Category Archives: christian counseling

April 28, 2008 · 10:53 am

Practicum Monday: Potentially Harmful Therapies


I was perusing the Journal of Psychology and Christianity (27:1, 2008; pp. 61-65) this morning and saw Siang-Yang Tan’s mini article entitled, “Potentially Harmful Therapies: Psychological Treatments That Can Cause Harm.” He was working of a similarly titled article by the so-called Ralph Nader of Psychology, Scott Lilienfeld of Emory U. (in Perspectives on Psychological Science, v. 2:1, 2007, pp. 53-70).

Some therapies on the PHT list would not surprise you. For example, Tan lists re-birthing techniques where you wrap up your client in blankets put them between the therapist’s legs so they can be healed from their birth trauma. Sadly, a teenager suffocated not that long ago here in PA when an unlicensed person attempted this with her client. Also, Tan lists the use of hypnosis with those with Dissociative Identity Disorder (DID).

But, you may be surprised to find that Critical Incident Stress Debriefing (CISD) also makes the list of PHTs. CISD (aka CISM) has been used for years with police and fire fighters to help them debrief from traumatic experiences and the thinking is that this prophylactic intervention helps exposed individuals avoid problems such as PTSD.  But there is evidence that such care may not only not help some individuals, it might actually harm others by increasing their arousal and those inclined to be hyperaroused appear to do better with no debriefing. For more of a critique of debreifing see DeVilly, Gist, & Cotton’s 2006 article in the Review of General Psychology (10:4) entitled, “Ready! Fire! Aim! …”

While CISD is not without merit and not always harmful, its popularity and widespread use without careful analysis should give us pause.

What widely accepted methods of Christian counseling also have the potential for harm?

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April 23, 2008 · 5:31 am

Divorce & Remarriage I: Confusion!


What is the right biblical and pastoral answer for those with real questions concerning divorce and remarriage? David Instone-Brewer in Divorce and Remarriage in the Church (IVP, 2003/6) suggests that much of our current advice and interpretation of Scripture on these matters are not clear nor sensible (hence the need for his book 🙂 )

The trouble with most theologies of divorce is that they aren’t sensible. They may give a reasonable account of most of the texts, in a forced way, but their conclusions just aren’t practical… (p. 13)

Instone-Brewer says most interpretations today fall into 2 camps: (a) there are 2 valid reasons for divorce; remarriage is not allowed unless one person dies, and (b) no grounds for divorce or separation.

The first interpretation isn’t logical says the author. “Why would Jesus and Paul identify these two grounds for divorce but not allow divorce for physical abuse or other harmful situations?” (p. 14) The second option is more logical but no more practical.

Adding to the confusion are those who just decide the bible isn’t practical and so try to extend the texts on divorce to cover adultery, abuse, abandonment, etc. While these are more sensible, their textual support is “dubious.”

Instone-Brewer came to see the texts in new light after studying the text AND first century Judaism and so the remainder of the book will be his conclusions in 4 sections
1. God is a divorcee (OT material). ch 2-4
2. Jesus’ and Paul’s teaching on divorce and remarriage (ch 5-7)
3. How this teaching should work and a look at marriage vows (ch 8-10)
4. Church policy on divorce and what it should do now (ch 11-15)

But the author can’t bear to stop the chapter now so he launches into what he didn’t find in the Bible: the words, “Those whom God has joined, no man can separate.” What Jesus DID say is, “let no one separate.” Why the distinction here? Is Jesus saying it is not possible to separate? If God has joined, then no one can unjoin? Instone-Brewer says no. What it means is that no one SHOULD separate.

Second, who are these words to? The one who causes it? The one who starts the proceedings? You get the inkling that Instone-Brewer believes it is the one who causes vows to be broken. Why? Well, God divorces us but he is the victim.

…his warning is not to the person who finally tidies up the legal mess after the marriage has broken down but to those who would violate their marriage vows and, in so doing, cause the marriage to break up. (p. 18)

Of course people do break their vows all the time and so if they are repentant, I-B says we should forgive them. But if vows are repeatedly broken, then the marriage is, “in shreds.” (p. 19).

