Counseling and Christianity: Five Approaches
Reviewed by Leah K. Clarke, Counseling, Messiah College
You are a Christian psychotherapist asked to provide consultation on a case. The client in question is a middle-class Caucasian male, a nontraditional college student, and a veteran. He presents you with academic struggles, poor social connections, and doubts about his faith. He also has a difficult family history, poor sleep, PTSD symptoms, childhood trauma, substance abuse, a son he has never seen, aggression toward women, noncompliance with medication, ambivalence about counseling, a possible brain injury, and is dropping hints about suicide. What is going on with this client and how do you help him? That is the daunting task put to five Christian psychotherapists in Counseling and Christianity: Five Approaches. The stated aim of this edited text is to help readers apply the concepts put forth in Eric L. Johnson’s previously published Psychology and Christianity: Five Views (2010).1 The views behind the five counseling approaches include levels-of-explanation, integration, Christian psychology, transformational, and biblical counseling. The editors’ descriptions of these views are readable and concise, and I found myself referring back to them as I got into the heart of the book.
Chapter 2 squarely aims the book at counseling students and educators. The editors take the time to explain why we should use theory to guide clinical work. The editors also connect to students and educators by imagining four new Christian professionals with different professional identities: social worker, Christian counselor, psychologist, and professional counselor. This encourages the reader to consider how their own (or their trainees’) backgrounds and spiritual development will impact their choice and use of a counseling approach. These introductions also seem intended to make the book inclusive of the various disciplines practicing counseling, although as a whole, the book’s language, sources, and focus on psychopathology reveal its root in [capital P] Psychology. This chapter wraps up with a description of the case of “Jake,” the client described above. I remain a bit baffled why such a difficult case was necessary. It seemed to highlight the five approaches’ similarities more than the differences (all five paid heed to the suicidality and brain injury in similar ways). The case is not fantastical but seems excessive for a text whose audience includes students and new professionals. I imagine educators could generate some fruitful discussions around initial reactions to this case (which in fairness is a learning objective of the chapter).
The five chapters describing the different approaches to “Jake” are set up as a loose continuum. Roughly put, the counseling approaches increase in their reliance on the Christian faith of the counselor and explicit incorporation of Scripture. The five chapters actually read more like a sandwich. The first and last approaches have some surprising similarities. Both are written in third person, which is reflective of their top-down approach, with the counselor in a seat of authority, driving the goals and process of therapy. They are also both problem focused, with the levels-of-explanation approach framing problems in the language of psychopathology and the biblical counseling approach framing them in the language of sin. Also, Thomas G. Plante’s take on a levels-of-explanation approach and Stuart W. Scott’s take on biblical counseling both seem to be on the extreme ends of the continuums within their own approaches. In Plante’s case, his approach does not require the counselor to be a Christian. His ideas about assessment and conceptualization would be familiar to any psychologist working in a secular setting. He does go in depth describing counseling interventions that find their base in Christian practices, such as the Spiritual Exercises of St. Ignatius. I think reading his approach will be reassuring to Christian counselors working in secular settings where they must diagnose clients. However I do think there is a missed opportunity to address what it means to be a Christian who is doing this kind of work, beyond just incorporating spirituality into counseling if the client is willing. In their description of the levels-of-explanation approach, the editors reference Warren Brown’s2 idea of resonance between the science of psychology and Christian understanding of the human condition. I would like to know how Plante’s approach resonates with his Christian faith. In the empathy he demonstrates with clients? In the high evidentiary standards he holds to ensure the best treatment available? His arm’s-length approach to the chapter does not provide this kind of insight, but again would provide a great point of discussion.
