Tag Archives: counseling

Considering a doctoral program?


In recent weeks I have had several students ask me about the pros/cons of doctoral programs in psychology. I would point those who know they want to attend a traditional clinical psych program to this book by the APA. It offers lots of helpful data on programs and what they require.

For those not sure what they want to do or if they should pursue doctoral studies, consider the following. If readers have additional questions we should consider, post them in a response and we’ll expand on these. This is my first pass:

What career doors do I want to open that are not available to me now? Do I want to teach? Do I see myself in private practice? In a research job? in the business world?

The PhD in Clinical Psych from an APA accredited program (and with an APA approved predoctoral internship) probably opens the most doors of all. This degree allows you to teach in both undergrad and grad depts., work in research settings, government settings, private practice, etc. There are specific kinds of jobs that it might not help: such as an area focusing entirely on social psychology or developmental psychology.

One caveat. If you want to teach in a MA Counseling program that is either seeking or already obtained CACREP accreditation (counseling accreditation sponsored by the ACA), you will need a PhD in Counselor Education (which entitles you to work towards an LPC credential). This is a recent and troubling change (turf warfare with psychology).

Part of your work dream should answer whether or not you are looking to work in either a secular or faith environment. Now, you can change your mind but there will be some doors that are easier to open with secular degree and other doors that a Wheaton/Fuller/Regent degree will open more easily.

What areas of counseling/psychology most excite you?

Try to be creative here. Think more than just private practice, 50 minute hour. Who do you know who is doing what you would like to do? Find out where they got their education? Be bold, ask them (even if you do so by email) what they would recommend as an educational route to do the kind of work they do now.

Programs tend to have both a model of psychology (some are CBT others are more analytic) and a focus (specialties). Further programs tend to either be scientist focused or practitioner focused.

Many programs are generalist, but it is helpful to have a specialty. Child? Forensic? Neuropsych? Geropsych? Marriage & Family?

Look at what the professors are publishing at the schools you are thinking about attending. Anything there excite you? FYI, professors love those who are excited to help them with their research

PhD or PsyD?

There are some differences. Typically, the PhD student completes a very rigorous dissertation (has more coursework in research and stats) but has fewer practice hours (maybe 800 total) leading up to their yearlong pre-doctoral internship year.

PsyD students tend to have a less rigorous dissertation (though my PsyD program acted more like a PhD) but have far more practice hours under their belts (maybe 2000!).

PsyDs do get teaching jobs but less likely in undergrad programs because of old assumptions (i.e., PsyDs are practitioners and PhDs are scientists).

Secular vs. Christian programs?

The first question: what is your current theological/biblical literacy level? How well do you understand the depths and complexities of your faith? How well versed are you in the controversies surrounding Christianity, Psychology, biblical counseling, integration, etc.? Your answer will dictate how ready you are to jump into a PhD or PsyD in clinical psychology. If your faith is weak, then you may want to strengthen it in an MA program at a Seminary. Or do some reading on your own. Psychology is not just an art and science, but a philosophy. You want to know what philosophy, even religion, you are imbibing. Sometimes the glittering images of psychology cause students to neglect the source of the power of change.

Practical matter: Christian doctoral programs in Psychology tend to be a year longer (because of extra bible/theology courses). Being a graduate of these programs will not harm you in secular settings (usually) if the program is accredited by the APA.

Obviously, programs and schools have identity. You graduate from Harvard, you get an identity. You graduate from Fuller, you get an identity—fair or not.

In my experience, secular programs tend to have less issues about a student’s Christian faith than do quasi-Christian programs or those housed in catholic institutions. These programs have had more fundamentalist-liberal wars and so you find faculty more sensitive.

If a student has a strong theological base, I would probably go for a secular institution unless you want the Wheaton/Fuller credential to open Christian doors.

Counseling Psychology vs. Clinical Psychology programs?

Not much of a distinction here anymore. I think the clinical one is more valuable (my bias) but once you have the degree, no one explores your transcript.

Would you rank the Christian doctoral program?