Again, I-B can’t wait to reveal his hand later and so concludes (a) the bible only allows victims to initiate divorce and Jesus’ problem with his hearers was that they had abandoned this idea for groundless divorce, and (b) the OT also allows divorce for abuse and neglect.

Well, what do you think? Should biblical intepretations be sensible (to us) and practical? I confess that I have never used sensible when considering whether my interpretation is good–at least knowingly. Seems much doesn’t make sense to me. But, it is an interesting way of thinking about these passages. If they are meant for us to use, they they should be practical, no?

I think he’s shortchanged us by limiting the typical camps on this topic. There are many who believe that there are a limited number of legitimate reasons and in those reasons, remarriage is possible.

For those really wanting to get into the topic, I would recommend two other writers: Jay Adams book on marriage, divorce, and remarriage. Also, check out John Piper’s lengthy document. He takes a very conservative (no remarriage) position–even more conservative than the official position of his elders.

Let’s see where I-B goes as he engages the OT next.   

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April 22, 2008 · 2:31 pm

Mind the gap


When exiting the train in England, you might hear the conductor telling you to “mind the gap” between the train and the platform. Consider another gap…

One of our pastors preached on Sunday from Hebrews 6:13-20. In this passage the writer of Hebrews reminds us of God’s promises and that they are sure because God does not lie and that he swears an oath on himself that his promises will be fulfilled (are being fulfilled in Christ).

And yet, our pastor remarked that there is a gap between our present feelings and the objective reality of God’s finished work. We live in that gap until heaven or Christ’s return. Our hope while we live in the gap is anchored in Jesus.

How do you deal with the gap? Seems much of counseling work is figuring out how to live and function in the gap, what to place our hope in, working to remember what is true, and living well with others who also struggle with their “gap.”

What have you found helpful as you “mind the gap?” 

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April 21, 2008 · 5:43 am

Practicum Monday: Is conflict necessary in therapy?


In the latest edition of the Journal of Counseling Psychology (55:2, 172-184), Nelson, Barnes, Evans, and Triggiano have published an article on the inevitable conflict between supervisor and supervisee–what leads to it, how supervisors react to it as well as supervisor strategies for managing it.

But, these lines about therapy caught my eye:

It is likely that conflict is as difficult to manage in supervision as it is in psychotherapy. Yet addressing conflicts successfully can be a healing and educational venture. The work of “tear and repair” in therapeutic relationships suggested by Safran (1993) and Safran and Murran (1996, 2000) is thought to be critical to optimal outcome in psychotherapy. The capacity of therapeutic relationships to recover from relationship breaches is thought to enhance client trust that relationships can survive misunderstandings and disagreements as well as client confidence that he or she can successfully resolve them. A skillful therapist can guide a client through the process of accepting the therapist’s inevitable fallibility, thus enhancing client capacity to accept his or her own… (172)

What do you think? Is conflict necessary for healing? I think yes. Otherwise, the client and the therapist idealize each other and so become blind to reality.

However, not all relationship breaches are good and we don’t always respond well to them, making matters worse.

How do you feel about conflict with your clients? With your counselor?

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April 16, 2008 · 5:41 am

Integrative Psychotherapy XIII: Concluding Thoughts


We come to the concluding chapter of Mark McMinn’s and Clark Campbell’s Integrative Psychotherapybook. They remind us that it was their endeavor to detail their model of integration, psychotherapy, and Christian approach. By integration they meant that they wanted to thoughtfully integrate a variety of psychological theories (as opposed to mindless or even pragmatic eclecticism) as well as their theological views of persons. Their version of integration is best defined, so they say, by the term theoretical integrationism (TI). “[TI] occurs when a person begins with a particular theoretical starting point and then extends the theoretical base by incorporating one or more additional theories” (p. 386). What is the heart of the IP model found in this book? McMinn started with CBT and CT and has incorporated relational approaches more likely found in dynamic models of therapy. Campbell is reported to have begun with interpersonal and family models and incorporated and practiced CT. I would suggest that CT is the heart of the IP model with relational and interpersonal understandings of persons included. I would suggest that there is little evidence of family models in this book.

