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Practicum and Ethics Monday: Deficient Trainees


Since both of these classes are in progress here at Biblical, I thought I’d bring up a rather touchy subject: impaired students. Ruth Palmer, Gwen White, and Walter Chung (a Biblical grad!) all of Eastern University have recently published an article in the Journal of Psychology and Christianity(2007, 27:1, 30-40) entitled, “Deficient Trainees: Gatekeeping in Christian Practitioner Programs.”

Palmer et al surveyed profs in master’s level counseling related departments at Christian colleges and universities to find out, 1. what percentages of students were perceived by the profs to be professionally deficient, to have received help or dismissal. 2. Whether or not the schools have formal gatekeeping procedures. 3. Whether senior level faculty and junior level faculty perceive the pressures of dealing with impaired students differently, and in part, 4. Whether views on grace, calling, and gifting have any effect on how faculty respond to deficient students.  Their study replicates one done on secular campuses.

Before I mention the results, it would be good to consider why this is important.

1. Because faculty are obligated to protect the public. The authors quote from the ACA code of ethics, “Counselor educators, throughout on-going evaluation and appraisal, are aware of and address the inability of some students to achieve counseling competencies” (ACA, 2005, Section F.9.b) (p. 31). This is a relatively new topic amongst programs. Previously, we merely taught our students but it was up to licensing boards to weed out incompetency. Not so any longer. And rightly so is this change. We have an obligation to remediate problems before sending folks to their fieldwork sites. When we bless a student with an internship, we are saying they are ready to work at an entry level. When we find students with significant relational, behavioral, motivational problems prior to graduation, the authors remind us that the data are “strongly linked to subsequent poor performance in clinical work. (p. 31)

2. Counseling programs tend to attract people who are working out their problems. In fact, the authors point to a study that reported first year counseling students showing more severity of problems on MMPI scales. (This may be partially explained away by the common tendency of students to think they have all the disorders of the DSM). While this isn’t necessarily a bad thing (could mean that students are more likely to be cognizant and empathetic to the trials of life), it becomes a problem when said students are either unaware of the extent of the problems, unwilling to work on these problems, or so overwhelmed in the moment as to not have the capacities to deal properly with the problem. I find most students very committed to personal growth and change. There are those, however, who are so desirous of the prestige of the position or of looking good that they cannot bear to admit their flaws. The authors point out the crux of the problem. “…there is a tendency of impaired students to resist submitting to ‘the very therapeutic process through which they wish to lead others,’… (p. 31)

3. Finally, turning a blind eye to student problems and/or mismatch in skill/profession/calling is akin to walking around the man and left to die on the side of the Jericho road (Luke 10).

Results of the study? The authors got responses only from 1/3 of the surveyed professors (the surveyees should be ashamed at their lack of cooperation with this important study! They ought to know better having all been through programs that value the research question). But from respondents they found,

  • Faculty of CCCU estimate an avg. of 10.9% of impaired students in their program (SD=9.89; I would have liked to see the modal response since the range was from 0% to 50%!! reported). This fits with the prior secular program survey.
  • Interventions with these impaired students only happens about 50% of the time (again a big SD with response rates ranging from 0% – 100% (yeah, right!)). 38% of faculty reported interventions less than 20% of the time.
  • What are some of the bigger reasons for not addressing these matters formally? Fears of lawsuits, institutional pressures (we need students to survive!), fear of poor teaching evals by junior faculty, and inadequate administrative support.
  • They suggest the need to have departments talk regularly about policies, students, and the need to follow-up with potential or actual problems.

Do we ever have impaired students at Biblical? Of course. But I am determined at dept chair to help those in need find help. I remember being a student at another seminary and seeing those that EVERYBODY knew should never be a pastor or a counselor and yet NOBODY (student or teacher) said a word. So, we have 6, 12, and 18 month evals collecting data from the student, profs of each class, peers, mentors, and supervisors to help catch a remediate problems when they exist and to encourage on-going personal growth even when they don’t exist. It still surprises me when I find counseling students balking about getting some of their own counseling. We really do want to be the one who has it together, don’t we. Me included.

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Overheard at Sandy Cove


In our discussion about race and implicit oppression:

If you manipulate history, you manipulate consciousness. If you manipulate consciousness, you manipulate possibilities. If you manipulate possibilities, you manipulate power.