No. Each one has their own strengths and liabilities. I would look at the professors at each and what they are writing/doing. Try to go learn from some professors you’ve come to respect. For example (and this is a limited sample. Some schools I haven’t really known much about)

Regent University (VA Beach): Mark Yarhouse, Jen Ripley and Bill Hathaway are topnotch Christian psychologists. With Mark you get the sexual ethics research as well as someone well-versed in Puritan writings. With Jen, you might get access to her and Ev Worthington’s work (forgiveness, couples, etc.). Of course Ev is at VA Commonwealth and so you might want to go right for him.

Wheaton: There are a number of great faculty there. But let me mention just three. Sally Schwer Canning is doing child and urban stuff. Bob Gregory is doing neuropsych stuff and William Struthers just published on porn and the male brain.

George Fox: At Wheaton I came to really respect Mark McMinn. He is now at George Fox (Oregon). He’s great to study under for psych testing and his integrative model. Plus, if you get in on his research team, he’ll teach you how to be a survey king or queen. He is a publishing machine!

Biola: Todd Hall and Jon Coe just published a key work called Psychology in the Spirit. It is going to be a significant work.

On-line vs. residential programs

Online programs only if they are APA accredited (psychology programs that is). You have to be a self-starter. These still get negative reactions from some of those in the position to hire you. In the PhD in counselor ed, both Regent and Liberty have programs with good quality eworlds.

Residential provides lots of time to interact with profs on a daily basis. There isn’t a way to really do this in the on-line programs (which tend to have lots of students in them!). You can get good peer relationships in on-line programs, sometimes even better than in person.

I’m sure I’ve left something out. What else should we consider? Of course, you should get your MA from Biblical Seminary. That way, you will be prepared to think Christianly, biblically, and yet able to think psychologically about the world. 😉

51 Comments

Filed under APA, biblical counseling, Biblical Seminary, christian counseling, christian psychology, Psychology

Cancer stories


We’ve all heard them. We’ve all told them. Either our own or someone else’s. If you are the person telling the story, you likely are trying to encourage hope and fight in the cancer sufferer. If you are the person listening to the story, you likely want to desperately believe that the miracle or cure story is going to be your story.While the success story of another is momentarily comforting, it doesn’t last.

Truth is, you don’t know your own story, whether you have cancer or not. You don’t know if you will live to be 100 or die tomorrow. Most of the time we don’t think about our mortality. Life is too busy to contemplate morbid thoughts.

Cancer in you or your loved one changes that. You wonder what your story is. You hope it is not like one person’s story and you try to hope that it is like the success stories you hear. But, you just don’t know.

Along with the stories come treatment recommendations and advice. These can be helpful, confusing, contradictory, or downright hurtful. It is true that your doctor matters. It is true that some traditional treatments are very effective and also very damaging. It is true that some have benefited from alternative or complementary treatments. It is also true that people die from both. What is also true is that the plethora of advice adds to the confusion.

Here might be some better things we can do and say:

1. What would you like me to pray for?

2. What is your next treatment decision and who are you talking to?

3. Can I ______ (something specific)?

And if you know the person well, you might ask:

1. What “stories” are you meditating on that you need to stop?

2. What is the one thing that is true for you right now? Or, what manna is God giving you for today?

3. What information would be helpful for your next decision?

4. Let’s talk about something other than cancer…how’s your garden coming?

5. What stories would you like to hear right now?

For counselors out there. It is a good reminder to limit the number of stories we tell our clients. These can encourage. Yes, it is true, people do get over depressions or anxiety attacks. They do repair broken marriages. These stories may encourage the person to take a step of faith. Or, they may cause them to stop, because those stories aren’t theirs.

3 Comments

Filed under counseling, stories

Helping sufferers without having suffered


Previously I posted this quote:

It is an easy thing for one whose foot is on the outside of calamity to give advice and to rebuke the sufferer

Attributed to Aeschylus, Greek playwright

I fully believe that we counselors are able to counsel those who suffer in ways we have never experienced. I need not be sexually abused to help those who have been. But, let us not believe that we truly understand those experiences we never knew. I have walked with a variety of people with terrible suffering. I think they found my listening and counsel helpful. But now that I am having their experience, I now know I knew NOTHING of what they were really experiencing.

We should not be hesitant to help. But be wary of easy advice!

