelters for the homeless, and a Mormon girl living in a home for juvenile delinquents was forced to go to Mass.

But social workers coming out of religious schools like Baylor are learning not to apologize for their religious orientation. Diana Garland, professor and chair of the School of Social Work at Baylor University admits that "All of us have biases. At Baylor we have a bias--that religion and spirituality are resources and strengths in people's lives." The danger, she says, only comes in a lack of respect for the worldview of clients.

In fact, many therapists seem to think it is fine to integrate religious beliefs into therapy as long as the therapist if up front about it. Joseph Walsh, Dean of the School of Social Work at Loyola University, a Catholic school, says "blending the two" is fine so long as the therapist says so quite clearly "on their letterhead and over their door."

Vande Kemp agrees. She stresses the importance of having "the option to choose a therapist who shares your values." More and more therapists are declaring themselves to have Christian, Buddhist, conservative Catholic, Methodist, Jewish, or transpersonal orientations. Faith groups, meanwhile, are inviting therapists to help them go places nobody might have imagined half a century ago. Not long ago, Vande Kemp was asked to speak at a meeting of the Sufi Psychological Association.