Category Archives: counseling

February 12, 2009 · 9:44 am

Persisting Conflict: Breaking the cycle


As you can imagine, most people I see in counseling settings have a conflict with someone in their life that doesn’t seem to resolve. The problem comes up again and again. Change the scenario, but the dialogue remains the same. Someone shuts down, someone presses hard, someone brings up the past, someone changes the subject, someone seems to agree at first but then later reverses their position. You get the picture.

There are many reasons why we fall into this kind of pattern. But, one comes to mind as a common reason: We want to be heard and we don’t feel like we are being heard so we keep doing things in order to be heard (silence, many words, loud words, etc.). The end result is both parties feel unheard and generally unwilling to really “hear” the other for fear their concerns will be ignored.

One way I try to break the cycle is to draw 2 intersecting roads. In most conflict, we are going different directions and we want the other to come with us. And when we consider going with the other down their road, it feels as if our road (concerns, desires) will be left far behind.

In order to break the cycle we have to stay in the intersection, without demanding that we go down either road. The intersection means that both of our concerns and interests are being considered. We stay there to hear without leaving. We fight the anxiety that staying there means giving up. It doesn’t. The intersection is to be a safe place (okay, in real life hanging out in an intersection probably isn’t the smartest thing).

When conflicting parties agree to hang out in the intersection, I find that most of the anxiety and fears of rejection or neglect subside. And frequently, parties agree that the concerns of both are legitimate. And just maybe they can find another road that they both can travel in safety.

What word pictures do you find helpful when confronting persisting conflict?

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Filed under christian counseling, christian psychology, conflicts, counseling, Relationships

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February 4, 2009 · 5:37 am

Try your hand at diagnosing clients…


Ever wondered if your counselor really knows what is in the Diagnostic & Statistical Manual (DSM, ver. 4TR)? Or do they just do the flip and dip method (let the large book open to any page and blindly point to a spot on the page)? Let’s hope not. Well, some professors are trying to increase the accuracy of their students via video vignettes.

One such person, Dr. Aaron Rochlen of U. Texas, has a website with 5 video vignettes available on his website (http://www.edb.utexas.edu/psychopathologypractice/index2.html) for students to watch and then try their hand at giving a DSM diagnosis.

Warning. Site is free. There are no answers given so don’t bother submitting your diagnostic considerations as they won’t go anywhere unless you send them to someone. Second warning: At least one of the “clients” uses some curse words.

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Filed under counseling, counseling science, counseling skills, Psychology, teaching counseling

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February 3, 2009 · 11:31 am

Improving Case Conceptualization?


For my counselor readers: What books or other helps have you encountered that improved your ability to conceptualize cases?

When we teach counseling skills we do the following (we do more than this but this is the general trajectory):

  1. Build basic helping/counseling skills (if you can’t connect with a person and build a trusting relationship, any knowledge you might have will be useless!)
  2. Expose students to a wide variety of problems (so they can understand and describe common problems in living or common pathologies–even if they are not sure of the causes of these problems)
  3. Explore human growth and development from a descriptive and biblical viewpoint (this at the same time as #2 so that they learn about common problems  and sufferings as well as what healthy and Godward lives look like in a fallen world)
  4. Teach case conceptualization (marrying client information (e.g., background info, presenting problems, attempts to solve the problems, etc.) with theoretical understanding of the person/problem/desired outcome.
  5. Build intervention repertoire during fieldwork.

#4 is the hardest, especially in a generalist program that doesn’t spend a great deal of time on theoretical models (we teach models as part of every course and our model of Christian psychology (biblical anthropology along with process oriented model) isn’t as defined as the old models (e.g., Rogers, Freud, etc.).

If you were teaching counseling to practicum students who needed help with conceptualizing cases, what resources would you turn to?

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Filed under biblical counseling, christian counseling, christian psychology, counseling, counseling science, counseling skills, Psychology, teaching counseling

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January 19, 2009 · 5:32 am

Things that scare counselors…


There are certain things that scare counselors. Some things are real, others are mere fantasies. Some are big scares others are smaller ones. When I teach ethics and we talk about liability, the tension in the room increases. When I teach about suicidal clients and the need for a proper response, the tension increases.

What do I fear? Not remembering a client’s name when I run into them in the public. I don’t think that has ever happened but I fear it nonetheless. More real is the fear of doublebooking, of walking into the waiting room and seeing two clients there for the same time. Now, that has happened to me and sometimes it has been my own fault. Even when it isn’t my fault, my stomach does a flipflop.

But now I have a new experience…being approached by a US gov’t official who flashes a badge and requests to speak to me in private about a matter. I had the feeling that one gets when the police car behind you starts flashing their lights. What did I do? Am I in trouble?

It turned out well however. After verifying his credentials and the release of information in hand, I learned a friend of mine was seeking national security clearances for his job. A couple of questions and the officer was on his way. Pheww…I’m not in trouble.