5 Comments

Filed under Uncategorized

Dealing with unexpected losses


Some years ago, my wife and I wrote an article for CCEF’s Journal of Biblical Counseling entitled, “The Bible and the Pain of Infertility.” Of all my published writings, this article has garnered the most responses from readers. I don’t think it is because it is so well written as much as it touches many where they most hurt. Even though the article is about infertility, readers have commented that they found it related to their loss of a loved one, the unexpected loss of a career, a chronic disease.

Not that long ago I was asked to review a chapter manuscript on pastoral care of infertile couples. I was shocked to learn that he could find no serious work (than ours) attempting to think pastorally about infertility. Not sure he is right but it probably means we need more on the topic.

I say all this because CCEF has put the article up for free on the top of their homepage. Click here for their homepage. Click the image at the top of their page and it should take you to the full text article.

Enjoy. Pass it on to others you think might benefit, especially those who suffer in secret.

4 Comments

Filed under "phil monroe", biblical counseling, CCEF, christian counseling, christian psychology, Christianity, counseling, Doctrine/Theology

Quick Review of Mike Emlet’s “CrossTalk”


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

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

Leave a comment

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

The good and bad of new diagnoses


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

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

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

6 Comments

Filed under christian counseling, Psychology

Do no harm?


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

Every counseling ethics code in existence includes this principle: Do no harm. This maxim is drilled into the heads of counseling students (and any other medical professional as well). Our work should help, not hurt. Who could disagree?

But pause for a minute and consider how you might evaluate whether an intervention helps or harms. What criteria will you use? From what vantage point will you evaluate the criteria you choose? If a medical treatment extends life for an ill patient that would seem good—unless it keeps them alive and in a vegetative state with no possibility of recovery. Some would then wonder if the treatment was indeed best. Or, is it harmful if marriage counseling encourages truthfulness between spouses leading to the revelation of a terrible betrayal leading on to divorce and financial ruin? If honesty is your criteria for helpfulness, then the intervention is sad but helpful. If stability is your criteria, then such counseling is harmful. We could go on and on. Do we use client interpretation of whether treatment is helpful or counselor observation? Do we consider the difference between short and long term evaluation? And importantly for Christians, do we consider only statistical analyses or do we also consider biblical categories (e.g., intervention “A” leads to increased positive affect but encourages clients to pray to another deity).

Despite the muddy water I just churned up, I want to argue that Christian psychology is well poised to help Christian counselors provide treatment that does not harm. This society includes some of the best philosophers, theologians, sociologists, clinicians, and researchers of our day. These members are interested in looking at how people grow and change, how the bible connects with everyday life, common human struggles and effective interventions, etc.

How then do we go about refining our practices and avoiding harm? Let me suggest some steps we might take:

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

2 Comments

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

Trusting in your own wisdom


I recently had the need to consult a couple of experts on a medical question. In doing so I re-discovered a maxim:

we trust in our own expertise to solve problem.

Or, more colloquially, if what we have is a hammer, everything looks like a nail. The psychiatrist puts her trust in her common tools. The neurosurgeon puts his trust in his scalpel. The neuropsychologist puts trust in the common diagnostic tools she uses.

Hmmm. I think I’m no different. I’d like to think that I’ll give my clients the right recommendation for treatment but when someone comes to me with a run-of-the-mill problem I must admit that I usually think I and my skills are up to the task.

Good care requires that I inform clients of other options. For example, if someone is depressed, I can provide counsel but they may wish to choose to see a psychiatrist for medication options. If a couple comes for therapy, I should inform them of the various kinds of therapy that might work equally well: EFT by a certified specialist, intensive Gottman style interventions (3 hour sessions every 3 weeks with lots of homework). Or, if a parent brings a child with ADHD like symptoms, do I suggest my style of intervention or do I recommend more careful diagnostics of a neuropsychologist’s exam? But even when we counselors tell clients of other options, they probably can tell we think fairly highly of our own counseling methods.

Don’t be surprised when surgeons want to use their knives, when oncologists want to ply their trade, or when nutritionists emphasize their health improving interventions. If you are seeking care, keep this human frailty in mind. And do be sure to ask more questions when you are seeking the best path for solving your problem.

