Friday, October 9, 2015

Friday, July 10, 2015

Response to a classmate who is an athiest ...

Susie (not her real name),

I am sooooo glad you posed these questions!  You really challenged me to work hard this final week of our course!

I have outlined the questions that you raised to the best of my ability in order to clearly provide the answers that you seek.

Would I only be working with the Christian population?
Would I hold Christian-based counseling techniques separately when working with the general population?
What are some Christian-based techniques for example?
What about Christian counseling’s efficacy?
Where are the boundaries / integrations in what is considered Christian counseling? 

Let me begin with a good definition of Christian counseling.  Gary Collins (1993), a pioneer Christian counselor, defined Christian counseling as counseling that is provided by a deeply committed, spirit-guided servant of Jesus Christ, who applies their God-given abilities, skills, training, knowledge, and insights, to the task of helping others move to personal wholeness, interpersonal competence, mental stability, and spiritual maturity.

My practice would not be limited to the Christian population, but would be made available to clients who would have a full awareness of my Christian worldview.  Just as I would be required to make my credentials and areas of experience known to potential clients, I would also make this information available.  As a Christian, I know how limited the choices are in Southeast Texas for good, sound Christian counselors who are grounded in the truth of Scripture.

According to Garzon, Clinton, and Hawkins (2011), Gallop polls consistently find that 90% of U.S. citizens believe there is a God, 80% try to live according to their faith, and about 85% self-identify as Christians. These percentages suggest that the majority of clients coming to therapy will have some sort of spiritual perspective.  However, the statistics for mental-health professionals are substantially different.  Delaney, Miller, and Bosono (2007) found that only 46% of clinical psychologists identified themselves as Christian, 38% endorsed other religions, and 16% were agnostic, atheist, or had no religious faith.

Many people are unaware that there are various types of Christian counselors. Some are lay or peer counselors who mostly work in the church. Recovery counselors work largely with addictions. Pastoral or biblical counselors also work largely in the church. Fourque and Glachen (2000) found that 42% of people seek help from clergy first for their emotional problems showing they have a desire for their faith to be addressed when they are in need.

Then there are professional counselors and clinicians who are state-licensed professionals across the disciplines of psychology, social work, mental-health counseling, marriage and family therapy, psychiatry and nursing. I was sorry to hear about the two incidents that you related, but I would question whether or not the counselor was a licensed professional in these situations.  It sounds like they failed to treat the whole client and were focused mainly on the spiritual issue. 

Here is my personal philosophy regarding the selection of a counselor.  If I needed brain surgery, I would not see a chiropractor.  I could justify that my D.O. or my dentist is a doctor, but he certainly isn’t qualified to meet my need for brain surgery. If I am a Christian, and struggling with a spiritual issue, I would look for a counselor who I can trust to help me find answers that are based on the truth of God’s word.  As a Christian, I believe that God’s word, the Bible is God’s standard for living. As such, I can find principles in his word to live by and that help me find solutions to life’s problems. 

The climate and setting for a Christian counselor should be the same as any other, characterized by a sense of safety, unconditional positive regard, and respect for the clients’ value system.  The goal of therapy would not be to impose my values on the client or to get them to believe what I think is right, but to help them determine if they are living up to their own values and whether those beliefs are leading to behaviors that negatively affect their lives or relationships with others.

Here is an example: If a client presents with symptoms of depression, I am going to use every tool available in my toolbox to offer help, including referring the client for a medical check-up and possible medication. I’m going to use the therapeutic techniques and skills that we are learning in our coursework, as well as applying scriptural principles, and offering to pray with the client if they are open to do so.

A wide variety of spiritual interventions exist for Christian counselors to use when appropriate. These could include prayer, devotional meditation, Bible study, forgiveness therapy, therapist spiritual self-disclosure, confrontation of sin, values exploration, church involvement, confession, spiritual resources and media, pastoral consultation, and referrals. The American Association of Christian Counselors offers resources for additional training which includes areas such as biblical counseling, addiction and recovery, and stress and trauma, etc.

