Using Scripture in Christian Counseling

Posted on February 21, 2010

In my mind, Christian psychology’s value comes from being able to develop a solid foundation and praxis of Christian care of souls-something that grows out of careful biblical/theological work as well as the study of human behavior. Those of us who have been talking about and doing Christian counseling for some time must admit that much of what passes as Christian counseling is either superficial Christianity (verses pasted on a theory that exists just fine without the verses) or superficial psychology (a model based on some tidbit of pop psychology research and then morphed in an exquisite but completely fictional science).

Instead of Sunday school applications (where Jesus is the answer to every question) counselors need solid examples of how to engage the Scriptures in therapeutic settings. In a recent issue of our journal, Edification (2:2), I’ve attempted to introduce some practical steps in using the bible in the therapy office. But, truth be told, many have not had good experience in seeing how one might engage the Bible in real life settings. We’re wary of the Band-Aid use of verses, the bible bullets, the superficial applications. So, it makes sense we don’t know how to engage both counseling and Scripture well.

In stark contrast to biblical superficiality, Dr. Mike Emlet has recently published CrossTalk: Where Life & Scripture Meet (2009, New Growth Press). I would encourage every Christian in the counseling world to read it. Mike’s book provides a great introduction to connecting (more of) the bible to real-life human trials and tribulations (e.g., beyond the Psalms!). Though he is a seminary professor and biblical counselor you won’t get bogged down into esoteric discussions of exegesis or genre (though you can see he understands the concepts) or finding a verse for every problem (though you can see he believes that everyone finds themselves in the pages of the bible).  Rather, Mike focuses on “redemptive dialogue” (vs. mere instruction) and how the Gospel is more than belief but the repetitive, transformative meeting with God. 

Here are three gems from the book to whet your appetite.

If you think your counseling training lacked clear teaching on how to think about Scripture and its application to everyday life (beyond timeless maxims and warnings); if you avoid using Scripture in counseling because doing so sounds trite, then I recommend you take up this book and consider how the narrative use of Scripture might enrich your counseling work.

Christian Psychology and Mindfulness

Posted on February 14, 2010

(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 third post. Dr. Monroe maintains his own blog at http://www.wisecounsel.wordpress.com/)

Christian psychology exists to promote distinctly Christian study of the nature of persons, problems and solutions. Eric Johnson, our society’s leader, has done a masterful job outlining the nature and foundation of Christian soul care in his 2007 Foundations (IVP) book. Now, the next step is for us to develop detailed conceptions of a variety of common human struggles and helpful interventions.

But Christian psychology need not re-invent the wheel. Other psychologies (e.g., secular, Buddhist, humanist, etc.) have explored common human behavior patterns in helpful ways. One such concept getting a fair amount of attention is that of “mindfulness.” I first read about mindfulness some years ago in the work of Marsha Linehan. Dr. Linehan is the main developer and researcher of Dialectical Behavior Therapy, a research supported treatment protocol for those suffering from Borderline Personality Disorder. Dr. Linehan has referred to herself as part behaviorist, part Buddhist, and part Dialectical philosopher. Her treatment consists of 4 main components, one being based on Buddhist principles of mindfulness. More recently, cognitive therapists have adopted mindfulness as an intervention in place of (or at least alongside of) the core work of challenging cognitive distortions. Since then a number of careful studies employing mindfulness as an intervention seem to indicate that the technique works-possibly even better than techniques designed to challenge or distract from anxious talk. Those who practice it see a reduction of anxious and depressive symptoms.  How might Christian psychologist think about mindfulness practice?

What is it?

Mindfulness is defined in several parallel ways. In short it is conceived of a non-judgmental, present-tense, accepting awareness. [I've blogged on mindfulness before. You can find these additional thoughts here and here]. It is the absence of judgmental attitude with an emphasis on describing rather than categorizing. It is the being focused on the present rather than the past or future. It is an attitude of openness to experience.

 How should we respond to it?

The Christian therapist might rightly have some concerns about mindfulness. Buddhist beliefs about the goal of eliminating desire do not comport with Christian theology. Further, Christians are called to judge between right and wrong. Clearly, relativism isn’t part of Christian doctrine. However, are there facets of the practice that do comport with Christian foundations of soul care? Some integrative counseling models might include mindfulness from a purely utilitarian standpoint: it can be described without emphasizing Buddhist foundations. However, a better process would be to develop a foundation for consciousness and awareness of one’s surroundings using Biblical principles and Christian tradition.

