2008 February-- Society for Christian Psychology

The Social Context of Psychotherapy

Posted on February 25, 2008

This is my last installment of the SCP blog for February. We are continuing our discussion of Tjeltveit’s book, Ethics and Values in Psychotherapy. Although I will not be able to finish the discussion of Tjeltveit’s book on the SCP blog, I will continue a discussion of it on my blog, and readers are welcome to follow along there (www.psychologyandchristianity.wordpress.com).

In Chapter 7 Tjeltveit discusses the “social context of psychotherapy.” That is, he locates the practice of psychotherapy in the context of how it functions within society. He discusses psychotherapy’s medical heritage including bioethics and medical ethics and the two emphases of “the idea of the professional and a focus on the individual client” (p. 132). Other influences from medicine include reductionism in the form of limiting psychotherapy’s focus to a medical focus of symptom reduction. He seems to suggest that there is much more to biopsychosocial problems than merely what is understood in terms of a “medical issue”.

The other major social context in which psychotherapy occurs is business. Psychotherapy has become a “business relationship” (p. 139) in which there is an exchange of services that occurs in the context of economics (in which resources either contribute or impeded goals being met) and limited financial resources (of third-party payors, including government, insurance companies, employers, and so on). Tjeltveit observes that there is a risk of a kind of “ethical reductionism” (p. 141) to the extent that businesses “consider economic considerations alone” (p. 141).

I agree with Tjeltveit that psychotherapy occurs in the social contexts of its medical heritage and business. The challenge for Christian psychology is to reflect upon these social contexts and make intentional decisions about how Christian psychology ought to function within culture and society – to cast a vision for such innovative practice. I dare say that most Christians practicing clinical psychology and related mental health disciplines - most Christians providing psychotherapy - do so out of these social contexts but do not reflect upon the heritage or consider the implications.

Let’s think about this: How do you see these social contexts shaping the field and the practice of Christian practice for good or for ill? For example, the use of the “50-minute hour,” the fee for service model, and billing services to insurance or employers. What would a distinctively Christian psychology have looked like had it not been shaped as much as it has been by these social contexts? Are there places in our culture where this is occuring? How might we develop innovative practice in this area?

Filed Under Christian Psychology, Ethics, Mark Yarhouse | 3 Comments

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