Psychology Psychology Journal Article Review: The Bible and the Christian Counselor Assignment

profileTT24
McMinnChapters34.docx

Psychology, Theology, and Spirituality in Christian Counseling

Mark R. McMinn

McMinn, M. R. (2012). Psychology, Theology, and Spirituality in Christian Counseling. Tyndale House Publishers, Inc..  https://mbsdirect.vitalsource.com/books/9781414349237

Chapter 3 Prayer

“Is it okay if we pray together before ending today’s session?” Christians answer this question in different ways. Some always say yes, insisting that prayer is an essential part of all Christian experience and should routinely be included in Christian counseling. Others say no, asserting that counseling should remain distinct from spiritual-guidance or pastoral interventions. Either answer oversimplifies the complexities counselors face.

What If This Happened?

Ms. Henry is a counseling client whom you have been seeing for two months. Referred by her internist because of her excessive medical and physical complaints, she quickly displayed symptoms of somatization disorder. She avoids virtually all painful emotions and ends up having repeated physical problems as a result—stomach pain, irritable bowel syndrome, headaches, and so on.

During today’s session, you have been trying to help Ms. Henry understand her feelings toward her unfaithful husband. She insists that she is not angry, that she is willing to forgive because she knows it is her Christian responsibility, and that she probably needs to be more attentive to his sexual needs at home. Throughout the session she sheds no tears, expresses no pain, and talks of how her Christian faith has allowed her to cope with this, her husband’s fourth extramarital affair. Near the end of the session, she looks at you and asks, “Is it okay if we pray together before ending today’s session?”

How should the responsible Christian counselor respond to Ms. Henry? Before answering this question, consider another situation.

What If This Happened?

Ms. Thomas has been in counseling for six months, working on her feelings of depression and fears of abandonment. She has made excellent progress and until yesterday has felt hopeful about the future and closer to God than ever before. Yesterday, her mother died suddenly of a heart attack.

During today’s session, Ms. Thomas cries freely, expresses her pain, and reflects on her fears of being abandoned by those closest to her. She stops crying near the end of the session, puts her handkerchief in her purse, and begins to stand up to leave. You stop her and ask, “Is it okay if we pray together before ending today’s session?”

Ms. Henry and Ms. Thomas are in different situations, and the effects of praying with Ms. Henry will be different from the effects of praying with Ms. Thomas. There is not a simple yes or no answer to either scenario. On one hand, agreeing to pray with Ms. Henry might encourage her to continue using her faith as a means of denial rather than as a route to truth. On the other hand, refusing her request to pray with her might hurt therapeutic rapport, and prayer might be an avenue through which she could begin exploring her feelings. Praying with Ms. Thomas might lend a sense of comfort and hope in the midst of her feelings of despair. However, it could also contribute to feelings of dependency at a time when terminating the counseling relationship is imminent. Praying with her now might help bring her feelings of comfort and peace, or it might cause her greater feelings of abandonment later when the counseling relationship ends.

One of the common questions during my graduate school days in the early 1980s was, “Does psychotherapy work?” I remember a lecture in which Hans Strupp, Distinguished Professor of Psychology at Vanderbilt University, debunked the question. A more appropriate question, Strupp insisted, was, “Which types of psychotherapy work for which clients under which circumstances?” Similarly, “Should counselors pray with clients?” is the wrong question to ask. Instead we ought to ask, “Which forms of prayer should we use with which clients and under which circumstances?”

If we focus too intently on the question of praying with clients in sessions, we overlook other important questions about prayer in counseling. For example, how often do we pray silently for our clients during a counseling session? How often do we pray for our clients outside of the counseling session? What about devotional meditation as a spiritual and psychological tool for relaxation and anxiety management? By looking at the framework established in chapters 1 and 2, we can come to informed decisions about the questions.

Foundations

Psychology

Though it is beyond the scope of this book to give a comprehensive literature review of prayer, it will survey the prominent themes in the psychological literature. The literature about prayer can be roughly divided into two categories: the effects of prayer and using prayer in counseling.

The Effects of Prayer

Prayer is a common human experience. Studies show that ninety percent of Americans pray.78 However, studies about the effects of prayer are surprisingly sparse in the psychological literature, and most studies that have been reported are plagued with significant methodological problems. Dr. Michael McCullough has recently published a review of the psychological effects of prayer, including helpful discussions of the problems with previous studies and ideas for future research.79

McCullough identifies several themes regarding the psychological effects of prayer. First, prayer is associated with a subjective experience of well-being. Compared with those who do not pray, or who pray infrequently, those who pray often tend to experience more purpose in life, greater marital satisfaction, religious satisfaction, and a general sense of well-being. An even better predictor of well-being is the extent to which people experience a subjective sense of God’s presence while praying. Those who experience prayer as a deeply significant, even mystical, experience have a greater sense of well-being than others. We must exercise caution in interpreting these results because most of the studies reviewed were correlational in nature. When two variables are correlated, as prayer and well-being are, it does not necessarily mean that one causes the other. It could be that people who pray are happier or that happier people pray more often. Alternatively, there could be some third variable that explains why prayer and well-being are related. For example, it may be that highly religious people are happier and that they also tend to pray more often than moderately religious or nonreligious people.80

Second, McCullough reviews the literature on using prayer as an aid in coping with physical pain and medical problems. A number of studies indicate that prayer is a helpful resource in coping with various medical problems. Other studies demonstrate that prayer is used often by those experiencing high levels of physical and emotional discomfort.

Third, several studies have considered the relationship between psychological symptoms and prayer. The few studies reported suffer from methodological problems and should be interpreted cautiously, but prayer appears to be positively related to abstinence for those in alcohol treatment and negatively related to fears of dying.

Fourth, one well-designed study demonstrated the effectiveness of intercessory prayer. Patients in a coronary care unit were randomly assigned to either the control group or the group that received intercessory prayer by a group that met outside the hospital on a regular basis. Neither the patients nor the researchers who assessed the outcome knew to which experimental condition the patients were assigned. On some (but not all) of the outcome measures, the recipients of intercessory prayer were healthier upon discharge from the hospital than the control group. The probability of some of the observed differences between groups occurring by coincidence or random chance is less than one in ten thousand!

These findings will come as no surprise to those who accept the Bible as authoritative. Nonetheless, the findings are important because they translate the effectiveness of prayer into the scientific language that is acceptable to those in mental health professions. Of course, these studies do not specifically address the focus of this book: What about the use of prayer in counseling?

Prayer in Counseling

Based on survey data, prayer appears to be a frequent but not routine part of Christian counseling and psychotherapy.81 Prayer is used with some but not all counseling clients, depending on the theoretical orientation of the counselor and the diagnosis of the client.82 Among those who view prayer as an important part of counseling, the methods of implementing prayer vary widely.

Some studies advocate praying aloud with clients during therapy sessions. In a recent survey of doctoral-level members of the Christian Association for Psychological Studies (CAPS), respondents reported using in-session prayer with approximately 30 percent of their clients.83 There are multiple motives for including prayer in a counseling session. Some counselors pray in session because prayer can enhance clients’ spiritual lives and clarify their perspectives. Craigie and Tan write from a cognitive-behavioral perspective: “Indeed, praying with clients that they may be liberated from resistant misbeliefs, that they may be empowered to do the truth, and that they may come into a deeper relationship with the truth can sometimes be a most powerful experience.”84 Others report using prayer because it models healthy interpersonal communication. Crocker advocates praying with couples in marital therapy because prayer models effective communication. “I believe that Christian pastors can use the traditional forms of prayer as a guide in teaching couples and individuals how to communicate well, and at the same time, can help the persons they work with come to a deeper understanding of the Christian life.”85 Still other counselors choose to pray with clients because their clients desire prayer to be part of the counseling relationship, and prayer enhances therapeutic rapport.86

It is important to note that none of these reasons for prayer is meant to undermine or dismiss the spiritual power of prayer. Prayer affects human interactions, but more important, it is a method of communicating with God. “It should be emphasized, particularly with prayer and imagery . . . that we take the position that it is the Holy Spirit who heals. The imagery and prayer approaches that have been described are not to be viewed as primarily psychological techniques or procedures. Rather, they should be viewed as vehicles to put clients, in the words of Foster, ‘in the way of God.’”87 Thus, for a variety of reasons many counselors choose to pray with clients during counseling sessions. To date, no empirical research has been reported on the effects of praying aloud during counseling sessions.

Others advocate using meditation, contemplative prayer, or imagery in counseling sessions, techniques that have received preliminary research support.88 Carlson, Bacaseta, and Simantona demonstrated that meditating on Scripture and liturgical prayer helped reduce anger and anxiety more effectively than progressive relaxation training or no treatment.89 Similarly, Propst found religious imagery, such as having clients picture Christ going with them into a difficult situation, helped reduce depression among religious clients.90

Although in-session prayer and meditation have received the most attention in the psychological literature, prayer can be integrated into counseling in other ways. Some counselors pray during sessions without disclosing their prayers to clients. Praying during pauses in the conversation is often a way not only to keep a spiritual focus in counseling but also to keep from impulsively filling the silence with unnecessary words.

What If This Happened?

Theresa is a lay counselor working in individual and group therapy with survivors of sexual abuse. She has been a lay counselor for two years and feels good about her counseling skills, but she has one nagging problem: she feels uncomfortable with silence and compensates by changing the subject. Many times her clients begin exploring painful emotions, become quiet, and then Theresa changes the topic.

What if Theresa develops a new habit? In times of silence, she trains herself to silently pray for the client sitting across from her. Lord, please embrace _______ with your love right now as she confronts this pain. Dear God, please help _______ see you clearly, even though there is such a cloud of evil in her past. As Theresa develops this new skill, she will be introducing the power of prayer into her counseling work and breaking a bad habit at the same time.

Silent prayer during counseling can also be used to sustain the counselor through difficult and stressful work. Schneider and Kastenbaum surveyed hospice workers and found that prayer helped workers cope with the demands of their daily interactions.91 Most often the workers used silent, private, spontaneous prayers and rarely prayed with the patients themselves.

Another way prayer can be used as part of therapy is by encouraging clients to pray outside of the counseling session. Finney and Malony found clients’ contemplative prayer outside the counseling sessions to be a helpful addition to psychotherapy.92 The nine adults participating in the study were trained in contemplative-prayer techniques after six weeks of psychotherapy, then kept records of their daily use of contemplative prayer throughout the remainder of therapy. The researchers used a time-series design to test the effects of psychotherapy alone versus psychotherapy plus contemplative prayer. The participants showed a striking decrease in subjective levels of discomfort as a result of psychotherapy plus prayer but little change on the scales used to measure personal spirituality. Because of the limits of the design (no control group), it is difficult to determine whether the overall benefits were due to psychotherapy, prayer, or a combination of both. Until more research is reported, we can only speculate that the use of prayer outside counseling sessions provides therapeutic benefit.

Finally, therapists can combine prayer and counseling by praying for clients outside of the counseling session. On the average, doctoral-level CAPS members report praying for 64 percent of their clients and view it as a valuable part of their clinical work.93 The helpfulness of praying for clients outside of a counseling session is impossible to test scientifically in a double-blind study because counselors would always know which clients they prayed for and might inadvertently change the counseling process as a result. Even without scientific proof, we can assume that praying for clients outside of sessions helps counselors maintain a ministry focus and helps counseling clients in their spiritual and emotional healing. “The prayer of the righteous is powerful and effective” (James 5:16).