Just as a hospital or doctor’s office collects information about a person’s ethnic, cultural, and religious background, my intake interview forms would include this type of information.  If a hospital knew that a patient was a Jehovah’s Witness, they would know that the person is likely to refuse a blood transfusion for religious reasons. In the same way, if a client in counseling indicated that he/she is an atheist, I would know that it would likely be offensive to offer to pray for that client. This is demonstrating cultural competence and respectf for my client.

In Caring for People God’s Way, Clinton, Hart, and Ohlschlager, (2005) outlined seven traits that anchor what is done in Christian counseling today. It is scripturally anchored, meaning that we believe that the Scriptures are the food and water of spiritual life. It is spiritual forming, meaning the Spirit of God does the work through the counselor as the helper. It is short term (6 – 10 sessions), solution-focused, and strength-based. It allows clients to tell their stories, because God reveals himself to us through our life story. Finally, it is scientific, meaning that it is submitted to the rigors of research and empirical evidence in the same way as any other counseling theories or techniques.

Also, in our coursework, we have been exposed to the important role that spirituality plays in the recovery of clients. A meta-analysis was conducted by Worthington, Hook, Davis, and McDaniel (2011) on religiously accommodated treatments. The results showed that when counselors adapted religious treatments, their clients had reduced psychological symptoms, and the effects are at least as strong as with secular treatments. Religiously accommodated treatments produced more positive spiritual changes and the most consistently effective psychotherapies or couple treatments have been Christian-oriented cognitive and cognitive-behavioral therapies (which are empirically supported treatments or ESTs) and forgiveness therapies. Worthington’s REACH forgiveness model as well as the Christian PREP approach have been proven to be efficacious and have also been designated ESTs.

My final comments would be to express my sincerest disappointment regarding your own negative experiences with Christianity.  You mentioned experiencing a lot of guilt and anxiety as a result of the beliefs you were taught. If you were my client, I might explain to you that God’s word says that there are two types of guilt, false guilt, and true guilt.  True guilt brings about Godly sorrow and is intended to lead to repentance or a turning from sin. False guilt condemns and is shame-based. False guilt occurs when Satan continues to accuse a person of something for which he / she has already obtained forgiveness.

Sin separates us from God but Jesus came to pay the penalty for our sin so that we could receive forgiveness and be brought back into a right relationship with our creator God. When we truly accept His forgiveness we experience freedom to enjoy the abundant life that God intended for us. Afterward, He continues to work in our lives to grow and mature us and provide the help and direction we need for life. That doesn’t mean that we won’t experience difficult circumstances, because we live in a fallen world, but He provides the strength we need, and brings helpers in our lives to help us overcome life’s hardships (and trust me I have had my share). Innocent   My personal experience of faith doesn't cause me to feel anxious or continually guilty. For me Faith stands for Forsaking All I Trust Him. It means allowing God in the driver’s seat of my life, trusting Him to get me where he wants me to go, and just enjoying the journey.

Truthfully, I don't know how it all will come together, but I know without a doubt God placed this goal and dream on my heart, and I am just taking it one day at a time and seeing what doors He opens for me.

Clinton, T., Hart, A., & Ohlschlager,G. (2005) Caring for People God’s Way: Personal and Emotional Issues, Addictions, Grief, and Trauma. Nashville, TN: Thomas Nelson.

Collins, G.R. (1993). The Biblical Basis of Christian Counseling for People Helpers. Colorado Springs, CO: NavPress.

Delaney, H.D., Miller, W.R., & Bisono, A.M. (2007). Religiousity and spirituality among psychologists: A survey of clinician members of the American Psychological Association. Professional Psychology: Research & Practice, 38(5). 538-546.

Fourque, P., & Glachen, M. (2000). The impact of Christian counseling on survivors of sexual abuse. Counseling Psychology Quarterly,13, 201-220.

Garzon, F., Clinton, T, & Hawkins, R. (2011) Spirituality in Counseling. In The Popular Encyclopedia of Christian Counseling. Eugene, Oregon: Harvest House.

Worthington, E.L., Jr.,  Hook, J.N., Davis, D.E., &  McDaniel,M. (2011). Religion and spirituality. Journal of Clinical Psychology: In Session, 67(4), 204-214.