The authors make brief mention of their theological integration in this chapter. They admit that they take a rather narrow view of Imago Dei and apply that to personhood and psychotherapy by looking at the image of God through the lens of functionality, structure, and relationship.

IP attempts to address life both at the level of symptom reduction AND transformation. The authors recognize that many things lead to transformation–not just therapy. However,

“Psychotherapy is only one means of transformation, but in today’s society it has become an important and ubiquitous one. Even within the church there appears to be a strong and growing interest in counseling and psychotherapeutic ministries, though suspicions about psychology persist in many congregations and denominations. Church-based counseling ministries are now commonplace, most pastors and church leaders have a referral network of therapists in their community, seminaries offer courses and degrees in counseling, and support groups and peer-counseling ministries are being established in many churches. This trend is encouraging insofar as it helps the church care for whole persons as Jesus ministered to the spiritual, physical, relational and emotional needs he saw in others” (p. 388).  

Notice the word, “insofar” in the previous sentence. The authors see increased chance for harm if we “conflate” psychotherapy and the church. They are concerned about two problems: (a) making the gospel about us (self-actualization) instead of Jesus work, and (b) having untrained and undertrained individuals offering therapeutic help and so causing harm to vulnerable people. They do not want to see the Church compromised by becoming therapeutic nor do they want to see the profession of counseling dumbed down by removing the professional, academic, and scientific groundings.

Finally, they end the book by listing 6 ways their IP model is comprehensive: (a) includes both psychology and christianity, (b) consider multiple domains of persons, (c) multiple dimensions of therapy, (d) includes both scientific and relational approaches, (e) christocentric, and (f) usable with both christian and nonchristian clients.

So, now that we have concluded their book, what do you think? Did it make you more interested in viewing therapy through the symptom, schema, and relationship lenses? Did their model seem usable in your context? Were their Christian foundations necessary, or said differently, how did their Christian beliefs change how they function with clients? Would a Christian therapist who loves Jesus but sees their work as being a relational cognitive therapist act any differently? I’m curious if you have a reaction.

Some of my reactions:

1. This is probably the best Christian integrative book I have read. They work harder in this book to make sure that they acknowledge the all-too-common superficial use of Christian beliefs in building a model of care. They also display much humility and do not want the church to water down the Gospel. Therapy isn’t everything for them. Christianity is trump, in their eyes.
2. There is almost no negativity directed at any other model. Most of us use other models as foils for why what we do is better. I congratulate them on being able to map out a model without attacking others. When they do point out weaknesses, it is in their perception of the limits of cognitive therapy.
3. The book is now in need of a follow-up that more deeply illustrates case material. What does IP look like in an extended case study. I would love to see that as a follow-up text. What they did provide were little snippets that had a lot of realism to them. I just want more. Here’s one little question. Does Scripture only come into play at the symptom level of change? It seems to by the way they write and don’t write about Scripture. Does Scripture have anything to do with transformation and experience? Scripture is not merely a cognitive or intellectual enterprise (though we often use it this way).
4. I might quibble with them on their Christology, though I found their positions not quite clear and so may not differ as much as I think. Christ’s death and resurrection IS the power for change (2 Cor. 5:16f). His life does inspire us but we cannot love others merely because of his life. I think they might agree with this, but I’m left with confusion as to where they stand here.
5. As expected, this is a text for therapy trainees. It sets out boundaries for the profession. Lay and church leaders can learn from this model, say the authors, but ought to be careful not to function as a professional. Even though I am a professional and I have found in teaching counselors that it takes character, the Holy Spirit, skill acquisition, and much practice to be a wise counselor, I am always a bit troubled by the boundary setting. It seems we are trying to protect our own domain. I do think there are wise counselors who never had any academic psychological training. It may not be common, but let’s remember that pastoral care has been helping people long before clinical psychology developed into a discipline. I would have liked to see a bit more work in informing the reader (a psychology trainee) about the dangers in trying to function like a spiritual shepherd.
6. I’m in concert with their model as it functions in session. We are conduit for reconciliation. Therefor our working relationships matter almost as much as our words and interventions. When we can reduce symptoms of suffering, we should. But, we also recognize the insidious nature of sin in our lives and must seek transformation of our minds and experiences in submitting them to reality as seen through God’s eyes.