Christian Theology

Theologian J. C. Lambert notes that prayer has two meanings in Scripture. In the narrowest sense, prayer is petition, asking God for something. In the wider sense, prayer is worship, reflecting on God’s character.94

Prayer as Direct Petition

Prayer as direct petition is often used by people in need, including counselors and their clients. But this creates an interesting tension. On the one hand, if God is sovereign and already knows the future, then what difference does it make for us to pray? On the other hand, if prayer can change the future, then is God not really sovereign? This tension reflects the larger discussion of theological determinism versus free will, a discussion that has gone unresolved through centuries of debate. Though we must appeal to paradox and mystery rather than attempt a thorough resolution of the debate between determinism and free will, Millard Erickson helps by discussing our partnership with God in prayer.95 When we pray, we humble ourselves and ask to become a partner in knowing and doing God’s will. From this position of humility, we can see God’s will more clearly, and God grants us our deepest desires. For example, only Peter walked on the water because only Peter asked (Matt. 14:22-33). By praying, we commit our will to partnership with God’s will.

“May the force be with you” is not a good understanding of petitionary prayer. We are not harnessing a power that we control, and we are not simply creating a positive, expectant attitude for good things to come. Rather, petitionary prayer creates in us a longing for God’s will. “Prayer is not so much getting God to do our will as it is demonstrating that we are as concerned as is God that his will be done.”96 Many prayers are not answered the way we would like, but we are to continue turning our hearts toward God and conforming our will to God’s will in prayer. Eventually we change. “In prayer, real prayer, we begin to think God’s thoughts after him: to desire the things he desires, to love the things he loves, to will the things he wills.”97

We are told in Scripture to pray persistently because persistent prayer comes from a sense of compelling urgency (Luke 11:8-10). Prayer is not to be a casual encounter like a Christmas list for Santa Claus; prayer should be an extension of the passions of our heart. By praying persistently and consistently, we remind ourselves to seek God while telling God our deepest desires.

Using petitionary prayer in counseling, where the counselor prays for the client, can help model the qualities of effective prayer. However, it can also introduce problems.

What If This Happened?

Mr. Baldwin prays at the end of each counseling session with Gene, his counseling client. Gene finds it reassuring and comforting to know his counselor prays for him. Gene also feels he can learn about prayer by observing his counselor. He has struggled with an inconsistent prayer life for years and feels relieved to know that God is now hearing his needs through his counselor’s prayers.

The good news is that Gene is learning about prayer and that his counselor is praying for him. There is also bad news. First, Gene may believe his counselor’s intercessory prayer removes his obligation to petition God directly. If prayer is partnering with God, then direct personal petition is an important element of effective prayer. Second, if prayer demonstrates a person’s desire for God’s will to be done, then it is an important personal discipline that should not be regularly delegated to another. Gene is losing an opportunity for shaping his character by relying on his counselor to pray for him. Third, the persistence of effective prayer might be compromised by the natural limits of weekly counseling sessions. The beauty of prayer is that we can approach God anytime: clients and counselors can pray outside of the office as frequently as they desire. Mr. Baldwin would be wise to teach Gene to petition God directly, both inside and outside of the counseling office.

Prayer as Worship

Christian prayer goes far beyond petitioning God with our needs. In prayer we confess our sinful nature (Ps. 51:3-5), give thanks for God’s providence throughout history (Ps. 136) and in our personal lives (1 Sam. 2:1-10), and express adoration to God (Rom. 11:33-36). In this wider context of understanding prayer, many mystics and religious leaders have written about spiritual and emotional healing.98

As with petitionary prayer in counseling, there is good news and bad news. The good news is that contemplative prayer and worship can open our spiritual eyes at the same time that it can distract us from our human habits of egocentrism and self-absorption. Those who have mastered self-forgetfulness understand worship through prayer. Prayer is, as Richard Foster writes, “finding the heart’s true home.”99 It is also good that Christian meditation appears to provide significant benefits in reducing anxiety and anger.100 The bad news is that some people have not established careful theological boundaries for their understanding of prayer and meditation and have drifted toward heresy.101 Thus, counselors who use devotional meditation and prayer in therapy should carefully evaluate their methods from theological as well as psychological perspectives.

Spirituality

The capacity to experience God through prayer is the center of Christian spirituality. Richard Foster begins his book on prayer with this invitation:

God has graciously allowed me to catch a glimpse into his heart, and I want to share with you what I have seen. Today the heart of God is an open wound of love. He aches over our distance and preoccupation. He mourns that we do not draw near to him. He grieves that we have forgotten him. He weeps over our obsession with muchness and manyness. He longs for our presence.

And he is inviting you—and me—to come home, to come home to where we belong, to come home to that for which we were created. His arms are stretched out wide to receive us. His heart is enlarged to take us in.102

Foster’s words welcome us to enter a place of rest, a place of wholesome spiritual renewal. Throughout the remainder of his book, Foster demonstrates that prayer is the door leading to such a place. Elsewhere Foster writes, “Of all the Spiritual Disciplines prayer is the most central because it ushers us into perpetual communion with the Father.”103 In his classic book, Prayer, Ole Hallesby comes to a similar conclusion: “Prayer is the breath of the soul, the organ by which we receive Christ into our parched and withered hearts. . .  As air enters in quietly when we breathe, and does its normal work in our lungs, so Jesus enters quietly into our hearts and does His blessed work there.”104

This, of course, raises a nagging question for many Christians. If prayer is so powerful and if it ushers us into God’s presence, why is it that we can fill our life full of prayer and yet so rarely experience God in deep ways? Many Christians pray before meals, pray throughout the day, pray in church, pray with children at bedtime, and still feel distant from God. How can this be?

Perhaps the spiritual power of prayer eludes us because we fail to have a balanced diet of prayer and other spiritual discipline in our lives. If prayer serves two functions in Scripture—petition and worship—we often overemphasize petition and neglect worship. “Lord, bless this meal to our bodies.” “Dear God, grant us safe travel to our destination.” “Heavenly Father, please restore my physical health.” We keep prayer lists in which we describe our petitions and record the dates of answered prayers. These prayer activities are good; petition is an important part of prayer. But we must remember that prayer is also an act of worship, a way of celebrating God’s character and gracious provision. Worship takes time.

Dallas Willard suggests that we cannot truly understand spiritually transforming prayer unless we are also practicing the disciplines of solitude and fasting.105 Time-pressured prayer rarely allows us to enter into meaningful worship. It is difficult to worship God through prayer when the lasagna is getting cold or when the congregation is anxious to get home before the play-off game starts. Worship requires us to reflect deeply on our need and God’s provision, insights that come most naturally in moments of quiet. Bill Hybels, in his book Too Busy Not to Pray, describes the importance of “RPM reduction,” slowing down each day to worship and listen to God through prayer.106

To pray meaningfully, we must understand our deep thirst for God. Hallesby writes: “Listen, my friend! Your helplessness is your best prayer. It calls from your heart to the heart of God with greater effect than all your uttered pleas. He hears it from the very moment that you are seized with helplessness, and He becomes actively engaged at once in hearing and answering the prayer of your helplessness.”107

We often cram our lives so full of activity that we fail to recognize our need for God. With solitude and fasting we are forced beyond our defenses of busyness, and we begin to see ourselves accurately as thirsty, needy people longing for a gracious Savior.

What are the implications for counseling? First, it seems clear that the transforming power of prayer cannot be fully experienced by praying at the beginning or end of a counseling session. Spiritually transforming prayer takes time and disciplined training. For prayer to be an active agent for change in a client’s life, it must become part of a disciplined spiritual life outside the counseling office.

Second, spiritually sensitive counselors may sometimes need to teach clients about prayer. Counselors give homework for a variety of reasons, and prayer homework can be considered a legitimate assignment for many Christian clients. Bill Hybels outlines a series of behavioral steps that he uses each day to pray: journaling, writing out prayers, and listening to God.108 Implementing these same steps can be a useful counseling assignment in many situations. Sometimes prayer training can begin in the counseling session, especially when devotional meditation is used as an intervention for anxiety-related problems. There are important ethical considerations for those using spiritual interventions, especially for those receiving insurance reimbursement for specified treatment protocols. These will be discussed later in this chapter and throughout the book.

Third, the insight people gain in counseling may often prove helpful in their personal prayer life. If effective Christian counseling brings people to a healthy sense of self-identity and greater awareness of their brokenness and the fallen human condition, then it also prepares people to reach out to God. Our sense of need propels us to meaningful prayer. Conversely, when counseling causes people to think of themselves as victims, their prayer life is hindered. Some people have been victimized and wounded by past events, and effective Christian counseling allows people to explore their pain, anger, and grief about past hurts. But deep inner healing requires more. Wounded people must recognize their personal need and their capacity to wound others before fully knowing God’s healing grace.

Psychological and Spiritual Health

From the preceding discussion, it seems clear that prayer is an important element of spiritual and psychological health. Prayer is at the heart of Christian piety, allowing us to humble ourselves and worship God and to bring our concerns directly to God. Preliminary scientific evidence, as reviewed earlier, supports the effectiveness of prayer in promoting health.

But we must also recognize that not all prayer is effective. In the Sermon on the Mount, for example, Jesus was critical of public prayers offered by those thinking more about the social impact of their prayers than about God (Matt. 6:5). Jesus taught, “Whenever you pray, go into your room and shut the door and pray to your Father who is in secret; and your Father who sees in secret will reward you” (Matt. 6:6). Jesus also condemned prayers of empty repetitious phrases and prayers of smugness (Matt. 6:7; Luke 18:9-14).

Because prayer is a good thing that can be misused, its use in counseling warrants careful monitoring. Some forms of prayer are always an important addition to effective counseling, and others can be easily misused and at times can work against the goals of Christian counseling. The amount of risk I associate with various forms of prayer is shown in figure 4.

Some forms of prayer are almost always wise and productive. What case could possibly be made against a counselor’s praying for clients outside of the counseling sessions? If, as Christian counselors, we are committed to the health of our clients and we believe in the power of prayer, then we have a spiritual obligation to pray faithfully for those in our care. These prayers of petition are to be persistent and regular, an essential part of the disciplines exercised by the spiritually vibrant counselor. It is encouraging to note that on the average, CAPS members report praying outside of sessions for the majority of their clients.109 Praying outside of sessions provides spiritual resources for counseling clients, while reminding counselors of the importance of humbly seeking God’s direction.

Similarly, praying for clients silently during pauses in the counseling dialogue is an excellent way to remind ourselves that we are imperfect ministers of God’s grace and truth, seeking the Holy Spirit’s guidance in each word and expression we use. Of course, if we are engaged in silent prayer too frequently or too actively during the counseling session, it could compromise our listening acuity, so the counselor needs to set some personal limits for silent in-session prayer.

Devotional-meditation assignments outside of sessions can also be helpful for many clients, especially those who are dealing with anxiety- or faith-related problems. Devotional meditation appears to be at least as effective as progressive relaxation in reducing anxiety and anger and should be considered a legitimate alternative for Christian counselors.110 However, it is important to recognize that devotional meditation is not equally appropriate for all counseling problems. Also, some counselors have expressed concerns that imagery and meditation are spiritually dangerous interventions.111

Devotional meditation can also be effectively used as part of counseling sessions. This is sometimes effective in behavioral interventions when muscle tension needs to be reduced. Also, imagery and meditation can be used in reducing symptoms of depression among religious clients and in modifying faulty core beliefs in cognitive therapy.112 The risk of in-session meditation is that the social demands of the situation might significantly change the worship experience. Clients might be concerned about being “spiritual enough” to please the counselor. Socially tense clients may find it threatening to close their eyes for a prolonged period during the session, wondering what the counselor is doing or thinking during those moments of silence. It is equally effective to make an audio recording of instructions and have clients do devotional meditation someplace where the social demands can be avoided.