Building a Christian psychology of mindfulness?

A Christian psychology of mindfulness might start by identifying the problem of distorted thoughts, perceptions and judgments and their genesis in the mind and heart. Second, the model of mindfulness might articulate the proper cognitive and attitudinal engagement in an unpredictable and frightening world.

The study of Buddhist mindfulness may encourage the Christian psychologist to re-investigate similar concepts from early Christian writings. For example, one might consider those spiritual disciplines designed to center one’s mind in Christ or to be “watchful” of thoughts. For example, IVP is preparing to release a new book entitled, Life in the Spirit: Spiritual Formation in Theological Perspective. In this book, James Wilhoit (Wheaton College) has a chapter on centering prayer. Building on the writings of Christian forbearers, he depicts a prayerful stance of observing the thoughts. The goal is not emptying the mind but maintaining conscious connection with the Spirit. Such activity opposes “what if” or “if only” kinds of hypervigilant thinking-thinking accompanying depression and anxiety and which hinders contentment.

In a recent phone conversation, Jim Wilhoit described the concept of watchfulness as an “intentional construal of the world” from God’s perspective. In my thinking, this form of mindfulness does not grasp after logical constructions (e.g., Psalm 131) but observes (a) the world as God sees it, and (b) the common but distorted scripts used as substitutes.

While I have not articulated a clear picture of a Christian psychology of the mind, I hope that my ramblings may encourage someone to build a rich model of mindfulness from our Christian tradition that avoids conceiving of the mind as only a logical instrument to talk ourselves out of feelings and perceptions.

Do No Harm

Posted on February 7, 2010

(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:

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.

Should Christian Psychology Become a Profession?

Posted on January 31, 2010

(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 first post. Dr. Monroe maintains his own blog at http://www.wisecounsel.wordpress.com/)

Right now, in the Commonwealth of Pennsylvania, lawmakers are considering a bill that would place more restrictions on who can provide counsel. Currently, the state has a number of mental health credentials. Among those is the Licensed Professional Counselor credential for those with a requisite master’s degree and post graduate supervised practice. If passed, the new bill will not only protect the title of “Professional Counselor” but also the practice of professional counseling. Per the law, one may not “style” themselves as a counselor unless they are licensed as such.

Who does this effect? This will especially impact the many Christian counselors who are not licensed but practice a form of counseling (aka biblical counseling, Christian counseling, etc.). While these counselors do not provide diagnoses or bill insurances they do collect fees, keep progress notes, maintain confidentiality, and provide counsel for those struggling with issues such as anxiety, anger, depression, marital conflict and the like. So, the 64 million dollar question: Do these unlicensed Christian counselors “style” themselves as professional counselors? And who decides the line between the two? As an aside, the bill does contain an exemption for pastoral counselors. Pennsylvania does not yet define that title but in other locales that title is reserved for those ordained, trained in a pastoral counseling graduate program, and doing work in church-related institutions.

Here’s where the bill gets interesting. It describes what typifies a profession that might overlap with counseling but have a separate (and thus exempted) identity and practice. Here are some of the criteria they might use to discern a separate profession (note my bolded text to emphasize interesting details):

1.  The group’s activity and focus must be based on an identifiable body of theoretical knowledge which, although it may include areas of common knowledge shared with social work, marriage and family therapy, and professional counseling, is demonstrably different, in the aggregate, from the body of theoretical knowledge underlying social work, marriage and family therapy, and professional counseling.

2.  The group must regulate entrance into professional membership by means of standards of knowledge, training and proficiency generally accepted by the profession with which it identifies.

3.  The group’s activity must be guided by generally accepted quality standards, ethical principles and requirements for an independent profession.

4.  The group must exhibit the ordinary accoutrements of a profession, which may include professional journals, regional and national conferences, specific academic curricula and degrees, continuing education opportunities, regional and national certification and awards for outstanding practice within the profession.

Thus, the state will consider whether one is a qualified member of a profession (and in compliance with that profession’s standards) AND counseling only in the scope of this profession.

This leads me to ask two questions. Does Christian psychology fit the definition of a profession? Should we seek to form our own credentials?