For those interested in Mark McMinn’s further work, you might check out his new book on sin, Sin and Grace in Christian Counseling (IVP, 2008). It is also written for the counseling practitioner.

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April 10, 2008 · 5:48 am

Local Group Therapy For Survivors of CSA


Penny Freeman, EdD, will be starting a 10 week group therapy group for women who have been sexually abused as children in the Doylestown, PA area. Penny is prof at Philadelphia Biblical University but will be doing this in context of her work as an associate of Randall B. Hicks & Associates.

Contact Marsha Hicks at 215.579.4116 to learn more about it if interested.

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April 7, 2008 · 10:33 am

Integrative Psychotherapy XII: Soul Care Via Relationships


In the last substantive chapter of Integrative Psychotherapy, McMinn and Campbell explore relationship-focused interventions. As we have seen in previous chapters, their therapy model begins by addressing problems at the level of symptoms and ends with considering transformation of the person via soul care. Before describing soul care interventions the authors want to set out a few of their beliefs:

  • “One does not have a soul but is a soul” (p. 349)
  • The soul is not another word for personality or self or even person. Rather it is bigger because it encompasses meaning and relationship 
  • Soul care is based on the life AND work of Christ. Some use Jesus as an example for healthy relationships but stopping with Jesus’ behaviors misses out on Christ’s atoning work in redeeming us. His work is based on both grace and truth–both necessary in any human to human soul care work
  • There are multiple forms of soul care but one should not confuse or integrate spiritual direction and psychotherapy. “Christ is central to all soul care” (p. 356) but each version has differing goals and methods. They suggest these as some of the differences between the two:
    Spiritual Direction                         Therapy
    spiritual functioning                          psychological functioning
    lifelong spiritual transformation        transforming a specific problem area
    spiritual advising                               guided discovery
    spirit centered                                   problem centered
    God focused                                      client/counselor collaboration
    under church authority                     accountable to professional standards

Relationship interventions, per the authors, must be founded on therapeutic alliance (a safe trusting and collaborative relationship between counselor and client), therapeutic frame (“a setting conducive to change”–predictable, with clear expectations, roles, etc.), and relational dynamics (the inevitable “dance that occurs in any close relationship” (p. 363)).

The relationship oriented therapist pays attention to the alliance, the frame, and the dance because they do not merely talk about the client’s life but client and therapist experience life in the session and this experience enlightens, informs, and recreates patterns in the client’s life. These dynamics are commonly referred to as transference and countertransference.

While discussing alliance, frame, and dynamics are indeed therapeutic interventions (my view), McMinn and Campbell go on to discuss 4 relational interventions designed to, “provide simultaneous support and confrontation (grace and truth) designed to promote psychological growth” (p. 372).

  • Empathy. Having the capacity to experience the client’s world “as if” it were one’s own–and so communicate understanding. Why is this important? M & C say it provides, “safety necessary to keep the client’s defenses down” (p. 374).
  • Confrontation. “Gently pointing out inconsistencies or discrepancies to the client” (ibid). The authors remind the reader that individuals do not do well when they feel their whole person is being confronted. One suggestion is given to focus on the impact of one’s words or behavior more than intent (folks are much more likely to emphasize their intent and defend against impact).
  • Interpretation. “…Connecting current behavior, feelings, and images to previous ones in the client’s life….Whne clients re-create their interpersonal problems in therapy through reenactment, testing or transference, they are not aware usually of the connection between their current reactions and the coping strategies learned in childhood” (p. 376).These interpretations are not merely made to correct thinking but to be used in the counseling relationship.
  • Role behavior changes. We learn to play certain roles in life. While these roles may be adaptive or understood as part of a larger family system, they may become maladaptive later. When clients experience and understand their role rigidity, they then have the opportunity to try on new roles within the safety of therapy.