For some clients, in-session prayer training might be an appropriate intervention. Just as some clients benefit from appropriate social skills or more accurate self-talk, others benefit from skills in spiritual disciplines. Clients can learn various types of prayer in sessions and then complete out-of-session homework assignments to strengthen their prayer life.

Prayer training holds potential but also introduces significant risk for several reasons. First, not all counseling is skills oriented. Those functioning from a client-centered or psychodynamic perspective may find that overt skills training detracts from the overall therapeutic process. Second, prayer training may pose ethical problems for counselors who are representing their techniques to insurance companies as mainstream interventions. This relates to a third problem—we have no scientific evidence for the effectiveness of prayer training. Although as Christians we may feel no need for such evidence (because we have experiential and scriptural evidence for prayer), we need to speak the scientific language of the mental health professions if our methods are to gain credibility.

Occasional in-session prayers of petition can be helpful under some circumstances. On the average, CAPS members use in-session prayer with approximately one-third of their clients.113 However, as the cases at the beginning of this chapter illustrate, prayer can be more or less useful in various situations. In-session prayer for those facing acute stress and grief reactions may often be helpful, and a prayer of thanksgiving can be a spontaneous act of worship in the midst of a significant breakthrough in counseling. But praying in other situations can be harmful. For example, praying with an actively schizophrenic or manic patient could be destructive and harmful to the fragile psychological state of the patient and to the treatment relationship.114

Finally, though some competent Christian counselors will disagree with me, I believe routine in-session prayer introduces significant risk and minimal benefits to the counseling relationship. On the positive side, routine in-session prayer can model a commitment to spirituality, and it can remind both the counselor and client of their desire to follow God’s leading. Some counselors advocate praying to invoke the Holy Spirit’s power in counseling, but these prayers can be done privately and silently without introducing the therapeutic risks of praying aloud. On the negative side, there are many concerns to consider. First, although praying with clients may teach effective communication skills, it is this type of praying that Jesus condemned when he told the religious leaders of his time to stop praying for social effect.115 Instead, Jesus taught that prayer should be an intimate part of a private relationship with God (Matt. 6:5-6). Second, counselors who pray routinely with most or all of their clients face a risk of praying words of meaningless repetition, as is common of prayers before meals. Prayer is not meant to be a ritual of special words that invoke God’s blessing hour after hour but a way of humbling ourselves before our just and gracious God. When we give up the essence of prayer and rely instead on the empty symbols of language, we grieve God and deceive ourselves. Third, although counselors sometimes pray to meet their Christian clients’ expectations, it is often more important to understand the origin of the clients’ expectations than to placate them. Religious practices can be used as a defense against insight and self-understanding, as was the case for many of the religious leaders that Jesus criticized. Fourth, praying aloud in counseling sometimes weakens the clients’ sense of direct accountability to God. “My counselor prays for me every week,” is quite a different experience from praying without ceasing (1 Thes. 5:17)! Fifth, praying together introduces a form of interpersonal intimacy that may not be wise in every counseling situation. Sixth, praying together inhibits some from disclosing important information. Because routine prayer may elevate counselors to spiritual-giant status in clients’ eyes, some will hesitate to discuss their struggles with sin, fearing a judgmental response.

Thus, some forms of prayer (e.g., praying for clients outside of sessions) are always helpful, and others (e.g., routine in-session prayers with clients) are sometimes helpful but pose significant risks. My goal is not to identify a list of good types of prayers and bad types of prayers but to keep the question at the beginning of this chapter in the forefront: “Which forms of prayer should be used with which clients and under which circumstances?” In answering this question for each specific counseling situation, it is important to remember the model of psychological and spiritual health described in chapter 2. Three specific questions can help counselors assess the appropriate use of prayer in a variety of clinical situations.

Will This Help Establish a Healthy Sense of Self?

In one sense, prayer may be a perfect illustration of getting beyond our human tendency to be self-focused to a state of self-forgetfulness. Those who are broken and weary find comfort in the presence of Christ (Matt. 11:28-30). Those who are self-absorbed must see beyond themselves to see Christ (Luke 18:9-14). Counselors can use prayer to help their clients gain perspective and a more accurate understanding of themselves.

What If This Happened?

Sabrina suffers from self-hate and an impoverished self-image. Sexually and physically abused as a child, Sabrina believes that she will always be hurt, abandoned, and rejected. After being in a healthy counseling relationship for several months, Sabrina starts feeling better and expresses an interest in strengthening her spiritual life. Her counselor assigns a meditation exercise that she completes three times weekly outside of the counseling sessions. Sabrina pictures herself in Christ’s presence. With a warm look of comfort on his face, Christ speaks to her, “Come to me, all you that are weary and are carrying heavy burdens, and I will give you rest. Take my yoke upon you, and learn from me; for I am gentle and humble in heart, and you will find rest for your souls” (Matt. 11:28-29). With time, Sabrina begins to experience an emotional warmth as she thinks of God’s love. Prayer plays an important role in her healing process.

Though prayer is ideally suited to help us get our eyes off ourselves and onto a loving Savior, we are adept at distorting prayer and allowing it to distract from a healthy sense of self. For example, what if Sabrina’s counselor has her do the same imagery exercise during a session? As she closes her eyes, trying to picture Christ, she instead is flooded with other distracting thoughts. What is my counselor doing while my eyes are closed? Am I relaxed enough? Do I have the right expression on my face? Is he staring at my body? In this context, prayer becomes a vehicle of greater self-focus and reinforces a faulty self-image.

Or what if Sabrina’s counselor prays routinely at the beginning and end of each session? Sabrina begins counseling feeling angry at God and silently questions whether there is a benevolent God. She asks herself, If God is so loving, then how could these awful things have happened to me in the past? Each time her counselor prays in session, Sabrina feels unspiritual and increasingly committed to hiding her doubts from her counselor. As a result, she does not feel free to explore meaningful issues of faith in counseling.

When prayer helps a client establish a healthy, accurate sense of self, it can be a helpful part of treatment. When it is used insensitively or as a perfunctory part of treatment, it can be spiritually and emotionally harmful.

Will This Help Establish a Healthy Sense of Need?

Prayer assumes need. “Prayer and helplessness are inseparable.”116 Jesus described this in a parable of two churchgoers in Luke 18. One man, a religious leader, pronounced his self-sufficiency, “God, I thank you that I am not like other people: thieves, rogues, adulterers, or even like this tax collector. I fast twice a week; I give a tenth of all my income” (Luke 18:11-12).

The other, a tax collector, prayed a simpler prayer: “God, be merciful to me, a sinner!” (Luke 18:13). The tax collector knew more about prayer than the religious leader did. Prayer requires a humble awareness of our need for God.

In the mental health professions, we value autonomy and self-confidence more than brokenness and neediness. I believe both are important. A healthy sense of self allows us to exercise freedom, accept responsibility, and make good decisions. A healthy sense of need allows us to keep our humanness in perspective and to keep us looking to God for hope and direction.

The tax collector in Jesus’ parable showed signs of both self-confidence and neediness. He had the confidence to come to the temple, though he knew he was a sinner, and to ask God for mercy, though he knew he was undeserving. He had the humility to admit his need and ask for help. Prayer that is used effectively in counseling is also based on both: enough self-confidence to ask for help and an accurate understanding of human need. God is found not by wallowing in shame or by feeling better about our human potential but by humbling ourselves and looking to a transcendent Creator for sustenance.

Today, the parable Jesus told might take a different form. Two counselors prayed with their clients. Counselor A prayed: “Dear God, help Sabrina recognize that she is a wonderful person created in your image. She is creative, energetic, fun, and caring. Help her see her value and stop being so critical of herself.”

Was Counselor A talking to God or to Sabrina? This prayer may help Sabrina’s self-image and self-confidence, but there are more direct ways to accomplish these goals. And more significant, this prayer may hurt Sabrina in her spiritual quest by communicating that God loves her because of her qualities rather than because of God’s gracious character.

Counselor B teaches Sabrina to meditate on Psalm 40:17 ten minutes each day: “As for me, I am poor and needy, but the Lord takes thought for me. You are my help and my deliverer; do not delay, O my God.”

Counselor B teaches Sabrina to recognize that God’s love does not depend on her qualities. At the deepest emotional level, Sabrina does not want to be loved because she is good enough to be loved; she wants to be loved regardless of her strengths and weaknesses. God offers such a love, and Counselor B helps Sabrina see it.

Will This Help Establish a Healing Relationship?

Because effective counselors simultaneously observe and participate in counseling relationships, it is important to anticipate the relational effects of various forms of prayer in counseling. Counseling requires a close, confiding relationship, and in many cases, praying together draws two people closer together. In this sense, enhancing the human interaction can be a useful side effect of praying together in counseling. After an initial therapeutic bond is established, however, the counselor sometimes has to watch that the counseling relationship does not become excessively close. A counselor and client share a temporary, transitional relationship, and the counselor must maintain sole responsibility for keeping the relationship at an appropriate level of interpersonal intimacy. When the counseling relationship appears to be getting too close, praying together in a session is usually not a good idea.

Similarly, those who are inclined toward dependency may naturally look to their counselors for emotional and spiritual strength. As counseling progresses, it is important for the counselors to give clients progressively more responsibility for personal spiritual well-being.

Most important, effective Christian counselors recognize that counseling relationships often point clients toward a healthier view of God. The counseling relationship is helpful when it displays aspects of God’s character; it is harmful when it becomes a means of personal power, grandiosity, or self-gratification. When prayer draws more attention to the counselor or the client than to God, it misses the mark. The beauty and changing power of effective prayer is accomplished as we humble ourselves and draw close to God.

Facing the Challenges

All the challenges of intradisciplinary integration discussed in chapter 1 can be seen in Christian counselors’ understanding and use of prayer.

Challenge 1: Moving from Two Areas of Competence to Three

Many Christian counselors have training in theological perspectives on prayer, and many have thought in depth about the psychological implications of using prayer in counseling. The third area of competence, spiritual formation, is less familiar to most Christian counselors.

Here we must make a distinction between basic and advanced competence. When first trained, counselors have basic competence in counseling interventions. With time and experience, they become better counselors and often gain advanced competence in psychological theory and technique. Most counselors do not gain advanced competence in theology or spiritual formation; theologians and spiritual directors have advanced competence in their respective specialty areas. Nonetheless, counselors can aspire to basic competence by reading and studying the works of theologians and spiritual directors and by practicing their suggestions.

This distinction between basic and advanced competency is important because counselors must not confuse their roles with the roles of theologians and spiritual directors. Counseling is not the same as spiritual direction, and it should not replace spiritual direction.117 In the same way, few Christian counselors are superb Bible expositors. Nonetheless, responsible Christian counseling is informed by a foundational understanding of theology and spiritual formation.

Those with basic competence in spiritual formation understand that prayer is an essential part of knowing God. Those with advanced competence view prayer as “the main business of their lives.”118 Prayer can never be captured by words in a counseling session or even by a weekly prayer journal. Prayer results from an awareness of being in God’s presence continually, a natural part of the inner life of those who have learned the most about walking with God. Thus, as Dallas Willard writes, we cannot know the power of prayer until we understand and practice the other disciplines of the inner life.

When Dr. Gary Moon and his colleagues surveyed religiously oriented graduate programs in counseling and psychology, their respondents reported prayer to have scriptural support and subjective value in counseling. Despite the perceived value of prayer, respondents indicated that little attention was given to prayer in the curriculum.119 Similarly, little emphasis was given to other disciplines of the inner life, including fasting, solitude, and meditation.

In the Wheaton College doctor of psychology program, we find it useful for students to take a spiritual formation course during their first semester of study. In addition to giving students an opportunity for focused study on the spiritual disciplines, it allows them to develop personal practices that enhance their spiritual development.

