My weekend course on Counseling individuals with Borderline Personality Disorder begins this Friday night (6 pm) at Biblical Seminary. Class meets 3 hours on Friday and then from 9 to 5 on Saturday. It is not too late to sign up for CEs. If you are LPC and in need of a bunch of continuing education, these will count towards your requirements.
Check out this page for more information on CEs at Biblical and how to register.
5 years ago a friend of mine asked if I wanted some purple cone flowers for my flower garden around my house. 
Having admired them in other gardens, I said yes and promptly planted them in a spot next to some other flowers. Turns out they were Brown Eyed Susans, a relative of the intended flower. And, further, they spread terribly. I enjoyed them the first summer but began ripping them out the next year as they spread through the iris and choked out some other plantings.
Now, some five years later, I am still pulling these plants. They grow and spread quickly. I never let them flower but pull them as soon as I can make sure I get them and not another plan that might be right in the same spot. When I pull them I know that some little root fiber remains and so I’ll be back pulling again in a week or so.
The truth is I will never be free from these plantings. I do have some choices:
I find this is much like our persistent life problems. Whether by naive choice or by something beyond our control, we develop persistent struggles with things like anxiety, depression, addictions, relational challenges, etc. While God sometimes provide miraculous removal of these struggles, we rarely find complete freedom from these kinds of struggles. We may not be in crisis mode forever, but total relaxation and assumption of no return of the problem is rare also.
So, we too have some choices:
Does this illustration work for you?
Filed under addiction, Anxiety, christian counseling, christian psychology, Christianity, counseling, Depression
What is similar and different counselors and beauty queens? Well, we both want to end human suffering and seek world peace BUT the counselor no longer talks as if it is possible in this life. We know that sitting in suffering is, in fact, an important act in this life.
So, for all you counselor types out there, I have a theology book for you. Currently, I am reading Suffering and the Goodness of God, edited by Christopher Morgan and Robert Peterson (Crossway, 2008).
Not all theology books are stuffy. Really. This one is very readable and helpful. Chapter one (Robert Yarbrough) lists 11 theses about suffering. I will not repeat them all here but each one is illustrated from Scripture and personal experience. Here is a taste:
1. Suffering is neither good nor completely explicable
2. Suffering in itself is no validation of religious truth
3. Accounting for suffering is forced upon us by our times
4. Suffering may be a stumbling block to Gospel reception
5. Suffering Creates teachable moments for Gospel reception (though this does not make suffering, in itself, good)
7. Suffering is the price of much fruitful ministry
10. Suffering unites us with other sinners we seek to serve
Lest you think this book takes a happy view of suffering, consider this quote:
It is certainly true that it is primarily God himself who in his redemptive activity has “caused us to be born again to a living hope through the resurrection of Jesus Christ from the dead” (1 Pet. 1:3). But this new birth does not take place in a vacuum. Rather it unfolds amidst earthly life, which is manifestly to some extent a vale of tears.
We sometimes wish to talk about “new birth” and redemption as if our suffering does not continue in this life.
The rest of the book addresses OT and NT interactions with suffering, the problem of evil and oppression and two chapters written by theologians about their own personal suffering. A good read if you realize you cannot ignore suffering or go back to some prior period of naiveté.
Brad Hambrick, a counselor in Georgia, has written an article exploring whether or not pornography use might provide grounds for divorce. It is a worthy read. His final answer is a qualified no but includes a lot of other helpful thoughts about the experience and what repentance ought to look like. Too often we get caught up in a yes/no focus to this question and miss significant issues. Seems there are several questions that need to be answered,
1. Is porn use a form of adultery given Jesus’ equating lust and adultery?
2. Does failure to repent or repetitive acts such porn use destroy the covenant so that it is impossible to live at peace with a spouse? In this case, the question is less about porn and more about refusal to honor a covenant. David Instone-Brewer writes about this from a NT perspective on the OT. I blogged about his thoughts some time ago and you can search “divorce” on this blog and find multiple entries. Instead of divorce, we could insert repetitive gambling away family income, repetitive risky behaviors.