My thoughts? Notice the difference in details and concrete interventions between the treatment of automatic thought problems in domain 1 and relationship interventions here in domain 3. It’s no wonder some counselors are more attracted to “doing something” with cognitive therapy and so avoiding the vagaries of interpesonal processes. And yet, McMinn and Campbell are correct that the therapeutic relationship between therapist and client allows both to move beyond talking about problems to experiencing stuckness and healing–and so to have the opportunity to experience a different response to the self and the world. Boundary setting is an intervention and provides wonderful fodder for healing conversations. Far too many students see boundary setting as something to be done to avoid trouble rather than a primary tool for change. Second, these 4 interventions for a good start but we need much more exploration of relational healing interventions than is possible in this introductory work. One such deepening would be Marsha Linehan’s work in validation and irreverence as means to allow the “here and now” to provide feedback to the oft invalidated client.

While I am very supportive of their primary goal in this chapter I do have a couple of questions:

  • Can we really separate psychological growth and spiritual growth from each other? I think not. This makes it messy when trying to define the roles of a spiritual director and professional therapist. But, I think any role differences are somewhat artificial, based on “turf” wars. Wise and careful directors and therapists use the same frame, neither gets too far with exhorting (McMinn and Campbell call this advising), and Christians in both fields ought to submit themselves to God as well as government.
  • How does Jesus transform the world? By example? By love? By the cross? While I am thankful for their strong Christological focus for their soul care, they aren’t quite consistent in their description of Jesus’ work. They do recognize that merely looking at Jesus’ loving examples is not enough. We must see him as God in the flesh. But they also suggest on p. 351 that Jesus transforms, “the world through the power of relationship.” It seems they suggest that he transforms the world because he so moved and influenced the disciples to establish the church. Why? They consider the relationship with the apostles to be the primary reason. While we are designed for relationship, we are not healed through relationships because Jesus so influences us. No, we heal through relationships because we have been reconciled through the cross of Christ. 2 Cor. 5 16f make this very clear. So also does Romans 5. There is little mention of the cross of Christ throughout this book. Funny, the one place in this chapter where the cross appears is on p. 354 when they quote Alan Tjeltveit, “We stand in need of grace. Through the cross, grace is available to us, always.” It would be interesting to hear McMinn and Campbell discuss why they place more emphasis on Christ’s relationships and so little on the cross.

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March 26, 2008 · 3:15 pm

Integrative Psychotherapy XI: Relationship focused interventions


We’ve been following the development of the theory and application of McMinn and Campbell’s 3 tiered Integrative model of persons and change. Now, in chapter 10, we arrive at the deepest and least objective level of change that takes place in counseling: therapeutic relationships. While some problems can be dealt with through skills and behavior change and other problems can be dealt with by exploring core beliefs and schemas, there are some core or “soul” problems that are best handled by being in a healing relationship. We’ll get to what that means in a moment…

The authors begin to tackle the problem of personality disorders. They describe how we all have personality styles, how some of those styles turn into problems (unthoughtful engagements with others), and how some turn into full-blown disorders (“defined as consistent patterns of behavior, evident since childhood or adolescence, which impair social functioning and cause significant distress to self or others.” (320)).

Functionally, some people are unable to step back from their assumptions and schemas and consider alternative perspectives. Such a person experiences their life but has a hard time observing their life without being sucked into negative experiences (see inset on p. 322). The therapist’s job is to try to maintain a relationship, focusing on the here and now (the relating that is going on between the counselor and counselee) in order for the counselee to gain new experiences and thereby develop a greater capacity to step back and see self.  “The working assumption of relationship-focused IP is that relationships change people” (p. 324).

Then the authors give a little summary of key personality theory by reviewing Freud, Horney, Stack Sullivan, and family systems models regarding how interpersonal patterns develop. They conclude by saying that our interpersonal patterns, “are formed early in life as a means of reducing interpersonal anxiety, maintaining a consistent perception of self in relationship to others, and as a means of stabilizing family life” p. 331). 