Like all good academics, we like to pose questions and avoid answering them. However, I do have some thoughts. First, we do have a theoretical knowledge base that is unique in its scope even if embryonic in its application. Second, while we do not have our own standards of practice, our parent organization, The American Association of Christian Counselors (AACC), does. And other Christian counseling membership organizations do as well. However, our biggest problem is that we do not limit members to only those who meet an observed standard of practice. There are no proficiency exams to hinder some from entry (again the AACC is now working to change this for their organization). Finally, there are many who would resist the separation of Christian psychology or Christian counseling as a distinct profession on the grounds that it would either ghettoize Christian counselors or lead to innumerable ideological authorities (biblical counselors vs. Christian psychologists vs. Reformed counselors vs. Catholic therapists, etc.). It is my opinion that our Society is enriched because we do NOT see ourselves as a profession. Thus, we have philosophers, theologians, psychologists, pastors, biblical counselors and many more within our ranks. We are well suited to avoid groupthink, in my humble opinion.

What do you think? Should Christian counselors seek their own professional identity and licensing body? What are the pros and cons of doing so?

What Should Christian Counseling Look Like?

Posted on July 26, 2009

What should Christian Counseling Look like?

(by Philip G. Monroe. Associate professor of Counseling & Psychology at Biblical Seminary. Dr. Monroe is our blogger for the month of July and this is his fourth post.)

This is a question I don’t intend to answer in this little post. However, I want to draw your attention to a book published in 2007 by H. Newton Malony and David Augsburger entitled, Christian Counseling: An Introduction (Abingdon Press).

Malony and Augsburger are well established professors at Fuller Seminary. In this little book they attempt to answer our question, What should Christian Counseling look like?

Here are some clues to what they want to accomplish in their book:

  1. We have no intention of doing a survey and, on the basis of the results, describing what Christian counselors do. In an unapologetic manner, we intend to detail the parameters of what we firmly believe should be the foundations and applications of Christian counseling” (viii).
  2. A change is afoot for them: “We perceived ourselves as training ‘Christians who counseled,’ more than ‘Christian counselors’” (vii).
  3. The change consists of a desire to rethink the foundations of the Christian faith on counseling practice: “We paid too much homage to current psychological theory instead of boldly proclaiming our explicit reflections on the implications of Christian faith for counseling practice” (vii).
  4. What has helped them move in this direction? Postmodern influences on psychology and philosophy of science and of knowing.

We should applaud their attempt and raise one question. We should applaud their willingness to identify how those involved in the integration of psychology and theology have been timid and wary of being explicitly Christian and biblical in one’s psychological theory. We should ask (as we read), however, are they re-thinking the model of integration from top to bottom or merely wishing to remove one specific issue within that model but continue with the same division of disciplines?

Consider Eric Johnson’s critique of the integrative task.

In different ways, the major approaches that most Christians have taken to psychology and soul care have assumed a disciplinary dichotomy between psychology and theology that has made it difficult to understand human nature holistically, through both empirical research and what the Bible teaches. Embedded in the modern conceptual framework that makes this particularly disciplinary division plausible, a more foundation question of this dichotomy has been simply inconceivable. But we must ask, from where did this disciplinary division arise? (p. 131 of his Foundations of Soul Care)

It may be that if we are going to make real progress in defining and delimiting Christian counseling, we have to first start with re-thinking how to deal with an unhelpful but longlasting division of disciplines.

Evaluating Models of Christian Psychology

Posted on July 20, 2009

(by Philip G. Monroe. Associate professor of Counseling & Psychology at Biblical Seminary. Dr. Monroe is our blogger for the month of July and this is his third post.)

Today I received a request to evaluate a new model of Christian counseling. The writer wondered if I had heard of it and did I have an opinion about its quality.

Let me admit to you that I love and hate this question. I love it because I love to discuss concepts, ideas, and approaches. And having read many of the key writers in my field I have some strong opinions too. But I hate the question because many often just want to know if they should put the book in the good book pile or the toss pile. However, in this case, I know my questioner is thoughtful and interested in the deeper conversation.