Challenge 2: Blurred Personal-Professional Distinctions

Virtually all mental health professions recognize the importance of the counselor’s emotional health for effective counseling. A distressed counselor is a dangerous counselor.120 The American Association of Marriage and Family Therapists (AAMFT) has addressed personal distress in its ethics code: “Marriage and family therapists seek appropriate professional assistance for their personal problems or conflicts that may impair work performance or clinical judgment.”121

The National Association of Social Workers has a similar statement in its ethics code: “The social worker should not allow his or her own personal problems, psychosocial distress, substance abuse, or mental health difficulties to interfere with professional judgment and performance or jeopardize the best interests of those for whom the social worker has a professional responsibility.”122

The American Psychological Association’s (APA’s) code of ethics requires that “psychologists recognize that their personal problems and conflicts may interfere with their effectiveness.”123 The American Counseling Association states that “the member avoids bringing personal issues into the counseling relationship, especially if the potential for harm is present.”124

These guidelines limit the extent to which a counselor’s life is personal, especially if personal issues affect professional work. In the same way, the personal prayer life of a Christian counselor—one who deals with the care of souls on a daily basis—is not private because the spiritual life of the counselor spills over into the counselor’s understanding of problems, ways of relating, and therapeutic strategies. Though Christian counselors might like to define clear boundaries between personal, spiritual, and professional concerns, no such lines exist.

A Christian counselor’s ability to understand the place of prayer in effective therapy is limited by the counselor’s personal spiritual disciplines. The first step for counselors who want to increase the use of prayer in their counseling work is to evaluate their personal prayer patterns.

Challenge 3: Expanded Definitions of Training

Because effective prayer in counseling emerges from a counselor’s inner life, the counselor’s level of spiritual maturity will provide an upper limit for the potential impact of prayer in counseling. Thus, training is intensely personal.

Several excellent books on spiritual formation and spiritual disciplines are available. Richard Foster’s books Celebration of Discipline and Prayer are inviting books with practical suggestions for personal training.125 Dallas Willard, in The Spirit of the Disciplines, argues persuasively for the importance of personal discipline and training in spiritual formation.126 Don Postema’s Space for God provides appealing and practical examples for prayer and spiritual development.127 Ole Hallesby’s Prayer is a passionately written classic affirming the essential role of prayer for the growing Christian.128 Reading is an important starting point, but practicing the inner disciplines, including prayer, is an essential part of spiritual formation. Each of these authors, and many others, describe helpful ideas for enriching one’s prayer life. These ideas include taking courses in spiritual formation, enlisting the help of a spiritual director, getting away for a time of prolonged solitude and prayer, and participating in weekly prayer groups and special events such as concerts of prayer.

Challenge 4: Confronting Dominant Views of Mental Health

Though we are in the midst of an encouraging trend that leaves room for religious values in counseling, psychology and counseling have generally been overly concerned with self-determination and egoistic goals.129 In stark contrast, prayer moves one’s eyes away from self and onto God. In this regard, Christianity and popular psychology often point in different directions: psychology toward greater self-determination and Christianity toward greater reliance on God.

Though some psychologists may pity those who deny personal freedom for the sake of religion, Christians believe that those who have journeyed far into self-forgetfulness by immersing themselves in the disciplined life of spiritual formation are not to be pitied. Rather, they are in the center of God’s will, where they find peace and comfort and joy to sustain them through life’s many challenges. Jesus put it succinctly: “For all who exalt themselves will be humbled, but all who humble themselves will be exalted” (Luke 18:14).

Challenge 5: Establishing a Scientific Base

Although psychologists once thought that religious ideas and practices were inversely related to mental health, there is growing evidence that this is not the case. From a scientific perspective, people with a profound intrinsic commitment to their religious faith are at least as healthy, and probably more healthy, than their nonreligious counterparts.130

Despite these encouraging findings, a great deal of scientific work needs to be done. The few studies reviewed by McCullough, described earlier in this chapter, have left unanswered many questions about prayer. And most of the studies that have been reported are only remotely related to using prayer in counseling.

What are the effects of audible in-session prayer on therapeutic alliance, on the depth of disclosure, and on counseling effectiveness? How effective are devotional-meditation assignments in reducing stress when they are used as part of a counseling treatment? Does an active prayer life lower the occurrence or recurrence rates of various psychological disorders? These questions, and many more related to the emotional and spiritual effects of prayer, need to be explored through scientific inquiry in the future.

Challenge 6: Defining Relevant Ethical Standards

Using prayer in therapy raises several ethical problems that must be carefully considered. First, the principle of competence requires that counselors use only those interventions for which they are trained. Those with graduate degrees in counseling, even if from religiously oriented programs, receive little or no training in using prayer as part of counseling.131

This does not necessarily mean that we can never use prayer in counseling but that we must take extra precautions to avoid misusing prayer and hurting people as a result. As discussed earlier in the chapter, seemingly innocuous practices such as praying aloud with clients to begin counseling sessions may have a harmful effect on some clients. We must be aware of the potential harm of the techniques used in counseling, especially techniques that are not well established as part of counseling theory and practice. Psychologists, for example, are instructed in their ethics code: “In those emerging areas in which generally recognized standards for preparatory training do not yet exist, psychologists nevertheless take reasonable steps to ensure the competence of their work and to protect patients, clients, students, research participants, and others from harm.”132 For Christian counselors, this might involve meeting with peers for ongoing consultation about the appropriate use of prayer in counseling, obtaining supervision from a more experienced Christian counselor, and diligently working to develop personal patterns of prayer.

A second issue of concern is informed consent. A client who agrees to counseling with the assumption that standard counseling techniques will be used may be surprised and disillusioned when spiritual interventions are used. Spiritual interventions, per se, are not necessarily unethical, but promising one type of treatment and then delivering another is unethical. The best solution to this problem is to describe the nature of counseling in a written informed-consent form that is reviewed and signed by the client before beginning treatment. The consent form will be different for each client and should include a discussion of spiritual interventions that might be used in treatment.

A related problem is whether or not spiritual interventions should be reported to insurance companies who pay for counseling services. Many insurance companies, especially managed-care organizations, require that specific treatment plans be submitted before the counseling is authorized. If a counselor plans to use prayer as part of counseling, should prayer be included on the treatment plan? The answer depends on the type of prayer interventions employed. Counselors who privately pray for their clients while implementing a standard form of treatment (e.g., cognitive therapy for generalized anxiety, systematic desensitization for simple phobia, interpersonal therapy for depression) should feel no need to report prayer as part of their treatment. If, however, a counselor is using devotional meditation or another form of prayer as a central treatment technique, then it should be reported in the treatment plan along with a rationale for its use. Some forms of counseling that are based exclusively on spiritual interventions may not be recognized as legitimate counseling strategies by insurance companies, and counselors will need to reconsider their counseling strategies or their desire for insurance reimbursement.

Finally, charging fees for spiritually based counseling presents a quandary for many Christian counselors. Spiritual directors and pastors have generally not charged for spiritual guidance. If counselors use spiritual-guidance techniques as part of their counseling, should they continue to charge for their work? Some Christian counselors are pastors and lay counselors who do not personally confront this question. For the remainder of Christian counselors, whose livelihood often depends on generating fees, this is a relevant and difficult question. Although there may be many responsible ways to address this fee quandary, the easiest resolution to the problem is to inform clients of similar alternative services available. If a fee-for-service counselor is using spiritual interventions exclusively and if those same interventions are available elsewhere at little or no cost, the counselor should inform potential clients of the other options before beginning counseling. If a counselor uses prayer as an adjunct to a counseling approach that requires advanced training, such as time-limited psychodynamic therapy, then the counselor ought to inform clients of other possible professional counseling approaches (e.g., cognitive therapy) but can limit the discussion to the counseling approaches used by other professional counselors.

Summary

Prayer is more than a counseling technique. It is the primary vehicle of growth in the spiritual life. Christian counselors who desire to use prayer as a vital part of their work must be committed to the spiritual disciplines of the inner life, including prayer, solitude, and fasting.

Despite the power and importance of prayer, bringing it into the counseling office is not a simple task. Counselors should carefully consider the potential effects of various forms of prayer before using them in counseling. Some forms of prayer, such as counselors privately praying for clients, are always useful; whereas other forms of prayer, such as routinely praying aloud in counseling sessions, introduce both potential benefits and risks to clients.

Initial studies of devotional meditation and religious imagery indicate that these forms of prayer can be useful in counseling, but most types of prayer have not yet been researched. In addition to the research task, Christian counselors need to define clear ethical guidelines for the use of prayer in counseling.

Upon Reflection

Of all the chapters in the book, this chapter on prayer has generated the most controversy. Some students and colleagues have told me how much they appreciate my relatively cautious approach to prayer in counseling while others have expressed how troubling they find this chapter. I find it an interesting paradox that my views of prayer engender such debate when this book emerged out of a place of deep personal prayer, as I described in the introduction. Perhaps this is a reflection of how diverse we are and of how valuable prayer is to each of us.

Readers have raised two concerns about this chapter. First, some have told me that I am much too cautious. Figure 4, and the narrative surrounding it, especially concerns some readers because I suggest routine in-session prayer can easily be misused in counseling. Second, some readers experience the chapter as too technical, as if I am reducing prayer to a set of techniques rather than approaching it as a profound spiritual opportunity to communicate with God. I will address both of these important concerns in this update. I will also mention a relational perspective on prayer and then close with a discussion of the reorienting nature of prayer.

How Cautious Should We Be?

In most ways, I’m a cautious fellow. I generally leave two seconds of space between the car in front of me and my own car on the expressway. In a group I’m usually more quiet than talkative, and I weigh my words carefully before I speak. I save money for a rainy day. I consider the ethical dimensions of counseling almost constantly, always trying to avoid situations that could harm my clients.

My approach to prayer in counseling emerges from my personality style as well as from my training in psychology and my experiences with prayer. Still, it is important for counselors in training to read widely on this topic and consider perspectives other than mine. Dr. Siang-Yang Tan, who is both a professor of psychology at Fuller Theological Seminary and senior pastor at First Evangelical Church of Glendale (California), has a perspective that is different from the one you find in this chapter. Siang-Yang is a friend and a person I deeply admire. He has nice things to say about Psychology, Theology, and Spirituality in Christian Counseling, but he has mentioned to me on several occasions how this chapter on prayer troubles him. Siang-Yang feels much more freedom than I do to pray regularly with clients in session. If you felt uncomfortable as you read my chapter, you will probably find Dr. Tan’s work to be inspiring and refreshing (see the reading list at the end of this update). Siang-Yang has also partnered with the Christian Association for Psychological Studies (CAPS) to make a video titled Cognitive Psychotherapy and Healing of Memories, which demonstrates prayer in counseling.

Dr. Tan also writes about the work of the Holy Spirit in counseling. The Holy Spirit moves in each Christian, guiding us toward godliness and truth while taking into account our unique personalities and abilities. The Holy Spirit’s moving in Siang-Yang Tan’s counseling may look slightly different from the Spirit’s moving in Mark McMinn’s counseling, and the Spirit’s work in your counseling may look different yet. This is a beautiful thing about Christian community—in our diversity we learn about God’s presence in the world.

Several years ago the American Psychological Association contacted me about doing a video on Christian counseling.133 In this video, I do a prayer exercise with my client, Celeste. She is a strong, capable, African-American woman who is quite comfortable carrying the weight of the world on her shoulders. In this prayer exercise, I have her relax and then repeat to herself the ancient Eastern Orthodox prayer known as the Jesus Prayer: “Lord Jesus Christ, Son of God, have mercy on me, a sinner.” In the exercise, we abbreviate the prayer to “Lord, have mercy.” It has a powerful effect on Celeste, and when the exercise is over, she is left with tears streaming down her face and a fresh awareness of how much pressure she experiences every day. I don’t always pray with my clients, for reasons described in this chapter, but there, in the midst of that APA studio, surrounded with three cameras and the accompanying camera operators, I clearly felt led by the Holy Spirit to pray with Celeste. This is my hope for all of us involved with Christian counseling, that we remain open to the Spirit’s work in our lives and in each counseling session.