McMinn and Campbell dig deeper to ask the question: how is it that these developing styles become rigidly used? How is that an early experience get “re-enacted” in adult life? They turn to 3 theories:

1. Interpersonal Process Approach. Unmet needs leads to anxiety which leads to internalizing negative feelings about the self which lead to treating others the same (ad nauseam). These interactions continue because they are familiar and they “work” for us by reducing anxiety (we can make sense of the world and they work to some degree).

2. Cyclical Maladaptive Patterns. A cycle develop that is played out in every relationship. These cycles are organized into 4 parts: acts of the self, expectations of others’ reactions, acts of others toward the self, and acts of the self toward the self (p. 335).

3. Reciprocal Role Procedures. As a person grows, they “develop more sophisticated ideas of where self ends and other begins. The growing child learns ways of relating with the other so as to maintain attachment between the I and the Thou….But each of these roles is reciprocal; that is, they are met with a response on the part of the other.”

Is there a Christian perspective on personality problems? The authors explain their take on the creation (that we are created to be in relationship) and fall (that because of our tendencies to use relationships for our own pleasures, self-deception, sins against us) we form patterns of how we see ourselves (usually victims). And finally, they briefly explore how redemption means experiencing safety and grace now in a manner to “reform faulty interpersonal patterns.”

My thoughts.Here the authors inject dynamic models of relating into the development of a mostly cognitive model–up to this point. They rightly recognize that we develop much of our sense of self in early stages of life and then cement those views in an on-going way–even when we hurt ourselves with those views. And true, we often see ourselves as victims. What is hard is to see that we are both victim AND victimizing at the same time. Unfortunately, they used up their space in the chapter in talking about how interpersonal processes can be broken without much theorizing about how and why present, positive interpersonal experiences change us and shape our constructs of self and why they change so slowly. It is somewhat easy to point out that our acting on and being acted on shapes us when we are vulnerable. But what happens in the now that enables us to open up and reconsider our identity without feeling like we lose ourselves?

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March 19, 2008 · 10:01 am

Integrative Psychotherapy X: Schema interventions for depression


In the last chapter the authors theorized about our propensity to live out of socially constructed schemas. Now in chapter 9 of Integrative Psychotherapy, McMinn and Campbell apply schema-focused interventions (domain 2–dipping beneath symptoms to core issues) to the problem of depression. But before they get to that task, they make these 2 points:

1. It’s “incorrect and potentially dangerous” (p. 278) to assume one does symptom focused interventions with anxiety problems and deeper level interventions for depression. Instead, the therapist ought to move seamlessly between them as needed. They remind the reader that their chapters are illustrations and not manuals.
2. There are useful symptom based interventions for the problem of depression that should not be overlooked: (a) medications (they explore fallacies that keep people of faith from using them and point out that meds are sometimes better than counseling alone), (b) behavioral techniques (keeping an activity schedule, assertiveness training), and (c) cognitive restructuring (keeping a dysfunctional thought and challenge record).

At this point the authors begin to illustrate their version of schema-based interventions. Unlike classic interventions (diagnosing the underlying schema and then correcting it), they describe recursive schema activation which is designed to “give clients many opportunities, session after session, to decenter [see life from another perspective] from the deep, persistent themes of their lives that can never be fully obliterated” (p. 288-9). The main difference between the IP model and the classic model is their humility in seeing schemas as understood and managed rather than corrected. Also, they desire to activate and experience schemas as much as talk about them.

The goal of this part of IP is to stand apart from one’s schema so as to see it and choose to deactivate it where it is not helpful. In the case of depression, it means standing back from “depressogenic thoughts” using mindfulness and spiritual disciplines. The client doesn’t challenge thoughts so much as he or she activates the schema in counseling over and over in a manner that allows distance and the possible formation of a new schema or identity.