Have you ever wondered how you might evaluate whether the next new book or model of Christian counseling is faithful to the Christian tradition? To good psychology? Should you recommend it or warn others away? I recommend the following “outside-in” procedure to help you come to that decision: 

  1. Look at the packaging. First, explore how the authors sell the model? How do they place their endorsements? How effusive are they? Do the blurbs overemphasize the qualifications of the endorsers (their degrees, books, positions)? Are the endorsers also clients or users of the model? Second, how is the model advertised? How do they speak of healing? Do they seem to promise more than what seems reasonable based on prior experiences of change? Your findings here may not tell you all you need to know but ought to tell you whether the author is interested primarily in selling a product or participating in the advance of the field.
  2. Model descriptors? All models need descriptor words so that the reader understands and can classify its connection (or opposition) to other models. What words do they use? What do they connect or disconnect from? This will tell you about who they like, dislike, and what they think their new model supersedes. Do they use many neologisms or combinations of words? For example (and I’m making these up), bio-spiritual attachment, theo-neuro healing. New words aren’t always wrong and can be useful. They can also be used to create impressions such as intentionally trying to sound biblical and scientific at the same time. Finally, how do they interact with Scripture? Many verses? A few that are deeply explicated? Stated theological suppositions without much support? Greek/Hebrew word studies leading to some previously unknown understanding of the human psyche or soul? Again, your impressions of descriptors ought to tell you whether or not the person is seeking superficial impressions of solid work or something more.
  3. Observations. Every author or model begins their conceptual work via personal experience. Some may be anecdotal, others may be more scientific. But whichever is the case, the author has made some observations about problems and the way things get better. These are important to evaluate as almost every model builder (even the most naïve or wrongheaded) sees something of value. You may find this portion of your evaluation most helpful to you. What does this person see that you have not? What fresh angle do they have on something that you have overlooked? Have you become pessimistic about change or about the bible’s role in emotional health? Do they challenge your view on things?
  4. Techniques. The interventions used by a model builder tend to be the most attractive portion of their work. They’ve spotted a problem and developed a solution or a process towards a solution. Often, readers skim for these tools in order to add them to their therapeutic belt-without considering how they fit into the larger scheme of things. Notice that interventions may work well but not always for the reasons the author suggests. Second, interventions usually produce an effect but does the effect lead in the right direction? For example, techniques designed to “get the anger out” have proven to have create short-term positive feelings but do not lead to long-term health (since anger’s root has not been touched). In your evaluation of techniques, what does the author see as most important?
  5. Philosophy and Worldview. Now we drill down to the foundation. What is the model really built on? This part of your evaluation is the hardest as many authors don’t explicitly tell you (sometimes they don’t know themselves!). How do they interact with scientific literature? Do they use it to make global and black/white statements about human functioning? Are they willing to identify either holes in their theories or raise questions that still need answering (empirical humility)? Do they deny the value of scientific research? Can you describe their view of human nature? Of the nature of problems (causes and correlations)? Of the sources of solutions to human problems? Of health and optimal living?

Once you have explored your model in question using this outside-in technique, you should have developed some impressions. What have you learned that gives you pause? Sometimes such pause forms the basis of our new learning; of rebuke of erroneous thinking. Other times, pause reminds us that stepping outside the norms of scientific endeavor or historic Christian beliefs ought not be done lightly. Second, what has the author observed about the world we live in that might be useful to you? What techniques might be employed by you that are in keeping with your understanding of the Christian life? What of the model is dangerous and misleading? In your overall review, is there enough of that is worthwhile? Will the casual reader be helped or led astray?  

Why is such careful evaluation necessary? During my recent trip to Rwanda I had a conversation with a Christian man working in an NGO. He started the conversation this way,

“Do you know what is wrong with Rwanda? Christians in name only. Rwanda is supposed to be 98% Christian and yet look what didn’t happen in the country during the genocide. Christians didn’t rise up en masse and say no to this terrible sin. I was in [a Muslim country] recently and their Christian population is under 3%. And yet Christians there are bold and active.”

Sometimes the greatest threat to Christian psychology is not secular suppositions from psychology or a world that has set itself up against the truth claims of Scripture. Sometimes, the greatest danger comes from inside Christian psychology-from those who are “in name only” looking to build their own empire and willing to do so through superficial use of the bible or the science of human functioning.

May the Lord make us wise as serpents and harmless as doves!

What is a Competent Christian Counselor?

Posted on July 12, 2009

What is a Competent Christian Counselor?

(by Philip G. Monroe. Associate professor of Counseling & Psychology at Biblical Seminary. Dr. Monroe is our blogger for the month of July and this is his second post. This entry first appeared in Phil’s personal blog in early 2009. You can find that blog at http://wisecounsel.wordpress.com/])

What makes for a competent counselor? There is a famous book on this topic. In it, Jay Adams focuses on the problems of secular psychology and the need for a new understanding of how people change that fits with Scripture.  Further, he argued that all people, especially pastors, are capable of leading others to change.