Is Prayer a Technique?

In a word, no.

As I mentioned in the introduction, I appreciate those who read this book and then let me know their thoughts. When students find the chapter overly technique-oriented, as some have, it troubles me deeply. A book on Christian counseling must, of course, consider the ethical, scientific, and practical dimensions of prayer, but we cannot reduce prayer to a set of strategies or techniques. So I want to add a few words in this update to let readers know more of my heart regarding prayer and counseling.

I am an evangelical Quaker. Lisa (my wife) and I attend Newberg Friends Church in Oregon, where Richard Foster once was pastor. (Foster is the author of several essential books on spiritual formation, including Celebration of Discipline, Streams of Living Water, and Prayer.) In the Quaker tradition, we spend a great deal of time in contemplative silence, attempting to hear God’s voice in the midst of our sometimes messy lives. Most Quaker meetings are no longer Christ centered, but evangelical Quakers still are. If I could wish one thing for counselors in training, it would be to experience a year or so in an evangelical Quaker fellowship, where they could learn the discipline of Christocentric silence.

Effective Christian counseling is very much like Quaker worship. We sit with clients, hear their stories, and hold their struggles, fears, and hopes up to God. Sometimes we speak, sometimes we do not, but always we pray. We pray as we breathe, inhaling the wisdom of God’s presence in this moment, exhaling our frantic need to have the perfect words or the exact technique to “fix” our clients. Sometimes we pray aloud with our clients—and here is where all the science, ethical issues, and techniques discussed in this chapter come in handy—but most often we do not. Still, we sit in prayer.

A former student of mine was a pastor before getting a doctorate in clinical psychology. He came to graduate school because of the helplessness he often felt sitting in pastoral counseling sessions. In graduate school he learned what to say and when to say it, and he became one of the best psychotherapists I have ever trained. But sometime after graduation he mentioned to me that he missed the old days when he felt helpless in sessions, because his helplessness became a motivation for praying to God. His not knowing what to say was a continual reminder to implore God for wisdom and guidance. The challenge facing this man is the same challenge facing all of us: how can we employ all the methods of our training while still remembering to bring each moment of our work to God in prayer? This is a lifelong challenge, and one that I gratefully accept as part of our ministry in Christian counseling.

Prayer and Relationship

Nineteenth-century English scientist Sir Francis Galton’s greatest claim to infamy was his pioneering work in eugenics, but his provocative conclusions about the utter uselessness of prayer may be close runners-up. Paradoxically, his antireligious zeal actually promoted research on prayer, spirituality, and religion in the twentieth and twenty-first centuries. Philip and Carol Zaleski credit Galton for much of the subsequent scientific research: “The subsequent history of scientific research on prayer has been, in a sense, nothing but a reaction to Galton’s devastating conclusions. Scores of experiments have been undertaken, many if not most by scientists wishing to vindicate the legitimacy of prayer.”134 Galton’s assumption was that prayer, if effective, should lengthen the life of the one who prays (or of one who is the subject of others’ prayers). Galton found that it does not. Though admirable in the parsimony of the dependent variable, Galton’s work was hampered by his imprecise assumptions about the nature of prayer and by his limited assessment of health benefits. A century and a half later, we now recognize various personal health benefits resulting from prayer and meditation, including postoperative emotional adjustment, pain management, lowered blood pressure, self-reported vitality and mental health, perceived closeness to God, responsiveness to psychotherapy, social connectedness, and—contrary to Galton’s assertions—perhaps even prolonged life.

But I wonder if all this good science may sometimes mask the purpose of Christian prayer, which is ultimately relational. In Scripture we see a God who longs for relationship with humans, even to the point that the eternal Word “became human and made his home among us” (John 1:14, NLT). Emmanuel means “God with us,” and the entirety of Scripture shows that God is indeed with us, in our joys and our struggles, in our waywardness and our repentance. Prayer is more a spiritual discipline to promote relationship with God than a method of promoting health. Consequently, Christians are likely to continue praying even when tightly controlled studies demonstrate that doing so does not “work” in producing particular health outcomes.135

If you ask people why they like to talk with and listen to their friends, will they say, “Because it works and helps me to live longer”? Probably not, though that may well be true. Instead, they will mention how they value connection with their friends. When we speak and listen to another, we build relationship. In the same way, speaking and listening to God is a way of building relationship.

I find value in the scientific study of prayer, but at the same time, it troubles me. Virtually all of today’s science considers prayer from a nonparticular perspective. That is, science views prayer as conversation with the divine, regardless of who the divine is taken to be. In this view, prayer is decidedly nonrelational. To the Christian, prayer is particular. It is relationship with the living God, revealed in the person of Christ, and mediated through the Holy Spirit. Let’s read the science and learn whatever we can from it, and then press forward toward a personal and intimate connection with God, which transcends the pluralistic methods of most science today.

The Reorienting Nature of Prayer

A challenge in my life has been making sense of my own struggles and weaknesses even as I help clients work through theirs. Because counseling is a one-way helping relationship, I should not and do not discuss my personal struggles with clients. Still, it is necessary to address my issues. I have found personal therapy, friendship, marriage, gardening, community worship, and prayer all to be useful as I face my own struggles while helping others with theirs. When I begin to lose my way, all these help reorient me to the sanctifying presence of God, which persists in the midst of my brokenness.

I sometimes experience an inner clamor as I sit with clients. I entertain thoughts of not being smart enough or spiritual enough or educated enough to help this person sitting across from me. It is a selfish clamor, focused on my own sense of adequacy rather than on this sacred work I am called to do. Henri Nouwen observes that we live in a world that is shouting, “You are no good; you are ugly; you are worthless; you are despicable; you are nobody—unless you can demonstrate the opposite.”136 Sometimes I hear all these inner shouts while I am sitting with a client, and then I remember to breathe, to pray, to reorient myself before God. This is not a visible action that my client would notice; it is merely an internal posture I take before God, much as I might shift my physical posture if one leg or the other starts feeling uncomfortable. In this reorienting prayer I remind myself of God’s presence in this fallen world and remember how much God loves me.

Then I remember that however lost I may feel at that moment, my clients almost certainly feel it more. They have come to my office disoriented, often having lost a sense of who they are and of their place in the world. Orienting myself helps get my eyes off me and back onto those who sit in my office.

Final Thoughts

The Christian language of being lost and saved has largely been usurped by soteriology (the doctrine of salvation). Still, I find that my saved soul gets lost in lesser ways throughout every day and every week. I get lost in the work I am doing, in the work I have yet to do, in my struggles and disappointments, in relational wounds, in my successes and self-aggrandizing fantasies. Over and over I have to return to the humble posture of prayer, to be found by God again, to be bathed in grace and redeeming love, to breathe in the abundant life. May this be a rhythm of life for all of us as Christian counselors so that we can help our clients, who also get quite lost at times.

Acknowledgment

I appreciate the assistance of Tyler A. Gerdin in helping me research and write this update. A doctoral student in clinical psychology at George Fox University, and part of my research team, Tyler also attends Newberg Friends Church, where he often contributes to worship with his trombone-playing skills.

Additional Reading

Siang-Yang Tan, “Inner Healing Prayer,” Christian Counseling Today 11, no. 4 (2003): 20–22.

Siang-Yang Tan, “Use of Prayer and Scripture in Cognitive-Behavioral Therapy,” Journal of Psychology and Christianity 26 (2007): 101–111.

Bibliography

Benson, Herbert, Jeffery A. Dusek, Jane B. Sherwood, Peter Lam, Charles Bethea, William Carpenter, Sidney Levitsky, Peter C. Hill, Donald W. Clem, Manoj K. Jain, David Drumel, Stephen L. Kopecky, Paul S. Mueller, Dean Marek, Sue Rollins, and Patricia L. Hibberd. “Study of the Therapeutic Effects of Intercessory Prayer (STEP) in Cardiac Bypass Patients: A Multicenter Randomized Trial of Uncertainty and Certainty of Receiving Intercessory Prayer.” American Heart Journal 151 no. 4 (April 2006): 934–942.

McMinn, Mark R. Christian Counseling. Washington, D.C.: American Psychological Association, 2006. Video.

Nouwen, Henri J. M. Life of the Beloved: Spiritual Living in a Secular World, 10th ed. New York: Crossroad Publishing, 2002.

Zaleski, Philip, and Carol Zaleski. Prayer: A History. Boston: Houghton Mifflin, 2005.

Chapter 4 Scripture

Karl returns home from his first counseling appointment, opens his Bible to Psalm 1, and begins reading. “Happy are those who do not follow the advice of the wicked, or take the path that sinners tread, or sit in the seat of scoffers.”

Karl sets the Bible on his lap and reflects on the past ninety minutes. He thinks about the relief he felt telling Dr. Listner things he had never disclosed to anyone before. He thinks of her comforting smile and how genuinely concerned she seemed to be. But Karl also has nagging doubts. If Dr. Listner is really a Christian counselor as she claims, why didn’t she mention God? Why didn’t she have a Bible on her desk or in a visible spot on her bookshelf? Maybe the Christian antipsychology books Karl has read are correct; maybe Dr. Listner is a priest of a rival religion. Maybe he is following the “advice of the wicked” by going to a Christian counselor. Maybe he was sitting “in the seat of scoffers” while swaying in the swivel rocker in Dr. Listner’s office.

Karl keeps reading: “But their delight is in the law of the Lord, and on his law they meditate day and night. They are like trees planted by streams of water, which yield their fruit in its season, and their leaves do not wither. In all that they do, they prosper.”

Karl sets the Bible down again and reflects on a new set of questions. Does this mean that my depression will go away if I reflect more on the promises of Scripture? Am I looking for help in the wrong place? How can I learn to delight more in God’s Word? Should I cancel next week’s appointment with Dr. Listner? Karl’s reflections on his first counseling appointment illustrate some questions Christian clients face when seeking help for their problems.

Dr. Listner has her own set of questions. In her personal times of studying and contemplating Scripture, she draws close to God and experiences a sense of comfort and purpose. She often memorizes Bible passages and recalls them in times of unusual stress. Why, she wonders, doesn’t she use Scripture more in her counseling work? Then she remembers.

There are several reasons Dr. Listner does not use Scripture more actively in her work with clients like Karl. First, like most Christian psychologists, Dr. Listner was not trained to use Scripture in counseling. She hesitates to use the Bible with Christian clients because she might be taking a verse out of context or misapplying a fundamental theological concept. Second, Dr. Listner has seen many clients, like Karl, who are depressed about being depressed. Several people in Karl’s church have told him that he would not be depressed if he took his spiritual life more seriously. Dr. Listner does not agree. She sees depression as resulting from a complex blend of interpersonal, biochemical, psychological, spiritual, and environmental factors. If she overuses Scripture with clients like Karl, she might communicate a simplistic view of depression that only makes her clients more depressed. Third, her theoretical orientation places her in the role of being a transitional object for Karl. If she introduces her own agenda by quoting or using Scripture, it might interfere with Karl’s ability to project past emotional conflicts onto his new therapist. Fourth, when Dr. Listner has tried using Scripture in past counseling, it sometimes has evoked rigid defenses in her clients, as if the Bible gives an excuse not to look at feelings and inner experiences. Fifth, some people have used the Bible for selfish purposes. Dr. Listner recalls the time when a man used 1 Corinthians 7 to insist that his wife should have sex with him whenever he wanted, regardless of the fact that his wife had recently been raped by a stranger.