Esther Perel: Rethinking infidelity ... a talk for anyone who has ever loved

Affairs are an active betrayal but they are also an expression of longing and loss. 

At the heart of an affair you will often find a longing and yearning for an emotional connection, for novelty, for freedom, for autonomy, for sexual intensity, a wish to recapture lost parts of ourselves, or an attempt to bring back vitality in the face of loss and tragedy. 

When we seek the gaze of another it isn’t always our partner that we are turning away from, but the person that we ourselves have become, and it isn’t so much that we are looking for another person but another self. 

Affairs usually follow recent losses … death of a parent, bad news at the Dr., a friend who went to soon.  They are an attempt to beat back deadness, and an antidote to death.  They beg to ask the questions “Is this it?” “Is there more?” “Will I ever feel that thing again?” 

Today in the west, most of us are gonna have 2 or 3 relationships or marriages and some of us are gonna do it with the same person.

Sunday, April 19, 2015

Fear, Anxiety, Neuroticism, and Depression

Have you noticed this saying going around the internet ...

"The phrase 'do not be afraid' is written in the Bible 365 times. That's a daily reminder from God to live every day being fearless"?
Did you know is it not actually true?

1. The phrase "fear not" in the intended context is only used 80+ times

2. The phrase “fear not” is used in other contexts, but you wouldn’t want them to apply to you

3. Other word pairings that would be equal to “fear not” (“do not be afraid”, “do not fear”, “be not afraid”) is used 30+ times

What IS significant is that the command "do not fear" is given more than any other command in the Bible (84 times). This should tell us something ... and I think it means that God intended for us to live without fear.

I recently took one of those online personality tests utilizing a really cool tool call Five Labs. Five Labs analyzes the language of your Facebook posts to predict personality using a method based on the world's largest study of language and personality. The report said I am "disciplined, inventive, restless, analytical, and outgoing". Wow! All of these were traits seemed very positive, except for the restless one, that one made me think, but overall I agreed 100% Plus it told me which of my friends have similar characteristics.  

What was really interesting was that it said I also scored high on openness, NEUROTICISM (yep, that's me!), and conscientiousness.  Now two of these latter qualities seem very admirable.  But NEUROTICISM??  not so much !   

So my next step was to look up the definition of neuroticism and here's what I found ... 

Neuroticism is a fundamental personality trait in the study of psychology characterized by anxiety, fear, moodiness, worry, envy, frustration, jealousy, and loneliness.

Yikes!  There's that word "FEAR" again, added right next to ANXIETY, and WORRY, and FRUSTRATION and LONELINESS .... ugh ... makes me neurotic just thinking about it.  

Then, since I am currently taking a course in Abnormal Human Behavior, I was doing some research on Major Depressive Disorder. Major depression is a disabling condition that affects a person's family, work or school life, sleeping and eating habits, and health in general. Depression can run in families, but can also be triggered by a stressful life change or event.

I discovered that Major Depression Disorder is referred to as "the common cold" of mental health, but don't let that description fool you.  Major Depression is the most serious, and the most life-affecting, mental health problem that people suffer. It can occur not only in adults, but also in children and teenagers.  

What was really enlightening to me is the fact that depression can occur by itself or in combination with other mental disorders and it co-occurs with anxiety more than 50% of the time.  For this reason depression is often mis-diagnosed as an anxiety disorder. Depression also co-occurs in people who suffer with chronic pain, dementia in the elderly, and with drug or alcohol abuse.

Now, back to my original thoughts on conquering fear. Not everyone who has fear will have an anxiety disorder, but you can see how progressively fear can lead to more anxiety and an increased risk for depression.  Knowing the risks that fear can lead to isn't likely to deter us from acting out of fear. So what's the solution?   

The answer is knowing the truth of God's word.  Only when we know and put our faith and trust in what the word says, can we truly overcome fear. Something helpful would be to find a scripture that directly relates to the fear you have. The next step would be to commit that scripture to memory. Maybe you don't think you can memorize scripture, but you can write it down and carry it with you or put it in a prominent place where you will see it. Read it over and over and say it aloud.  The scripture will become a part of you and when you are tempted by fear, the Holy Spirit will bring the truth to your mind and calm your spirit.

