Category Archives: christian counseling

February 22, 2010 · 12:41 pm

Quick Review of Mike Emlet’s “CrossTalk”


In my last guest post on the Society for Christian Psychology blog I give a brief review* of Mike Emlet’s new book: CrossTalk: When Life & Scripture Meet (2009, New Growth Press). I can’t say enough great things about the book. If you haven’t looked at it, you should. One of the big beefs I have with the Christian counseling world is that we either abuse or ignore the bible in the therapeutic context. Mike’s book does a world of good in rectifying two problems: (a) only using tiny portions but seeing most of the bible as unusable in ministry contexts, and (b) missing the big picture of how God connects to hurting people and how their hurts connect to God’s story.
Check out my blog post on the SCP site using the link above.

*I did receive a free copy of Mike’s book from the publisher but that did not influence my views of the book. More likely would be my friendship with him and any dinner his wife, Jody, might offer. 🙂

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Filed under biblical counseling, Biblical Reflection, CCEF, christian counseling, christian psychology, counseling skills, Doctrine/Theology, teaching counseling

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February 17, 2010 · 11:40 am

Thoughts on sport, romance, and perversion


I’m not particularly the romantic type but certain things tend to spawn warm fuzzies in me. One such thing is the Olympics. Watching young men and women throw their all into sport for the chance to win (even though most won’t even come close) is one of those things. I recall the same feelings as I lived and breathed track and cross-country running in high school. I have fleeting desires of being able to race that fast, throw every cell into an activity, to think that succeeding will be the best. But then, my aching ankles and knees remind me of the consequences of doing so…

Pairs figure skating, in my mind, is one of the best illustrations of sport, romance, and perversion. It is definitely a sport. Have you ever tried to skate? To skate and jump off the ice…and not have a brain injury? To catch someone spinning over your head? To do all that and look graceful? But pairs are also supposed to be artistry and poetry.  The couple skates in a way to tell a  romantic or romantic/tragic story. But with the new scoring system couples are rewarded with moves, jumps, catches, positions. They are not as well rewarded for fluidity, artistry, and poetry. Maybe I’m showing my age but I found very few of the skating pairs very interesting this year. The couple that won certainly were interesting, both on the ice and their personal story. But, many just skated to music and did the moves they knew would get higher scores.

In my mind, it perverts the romance of the sport. Sure, the skaters are athletic. Sure, the moves they do are amazing taken one at a time. But, I would liken it current pop hip-hop lyrics that skip all the romance and just flaunt or demand raw sexual activity. Forget the dinner and the candles, just give me sex!

If you were watching the long program of pairs, you may have seen a Canadian couple. They fell and so wouldn’t have medaled. However, I think they had more romance and art in their skating than all of the first three combined.

Which leaves me one question. Are we beyond romance in this day and age? Missed something on television? You can catch the 30 second clip of the most important points on video. Don’t want to watch a whole football game? You can get the highlights instead. Seems we like things raw and to the point.

Maybe this is the sin of Cliffs Notes 🙂

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February 15, 2010 · 5:03 am

Conference Announcement for the Society of Christian Psychology


One of the things I love about the Society for Christian Psychology is the diversity of professionals in the  membership. We have biblical counselors, clinical psychologists, sociologists, philosophers, and theologians. And starting this year, we have two different conferences, one for counselors and one for academics. I would like one that caters to both but this is still good. Anyway, the next academic conference (focusing on human agency) is next September 17-18 at Southern Seminary. For more info on the presenters, their paper topics and conference details, click here: 2010 Conference announcement titles

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February 12, 2010 · 5:36 am

The good and bad of new diagnoses


A draft of the next edition of the Diagnostic & Statistical Manual (DSM-V) has been posted to their website and open for comments by users. The website breaks out the changes being considered in categories so it is easy to find your area of interest.  The final edition isn’t expected until 2013.

Diagnostic changes can be a help and a problem at the same time. When DSM IV removed Multiple Personality Disorder in favor of multiple diagnoses for clarifying dissociative symptoms, that helped clinicians be more descriptive of their client’s struggles. In this new proposal, they plan on eliminating Asperger’s Disorder and subsuming a number of diagnoses (Retts, PDD, etc.) into one diagnosis: Autistic Disorder. I would think this would not be helpful as it reduces specificity.

How about this new entry: Temper Dysregulation Disorder with Dysphoria? A new diagnosis for children? I think it may help in that it might hinder the ever popular “bi-polar” label given too quickly to children (and accompanied with serious meds). On the other hand, it probably will make quite a few roll their eyes. The label doesn’t have that ringing medical sound to it. Not that I’m disparaging the symptoms it tends to cover. There are children who mood is so easily dysregulated, whose reaction to frustrations are way over the top. These children tend to be impulsive to boot. Something isn’t right, but what best identifies their struggles; the etiology of their problems?

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February 8, 2010 · 8:29 am

Do no harm?


[This is the second guest post I am making over on the www.christianpsych.org. You’ll have to click the link to read the whole post…]

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:

[rest of post on www.christianpsych.org.]

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February 2, 2010 · 2:27 pm

The unpardonable sin


Ed Welch has a good post at www.ccef.org on the “unpardonable sin” passage found in Matthew 12. This is a worrisome passage for many–especially those with scrupulosity (aka Obsessive Compulsive Disorder). He hits the nail on the head that the flip answer, “if you are worried about this, you haven’t committed it” is both likely true but also insufficient for the true worriers among us. So, his post goes in great detail about the passage, its context and good conclusions to draw from it. Well worth your read!