Many of Karl’s questions about the absence of Scripture in his first Christian counseling experience seem valid. So do many of Dr. Listner’s concerns about using Scripture in counseling. So what is the right answer? Should Christians use Scripture in counseling or not? This question, like the similar question about prayer posed at the beginning of chapter 3, is too general to be meaningful. A better question is, “In what ways should Scripture be used in counseling which clients and under which circumstances?” Though Christian counselors answer this question differently depending on professional, religious, and ideological assumptions, various methods of using Scripture in counseling deserve careful consideration and critical evaluation.

Foundations

Psychology

Psychological journals and books include numerous references to Christian Scriptures, but few have direct relevance to Christian counseling, and even fewer are directly related to using the Bible in counseling. As with the previous chapter, my goal is not to provide a comprehensive literature review but rather a sampling of the types of articles and books that have implications for Christian counselors.

Psychological Perspectives on Scripture

Many psychological critiques and evaluations of scriptural principles and characters are available. Between January 1990 and May 1995, the word Bible was included in 105 articles referenced in PsychLit, an electronic index of psychology journals. The majority of these articles pertain to a psychological evaluation of a biblical concept or person. This is not surprising. As interest in narrative psychology increases, the tools of literary criticism are more widely used in psychology journals. For example, a number of authors have produced psychoanalytic critiques of biblical characters in recent years.

Applying psychology’s methods to understanding the Bible appears to be relatively rare among explicitly Christian authors, perhaps because we fear the diluting of scriptural truth with contemporary literary or social-scientific theories. However, some Christian authors cautiously advocate using psychology and careful biblical scholarship to understand the characters and stories of the Bible.137

Scriptural Support of Counseling Models

Some authors have used Scripture as a foundation for developing responsible counseling strategies and techniques that share common features with traditional models of psychotherapy. For example, a number of authors have advocated models of Christian counseling that demonstrate a commitment to Scripture as well as psychological theory.138

Others have used Scripture to support existing counseling methods or models. For example, Daniel Sweeney and Garry Landreth describe scriptural support for using play therapy in treating children.139 A number of authors use Scripture to support various forms of cognitive therapy, especially rational-emotive therapy.140 One author concludes that “RET is based on a thoroughly biblical principle, the importance of what one thinks.”141 Using Scripture to support existing models of psychotherapy has generated some conflict and concern among many Christians. Some Christian antipsychologists see psychology as a competing faith, arguing that it is completely incompatible with Scripture.142 Others have offered more measured criticism, suggesting that we must carefully evaluate worldview assumptions before importing and modifying a psychotherapy technique and calling it Christian counseling.143

Using Scripture in Counseling

Some counselors advocate using Scripture as a therapeutic intervention. For example, various authors have suggested using Bible passages in church-based recovery groups to help confront themes of codependency, using Scripture in marital counseling to help couples recover from sexual affairs, using Bible stories in individual child therapy, using the Bible to confront irrational beliefs in RET, and using Scripture memory and meditation as homework in cognitive therapy.144

In one survey, almost half (43 percent) of the members of the Christian Association for Psychological Studies (CAPS) reported explicitly teaching biblical concepts to clients. Over two-thirds (71 percent) implicitly used biblical concepts in their counseling work.145 While these survey results suggest a relatively frequent use of biblical concepts in counseling, they do not address the actual direct use of Scripture in counseling. In another survey of CAPS members, respondents were asked to describe Christian interventions they used in counseling.146 Of the interventions reported, 13 percent involved the direct use of Scripture in counseling. When some of the same respondents were interviewed and asked to describe critical incidents they had faced in counseling and the interventions they used in response, only 3 percent of the interventions described involved the direct use of Scripture. Thus, it appears that directly using Scripture as part of counseling is relatively rare, even among Christian counselors.

The Bible as a Self-Help Book

Another use of Scripture in psychology is not limited to Christian counselors. Some have suggested using the Bible as a self-help book with religious clients. Even Albert Ellis, a self-proclaimed atheist and outspoken opponent of devout religious faith, had this to say about the Bible in a recent article: “I think that I can safely say that the Judeo-Christian Bible is a self-help book that has probably enabled more people to make more extensive and intensive personality and behavioral changes than all professional therapists combined.”147

Although Christians may dislike the idea of reducing the Bible to a self-help book, it is heartening that some non-Christian therapists perceive an increasing need to work within the value systems of Christian clients.

Though the Bible offers much more than self-help, there are times when clients are searching for answers that can be readily found in Scripture. For example, counselors who use cognitive therapy often work with clients to modify faulty core beliefs that have contributed to poor self-awareness and unnecessarily painful emotional experiences. Meditating on Scripture can help Christian clients change these beliefs. Those who believe they are completely unloved and destined for rejection can meditate on Paul’s words to Roman Christians: “But God proves his love for us in that while we still were sinners Christ died for us” (Rom. 5:8). Those who believe they are all alone, isolated and abandoned, can remember the psalmist’s proclamation: “God is our refuge and strength, a very present help in trouble” (Ps. 46:1). Those who feel overwhelmed with life’s burdens and God’s apparent distance can recall the words of James: “Indeed we call blessed those who showed endurance. You have heard of the endurance of Job, and you have seen the purpose of the Lord, how the Lord is compassionate and merciful” (James 5:11).

Untapped Potential?

The perspectives and studies reported here reflect the ways various authors have used Scripture in counseling. However, there may be many additional possibilities that have not yet been explored. Dr. Eric Johnson argues that the Bible belongs in psychological science and suggests eight ways Scripture can influence Christian counselors and psychologists.148 First, the Bible plays an experiential role in our lives, providing a rich resource for wisdom and personal maturity. Second, Scripture plays a foundational role, providing a common starting point for understanding our basic assumptions and beliefs. Third, it plays a contextual role that allows us to understand human nature, meaning, and purpose in life. Fourth, Scripture plays an axiological role, giving us standards for what should be. Fifth, the Bible plays an anthropological role, providing us an awareness of the historical narrative of human sin and divine redemption. Sixth, it plays a canonical role, providing an unchanging standard of truth. Seventh, Scripture plays a dialogical role, providing rich resources for discussion and comparison between psychological knowledge and special revelation. Eighth, the Bible plays a creative role, allowing us to consider and explore concepts and ideas that might not be considered from a purely psychological worldview. These eight roles that Johnson outlines suggest that Christian counselors have only begun to explore the potential of integrating the Bible and psychology.

Christian Theology

Even if theologians agreed on the role of Scripture in theology, it would be impossible to summarize in a few pages. To complicate the task further, theologians do not agree. Traditionally, Scripture has been seen as the essential foundation for Christian theology. David Kelsey suggests that “virtually every contemporary Protestant theologian along the entire spectrum of opinion from the ‘neo-evangelicals’ through Karl Barth, Emil Brunner, to Anders Nygren, Rudolf Bultmann, Paul Tillich and even Fritz Buri, has acknowledged that any Christian theology worthy of the name ‘Christian’ must, in some sense of the phrase, be done ‘in accord with Scripture.’”149 But Kelsey goes on to point out that theology has changed in the past fifty years, and now a number of theologians argue that “Scripture does not, and indeed, some add, cannot serve as authority for theology.”150 Revisionist theology has risen to prominence with postmodernism, and Scripture is sometimes reduced to a literary construction of human attempts to understand God.

The few comments I make here are limited by my assumption that newer theology is not necessarily better theology; I begin with the belief, shared by Protestant theologians through the centuries, that Scripture is an essential tool for knowing God. Even with this assumption, there is considerable debate about the role of human reason in approaching Scripture. Because of the vastness of the topic, the lack of agreement among theologians, and my limited theological training, I make no attempt to survey the role of Scripture in Christian theology here. Rather, I will focus on one specific problem regarding Scripture and theology and discuss two implications for how Christian counselors understand Scripture.

The Problem: The Chicken or the Egg?

Theological views of Scripture are plagued by the chicken-or-the-egg problem. Do we first know God through reason, as Thomas Aquinas believed, and then understand Scripture because we understand God? Or do we first know Scripture, which allows us to know God? In other words, is our knowledge of Scripture shaped by our prior knowledge of God, or does it work the other way around? Each view has been supported by reputable scholars. Theologian Millard Erickson proposes that this debate is unnecessary, that we can presuppose both a knowledge of God and a knowledge of Scripture as simultaneous and inseparable.151 God cannot be known apart from Scripture, and Scripture cannot be properly understood without knowing God. Just as Scripture helps us know God, God helps us understand Scripture. Until we know God, our views and understanding of Scripture are clouded by our disbelief. But with salvation comes a cleaning of the lenses—a capacity to understand God’s Word more clearly, though not perfectly.152

In the same way, we must know something about ourselves in order to know God. In the first of his Institutes, John Calvin argued that knowledge of self and knowledge of God are inseparable.153 We cannot fully know ourselves without understanding God’s character, righteousness, and love, and we cannot fully know God without understanding ourselves, including our capacity for sin, our human frailty, and our deep longing for someone transcendent.

Knowledge of self, God, and Scripture are intertwined. This is what scholars call the hermeneutic circle—the text cannot be separated from the perspectives of the reader, and the reader’s perspectives are influenced by the text. The text affects our views of God and self: we see our need for God by understanding ourselves as revealed in Scripture. God affects our capacity to understand the text, and so does our humanness: we understand Scripture because God has graciously granted us eyes to see, but even those eyes are affected by our fallen human nature.

These interconnections of human nature, God’s character, and Scripture have at least two important implications for Christian counselors interested in using Scripture in counseling.

Implication 1: Respect

First, we must cultivate and maintain respect for the Bible. Scripture is our primary way of knowing God. It is God’s authoritative revelation to humankind. We call it special revelation. Yes, we see God in nature, but nature worship without special revelation leads to animism and other heresies. Yes, we know God through prayer and meditation, but the New Age movement demonstrates the directionless confusion of spirituality unbounded by Scripture. We need Scripture to understand God. John Calvin writes that “Scripture, collecting in our minds the otherwise confused notions of deity, dispels the darkness and gives us a clear view of the true God.”154

When we claim “all truth is God’s truth,” we are both correct and incorrect. All that is true, whether discovered through science, literature, philosophy, theology, counseling, or Scripture, comes from God. However, science, literature, philosophy, theology, counseling, and Scripture are not equally direct ways of knowing God, and every way of knowing God is limited by our hermeneutic methods for understanding truth. Scripture is the most direct way of knowing God; therefore it deserves our respect.

What does this mean for the Christian counselor? We must not hesitate to revere the God revealed in Scripture as the ultimate standard of truth. Postmodernism has pushed mental health disciplines toward accepting personal “truth” as equally valid to God’s transcendent truth. Christian counselors should resist the trend. When we look for truth, we don’t first look inside ourselves or inside our clients; we look to God. However, communicating our respect for Scripture without inducing shame or excessive submission in our clients can be challenging.

What If This Happened?

Your client, Frank, has been reading books on relaxation and meditation techniques. The books were assigned by a previous counselor, and they seem to be helping him cope with his anxiety problems. In the middle of today’s session, you are discussing the loneliness Frank felt as an only child raised by two busy professional people. He becomes tearful, puts his head between his hands, and sits silently for several minutes. Eventually he lifts his head, looks you in the eye, and says, “I’ve been thinking about this, about how lonely I feel. Sometimes I just feel stuck, as if there is nothing I can ever do to feel any better. But I know that’s not true. There is a way out of this. I just need to keep looking inside myself. I’m learning a lot in these meditation exercises. If I keep looking inside myself, I know I will eventually find the truth.”