Seems about right. When we tell a history in a particular way, we can change how we think about ourselves (we’re pretty good, right?) and change how what possibilities we consider and ultimately the power. We talked about this especially when white folk ignore or deny the Blackness of biblical figures.

Also overheard here at our faculty retreat: “That’s going to hurt. Us 40-50 somethings have played basketball both nights. We’re not a particularly in shape group and so we can feel the creaks and the pains a comin.

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Things heard at Sandy Cove


Yesterday, we dwelt on Acts 15 and the story of the Jerusalem Council. Notice that even though the Gentiles had evidence of the Spirit, some considered them unsaved due to the lack of circumcision. We wondered what we burdens we place on others that are not Gospel burdens. We also noted that the solution was to not overburden Gentiles in their turning to Christ and not to so disturb the Jews in the area of idol worship (meat sacrificed to idols).

In our discussion of race in America, our speaker suggested that 11 am on Sunday morning is NOT the most segregated hour. But, the 6 pm news hour is just that (given the sense that black crime is the only kind of crime happening.

More later.

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Retreating to the bay


The Biblical faculty are spending the next 3 days at Sandy Cove in MD for a retreat to discuss where we’ve been and where we’re going. Of particular focus is the next steps in racial reconciliation and how our curriculum will continue to change. Should be good. That said, I’ll probably not have much here until Friday as I hope to spend some time walking on the shore.

Sandy Cove Ministries

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APA says sexual orientation isn’t biological but from yet to be determined factors


Last week I commented on sexual identity formation in little kids. It spawned a large number of comments, both on and off topic. Hesitantly, I will make another post on the topic of sexual identity–this time from a brochure published by my own clinical association.

The American Psychological Association (APA) has a pamphlet on sexual orientation and homosexuality designed to aid understanding and reduce prejudice. My friend, John Freeman, gave me this to me and pointed out an interesting line which we’ll look at in a moment. But first, let me summarize the pamphlet

Sexual orientation, according to the APA is

“an enduring pattern of emotional, romantic, and/or sexual attractions to men, women, or both sexes. Sexual orientation also refers to a person’s sense of identity based on those attractions, related behaviors, and membership in a community of others who share those attractions.”

Right away it is clear they don’t really distinguish between attraction and identity and orientation and identity. You see the simple equation: attraction=orientation/identity. This is where Yarhouse’s studies with individuals within a gay affirming church give ample concrete evidence that such an equation is simplistic and mischaracterizes a set of complex issues. The reality is that one may recognize an attractional pull without it forming a private or public identity.

The APA document continues with the following,

“According to current scientific and professional understanding, the core attractions that form the basis for adult sexual orientation typically emerge between middle childhood and early adolescence.”

Again we see the attractions = orientation. This fits with the popular identity development theory that one moves from discomfort with to pride in attractions and accepts orientation as a given. Interpretive assumptions are given short shrift here.

Now to the good stuff. The brochure asks the question: What causes a person to have a particular sexual orientation? And here is their answer,

There is no consensus among scientists about the exact reasons that an individual develops a heterosexual, bisexual, gay, or lesbian orientation. Although much research has examined the possible genetic, hormonal, developmental, social, and cultural influences on sexual orientation, no findings have emerged that permit scientist to conclude that sexual orientation is determined by any particular factor or factors. Many think that nature and nurture both play complex roles; most people experience little or no sense of choice about their sexual orientation.

This is an interesting paragraph. The APA rightly recognizes that no one factor is likely to determine later orientation. In fact, we’re not really at a point where we can say one factor is X% of the equation. There is no equation yet. It doesn’t mean we won’t have a better sense of it in the future, but as of yet, the problem is not merely a biological process. So, this opens the door to choice and manipulation of one’s orientation unless one subscribes to behavioral naturalism–something most of us would not accept in other areas of life. Obviously no one is suggesting that sexual orientation is as transitory as a passing fancy. And yet the APA recognizes that even when folks don’t experience themselves choosing orientation, there is an interpretative and choice element however subtle and slow the process.

At this point the brochure turns to the problem of discrimination and its impact on gay and lesbian people. No matter your beliefs about homosexuality, you ought to recognize that there is great stigma and mistreatment for those so identified (and also for those who may not fit stereotyped roles but do not have a gay identity). Then the brochure covers the question of mental disorder. 