3. What would be evidence of repentance? Does any relapse equate to total failure? How many relapses equal refusal to repent?
Rather than just focus on the “big” question, it might be helpful to ask more immediate concerns. Does the porn user agree to utter transparency? Are they demanding something in return for their abstinence? Are they still trying to control their treatment?
For those who follow the link, I’d be curious your response. Read it from a user’s perspective and also of the victim spouse.
Check out this video of Julie Lowe showing off (in a good way!) her counseling office designed for counseling kids. Julie is at CCEF and an adjunct at Biblical Seminary. She is a Licensed Professional Counselor (LPC) and trained in play therapy. Here’s the link. [Link was broken, now fixed]
My school, Biblical Seminary, has a variety of summer classes, from on-site intensives to weekend only to totally on-line. Click the link if you are trying to figure out what enrichment you will pursue this summer. The page that pops up will list both classes and free events. Those of you looking for counseling CEUs may be able to get credit too!
Finishing up the Ethics course in the next week. There are two kinds of ethical errors in counseling: conscious violations of ethical practice and blunders.
Forrest Gump’s quotable line, “Stupid is as stupid does,” is ringing in my head as I write this post. We do stupid stuff–stupid as in without thinking. Most of our blunders are just that–things we never intended but did absent forethought. Example? Oh, I don’t know, like walking through a dark room while talking on a cell phone and resulting in a face plant over an unseen chair. That kind of thing…and the real reason why I’m hearing Gump in my head.
We all go through parts of our life in unthinking auto-pilot. Consider the equivalent in counseling: Starting a first session but forgetting to cover informed consent because you are focused on helping the person in front of you. Or, handing out personal contact information because the client asked nicely (but never considering ulterior motives). Or, calling back a spouse of one of your clients and discussing issues but failing to remember you do not have a release to speak to them. These are some of the unthinking blunders we may make.
Are there root causes to blunders? Try on some of these:
1. Naiveté. Taking the comments of others without considering context or motives. I am not suggesting that good counselors need to be suspicious. Rather, we need to be realistic, critical thinkers who employ wisdom. We need to consider motives, consequences, impact, etc. We need to think beyond the immediate moment.
2. Reactivity. Some of us are just more reactive or instinctive driven. This may be personality driven. However, it may also indicate that we are being driven by unexamined desires (e.g., “I want this person to like me”; “I want to defend myself from an accusation”).
3. Over-confidence. Sometimes our blunders come from overconfidence. We’ve all heard the evidence that talking on the cell phone while driving raises our risks of having an accident. But most of us do it anyway. Why? We don’t think or perceive ourselves as compromised. We consider ourselves better than the rest. Sometimes, blunders in counseling come from an unsupported confidence in self–I will act right because I am an ethical person. When we are overconfident we have placed our trust in something that may be good but not right in a particular situation.
4. Fear. Yes, fear. It can lock us up causing us to stop using our training and intellectual capacity. This is the counseling version of driving right into the thing you were trying to avoid. Fear paralyzes.
5. Group think. Group think happens when we stop asking questions and as a whole foreclose on other hypotheses. An agency may create this problem by how it manages staff meetings, supervision. As a group we may become comfortable with an ethical breach in such a way that it becomes normal–unseen.
Can you think of other root causes of unthinking ethical blunders?
[note: I found this document in my Ethics course files. I think I wrote this some time ago…but I don’t remember. It is possible that I received a WORD document with this in it from someone else. If so, I apologize for posting without acknowledging the source. Ah, the joys of aging.]
Professional counseling is founded on the assumption of the patient/practitioner relationship. The practitioner/expert provides a needed and appropriate service and the patient pays a reasonable fee—or their insurance company does for them. However, the extremely personal nature of counseling work often creates strong feelings between client and therapist and consequently the client may wish to bring a token gift signifying their thankfulness for a job well done.
Gifts beyond the token category provide therapists with “gain” and likely disrupt the fee/service relationship mentioned in the previous paragraph. While gain may not cause actual harm and may be unavoidable, the wise counselor remains aware of possible sources of gain and their consequences.