While this book is an important work, it fails to identify competent counseling skills and the nuances of the change process. Let me suggest seven necessary capacities for the competent Christian counselor:

1. Spiritual maturity. Not only must the counselor know the bible, its story line, etc., they must also have understood and experienced the Gospel, show a maturing trajectory towards holiness and awareness of the diversity within Christianity. In the words of one of my theology colleagues, they must know the difference between dogma and doctrine and opinion. And, they must evidence the fruit of the Spirit.

2. Self-awareness/insight. One can be spiritual mature, but not particularly insightful about the self. The competent counselor has a grasp of his or her own narrative (and how the Gospel story is changing it) and how it impacts past and present relationships. The competent counselor understands their strengths and weaknesses and is not defensive.

3. Capable of building trusting relationships. Nothing much good comes from counsel provided by standoffish and stand-above kinds of counselors. The competent counselor is able to build trusting relationships by being interested in individuals (more so than in outcomes), able to walk in another’s shoes, cross cultural lines, and able to empower others more than tell others what to do.

4. Flexibility in response styles. The competent counselor understands the need to use a variety of conversational responses depending on the needs of the client. This means sometimes questions are appropriate, other times silence. Other responses include reflections, summarizing, focusing, confronting, joining, problem-solving, self-disclosing. Counselors who only use one or two of these styles will not be able to work well with clients who find those particular styles problematic. The competent counselor is intentional in her or his choices of responses.

5. Assessment and Hypothesis skills. The competent counselor is able to move from their counselees’ problems and descriptions to a wider view of the person and their situation and back again. This counselor is able to pull multiple pieces of data into a cohesive understanding of the situation. In doing so she forms and tests possible hypotheses that clarify motivation for behavior as well as point to interventions. For example, is the child’s behavior merely rebellious or is it ADD or anxiety based?

6. Observation skills. The competent counselor not only understands people, their needs, potential solutions, and has the capacity to use multiple response styles, but is also able to observe their own impact on the counselee. They observe subtle reactions from clients and seek to moderate their counseling style and/or gently explore the meaning of the reaction. Without these skills, the counselor blithely works toward a goal without knowing if the counselee is really following.

7. Ability to care for self. Finally, the competent counselor recognizes personal limits, boundaries and actively seeks to sustain a life of personal care. Far too many counselors confuse sacrificial giving with bypassing appropriate care for one’s own spiritual well-being. Just because one is spiritually mature one day does not mean such maturity is permanent. Neglecting personal care will likely diminish all other counselor competencies over time.

The Christian Psychologist and Healing

Posted on December 10, 2008

In the last post, We looked at several base assumptions about God’s healing activity. The Christian counselor rightly looks to God to be the power source in any positive change and healing in the lives of counselees. But, our counselees come from quite different vantage points. Some are looking for a secret method for instantaneous healing. Others despair that God cares about their situation. Others wonder if it is okay to ask God for help since their pastor or friend has warned them off from seeking help from prayer warriors or medicines and only to trust God in their pain.

So, a set of assessment questions may guide us as we consider how to talk about healing with our clientele.

1. What attempts has the person made in seeking freedom from their emotional or relational struggles? Do they focus on medicines? Healing prayer? Fatalistically waiting?

2. What do they believe about God and his concern for their situation? He’s concerned and doing something about it? He’s concerned but punishing them for past behavior? He’s concerned but unable to do anything? He’s unconcerned?

3. What is our experience with healing and change agency? Do we focus on skills or behaviors? Experiences? Do we resist healing talk due to observed abuses? Do we tend to focus on either spiritualization of life or pragmatic approaches to problems?

These kinds of questions may help us determine how best to respond to the concerns of our clients. They may cause us to question our own counseling habits (e.g., emphasizing vs. ignoring prayer as a tool; emphasizing behavior change vs. gathering spiritual insights, etc.)

When someone wants God to heal them, do we encourage this behavior? How? Are we aware of the dangers (e.g., minimizing God’s healing activity, searching for the reasons why they are unwell, etc.)?

As we seek to work as ambassadors of reconciliation (2 Cor. 5:16f), let us examine ourselves and make sure we understand the healing character of God and to remind our struggling friends and counselees that God is in the business of healing us–day by day.

[by Philip G. Monroe. Associate professor of Counseling & Psychology at Biblical Seminary, moderator of this blog and author of www.wisecounsel.wordpress.com]

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