Pride, Complacency, and Marriage
June 11, 2009
Some advice you might not hear every day.
Make sure the word “divorce” is in your vocabulary. I can’t tell you how many times I have heard the opposite preached. I think I understand what those pastors and marriage counselors are trying to say. I assume they are speaking to commitment; admonishing others to stop threatening divorce and get busy solving problems and strengthening their marriage. If that’s the case, its good advice. But if meant literally, and I believe it often is, then its bad advice.
You can read the whole thing at SBC Impact!.
Notes & News
June 8, 2009
A collection of posts and articles that caught my eye this week.
Marriage & Relationships
Myths about Soul Mates
As you can see, some people have soul mate concepts that are close to what just about anyone would say is a truly great marriage — and one reasonable to desire and build. Others describe (and probably seek) a level of sublime connection and completion that seems virtually impossible to achieve. In addition, some writers say that there is not just one perfect soul mate for you while others clearly imply that there is — one perfect person who it’s all-important for you to find.
7 reasons why your spouse would cheat on you
But this is not a post about protecting your marriage from an affair. This is a post about learning why your spouse would possibly commit an affair (which will ultimately help you protect your marriage from an affair). I do want to make perfectly clear that NONE of these seven reasons are your fault. It is never your fault that your spouse chooses to have an affair to cope with something broken in the marriage. But do understand that affairs are a huge signal that something is broken. Here are 7 reasons that will help answer the question of, “Why?”:
Any relationship, engaged or married, is going to have bumps and stresses, some minor and some major. But a healthy relationship is one that will generally make forward progress when it’s all averaged out over time, meaning that through the trials the two of you have learned more about God and each other and have deepened your relationships in both areas. So don’t worry that you’re having issues, that’s normal.
A Comprehensive Review of Recent Research (pdf)
Why texting is hazardous to your life
1. Texting give us the illusion of connection. We can send a message to communicate with another but don’t really call it a connection.
2. Texting provides an opportunity to jab each other when angry but avoid (for a few moments anyway) seeing the impact of that jab. Sure, we could say these silly and immature things to the other’s face, but with the advent of texting we don’t have to admit to ourselves that our words have impact.
3. Texting allows another to keep a record of our wrongs; to read it again and again and maintain the hurts. Yes, we can remember words spoken in anger, but keeping a copy would be tempting and very dangerous.
Mental Health
How Do You Find a Good Therapist? An Interview with Dr. John Grohol
I think finding a good therapist to work with is a challenging prospect, even when you have a recommendation or two from a trusted friend or your doctor. Why is it so difficult to find a good therapist? Because the qualities that might be ideal for one person may not work as well for another. A therapist is more than a plumber for your mind; you can’t just pick one at random from the Yellow Pages. Well, you can, but you may not find the right one using that method.
Searching for Risk Factors of Suicidal Events During Antidepressant Treatment
…youths with suicidal thoughts and more severe depression prior to treatment were at higher risk for suicidal events while undergoing treatment.
Antidepressant Ineffective for Repetitive Behaviors in Autism
Despite common off-label use, the antidepressant citalopram (Celexa) has no effect on repetitive behavior in young patients with autism spectrum disorders, researchers said.
When Adult Patients Have Anxiety Disorder, Their Children Need Help Too
…the study suggests that as few as eight weekly family sessions of cognitive behavioral therapy go a long way to prevent or minimize the psychological damage of childhood anxiety.
Let’s Expand Our View of Depression: You’re More Than Your Biochemistry
Depression is more a social problem than a medical one, and no purely biological cure will be found for it any more than biology alone will cure other social ills such as poverty or child abuse.
Alphabet Soup
June 1, 2009
People seeking a counselor can be easily overwhelmed by all of the abbreviations and credentials on a counselor’s business card. All do essentially the same thing; each comes with a different type of training and a different set of underlying assumptions about how best to provide counseling.
Let’s start with the title.
A psychologist is some one who has earned a Ph.D. or a Psy.D. (Doctor of Psychology) and is licensed as a psychologist. In my state, Oklahoma, one can only use the title of “Psychologist” if he/she is licensed; merely having a doctorate in psychology isn’t enough. Psychologists typically have the most training in psychological testing and assessment.
A Licensed Professional Counselor (L.P.C.) must also be licensed by the appropriate board but may not have a doctorate. A L.P.C. typically has a Masters degree: it could be an M.A., M.S., or M.Ed. (Master of Education). L.P.C.’s typically have less training in testing but are able to diagnose and treat mental health disorders.