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Filed under Anxiety, counseling, counseling and the law, ethics

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January 15, 2009 · 5:16 am

Some critical thoughts about Biblical Counseling


For those reading this site interested in christian counseling and more specifically, biblical counseling, I have a quote below for you to muse about. I’d like to hear your reactions to the author. Is he right? If not, what is wrong with his critique of the biblical counseling movement or wrong with his insistence on producing evidence of the effectiveness of biblical counseling?

The quote comes from the website www.christiancounseling.com (The Association of Biblical Counselors) which publishes an ejournal for paying subscribers. On occasion they publish interviews with those outside (but friendly with) biblical counseling. Some of their interviewees, like myself (November issue) have a foot in their world but also one in the professional world. FYI, there are more and more of us who reject the necessity of separating clinical care from biblical care but do not believe the integrative attempts of the past were all that useful either.

In September they interviewed a Dr. Stephen Farra, professor at Columbia International University and director of their psychology or counseling program. You can find him and his writings at www.ciu.edu/faculty/bio.php?id=12. He has one work there on his model of counseling called Accountability Psychology, a biblically based CBT model.

After lauding the biblical counseling movement for its deconstructive work of then accepted notions of christian and secular counseling, he says, 

…the biblical counseling movement has been better at critique than positive creation, however. Whenever I seek for an answer as to whether Biblical Counseling has developed clinically powerful counseling methods to help meet the needs of most of those suffering from severe psychological disorders, all I find are a few anecdotal accounts of counselor-reported recoveries for a few individuals… To “get it right,” we do need to move from “integration” to biblical consistency, but we must also move from anecdote to evidence. The Biblical Counseling movement needs to squarely face up to its need to provide solid, empirical evidence of effectiveness and efficiency. Without a solid evidence-based, “best practices” approach, Biblical Counseling will continue to be seen by most Christian counselors in the country as primarily a theological-critique society, making some interesting and valuable points along the way, but without practical means for helping many of the suffering souls who come to us seeking help.

Theological consistency and doctrinal purity is vital, but it is half the battle. The other half is showing that the recommended procedures really work for most people suffering with particular disorders.

Well, what do you think? I’m not looking for anyone to trumpet the superiority of biblical counseling or trash it. In fact, I think biblical counseling has one of the best understandings of biblical anthropology out there. But, should it seek empirical evidence for its methods? While empiricism isn’t the only means of truth, it does tell us something. How would one test the effectiveness of biblical counseling? That all would depend on the outcomes sought–which raises a good question: Does biblical counseling seek to reduce anxiety and depression or sinful or immature responses to it? Is it primarily discipleship or is it counseling to reduce the experiences of what has been commonly known as mental illness?

Good questions to mull over.

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Filed under biblical counseling, christian counseling, christian psychology, Christianity, counseling

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January 7, 2009 · 4:49 am

Psychology for the (Christian) Masses


So, the other night I had woke up with thistitle in my head that I couldn’t get it out of my mind. Its an academic’s kind of dream/wake state–a book idea. I wondering if you have ideas to flesh this out a bit after reading some of mine.

The title came, I think, as a result of a Miroslav Volf’s comment that consumerism, not religion, was the opiate of the people. Lightbearer provided us with the context of Karl Marx’s quote. And many of summarize his point but saying that something (religion, psychology, anything) is for “the masses.”

So, I got to thinking about the tendency among evangelicals to fall into one of two trap about psychology. Either they use it unthinkingly (cut and paste bible verses on theories without much thought) OR they reject it because psychology is unbiblical and only rank secular humanism. But, I can’t tell you the amount of conversations I’ve had about the benefits of psychological study–whether about medication, therapeutic interventions, professional ethics, etc. where it was clear that few had ever drilled down below pop psychology to understand both its value and presuppositional foundation.

So, here’s my thought. What if we developed a resource for Christians to come to that would give thoughtful, sometimes lighthearted, but always honest answers (and nonanswers when they are better) about psychology, psychotherapy, medications, psychological testing, etc.

Here’s some of the questions that tend to come up most frequently (from my memory of the last 2 months)

1. Is it wrong to take psychiatric medications for my depression? Shouldn’t I be able to either handle it or get over it using spiritual resources?

2. How do you know if the problem is demonic or psychiatric?

3. Should I ever go see a secular therapist?

4. Isn’t Mindfulness really just a Buddhist form of meditation?

5. Should I go for healing prayer for my mental health problem?

6. Isn’t ADD/ADHD just a fad?

7. Can I divorce my spouse because they refuse treatment?

8. Can pedophiles ever return to the church in a safe manner?

9. Can leaders who abuse their roles ever be restored to leadership?

I’m sure there are more. What else would YOU want to read about regarding psychology/psychotherapy from a christian perspective?   

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Filed under biblical counseling, christian counseling, christian psychology, Christianity, counseling, counseling science

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November 25, 2008 · 5:34 am

How to pick a seminary?


Of course the right answer is: “Biblical Seminary is the ONLY seminary where you’ll get the best masters in counseling education.”

But in case you’d like a little more depth and breadth in answer the question about whether seminary is right for you, Derek Cooper has a new book: So You’re Thinking About Going to Seminary (2008, Brazos). Derek came by this wisdom by attending several seminaries and so if you want a good feel for what seminary is like and how you can decide if it is for you, you ought to buy the book.