I also found myself wanting more from Scott’s biblical counseling take on “Jake.” Scott very clearly and confidently describes the philosophy of biblical counseling and how “Jake” would be seen through that lens. The distinctives of biblical counseling, as Scott describes them, are the incorporation of church involvement as a necessary component of therapy, the expectation that the Holy Spirit will work through the use of Scripture to affect change, and accountability being part of the counselor’s role. I had a hard time picturing how these distinctives would be executed in working with “Jake.” How does one hold accountable a client who is resistant to counseling? How does a counselor focus on the client’s sin without alienating and shaming him? I am sure Scott would have very sound responses to these questions; I just did not see the answers in the chapter. The first and last approaches may not be very winning to neophyte counselors. To get a fuller picture, it may be helpful to read other authors within biblical counseling and levels of explanation approaches.
Chapters 4, 5, and 6, the meat of the sandwich, apply the integration, Christian psychology, and transformational approaches. The differences among these approaches are less stark and their authors are admittedly hesitant ambassadors. Mark McMinn’s outlining of the integration approach is written in a very charming and engaging way. He describes a “best of three worlds” approach, incorporating psychology, theology, and spirituality. He writes in the first person and gives the clearest glimpse into both the mind of the counselor and the action going on in the counseling room. He does this by laying out his case conceptualization model and providing imagined dialogue between the counselor and Jake. I think his introduction to schema-focused therapy will assuage counselors’ and students’ hunger for what to do in counseling.
Diane Langberg was selected to discuss the perspective of Christian psychology. She writes in the second person, which echoes her team treatment approach and emphasis on building a relationship with “Jake.” She lays out three phases of counseling. Spirituality and Scripture are not emphasized until the final stage. The incremental incorporation of explicit Christian counseling interventions (such as reading Scripture) is a bit surprising given the introduction of Christian psychology as being cautious about secular interventions. But sound rationale is provided and she taps into the growing trend of trauma-focused therapy. I think many counselors will see themselves in the work she describes, or will want to aspire to it.
The transformational approach is the new kid on the block and Gary Moon is hesitant to claim adherence. Perhaps because of this the first third of the chapter is devoted to describing the approach and the context for its emergence. Moon seems a teacher at heart and has inventive ways of revealing the approach which he describes as “maintain[ing] a primary focus on personal spiritual transformation—for both the counselor and counselee—while looking for ways to incorporate insights and techniques from each of the five approaches” (136). His approach to “Jake” is broader than the others in that the specifics of the case do not seem to drive his decisions as much as his therapeutic style. But he provides some interventions that would be helpful to a wide array of clients.
The concluding three chapters are useful tools for educators and for readers who are seeking to implement one of the approaches. The editors provide discussion questions, thoughts about comparing and contrasting the approaches, and guidance for readers on identifying the approach that fits with their spiritual calling. They conclude with four case studies, not as complex as the story of “Jake,” which can be used for discussion or practice in applying the approaches. Some of this content does presume knowledge of the Five Views book. I did find that the Five Approaches book could stand on its own although it certainly sparked interest for further reading. The editors seemed to begin to address how the five approaches might be situated in diverse cultural and socioeconomic settings (SES) but this discussion was not developed. Cultural and SES implications were something to which the contributors paid varying levels of attention. Given the globalization of both Christianity and psychotherapy, this seems a very important next step for the Five Views and Five Approaches. I would wager that in some parts of the U.S., Christians with low SES have more access to counselors than pastors.3 Expansion of Medicaid under the new healthcare law may increase this. This presents an enormous opportunity but calls for a reckoning among Christian counselors.
Translating “Five Views” into “Five Approaches” is a logical and worthwhile, but not simple, endeavor. I commend the editors and contributors on a well thought-out text that will serve as a useful tool for students, educators, and clinicians who strive to reconcile their Christian faith with the work of counseling.
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Footnotes
- Eric L. Johnson, ed., Psychology and Christianity: Five Views (Downers Grove, IL: InterVarsity Press Academic, 2010).
- Warren S. Brown, “Resonance: A Model for Relating Science, Psychology, and Spiritual Issues in Counseling,” Journal of Psychology and Theology 23.2 (2004): 110.
- Philip Schwadel, “Poor Teenagers’ Religion,” Sociology of Religion 69.2 (2008): 125.
