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Consideration of client treatment preferences specifically has implications for treatment engagement and retention; however, research on the relationship between preferences and client R\/S identification is mixed. The current project included two studies of R\/S-unaffiliated (Study 1, <jats:italic>n<\/jats:italic>\u2009=\u200996; Study 2, <jats:italic>n<\/jats:italic>\u2009=\u2009135) and Christian (Study 1, <jats:italic>n<\/jats:italic>\u2009=\u200990; Study 2,<jats:italic> n<\/jats:italic>\u2009=\u2009132) participants in the USA. Study 1 investigated differences between these individuals with respect to attitudes toward mental health, preferences for therapist characteristics, and treatment preferences. Study 2 replicated Study 1 in a different community sample and considered how the degree of engagement in R\/S services and activities may play a role in therapy-related variables. Results indicated that Christian individuals differed from R\/S-unaffiliated individuals in regard to beliefs about the causes of mental illness; preferences for therapists of the same religion, race, and sexual orientation; and preferences for certain therapy tasks (e.g., homework, psychoeducation, learning skills) and types of therapy (e.g., group, family, couples). Results also indicated that preference for same-religion and heterosexual therapists increased as R\/S engagement increased. Our findings highlight the importance of R\/S in understanding mental health perceptions and treatment preferences and have implications for clinical practice.<\/jats:p>","DOI":"10.1007\/s10943-025-02332-4","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T07:54:50Z","timestamp":1747382090000},"page":"2034-2052","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Attitudes and Preferences Regarding Mental Illness and Treatment Among Christian and Religious\/Spiritual-Unaffiliated Individuals in the USA"],"prefix":"10.1007","volume":"64","author":[{"given":"David M.","family":"Schultz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9630-2705","authenticated-orcid":false,"given":"Tiffany M.","family":"Harrop","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1443-3125","authenticated-orcid":false,"given":"Olivia C.","family":"Preston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9619-8351","authenticated-orcid":false,"given":"Brian A.","family":"Bulla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7110-3993","authenticated-orcid":false,"given":"Taylor R.","family":"Rodriguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5333-4475","authenticated-orcid":false,"given":"Jacob A.","family":"Finn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0014-8502","authenticated-orcid":false,"given":"Joye C.","family":"Anestis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"2332_CR1","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1037\/a0025266","volume":"58","author":"RR Cabral","year":"2011","unstructured":"Cabral, R. 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