Is homosexuality a mental health disorder? No says the APA and I agree based on the definition of mental illness where it has to cause distress. Not all with a gay identity are distressed, period. This really isn’t the issue.

The brochure goes on but I will mention only one last section. They discuss the validity of therapy intended to change orientation. They state there is, “no scientifically adequate research to show that therapy aimed at changing sexual orientation is safe or effective.” First, this sentence is full of highly charged words whose meaning can be debated: adequate…safe…effective. What constitutes adequate? Safe? Effective? There is some data that is not merely anecdotal suggesting that change is possible and not unsafe (see Yarhouse and Jones’ Ex-Gays(IVP). Now, their data isn’t as strong as it could be, isn’t overwhelmingly positive, but neither can it be denied as an anecdote. On the flip side, there isn’t any adequately scientific data suggestive that change therapies are unsafe and ineffective. Both sides of the research agenda have the same set of weaknesses that one would expect in researching this particular population (i.e., convenience samples).

I agree with the APA that we therapist must respect and person’s right to self-determination. But the APA violates this very principle by disrespecting those who have carefully thought about change. It is a paternalistic stretch to say that every person who wishes to change orientation only does so because of biases or because of a fundamentalist upbringing. The APA wants to be sensitive to a client’s “race, culture, ethnicity, age, gender, gender identity, sexual orientation, religion…” as long as their religion doesn’t guide them to see sexuality in a different light.

All in all, the APA takes a complex set of factors and ends up with, “It just is, so be nice!” I’m all for reducing mistreatment and violations of constitutional rights. But, I expect my scientific organization to spend my dues in a more balanced manner–faithfully representing what is true, whether attractive or not.  

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Divorce & Remarriage III: God as divorcee


In chapter 3 of David Instone-Brewer’s, Divorce and Remarriage in the church (IVP), we find that adultery in the OT results in either literal death or death of the marriage. But do other things also end marriage (abuse, neglect, cruelty)?  Why, I-B asks, “wouldn’t God allow divorce in these situations?”

The author argues that God DOES have other grounds for divorce:

Consider Ex 21:10-11. This text suggests to the author that God makes provision for a woman to be free from the marriage if her husband marries a second wife and fails to provide food, clothes and sex for the first. Instone-Brewer makes the important point that this is considered “case law” and not a statute. 

“Case law is a collection of decisions made by judges in actual cases that established a new legal principle. These rulings can be applied to other cases that share something in common with the case that established the principle….[this passage] is case law, so we ignore the details about slavery and polygamy and look for the principles that apply to all marriages that involve neglect. The rabbis found the following principles in this text, and I think they were right. They reasoned that if a slave wife had the right to divorce a husband who neglected to supply food, clothing and conjugal love, then a free wife would certainly also have this right. And they argued that if one of two wives had this right, so did an only wife.” (p. 36) 

So, I-B argues that there are 4 total grounds for divorce in the OT: neglecting food, clothing, sex, AND adultery. He reports that these 4 obligations are found in Jewish vows. He does admit that in the rabbinical literature, men could not be divorced for adultery since they could choose to have a second wife. And her reminds the reader that Jesus ends this “loophole”  by teaching monogamy.

I-B uses this text to remind the reader that only the victim could choose to enact the divorce. And the OT is replete with evidence that God marries Israel and Judah and both break the marriage vows or covenant/contract. God, the victim of this spiritual adultery, chooses to divorce Israel and separate from Judah (later to be reconciled) (Jer 3:8).

Israel did not know anything about God’s wonderful future plans while she was heading for divorce, and she stubbornly continued to break her marriage vows. All the prophets portray God acting in a forgiving and patient manner–he didn’t divorce her immediately and gave her many changes to repent. But Israel, his wife, continued to sin, refusing to honor her vows, and God reluctantly had to divorce her. The marriage was broken and dead, and God merely carried out the legal formalities of divorce that recognized that fact. (p. 41)

Why does God hate divorce? I-B says it is because he has personal experience of the pain of it.