How do you respond? Here are three possibilities:

Option 1: “Yes, it is important to keep searching inside yourself for your values and your ideas of what to do next. But I’m wondering why it is so important to find the answers inside yourself.”

Option 2: “Good idea. It is really very important to keep searching for truth.”

Option 3: “I don’t think you’ll have much luck looking inside yourself for truth. The Bible teaches we find truth through Jesus. Jesus said, ‘I am the way, and the truth, and the life.’”

Though a good case might be made for any of these responses in some counseling situations, I prefer option 1. It gently challenges Frank’s assumption that he will find truth inside himself without introducing harshness into the conversation. Option 1 is likely to lead into a meaningful discussion of the place and authority of Scripture in Frank’s life. Option 2 unintentionally reinforces Frank’s idea that he will find truth inside himself. Option 3 may be so abrupt that it will stop Frank from exploring further. He might agree with the counselor only to avoid disapproval.

Implication 2: Humility

Second, while we must respect the authority of Scripture, we should also assume an attitude of humility regarding our interpretations of Scripture. Although Scripture is special revelation, inspired by God, it is always interpreted by fallible humans (2 Tim. 3:16). Yes, knowing God helps us understand Scripture more clearly than before, but we still bump against the limits of humanity. Thus, our humanness and the hermeneutic strategies we use in interpreting Scripture limit our capacity to understand truth.155

What If This Happened?

Nancy and Thom Baker come to see Roberta, a lay counselor, for marital help. One of the difficulties the Bakers face is conflict over their domestic roles. Nancy wants an egalitarian marriage, but Thom wants a more traditional, male-headship marriage. Roberta listens carefully to both Nancy and Thom, encourages them to express their desires and opinions to one another, and helps them look at the deeper psychological beliefs that are operating beneath the surface of awareness. Thom is operating from the assumption that only the strong survive and one has to be tough in this world to succeed. He tries to run his family the same way. Nancy is operating from the assumption that her worth depends on the approval she elicits from others. Most of her friends and extended family are in egalitarian marriages, and they frequently question and criticize her about her more traditional marital role. She wants to change her marriage to gain social approval from those she cares about.

Roberta considers her two possible responses. One option is to use Scripture to teach the “right way” to structure a marriage. Roberta is committed to an egalitarian marriage and has been persuaded by several recent books that her views are supported in Scripture. She could try to persuade Thom. A second option is to coach Thom and Nancy as they work to understand each other better and to search Scripture themselves for the best way to structure their marriage. Which option should Roberta choose?

A hermeneutic of humility moves Roberta to select the second option. Though she is convinced that Scripture teaches a certain way to structure marriage, she also recognizes that others interpret Scripture differently from the way she does and that her job as a counselor is not to indoctrinate clients to her way of thinking.

I am not suggesting that Christian counselors should avoid taking firm doctrinal positions on scriptural teaching. With careful hermeneutic strategies, we can minimize the intrusions of our faulty human reasoning and boldly advocate scriptural truth in a postmodern society that often overlooks transcendent truth. However, when we interpret controversial passages, we are wise to remember the hermeneutic circle and humbly recognize that our human biases and sin will influence and limit our understanding of God and the Bible.

Spirituality

Two people see an apple. One responds analytically, investigates the apple, and says, “This is red on the outside, crisp on the inside, and tastes sweet and pleasant.” The other reflects on past memories and says, “My grandmother used to make the most delicious apple pie! She sprinkled cinnamon sugar on the crust, baked it just right, and served it piping hot.” Both are responding to the apple; both are correct; but they emphasize different aspects of reality.

So it is with Scripture. One person, a theologian, approaches Scripture analytically, trying to understand how special revelation can be accurately interpreted in order to understand God better. Another person, or perhaps the same person at another time, approaches Scripture reflectively and experientially, contemplating God by meditating on Scripture. Though both approaches are important in both theology and Christian spirituality, the contemplative approach to Scripture is of central importance in spiritual formation. Richard Foster puts it well: “Whereas the study of Scripture centers on exegesis, the meditation of Scripture centers on internalizing and personalizing the passage. The written Word becomes a living word addressed to you.”156

Dr. Jim Wilhoit, who teaches courses in spirituality at Wheaton College, loves to tell of the time when he and Carol brought their slightly jaundiced newborn daughter home from the hospital. They secured her in an infant seat and placed the seat next to a window so the natural light of the sun could heal her jaundiced body. What a beautiful picture of God’s healing presence in our lives. But we have to place ourselves in the way of God’s light. Meditating on Scripture is a way to place our frail, ailing selves in the presence of God’s healing warmth. This is not an exercise in theology. In fact, Foster warns that meditating on Scripture is “not a time for technical studies, or analysis, or even the gathering of material to share with others.”157 Scripture meditation is deeply personal, providing healing light and spiritual sustenance for all who long for intimacy with God and who dare to admit their neediness.

There are at least two purposes for using Scripture during times of meditation. First, it provides substance for contemplation.158 The psalmist writes of the godly, whose “delight is in the law of the Lord, and on his law they meditate day and night” (Ps. 1:2). Elsewhere in the Psalms we read, “Oh, how I love your law! It is my meditation all day long. Your commandment makes me wiser than my enemies, for it is always with me. I have more understanding than all my teachers, for your decrees are my meditation” (Ps. 119:97-99). Unlike meditation in Eastern religions, where the goal is to empty one’s mind, the goal of Christian meditation is to fill one’s mind with an awareness of God’s presence. Scripture provides rich material to fill our thoughts and direct our paths.

What If This Happened?

Pastor Neal is tired. He counsels fifteen people each week, prepares sermons, visits parishioners, and spends as much time as possible with his family. Lately, he has been feeling discouraged about the slow changes he sees in his counseling clients. Sometimes he feels angry that people resist change. Other times he feels bored and drowsy during counseling sessions.

Pastor Neal recognizes the signs of excessive stress and decides he needs a change. He blocks off a day on his calendar and arranges to go to a nearby retreat center for a day of solitude, prayer, and meditation. Pastor Neal takes only himself and a copy of the Bible. Scripture will be his food, his recreation, and his business for the day. Throughout the day he strolls the grounds, reads the Bible, naps, prays, meditates, and returns with renewed energy and a clearer image of God’s nature.

Second, Scripture provides important theological boundaries for spiritual meditation. Richard Foster writes, “For all the devotional masters the meditatio Scripturarum, the meditation upon Scripture, is the central reference point by which all other forms of meditation are kept in proper perspective.”159 Without scriptural boundaries, the practice of spirituality slips into heresy and self-worship, as we see all around us in contemporary culture.160 For example, one medical doctor, who describes herself as a practitioner of “soul work,” reports that the “overriding bible” of her work is that “you attract what you dwell upon. You attract what your own vibratory rate is.” She goes on to describe her interest in shamanic soul-retrieval work and past-life therapy.161 Although our imagination is a gift from God, we need Scripture to provide a theological and historical anchor for it. Otherwise, our imagination is guided by passing fads and self-interest disguised in various forms.

Scripture is an essential tool for spiritual formation. It provides both resources for spiritual contemplation and boundaries to keep us from slipping away from truth.

Psychological and Spiritual Health

How and when should counselors use Scripture to move clients toward greater psychological and spiritual health? Let’s look at this question in two important ways: one general and one more specific.

Generally, we are concerned about Scripture in choosing our counseling strategies and theories, even those that do not specifically involve using the Bible in counseling sessions. Dr. Stanton Jones, chairperson of the Wheaton College Psychology Department, has developed a useful system for considering how we might conceptualize Scripture in counseling, based on four types of counseling strategies.162 First, some counseling strategies are directly derived from Scripture. For example, some cognitive therapists teach clients to use Scripture references to counter faulty dysfunctional thoughts, just as Paul taught Christians in Philippi to think about things that are honorable, pure, pleasing, and commendable.163 Second, some counseling strategies are generally supported by implication in Scripture. For example, using religious imagery as a technique for depressed clients is consistent with Scripture, though not specifically taught or commanded in Scripture. Third, some counseling strategies are not discussed or implied in the Bible but are not inconsistent with Scripture. For example, using progressive muscle relaxation to control anxiety symptoms is neither advocated nor prohibited in Scripture. Fourth, some counseling techniques are inconsistent with Scripture. For example, the counselor who advocates adultery as a treatment for midlife depression is contradicting a principle of Scripture.

We can see several benefits to this classification system. First, it reminds us that using Scripture in counseling is not just a matter of quoting or memorizing Bible verses. Our views of Scripture can be considered in selecting every technique, even those that have no overt religious connections. Clearly, Christian counselors need to avoid interventions that fall into the fourth category—those that are incompatible with Scripture. Second, this classification allows us to recognize and confidently use counseling techniques that are compatible with Scripture, even if those techniques were developed by non-Christians. During some sessions, Christian counseling may be almost indistinguishable from other forms of counseling yet still be effective. Third, it reminds us to scrutinize our counseling strategies and perspectives carefully. In evaluating the messages of prophets, Paul instructed the believers at Thessalonica to “test everything; hold fast to what is good; abstain from every form of evil” (1 Thes. 5:21-22). We have a similar obligation as counselors. As we test new theories and techniques with Scripture, we can abstain from certain counseling strategies that contradict Scripture and hold fast to those that are compatible with Scripture.

In addition to making a general evaluation of scriptural support for counseling methods, it is also important to consider the specific effects of directly applying Scripture in counseling. When is it wise to quote Scripture to a client? Is Scripture memory appropriate in counseling? Is Bible meditation an appropriate homework assignment? To address these complex questions, it is helpful to consider the three questions derived from the model presented in chapter 2 as applied to two counseling scenarios.

What If This Happened?

You arrive at the office, sit at your desk, sip on a cup of bitter coffee, and check the day’s schedule. At 2:00 you are seeing Pete and Kate Balistic, and at 3:30 you are seeing Richard Yavis. Each session will pose different challenges. You start planning.

The Balistics have been coming to see you for two months, sometimes for individual sessions and sometimes for joint sessions. They started seeing you at Pete’s insistence when he found out about Kate’s affair. She dutifully stopped the affair, agreed to counseling, and has been working to move forward with her life. She is disappointed with her marriage and cannot yet promise Pete that she wants to stay married. Pete is trying to help you counsel Kate. He comes each week with a typewritten list of evidence that Kate has not truly repented and that she is refusing to submit to her marriage vows. Pete loves Scripture, and at the top of his list each week are one or two Bible verses that he uses to support his allegations that Kate is a vile sinner and an unworthy spouse. Interestingly, Kate never fights back. She recognizes that she is a vile sinner, expresses regret for her affair, but does not feel ready to commit to the marriage. From 2:00 to 3:30 ought to be interesting today.

At 3:30 Richard Yavis will be flipping through a Sports Illustrated in the waiting room. As you usher him into the office, he will make some comment about the NBA play-offs, but as soon as he sits down, he will be working. Insightful, motivated, articulate, Richard is the ideal counseling client. For the past three months he has been seeing you for help with depression and has been feeling much better recently. For the last several weeks, you and Richard have been exploring the profound sense of loneliness he experienced as a child and how he tries to be perfect in order to win approval and cope with his loneliness. Like Pete, Richard loves Scripture.

Will This Help Establish a Healthy Sense of Self?

Three people are involved in these two counseling sessions, and the proper use of Scripture in counseling may be different for each of the three. Pete does not have an accurate view of himself. Rather than acknowledge his anger and sadness about Kate’s affair, he has shielded himself by using logic and by hurling accusations in Kate’s direction. He has cloaked himself with self-sufficiency, not because of narcissism, but because it hurts too much to face his feelings of loss. How could Scripture be used to give Pete a healthier and more accurate awareness of himself?