A licensed Marriage and Family Therapist (L.M.F.T.) will have a Masters degree of some sort (M.A., M.S., etc.). L.M.F.T.’s can do the same kinds of things as the other licensed mental health professionals: their training prepares them to view disorders from the perspective of the whole family, not merely the individual.
A Social Worker will have earned either a M.S.W. (Master of Social Work) or a M.S.S.W. (Master of Science in Social Work). Social workers usually have to choose a clinical track or social/community services track.
A Psychiatrist is a physician – either a M.D. or a D.O. – with training in psychotherapy with an emphasis on the management of psychotropic medications.
Some professional counselors, marriage/family therapists, and social workers may have earned a doctorate, but it is not necessary for them in order to practice independently.
Additionally, physician assistants may see patients if they are under the supervision of a psychiatrist; clinical nurse specialists may be able to see patients independently in some states; Oklahoma recently began to license alcohol/drug abuse counselors (L.A.D.C.’s).
That doesn’t even touch the ministers and chaplains who have special training in counseling.
Making a Referral: 2
May 25, 2009
The first step in making an effective referral is believing that referral is an appropriate and professional service which is in the client’s best interest. If we believe that the client is being short changed by our referring them, we will often not be effective in making referrals.
The second step in making referrals is to know the professionals and other resources available in our community. It is important to get to know professional Christian counselors, hospital personnel, and a variety of physician specialties such as family physicians, pediatricians, obstetricians and gynecologists, and psychiatrists. As we get to know these professionals and how they work, we can feel more confident that those we refer will be in good hands.
A third step in making effective referrals is to be able to convince clients that the referral is necessary. It is important that we be honest with our clients and that we let them know when there is a more professionally skilled person who is best to treat them, or that we may have conflicts in dealing with a particular client or their problems. It is also important that we have enough self confidence and integrity to be able to be honest about the limits of our professional competence. We each have an area of specialty. No professional can be all things to all people.
A fourth step in making effective referrals is to be able to educate the client about what the professional we are referring them to will be able to do for them that we are not able to do. It is also helpful if we can assist the client in becoming more comfortable with the person we are referring to by informing them that we know the person personally, and that in our experience with them they can be trusted and are helpful.
A fifth step in making effective referrals is the ability to allow clients to express themselves and their feelings about referral. Some clients may be angry, some clients may feel depressed or betrayed, and other clients may be afraid. It is important to allow the client to discuss these feelings. It may be necessary for us to offer reassurance and clarification of any misunderstandings. It is also important that we allow clients to know that we do care for them and that we intend no malice or harm by making the referral. Redefining what your relationship will be like after the referral is completed is strongly recommended.
The sixth step is getting the client to make a commitment to follow through with a referral. If we simply say to a client, “I suggest you call a counselor,” and we are not specific about who we are referring to, the chance of follow through is extremely small. If we ask the client if they will commit to making the phone call, and when they will make the phone call to make to appointment, then there is a significantly increased chance of follow through.
Sometimes it is a good idea to allow the client to make the phone call from your office. Particularly, when the client has made a commitment to follow through with a referral, but we sense that if the client hesitates the resolve will weaken, it is a good idea to have the client make the phone call from our office. Sometimes it is effective to ask the client if you can make the phone call for them. Making the initial phone call sometimes makes it easier for the client to follow through.
Most professional offices will ultimately require that the client make a call themselves directly before appointments will be established. If a client is unwilling to talk with a counselor or with an intake counselor over the phone they are often likely to cancel or not show up for their first appointment. Also, many professionals give instructions to help prepare the client for their first appointment and obtain information that will reduce some of the initial paperwork.
A seventh step in making effective referrals is agreeing on what information will be shared with a new professional. If we have previously provided counseling, testing, or any other service, it is important to discuss with the client whether they wish those results be forwarded to the professional we are referring to.
Professionals require a signed release in order to disclose information. Counselors are bound by a code of ethics and laws that require guarding client information and client confidentiality. In the case of pastors and physicians making referrals to professional counselors, it will be necessary to sign a two way release of information in order for information to legally be exchanged as we serve as teammates in helping our clients. It is important that we explain to our clients that working together is in their best interest. As we are able to communicate we are able to work as a team which often speeds the process and increases the chance of successful outcome.
The final step in making effective referrals is follow up. It is important for us to check with clients to make sure that they made the telephone call and established an appointment. It is also important for us to follow up with our clients following their first appointment with their counselor. When people come for counseling they are often confused, anxious, and sometimes disoriented. Sometimes clients will come away from sessions with mistaken impressions or misunderstandings of something that was said in the counseling process. Counseling is a painful process and sometimes raises resistance.
(Adapted from our corporate web site: www.cfitulsa.com.)