God does not criticize the legal process of divorce or the person who carries it out; otherwise he would criticize himself, because he had to divorce Israel. God hates the breaking of marriage vows that results in divorce. He says that breaking these vows is being “faithless,” because it breaks the marriage covenant or contract. (p. 42)

So I-B concludes by recognizing the OT view of marriage as a contract (agreeing to be faithful and to provide food, clothes, and love) that can be dissolved (not required to dissolve) by the victim if the contract is broken. He will look next to Jesus’ words in the NT

MY THOUGHTS? The OT is very concerned about abandonment of vulnerable and weak individuals (e.g., widows, orphans, aliens). And so the divorce statements in the OT is to men who have the power to abandon. Women did not. But, I-B seems to make a strong case for these issues to brought forward to today. Where it gets messy is who interprets abandonment? Sinners! Sinners who can shape interpretations to their own benefit. I wanted more sex, more clothes, more of you and less of your work. Are these also all grounds for divorce? While I like I-B’s work with the Ezek. passage it seems like it raises many more questions.  

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On Funerals


I attended a funeral of a co-worker yesterday. Ken Rush served his church, denomination, and Christian higher education. At his funeral, he was lauded for living a life faithfully to Christ, from start to the end–even through his cancer. It was moving.

As a kid I didn’t attend many funerals. Not sure if that was because I didn’t like them (I didn’t) or because culturally kids were kept away. Anyway, some of the most memorable services I’ve attended have been funerals for beloved saints.

While the pain and grief are not good, the funeral affords me a time to reflect on our mortality, God’s goodness and message of hope in the life of the Christian. They are important since they remind us what IS important. We get so carried away with life that we forget how short and fragile it is, and that this life is not the main event.

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Finding the cause of America’s gas problem


Okay, I know yesterday’s post was frivolous but I want to share some funny lines from a brochure found at a gastrointestinal practice, America’s hidden gas problem.

The brochure is entitled: Gas.

Its point is to teach us the many causes. So, lets see what it has to say.

Gas may be caused by excessive swallowing of air…Air swallowing may be lessened by the following:

Meal times should be quiet, unrushed, and regular. Eat slowly and chew well. Listen to some relaxing music. Many families take advantage of being together at meal time to argue. Postpone tense discussions until well after meal time.

I’m sorry. I eat with 2 gradeschool boys. Meals are rarely relaxing. And yes, I wait with anticipation so I can get into an argument with them. Maybe we were wrong about waiting an hour after eating to swim. We should have been saying no to arguments to avoid gas. Now, here are some more tips:

Stop trying force up belches…This leads to a vicious cycle of belching and swallowing air.

Avoid sipping hot drinks. Carbonated beverages may also cause some gassiness.

Avoid chewing gum or sucking on hard candies…

Avoid ice cold drinks.

Avoid milk and milk products including milk, puddings, ice cream, cheeses, pizza, cheeseburgers, cakes, breads, pancakes.

Wheat, oats, barley, and rye make some people gassy.

Legumes…make just about everyone gassy.

Fruit sugar (fructose)…makes about 50% of people gassy!

Sorbitol…will cause gaseousness if used excessively.

Nervous tension may cause a worsening of gas. Anger, anxiety, and depression have all been incriminated. Some form of sedation or supportive therapy may be helpful in some people

Sedation? Really? Has anyone sought sedation for their gas problem? Maybe if I am sedated I won’t care if I’m farting alot.

Okay, so what CAN I have? The pamphlet suggests live cultured yogurt and hard cheeses are low in lactose (which causes many people discomfort) and rice. That’s it for suggestions.

I guess I’ll have a lukewarm glass of water and some rice please…and put on some muzak to calm my anxious heart.

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Short sleeves


My 8 year old has a thing about short sleeves. He wants to wear them all the time, whether the high temp. will be 20°F or 80°F. For awhile we had a rule, if the high temp is going to be less than 50 then he has to wear long sleeves. But we’ve given up that rule because we’d prefer his chilly arms over his moaning and groaning. Seems other kids wear tank tops to 2nd grade all winter.

Not sure why he has this fixation. Anyway, this morning I come to the breakfast table with a shortsleeve shirt for the first time this Spring. His first words, “Finally, you’re wearing short sleeves.” No joke.

Not sure which is more interesting to me: the fact that he knows this is the first short sleeved shirt I’ve worn since last Fall or that his fixation isn’t merely limited to what he wears.

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World Autism Day


Note: For those looking for the next installment of Integrative Psychotherapy, my apologies. Will be up soon.

Today is World Autism Awareness day. You should check out www.autismspeaks.org. If you register on the site you can see short videos that show the early signs of autism in children (along with those who do not have it).

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