In it he orients readers to what seminary is and isn’t, the kind that is attached to universities and the free-standing kind. That would probably have helped my wife back when she showed up for summer Greek, about a year after becoming a Christian. When she first heard about seminary, she assumed it was a place only for priests.

Cooper also helps the reader to consider the value and benefits of non-denominational versus denominational seminaries, the kinds of degrees available as well as potential jobs with each degree. Even better, he helps the newbie think through the kinds of courses likely to be taken in  some of these degree courses. What I like is that he gives numerous school examples so that by the end of the book, the reader has truly been exposed to the best of theological education in the United States and Canada.

The middle section of the book helps the seminarian find ways to finance, survive, even flourish during grad studies. Yes, you don’t have to lose your faith or your marriage if you go to seminary. But don’t assume your studies alone will promote spiritual growth.

He has one chapter that covers matters of ordination and licensure. If you are considering becoming a licensed counselor AND you are thinking (rightly) that seminary is a great place to do that, be sure to read his admonition to check with your licensing body (State or Province) to see what THEY require and do not assume that the school automatically covers every required course.

My only negative is that he didn’t say on every page that BIBLICAL SEMINARY (www.biblical.edu) is by far the BEST school in the world. But then, if he did, that would make us look bad since he would be lying. But, if you do want to hear Derek in the flesh, join our counseling program and take his “Counseling and the Biblical Text” course since he adjuncts for us.

I’ve asked Derek a few questions and so tomorrow, I’ll post his answers. Really, this is a good book if you are considering a ministry career and wonder if Seminary is necessary and what it is all about. And if you are the “cut to the chase” kind of reader, he has really good summaries and charts to help you make your decision.

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Filed under Biblical Seminary, book reviews, counseling, Doctrine/Theology, writing

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November 18, 2008 · 5:43 am

CCEF recap: David Powlison’s “Escape to Reality”


Sunday morning, David Powlison gave a plenary talk entitled, “Escape to Reality.” He used 1 Corinthians 10:13-14 as his launch text. It was vintage David, chalk full of many examples of both soft and hard addictions. One could easily take his 10 points (which I don’t have exactly because I was sitting with my son who was lounging across me) and turn them into a 10 week bible study or SS class. As I remember them, he made the following points about the path back to reality:

1. Wake up (to see God, self, and other)
2. Own up (without excuse)
3. Stop the Death spiral (sin, guilt, and shame all tempt us inward. But we see in Christ, someone who is able to stay connected to God and other on the Cross even with the pain)
4. Connect to others (We need others to talk to so that we hear ourselves and get good feedback) SO, ask for help!
5. Ask for forgiveness (and none of that, “If I hurt you…” kind of half hearted repentance)
6. Forgive those who have hurt you
7. Rethink the problem of pain (pain shouldn’t be ignored or used as excuse)
8. Rethink the problem of pleasure (we vacillate between workaholism and overindulging in pleasure. We are made for pleasure but within bounds)
9. Re-evaluate the struggle. When someone shows signs of stopping addictive behaviors. Maybe they only go into a rage 3 times in a week instead of 12. That’s something to celebrate. But of course the struggle continues and there’s more to repent.

Um, I’m missing the tenth. Someone there remember what it was?

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Filed under addiction, biblical counseling, Biblical Reflection, counseling, Forgiveness

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November 11, 2008 · 5:29 am

The addict in us all


Later this week, CCEF will hold their annual teaching conference in Valley Forge, PA. The theme this year is addictions. I have the pleasure of teaching on Friday along with their faculty/staff. Also teaching are Diane Langberg, John Freeman, Leslie Vernick and guest appearances by Mark Driscoll and music by the Gettys. Will have my slides up here after the conference. I will be outlining two main techniques useful in the early stages of counseling those struggling with addictions.

Should be a fun time. If you come, stop by the Biblical Seminary table to chat…

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Filed under addiction, biblical counseling, christian counseling, christian psychology, counseling, counseling skills, Ed Welch, Psychology

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October 8, 2008 · 5:01 am

Comfort is in the eye of the beholder


When you read the lament Psalms are you comforted? Do you feel God’s care for your plight? Over the years I’ve had a number of conversations about this topic. Some find great comfort in reading about God’s concern for his people in the midst of their suffering. Others prefer to hang out in more positive, praise oriented passages in order to meditate on the good things God is doing. Some find more comfort in realism now, others find comfort in expectantly meditating on heaven.

How about you? How about those you might try to comfort in their time of misery? Does empathizing with the depths of trouble being faced (e.g., “Wow, what you are going through is incredibly hard!”) help or does it endanger more depressing thoughts? Does talking of ultimate delivery in heaven help or distance you from your friend? It is key for us to find out as we walk with those going through the valley.

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Filed under biblical counseling, Biblical Reflection, christian counseling, christian psychology, Christianity, Christianity: Leaders and Leadership, counseling, suffering, teaching counseling

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