Alona Schneidman, David Roe, Yaara Zisman‐Ilani, Carmit‐Noa Shpigelman
BACKGROUND: While religious beliefs are known to affect help-seeking pathways, little is known about how they shape engagement in first-episode psychosis (FEP) care. The purpose of the present study is to explore how religious belief, religious identity and cultural norms shape engagement with FEP care. METHODS: Semi-structured interviews were conducted with 23 NAVIGATE participants in Israel. The sample comprised 11 Ultra-Orthodox (UO) and 12 non-observant (Non-Obs) Jewish FEP participants. Thematic analysis was used to identify themes related to religious factors in FEP care engagement and the therapeutic alliance. RESULTS: Two main themes emerged. The first focused on how faith contributed to participation in NAVIGATE by framing FEP care as God's will and viewing therapy as a spiritual experience. The second focused on trust issues, emphasising autonomy and collaborative decision-making. Across both themes, the therapeutic relationship emerged as a critical independent source of NAVIGATE engagement. CONCLUSIONS: Findings indicate that religiosity shapes day-to-day engagement throughout FEP care, extending beyond initial help-seeking. Implications are discussed with a focus on dialogue, psychoeducation and communication and on combining religious responsiveness with a strong therapeutic alliance.