Consider the following examples and check whether you think they may be problematic:
Should the counselor in any of these scenarios accept the tickets? Does the cost of the gift or the wealth of the person giving a gift matter? Would it change your answer if the gift were a week’s stay at a beach house? Does it matter if the student is currently in a class with the teacher or not?
Gifts are a form of gain. Others may come in other forms of benefit for the counselor. If the counselee owns a publishing company, should the counselor accept an offer to have him or her publish his next book? If the counselor has a non-profit ministry, should he or she accept client gifts to that ministry? If a client offers to sit for a testimonial ad for the counselor’s new technique, should the counselor accept?
Gifts, though, represent expressions of thankfulness and thus a policy of rejecting all gifts may bring harm to the counseling relationship.
Wise Counselors explore with their clients any possibilities of gain and their potential consequences. Counselors consider how gains may harm the client or create an indebtedness that in the future clouds clinical judgment. For example, counselors do not accept gifts or fee sharing from treatment facilities in return for referrals. On the other hand, a cup of coffee brought to the session likely is just a cup of coffee, a friendly gesture. Christmas cookies are a small but personal thank you for a job well done. But, don’t assume that small gifts can not produce a quid pro quo (this for that) interaction. So, back to our first line in this paragraph. Take the time to explore the meaning of an offered gift and be willing to talk about it with clients.
Filed under christian counseling, christian psychology, counseling, counseling skills, ethics
I was sent a new book to review (which I am not planning to do). Since it has to do with pastoral ministry to couples involved in a particular sexual crisis I thought I’d give it the 5 minute skim. In doing so I got a great image: The warden in the relationship. This is the person who was wronged in some terrible way and is now the warden who determines the accountability of the offending party.
When one has broken trust and is now trying to regain that trust, they must become entirely transparent. Their can be no hint of deceit, no unaccountability in any area of life. Not only must the person allow for accountability but they must show evidence they actually desire it and do not chafe at their limitations in life. But what of the other partner? The author says this:
It is not OK for one, considered to be the initial perpetrator, to live totally accountable in his life of genuine repentance, while the other partner never moves off being the warden of the relationship.
How does one fall into this position? The author says “just going with the flow of feelings about the injustice and harmfulness of things is all that is necessary to become the warden, and to never really forgive.” This, I must say, is in the larger context where he also says forgiveness does not require trusting the other or repatriating the other.
In much of Christian counseling, wardens get a raw deal. It is so obvious that they are demanding of a standard of perfectionism, judgmental, unwilling to be vulnerable, etc. It is easy to see this and to go after the hardness of heart that is evident in the warden while accepting the “repentance” of the offender at face value.
It is true that the warden must relinquish the position of judge if the relationship is going to survive long-term in any healthy manner. This does not mean the person stops taking stock of the offender’s actions and attitudes. Nor does it mean that they can forego self-examination.
Here’s my questions:
Ever felt that a 10 minute session every day might be more beneficial than a 1 hour session once a week? While a short session cannot dig very deep, it can keep a person on track. One of the frustrating things about counseling is the fact that a client may leave with direction and clarity only to return 7 to 21 days later with confusion. What seems clear in the office becomes foggy in real life. It isn’t that much different from learning a language or algebraic formulations. You think you have it then you try to apply it to a novel situation and you realize you don’t have it quite down.
The phone call session should be short, directed at problem-solving, remembering a previously learned solution, or improving hope and motivation to continue some difficult task. Consider this for marital discord. So easily conflicted couples stay cold and distant between episodes of conflict. Short sessions may help them remember to soften each day and be more inviting of non-conflict interactions.
There is some support for this kind of interaction, though not in therapy literature. The support comes from addiction quitlines. Those who call in and gain support are more likely to remain abstinent than those who try to do it on their own. Sadly, insurance companies do not support this kind of interaction (they do not cover phone sessions). They should, it would likely save money in the long run.
Musings on Faith and Psychology 