Notes & News
May 23, 2009
A list of blog posts and news articles that I found interesting. I hope you do, too.
Marriage
- From Corey at simple Marriage: Marriage Is All About Growing Up.
- Friend and blogger Paul Burleson is celebrating 50 years of marriage.
Psychology/Counseling
- Do Antidepressants Dull Your Emotions? An Interview with Ron Pies, M.D. on PsychCentral.
- Leaders of the American Psychiatric Association talk about the process leading to DSM-V (from MedPageToday).
- Teens who believed they were overweight were at greater risk for suicide attempts compared to those who did not believe they were overweight. Read the Journal of Adolescent Health article here.
- Also from MedPageToday, a report on possible changes in the DSM: “Some familiar disorders may be dropped and diagnostic criteria for others are in line for substantial revision in the forthcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Schizoaffective disorder and gender identity disorder are among those that may be on the chopping block, according to members of the working groups leading the revision who spoke here at the American Psychiatric Association annual meeting.”
- John Grohol at PsychCentral exams the effects of the recession on mental health services: Recession? Mental Health Use Has Doubled.
Christianity
- Baptists and the Emerging Church from the Tall Skinny Kiwi.
Making a Referral: 1
May 18, 2009
Nearly all helping professionals at some time or another find themselves needing to make a referral to another specialist. Whether one is a physician, pastor, or a psychologist, we sometimes find that the client’s needs and goals can best be met by someone who has special training beyond what we possess. Sometimes we discover that the client’s needs conflict with our own needs, as in the case of a pastor who may have a client in need of intense, long term counseling. To provide such counsel with very many people would distract the pastor from his responsibility of ministering to the whole church.
Referral is a skill. Making a referral is like any intervention in a professional’s toolbox. If the helping professional is skilled in making referrals, clients often follow through and seek the services of the one to whom they are being referred. As with any skill, referral may be ineffective if we are not confident and competent in making referrals.
Helping professionals are sometimes reluctant to make referrals because they feel guilty that they are not able to help, or they may feel that referral casts doubts about our competence. We may be fearful that the client will perceive the referral as rejection. When a client expresses resistance to seeing a professional therapist, we may be tempted to attempt to provide the counseling ourselves, even though it may be against our better judgment.
Referral is particularly advisable when we recognize that we do not have the competence, training, or experience in dealing with the unique problems that are being presented to us. To practice beyond one’s training is considered unethical for professionals and is frequently a factor in malpractice lawsuits. Helping professionals must not allow their own feelings of guilt or fear of a client feeling rejected to keep us from doing the professional and competent thing which is sometimes to refer.
It is best not to work with some clients. It is advisable to refer when we find ourselves sexually attracted to a client, when we find ourselves angry, when we dislike our client, or in cases where there is a potential conflict of interest due to our other relationships with a client. Dual relationships increase the possibility of our objectivity and judgment being hindered when making diagnosis or treatment decisions.
Referral is appropriate whenever we have provided counseling services to a person who is not showing signs of improvement. After a reasonable period of receiving counseling, clients should show signs of improvement. If they do not, it is our ethical responsibility to not continue counseling when it is not producing progress. We also have an obligation not to abandon a client in distress, but we are responsible to facilitate a referral to another helping professional.
(Adapted from our corporate site: cfitulsa.com.)
What to Expect from Christian Counseling: II
May 4, 2009
An individual may come to counseling expressing a desire to overcome problems with depression. A counselor needs to hear their client’s own theory about what may be contributing to their depression. The counselor also may help the client investigate new areas they have not considered. In counseling, clients may be helped to discover their blind spots about the problem that brings them to counseling. After goals are established, the counselor then helps the client plan a strategy for resolving the problem.
Counselors use a variety of tools and techniques to help people change the things that they seek to change. At times a skilled counselor may ask a series of diagnostic questions or administer tests designed to assist them and their client in gaining greater insight into the nature of the problem. At other times counselors recognize that clients may lack life skills such as communication skills, conflict resolution skills, skills to enhance and sustain intimacy, and skills in the management of their thought life and emotions. Counselors may teach clients new skills to help them overcome the problem that brings them to counseling.
Counselors often use homework assignments as a tool for enabling clients to translate learning from the counseling session into their daily life. If clients are open to what the bible has to say, and if clients are receptive to prayer, the Christian counselor may utilize teaching from scripture, bible study assignments, and prayer as tools to assist people in growing in their knowledge of God’s will, and in their relationship to Him and others.