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February 1, 2010 · 5:49 am

Blogging this month for the Society of Christian Psychology


This month (really, the 4 Mondays of February), I’ll be the guest blogger at the Society for Christian Psychology’s site. You can find it at www.christianpsych.org or from my links on this page. Here’s a tease from my first post:

Should Christian Psychology become a Profession?

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):

[For the rest of this post, click here.

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January 22, 2010 · 11:53 am

Update on PA HB 1250


Posted previously here about the bill proposed to go to the PA legislature that will change the Licensed Professional Counselor credential from a title act to a practice act. This would further restrict non-licensed counselors from “styling” themselves as a licensed counselor, from offering the services of a counselor. Already one cannot call themselves a professional counselor or similar titles. But these changes would eliminate many from practicing. This bill (see here for bill with highlighted changes. Go to page 10 to see most pertinent changes and list of exempted individuals) is being voted on by the committee on 1/27.

Note that the exempted parties include “pastoral counselors”. In PA they are not defined. However, in other states they are defined and licensed. Thus, who will determine who is a pastoral counselor and what to do with the overlap between the two? In other states, a pastoral counselor must be ordained and trained in pastoral counseling. Also, psychologists supervising unlicensed people with counseling degrees may be exempted but there is still fuzziness in the law.

It all comes down to the definition of “styling.” See this quote from page 10:

Only individuals who have received licenses as licensed professional counselors under this act may style themselves as licensed professional counselors and use the letters “L.P.C.” in connection with their names. It shall be unlawful for an individual to style oneself as a licensed professional counselor, advertise or offer to engage in the practice of professional counselor counseling or use any words or symbols indicating or tending to indicate that the individual is a licensed professional counselor without holding a license in good standing under this act.

Section 3.  The act is amended by adding a section to read:

Section 16.4  Unlicensed practice prohibited.

No person shall engage in the practice of as a licensed social work worker, licensed clinical social work worker, licensed marriage and family therapy therapist or licensed professional counseling counselor in this Commonwealth unless the person holds a valid license to do so as provided in this act. The provisions of this section shall not apply to the following persons:

If you are in PA and one of these representatives (scroll down for the list) are from your district, you may wish to register you opinion on the matter.

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January 20, 2010 · 3:09 pm

Harmful counseling?


This month’s edition of American Psychologist has several interesting articles about the negative effects of therapy. The article by David Barlow, “Negative effects from psychological treatments”, provides a good overview of the effectiveness research controversies. But instead of focusing on how best to collect data about the benefits of a treatment, he gives some attention to looking more clearly at who benefits from a treatment and who is made worse (using dismantling type studies).

The next article (by authors Dimidjian and Hollon) gets at the definition of harm. Defining harm is rather complex. That a client may not get better from a treatment or may get worse during a treatment is not necessarily evidence that the treatment caused harm. And true to form, we have to accept that some treatments may both harm and help (they give the illustration of a nursing mother on medications: it may help her and yet harm her baby). Or, a treatment may make someone worse at first but then help them later on. Or, the treatment may be just fine but the practitioner may use it in a way that is good or bad. Finally, a treatment may be thought of as harming a patient when in fact what is seen is the normal trajectory of the disease.

So, how do you get at understanding whether a counseling treatment harms? They offer a number of methods for research which I won’t get into here.

Finally, the last article covers training implications (Castonguay et al). They cite therapists’ frequent underestimation of treatment failure and client deterioration. Looks like about 5-10% of clients get worse in treatment. If one wants to train counselors to avoid more failure how might one do that? Castonguay et al suggest that one do so by beefing up (a) proper therapy skills, and (b) skills to identify potentially harmful treatments. On p. 45 the authors include a table of training recommendations, which include

  • expose trainees to list of potentially harmful treatments
  • help trainees monitor change and deterioration
  • enhance relationship skills
  • learn and practice interventions that are empirically supported
  • prevent and repair a variety of relational pitfalls
  • adjust treatment choice, expectations, etc. based on client characteristics
  • Address trainee’s issues (anxiety, hostility, defensiveness, naiveté, etc.) that may hinder counseling

Every counselor fears harming another; fears not helping enough. And it is often unclear whether our work is having its intended impact in the moment. However, there are things we can do to keep the communication lines open and thus listen to our clients about what is helping or not helping. This is what keeps us on our toes. What works for one person harms another. We must not get wedded to one way of helping.

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January 18, 2010 · 10:54 am

Counseling skills help pastors cope?


A couple of people sent me links to a recent news item out of Britain concerning the value of teaching counseling skills to pastors. Researchers there found that pastors who do a lot of emotion laden work with parishioners bear a heavy load (pretty obvious so it is nice to see that research doesn’t say otherwise). Those pastors with counseling skills training seem to cope better with the distress. I’ve not seen any in-depth description of the study so I can’t comment on why this might be the case. It could be that pastors with counseling training are more self-aware. It could be they are more positive on the benefits of talk therapy and so utilize it for themselves. It could be they feel more effective in their counseling work and therefore feel less helpless.

Whatever the case, I’m happy that it supports my coursework teaching counseling skills to pastors.

Read about the research:  CT’s news blurb, Medical News blurb

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