Just how does this work in therapy? McMinn and Campbell suggest these strategies:

1. Taking a life history to identify re-occurring themes that might signify the presence of maladaptive schematics (e.g., long history of feeling rejected by others). In taking the history, the client not only tells but re-experiences the schema with the counselor
2. Schema inventories. They mention one in particular: www.schematherapy.com. These are used to get the client thinking about schemas that contribute to their problems.
3. Discussion of faith. The therapist explores how the client’s view of God fits in their view of self. The assumption is that a maladaptive schema likely contains distortions of the character of God. The goal is to understand at this point, not correct.
4. Moving from specific to general. Clients often describe recent painful events (and thoughts and feelings). The therapist encourages the client to explore how these thoughts and feelings fit their general conclusions in life (e.g., people always leave me).
5. Looking for themes. The counselor looks to articulate and activate themes and creates space for the client to do the same.
6. Evoking emotions. The counselor needs to move from an intellectual discussion to the emotions attache to the schema. Often-times, this means using the here-and-now to explore emotions. Otherwise clients only report on feelings in a disconnected manner. If so, they remain disconnected from the insights they gather.
7. Guided discovery (vs. just telling the client the interpretations). The authors present a good illustration  of the difference between telling and collaboration on p. 298.
8. Imagery and meditation. The goal here is to use these techniques to activate and deactivate schemas. Why? They suggest these techniques support safety (to limit overwhelming oneself). They do note that while prayer may help in schema alteration its primary purpose is to connect with God and shouldn’t be thought of as some technique apart from its main purpose.

Finally, in the last 13 pages the authors take up how recursive schema activation is a bridge-building exercise. It bridges cognitive processes (logic, analysis) and emotional and relational processes; unconscious and conscious processes; past and present; events and meanings that we give them; schema activation and deactivation. They conclude that not every person has the psychological resources to deactivate schemas once activated and point the reader to the next two chapters where relationship interventions will need to be used.

MY THOUGHTS: This is a good chapter that describes what I think is core to therapy: self-observation in a safe environment that happens as much through experience as it does through logical analysis. The reality is that our schemas shape our sense of self and the world as much as our 5 senses do. We think we merely ascertain what is happening to us but in fact we are prepping our critical thinking with assumptions. Here’s my question. Is the schema something that can be changed. I hear the authors saying that they aren’t all that optimistic about it but just maybe we can control it, decide not to listen to it. In part I agree. And yet I don’t want to underestimate just how much a person can change their outlook on life and self. Where I think the biggest challenge lies is helping clients feel safe enough to accept that they make these assumptions. In couples counseling I find many/most couples unwilling to consider the possibility that their assumptions about their no-good spouse were formed before the ever met their spouse. They come wanting to fix the marriage and part of my job is to help them see that before they can fix the marriage they need to understand how their responses tell a lot about themselves and maybe less about their spouse than they think. This is hard for counselees to accept because it sounds to them that they are responsible for their spouse’s bad behavior. Helping a client not live in all/nothing thinking is my challenge. Further, I must make sure not to fall into “telling” mode when helping someone come to this realization. Sometimes I want to speed up the process and thereby lose the client.

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March 14, 2008 · 12:06 pm

Note-taking in sessions?


Counselors have vastly differing styles of counseling. Some choose to be directive, others are remain passive even when the client wants them to give advice. We are different because of our varying theories and personalities. But I always assumed that most counselors do not take notes during sessions unless needing to record very specific details (say taking a family genogram or collecting details for a psychological report). But after having conversations in several different locations I learn that many write during the session. They write down key client phrases and other things that they wish to come back to and explore at a later date.

I’m curious about your experiences–either as a counselor or counselee. Was there note-taking going on during the session and was it helpful (for both)? Did it cause problems?

I don’t take notes in session so that I can stay engaged in good dialogue with my clientele. I don’t want to miss subtle details and I don’t want to break up the work by taking a note. It seems to me that if I take a note during the session, the client waits for me to do so and then they move out of an experience to only describing an experience–and so distance themselves from their feelings and thus any insight or intervention is also distant.

What do you think?

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