Occasionally a couple comes to counseling where the Christian spouse has coerced their non-Christian spouse to come to a Christian counselor. Occasionally the Christian will attempt to align themselves with the counselor, hoping they will side with them against their partner. Sometimes the Christian has been preaching and judging their spouse, and their secret hope is that the Christian counselor will join them in preaching to their non-Christian partner. It is extremely important that the Christian counselor assist these clients in learning a more effective way to disagree with their partner. It is also important for the Christian counselor not to take sides against any family member, but to always show respect to all family members.
As professional Christian counselors, we are committed to respect each person’s right to self determination and the exercise of free will. Though we attempt to steer our clients in a biblical direction, we never take responsibility for their life. We never coerce anyone to take a particular position. Advice may be given in the form of helping people identify alternatives and assisting clients in considering the pros and cons of each possible course of action. Counselors may assist clients by suggesting steps that may be taken to achieve a particular outcome. Counselors may gently and respectfully challenge myths, faulty thinking or reasoning, inconsistencies, and immoral behavior.
Though Christian counselors recognize man’s need for God, Christian counselors are not primarily evangelists. As is the case with all Christians, we are commanded in the great commission to go and make disciples. We at Christian Family Institute take a relational evangelism perspective. We hope to build loving and respectful relationships with all people, and to let our Lord’s light shine from our Christian lives. We show compassion for the struggles that people experience. We never give advice contrary to scripture.
Some Christians have defined “Christian Counseling” as only giving “spiritual and Biblical counsel”. This model assumes that the only tool a Christian needs is to read scripture to clients, and this is then called “Christian counseling”. We believe that whenever we help a client live an abundant life that is more conformed to the will of God, or find practical answers to problems, this is Christian counseling. Therefore, there is no distinction between the “secular” and “spiritual” realms. If we help a single parent manage impulses to mismanage money, this is “spiritual” counseling. We believe “secular counseling” is done without regard for spiritual and Biblical truth.
(Adapted from our corporate web site.)
What to Expect from Christian Counseling: I
May 1, 2009
Prospective clients have formed their expectations of counseling based on what they have heard from other people, read, and seen on television and in the movies. When a client comes to counseling, all of these previous experiences lead the client to have a certain set of expectations about what the experience will be like. If a person has watched One Flew Over the Cuckoo’s Nest
Some clients come to counseling expecting the counselor to be a judge in settling relational conflicts. Clients who come with this expectation attempt to present their case in a convincing way, expecting the counselor to rule in favor of one or another. Other clients come to counseling expecting that counseling will involve the counselor listening only. This expectation has been fostered by the writings of Carl Rogers in his humanistic psychology. Most clients today find the client-centered non-directive approach disappointing, and do not find it satisfactory. Others who have read Jay Adams work Competent to Counsel, expect that the counselor hunt down “the sin” that is the cause of the problem.
The Christian Family Institute model of counseling involves listening to clients tell their story. Clients are asked in the early phase of the first counseling session what brings them to counseling. Clients are encouraged to share the distress of their life that has caused them to seek professional services. Clients are also encouraged to bring other involved family members to the counseling session when possible. Unlike individual approaches to counseling, a family systems approach attempts to respect each person’s unique perspective on the problem. Family and marital counseling also encourages family members to talk to one another and to resolve their disputes with one another. Individual counseling sometimes fosters a belief that the counselor is siding with one person against another and may put the counselor in a position of operating with only half of the facts.
As counselors listen to each family member’s perspective on the problem, the counselor attempts to establish counseling goals in collaboration with family members that meet their needs and expectations. In a marriage counseling session, one partner may complain that there is not enough communication while another partner complains that there is not an adequate sexual relationship. The counselor attempts to establish mutually agreeable goals for the resolution of the problem to both partners’ satisfaction.
An individual may come to counseling expressing a desire to overcome problems with depression. A counselor needs to hear their client’s own theory about what may be contributing to their depression. The counselor also may help the client investigate new areas they have not considered. In counseling, clients may be helped to discover their blind spots about the problem that brings them to counseling. After goals are established, the counselor then helps the client plan a strategy for resolving the problem.
(Adapted from our corporate web site.)
Integrating Psychology and Christianity
April 27, 2009
Basic Assumptions. The counselors I work with have worked together to compare ideas about the integration of psychology, and marriage and family therapy with biblical theology. Counselors recognize that Christian counseling must first start with a Christian who has been brought to new life in Christ. Prior to our conversion we were dead in our sins and transgressions (Eph. 2:1). “But because of His great love for us, God, who is rich in mercy, made us alive in Christ even when we were dead in our sins and transgressions” (Eph. 2:4). As counselors we recognize that spiritual things can not be understood unless one is born of the spirit of God. To the non-Christian, spiritual things seem foolish (I Cor. 2:14). After one has become a Christian and begins to grow in faith and a knowledge of God’s Word, our entire value system is shaped by our Christian faith, our bible study, and our life of prayer.
