(by Philip G. Monroe. Associate professor of Counseling & Psychology at Biblical Seminary. Dr. Monroe is our blogger for the month of February and this is his second post. Dr. Monroe maintains his own blog at http://www.wisecounsel.wordpress.com/)

Every counseling ethics code in existence includes this principle: Do no harm. This maxim is drilled into the heads of counseling students (and any other medical professional as well). Our work should help, not hurt. Who could disagree?

But pause for a minute and consider how you might evaluate whether an intervention helps or harms. What criteria will you use? From what vantage point will you evaluate the criteria you choose? If a medical treatment extends life for an ill patient that would seem good-unless it keeps them alive and in a vegetative state with no possibility of recovery. Some would then wonder if the treatment was indeed best. Or, is it harmful if marriage counseling encourages truthfulness between spouses leading to the revelation of a terrible betrayal leading on to divorce and financial ruin? If honesty is your criteria for helpfulness, then the intervention is sad but helpful. If stability is your criteria, then such counseling is harmful. We could go on and on. Do we use client interpretation of whether treatment is helpful or counselor observation? Do we consider the difference between short and long term evaluation? And importantly for Christians, do we consider only statistical analyses or do we also consider biblical categories (e.g., intervention “A” leads to increased positive affect but encourages clients to pray to another deity).

Despite the muddy water I just churned up, I want to argue that Christian psychology is well poised to help Christian counselors provide treatment that does not harm. This society includes some of the best philosophers, theologians, sociologists, clinicians, and researchers of our day. These members are interested in looking at how people grow and change, how the bible connects with everyday life, common human struggles and effective interventions, etc.

How then do we go about refining our practices and avoiding harm? Let me suggest some steps we might take:

• 1. Collect and make available the most common forms of harm done by Christian counselors. Such harm may come from (a) blatant misuse of Scripture, (b) violations of Scripture’s mandate to love and protect vulnerable people, (c) using pop psychological principles and interventions that have been illustrated to be at least potentially harmful to many clients, and (d) using interventions without consideration of outcome. For example, Scott Lilienfeld of Emory University attempts to identify and operationalize “potentially harmful therapies” in both academic and popular writings (e.g., his 2007 article, “Psychological Treatments that Cause Harm” in Perspectives on Psychological Science, v. 2:1).
• 2. Encourage more clear and outcomes-based curriculum for counseling students addressing baseline knowledge and skills regarding biblical anthropology, epistemology, philosophy of science, as well as the usual training of counseling interventions. Include training in identifying harmful practices and identifying characterological bases of counselor harm. We have to admit that most harm comes not from naïveté but from selfish desires to use clients.
• 3. Encourage more objective research on our most favored Christian practices and beliefs used in counseling.

That would be a good start. Now, I’m not under some delusion that we will agree completely on any one of these issues. But, clarifying agreement, identifying disagreement might bring our work into better focus. I suspect we will find much that ought to be fixed and a sadly needed increase in Christian counselor humility.