2 Comments

Filed under christian psychology, Insight

Perpetuating vulnerable feelings?


Feel unsure of your mate’s love for you? Should you tell them that you are not feeling safe or secure in the relationship? When you tell them (accuse them of not caring?) and they profess their love for you, what will tell you that you can believe their promises? What will tell you to doubt their words?

Two Yale University psychologists (E. Lemay, Jr and M. Clark) explore this problem in 2008 in their “Walking on Eggshells: How Expressing Relationship Insecurities Perpetuates Them” (Journal of Personality & Social Psychology, v95, 420-441).

Their study is fairly long (5 studies in fact). But here are some key points.

When people feel insecure about a partner’s regard and acceptance, they often judge their own prior behavior as having communicated insecurity and emotional vulnerability to the partner. Consequently, they come to believe that they are viewed as especially insecure and vulnerable. Then, due to shared beliefs that people walk on eggshells around insecure, vulnerable others, such reflected appraisals of vulnerability elicit doubts about the authenticity of the partner’s expressions of regard and acceptance. Once authenticity is doubted, positive expressions are discounted, negative expressions are augmented, and hidden negative regard is inferred even when partners are accepting and actually hold positive regard. (p. 436)

What they are saying is that our own anxiety fuels are belief that they know we are vulnerable and are tiptoeing around us and that we doubt they love us and then we read their actions through a lens that denies the evidence of love and declares their love to be inauthentic. Which of course, we then share with them. Repeat this action and sooner or later they don’t want to be declared a liar anymore and distance from us thereby proving our deepest fears of abandonment.

In short, anticipated rejection leads to presumption that it has happened and that any activity countering that presumption is rejected and re-read through the lens of rejection. Because that is what we believe happens to weak people–they are abandoned.

So, should we keep our fears to ourself? No say the researchers. Then what should be done? The researchers say only a little on this (since it is not the focus of their research here). But, challenging cognitive distortions are at the top their list? What distortions in particular? Believing that others see you as weak as you feel; challenging the interpretations of another’s motivation. Also in their suggestions is practicing reading the commitment of the mate to the relationship by re-appraising and collecting the evidence of authentic responses from that mate.

The next time you feel the need to express your fears that your mate doesn’t really love you check to see whether your insecurity isn’t already telling you the answer you fear and rejecting evidence to the contrary. Dig a little and you may be able to find evidence that shows they love you. Then, be specific and tell them one concrete thing you would like to see changed, something that bothers you. Do it in love so as to not trigger their fears that you do not love them. Be wary of listening too much to your fears!

5 Comments

Filed under Anxiety, counseling science, Psychology

Psychiatric labeling: The problem isn’t the label


Christians tend to have some strong feelings about counseling, psychology, psychiatry and similar terms. Come to think of it, most people, regardless of faith, have strong feelings about these topics. Experiences dictate much of these reactions. Experiences, such as:

  • experiencing or hearing of a mental health representative (mhp) belittling Christianity
  • experiencing or hearing of an arrogant, controlling, or completely incompetent mhp
  • experiencing or hearing of a positive experience where someone found relief or change or insight
  • feeling either helped or stigmatized by a received diagnosis or a use of medication

In psychopathology class tonight, we will explore the background behind psychiatric classifications. How did we get the Diagnostic and Statistical Manual? What are its underpinnings? There are a couple of common concerns about the DSM

  • It purports to be atheoretical and descriptive only
  • Diagnoses suggest objective and distinct “things”
  • It medicalizes problems in living
  • Under one diagnosis (e.g., depression) you can have such wide variety of symptoms
  • Therapists have sizeable disagreements on diagnoses so are they all that helpful?
  • It is leveraged by insurance in ways that make it a liability
  • It doesn’t address matters of the heart or spirit
  • It has political overtones
  • It treats most problems in an individualistic fashion without account for family systems

Every one of these concerns has merit. However, the biggest problem I have is not with the DSM itself but with many of its users. The complaints that are raised about the DSM usually come from someone mis-using the DSM.

Remember the simple explanation of a problem almost always distorts it. Thus, the simplistic use of diagnostic labels almost always does damage.

3 Comments

Filed under counseling, counseling science, History of Psychology, Psychology