As we grow as Christians, all of our principles are transformed by scripture. Whatever other wisdom we might find useful from psychology and other sources must be judged by scripture.
Counselors are called to counsel. Counseling is not a profession unrelated to our faith. Just as ministers are called to the ministry, Christian counselors are called to the ministry of counseling. The scripture indicates that each Christian is given spiritual gifts for the purpose of ministry to the Body of Christ (I Cor. 12:7). For Christian counselors, spiritual gifts will be manifested in the style of counseling that the counselor provides.
Christian counselors must recognize that all people have a need for Christ. As Christian counselors we recognize that God’s Word is absolutely reliable and authoritative in all it speaks to, particularly matters of faith, lifestyle, and morality. Christian counselors derive their sense of morality from God’s absolute Word. In practice we are committed to loving all persons whether or not they are Christians.
Human beings function and malfunction as a result of a complex and seamless interaction between biological, psychological, social, and spiritual forces. Malfunction in any one of these areas produces a ripple effect. If a person has a cavity in one tooth, the pain may radiate to many surrounding areas. So also do symptoms spread in any of the bio-psycho-social-spiritual dimensions.
As Christian counselors we also recognize the value of psychology, marriage and family therapy, counseling, psychiatry, and medicine. Persons who consult with us are often concerned about problems these disciplines may address. For one client the issues that bring them to counseling may be of a moral nature involving guilt and confusion. The next client that comes to us may be experiencing the consequences of sin in their life. The next person who comes may have been sinned against by others who were abusive and are attempting to recover from the damage that was done to their life. The next client who comes to counseling may be experiencing psychological symptoms related to a genetic or medical condition. As Christian counselors we depend on the Holy Spirit as well as our training in these disciplines in order to be effective in helping people with their concerns.
This approach would be classified by Collins (1975) as a “Christian Professional” model. We would classify it as a “spoiling the Egyptians” approach according to the Crabb (1977) model.
(Adapted from our corporate web site: cfitulsa.com.)
Different Types of Christian Counseling: II
April 23, 2009
Since the writing of Collins article in 1975, all five categories are alive and well. Evangelicals have increasingly steered away from the clinical pastoral education movement. Seminaries have strongly embraced the evangelical pastoral counseling and the Christian professional movement in counseling. Many seminaries have developed masters and doctoral programs integrating both theology and the practice of psychology and counseling. Christian graduate schools have flourished with strong enrollments in the areas of psychology, counseling, and marriage and family therapy. In spite of the increase in Christian counseling, a number of authors have been critical of whether or not Christianity and psychology are compatible at all.
Lawrence J. Crabb (Effective Biblical Counseling: A Model for Helping Caring Christians Become Capable Counselors
The second approach is the “tossed salad” approach. Crabb suggests that this approach is like a salad bowl in which a variety of ingredients are thrown into the bowl and tossed about. The problem with the tossed salad approach is that psychological notions are often accepted uncritically and without an understanding of the conflicting world views (i.e., humanism, existentialism, modernism, etc.) which are often represented in psychology. Consequently a number of unbiblical ideas may creep into this counseling.
The third category that Crabb refers to is the “nothing buttery.” In this approach the Christian counselor accepts nothing but the scripture as the basis for Christian counseling. The writing of Jay Adams would fall in to this category. Adams suggests that psychology has nothing to offer the Christian counselor, and psychology is always in conflict with biblical ideas. If one is true to this position there is never a need to study any counseling approaches, medicine or psychology.
The fourth approach and the approach that Larry Crabb takes is the position he calls “spoiling the Egyptians.” In the spoiling the Egyptian’s position the Christian counselor is first thoroughly grounded in the Word of God. Just as God made provision for the Israelites carried out of Egypt the spoils the Christian counselor critiques the findings of modern psychology and takes from them tools which are consistent with our biblical perspective. The Word of God is absolute in authority, and the only truly and fully reliable source of knowledge. Psychology on the other hand is a field that attempts to use the scientific method to investigate a variety of man’s problems, and seeks to determine what works in helping people resolve their problems. This approach recognizes that scripture is “ALL TRUTH,” but may not contain “all truth”. Knowledge exists beyond the scripture about many subjects including psychology, medicine, family life, etc. The Christian counselor operating from this approach takes what is useful and consistent with scripture while discarding the rest.
(Adapted from our corporate web site: cfitulsa.com)