I didn't say it would be easy, this habit takes practice.  It also takes practice noticing the things that prompt you to be fearful, worried, and anxious. (Some refer to this as "mindfulness".) But the more you incorporate this habit into your daily life, during your quiet time, or devotional time, the more you will find yourself living a life without fear.

Tuesday, February 10, 2015

Here are my notes from my textbook reading on the subject of family systems and substance abuse this week. 

Ackerman (1983) states that the "key to surviving in an alcoholic home is adaptation" (p.16). 

We know that one of the developmental tasks of children is to learn to adapt to their surroundings. Therefore, the adaptation to a dysfunctional, chemically dependent system will create dysfunctional behaviors in children as they interact with outside systems and as they grow into adulthood.

No matter what your belief about the etiology of addiction, - biological, sociological, psychological - it clearly passes from generation to generation.

Many addictive families share common characteristics.  Secrecy (disengagement), for example is extremely important. Denial of the problem is also paramount. Family members will go to extreme measures to keep the secret and to avoid dealing with the issue of alcohol / drug use.

Characteristics of addictive families: 
1. Hypervigilance - constant state of fear 
2. Lack of trust 
3. Inability to identify and express feelings 
4. Highly vulnerable to shame 
5. Afraid of abandonment 
6. Communication is angry, hostile, and critical 
7. Intense love or hate 
8. Totally in control or totally out of control 
9. Either enmeshed or disengaged 
10 Partners are so interrelated they are inseparable emotionally, psychologically, & sometimes physically from each other or from their drug of choice 
11. Behaviors center around "If you love me, you will (or will not) ...."  

Mal-adaptive behaviors: 
1. Being over-involved 
2. Obsessing 
3. Attempting to control another's behavior 
4. Trying to gain approval of others 
5. Making great sacrifices for others
6. Repeating the same pattern seen in family of origin 
7. Seeking out abusers to marry 
8. Either totally dependent or totally disregards feedback of others 
9. Drawn into relationships with needy individuals 
10. Shields the abusing partner from unpleasantness 
11. Pattern of preserving balance becomes a coping mechanism 
12. Enabling - a form of protection - anything done to protect the chemically dependent person from the consequences of his behavior  - results from attempting to adapt rather than confronting

Research supports that substance abuse in families impairs a child's physical, social, and psychological development in a way that may lead to an adult with mental illness or substance abuse issues (McCrady, Epstein, & Kahler, 2004).

Children in these families are at high risk for the development of a variety of stress-related disorders including conduct disorders, poor academic performance, and inattentiveness.
Children in substance-abusing families are socially immature, lack self-esteem and self-efficacy, and have deficits in social skills.  Furthermore, because these children live in chronic chaos and trauma, they might develop long-lasting emotional disturbances, antisocial personality disorders, or chemical dependence in later life. Children may become addicted to excitement or chaos and may develop inappropriate behaviors such as fire setting or, conversely, may become the "superresponsible" child in the family, taking on parental roles.

Factors that impact the parental chemical dependence on children: 
1. The sex of the abusing parent 
2. The sex of the child 
3. The length of time the parent has been actively abusing 
4. The extent of the abuse/ dependence on the chemical 

Four family structures of alcoholic families: 
1. Functional - abuse is connected to social or personal problems
2. Neurotic enmeshed - stereotypical -
3. Disintegrated - separation occurs between the abuser and other family members.
4. Absent - permanent separation between the chemically dependent person and the other members.

Ackerman, R.J. (1983). Children of alcoholics: A guide book for educators, therapists, and parents. Holmes Beach, FL: Learning Publications.

McCrady, B. S., Epstein, E.E., & Kahler, C.W. (2004). Alcoholics Anonymous and relapse prevention as maintenance strategies after conjoint behavioral alcohol treatment for men: 18 month outcomes. Journal of Consulting and Clinical Psychology, 72(5), 870-878. 

Stevens, P., & Smith, R. (2013). Substance abuse counseling: Theory and practice (5th ed.). Boston: Pearson.