Should a counselor use Scripture to confront Pete with his self-deception, perhaps reminding Pete of his obligation to love Kate as Christ loves the church or his obligation to forgive Kate as Christ has forgiven him? Probably not. Pete is already using Scripture to protect himself and remain self-sufficient. He can move forward and admit his need for comfort only by getting past his logical defense system.

With Pete, it makes more sense to focus on the therapeutic relationship, perhaps by meeting with him individually for several sessions and encouraging honest disclosure of his feelings of fear, sadness, and anger. Scripture might be used as a contemplative tool, either inside or outside of the counseling sessions. For example, Pete’s counselor might teach him to contemplate passages from the book of Hosea or the passage in Matthew 11:28-30, paying close attention to his own emotional response to Kate’s unfaithfulness. Once he acknowledges and begins to deal with his brokenness and pain, he will have less need to criticize and humiliate Kate.

Kate also has an inaccurate view of herself, but her self-sufficiency is rooted in a deep sense of inferiority. From as early as Kate can remember, she has considered herself worthwhile only if she has the approval of everyone around her. When she met Pete, she loved his rugged, decisive style. They married, and at first she loved to submit to his leadership. He appreciated her, and she was happy. But with time, the demands kept coming; he stopped showing as much appreciation; and Kate’s happiness began slipping through her fingers. When another man showed her attention and appreciation, she was drawn off into another romance. Now she has no one’s attention, no one’s appreciation. She is sad, lonely, and confused, and she protects herself from further criticism by remaining aloof from Pete.

Should the counselor side with Pete and use Scripture to demonstrate Kate’s apostasy? Probably not. Kate will see herself honestly only in the context of a nurturing counseling relationship. If the counselor takes Pete’s side, it will make such a relationship impossible. Ultimately Kate needs to admit her sin, but she will not be able to if she is constantly feeling the need to defend herself. Once she feels safe with her counselor, she will begin exploring her sin. Scripture might be used effectively with Kate, but not in a harsh, confrontive way. Kate might find tremendous comfort in Scripture if it were not used to control her, as Pete has done for years. In the process, Kate might learn to view herself more accurately as a child of a loving Creator who provides us with moral boundaries that help us establish an abundant life that brings honor to God.

Richard’s sense of self is changing. He has identified his self-sufficient efforts to earn approval through perfectionism and is learning about relationships based on love, respect, and honest expression of need. Explicitly using Scripture in counseling might be very helpful for Richard. For example, he might memorize Titus 3:4-7: “But when the goodness and loving kindness of God our Savior appeared, he saved us, not because of any works of righteousness that we had done, but according to his mercy, through the water of rebirth and renewal by the Holy Spirit. This Spirit he poured out on us richly through Jesus Christ our Savior, so that, having been justified by his grace, we might become heirs according to the hope of eternal life.” Scripture might help Richard get his eyes off himself by experiencing God more richly, entering further into an awareness of God’s gracious presence in his life.

Will This Help Establish a Healthy Sense of Need?

Pete has a clear sense of Kate’s need, but he does not acknowledge his own brokenness. Thus, if Scripture is used in working with Pete, it should be related to his need and not Kate’s. It is important to recognize that Pete already feels broken, but he has hidden his inner feelings beneath a facade of self-righteousness. His counselor will probably not need to confront Pete; just providing a safe relationship will be enough for Pete to begin exploring his feelings. Even if confronting Pete is necessary, it should be done only after a safe counseling relationship has been established.

Though Kate has not expressed much remorse about her affair, she is inwardly overwhelmed with brokenness and need. It is unnecessary, and probably damaging, to use Scripture to confront Kate with her sin. It is wise to follow the pattern Jesus used when confronted with a woman caught in adultery. First he said, “Neither do I condemn you” (John 8:11); then he said, “Go your way, and from now on do not sin again.” Counseling with Kate should follow the same pattern, with a counselor first accepting and understanding her, then working with her to strengthen her commitment to marriage.

Richard has been insightful enough not only to recognize his unrealistic goals of earning approval through perfection but also to explore his long-standing feelings of loneliness. Although Scripture may be useful in other ways, it is probably not necessary to use Scripture to establish Richard’s sense of need for God and others.

Will This Help Establish a Healing Relationship?

Pete, Kate, and Richard are different people, and each will have a distinctive response to the use of Scripture in counseling. Sometimes using Scripture in counseling helps establish a close working alliance, and at other times it distracts from a healthy therapeutic relationship. For example, Kate might have a negative response if her counselor uses Scripture and might become more resistant and cautious in exploring her thoughts and feelings. Even with good intentions, counselors can sometimes introduce relational problems by explicitly using Scripture in counseling.164

Problem 1: I thought you were a counselor. People often choose Christian counselors because their usual religious experiences have not helped them resolve their problems. They are looking for something different from what they find in church on Sunday morning. If counselors use Scripture unwisely, they may violate clients’ expectations about counseling and slow down the rapport-building process.

Problem 2: May I say something? If counselors become too strident in providing Scripture for clients, they may end up talking when they should be listening. Many forms of counseling include didactic components, but when the sessions start feeling like lectures or lessons, clients will often distance themselves from the counseling process.

Problem 3: The safe zone. Some counselors may use Scripture in order to keep counseling sessions at an intellectual, logical level of communication. This may reflect the counselors’ own sense of insecurity and desire to avoid emotions as much as an ideological commitment to using Scripture. Effective counseling usually reaches deep into a person’s emotional state and requires more than an intellectual look at life. Of course, Scripture can be used in emotionally sensitive counseling as well, so this criticism does not apply to all uses of Scripture in counseling.

Problem 4: Overconfidence phenomenon. Many social-psychology studies demonstrate that humans are consistently more confident than they are correct. Even incorrect opinions are cherished and believed tenaciously. When we approach Scripture, we are vulnerable to the same phenomenon, so we may not readily recognize the limits to our hermeneutic strategies. Thus, counselors who use Scripture explicitly are vulnerable to appearing and being arrogant in the biblical interpretations. Arrogance hurts rapport!

Problem 5: Overreliance phenomenon. Finally, we may rely excessively on Scripture when we could be using other counseling strategies. Cognitive-therapy strategies can be quickly and effectively applied to treat panic disorders. Behavioral strategies reduce phobic reactions. If we rely too heavily on Scripture, we may miss other valid treatment options. Because the therapeutic relationship is built on the assumption that the counselor knows how best to treat the client’s problem, overreliance on a less direct technique can hurt the therapy relationship.

One approach to this list of problems is to say, “I don’t care. Scripture is truth, and I will continue to use it in counseling. I refuse to sugarcoat truth!” For those inclined to respond this way, it is important to remember that truth is almost always communicated in embodied form. Most of what we know about grace and salvation is accessible to us because Jesus was incarnated and demonstrated a living theology. To some extent, our understanding of God is affected by the ways our parents treated us. We remember movies and stories more than essays because we are quicker to observe and understand truth that is embodied. In the same way, truth is communicated more by who the counselor is than by what the counselor says. The vitality of Scripture in counseling is limited by the quality of the counseling relationship.

Though less important than a client’s relationship with God, the counseling relationship is often the mechanism by which God’s grace is introduced to a hurting person. By fostering a healthy Christian-counseling relationship, with or without the explicit use of Scripture, we provide clients with a glimpse of God’s grace.

Facing the Challenges

Challenge 1: Moving from Two Areas of Competence to Three

Psychological competence in counseling is important. The best counselors use Scripture only after carefully considering the psychological implications and the effect on the therapeutic relationship. Unfortunately, as with other religious interventions, the use of Scripture is rarely discussed in graduate training programs, even programs with a religious orientation.165 Not surprisingly, explicitly using Scripture in counseling is relatively rare for Christian counselors.166 In reporting this, I am not suggesting a dismal state of affairs: it seems caution is appropriate in using Scripture in counseling. However, competence brings increased freedom, and Christian counselors who have carefully considered the implications of various religious interventions are better prepared to use Scripture confidently and appropriately in their clinical work.

Basic theological competence is also important. Counselors who understand the authority and position of Scripture in Christian living are better prepared to deal with the complex issues they uncover in the counseling office. Counselors without minimal theological competence are at risk of creating a theology based on the human problems seen in the counseling office, and they may distort Scripture to fit preconceived theological notions.

Understanding the role of Scripture in spiritual formation is also important for Christian counselors. We need to be concerned not only about theologically proper and correct use of Scripture but also about the power of Scripture. Scripture was given to help transform our lives. It is powerful, active, and useful for training ourselves to be righteous (Heb. 4:12; 2 Tim. 3:16). Competent Christian counseling calls us to know the power of God in transforming lives and the vital role Scripture plays in the transforming process. This type of training can rarely be accomplished in the classroom. But it calls us to lives of spiritual discipline and a personal love for Scripture.

Challenge 2: Blurred Personal-Professional Distinctions

In one sense, using Scripture in Christian counseling can be limited to a professional discussion. For example, certain Scripture passages can be used to dispute various forms of unhealthy self-talk.167 These verses might be equally effective as counseling tools regardless of the counselor’s personal religious values. In the same way, a counselor might learn to use facial expressions to communicate interest and active listening, and those expressions might be helpful even if the counselor is not actually listening.

But in another sense, the use of Scripture, like the use of active listening skills, is a reflection of the counselor’s inner life. Appearing to listen is no substitute for listening. Appearing to love Scripture is no substitute for loving Scripture. Our inner life, shaped by God’s transformation of our character through Scripture and other means, is our greatest resource in helping hurting people. A Christian psychiatrist writes, “The healer who would be spiritual, who would practice healing in a Christian context, must be constantly vigilant for the falsely spiritual in his/her practice. Genuine spirituality will be evidenced by the appearance of fruit of the Spirit (love, joy, peace, patience, etc.) in the practitioner.”168

When Scripture is used creatively, spontaneously, and confidently in counseling, it is only because the counselor is so close to God’s Word that the ideas and principles in Scripture have become contagious. For counselors with this type of love for Scripture, the goal is not to carefully pick and choose verses that can be integrated into counseling practice but to be saturated by God’s Word so that counseling practice (and every other part of life) is transformed and renewed by God’s presence. Sometimes these counselors explicitly use Scripture in counseling, and sometimes they do not. But they routinely consider the themes of Scripture when evaluating, planning treatment interventions, and relating to clients.

Challenge 3: Expanded Definitions of Training

How do we train ourselves to use Scripture sensitively for the spiritual development of our clients? By first learning to use Scripture in our personal spiritual development. I offer two suggestions.

First, both Dallas Willard and Richard Foster describe study, including study of Scripture, as an important discipline for the spiritual life. Willard describes study as an important contribution that we make to our relationship with God.169 This is not necessarily the cram-for-exam type of study that we learn in college and graduate school. It does not require us to have a desk filled with open commentaries, Bible dictionaries, lexicons, and so on. Rather it is a commitment to reading and to trying to understand God’s will revealed in Scripture. Foster suggests selecting a book of the Bible and reading it straight through to identify the themes and flow of the book.170

Second, using Scripture for spiritual growth requires time for reflection. We get accustomed to reading quickly to survive the challenges of the academic and professional worlds, but reading quickly is not an effective goal when approaching Scripture. After reading a book of the Bible through in one sitting, it might be helpful to spend thirty minutes per day for the next year reading it very slowly and reflecting on the promises of Scripture. Willard instructs, “We not only read and hear and inquire, but we meditate on what comes before us; that is, we withdraw into silence where we prayerfully and steadily focus on it. In this way its meaning for us can emerge and form us as God works in the depths of our heart, mind, and soul.”171 Meditation is an essential part of the spiritual discipline of study.

Challenge 4: Confronting Dominant Views of Mental Health

Insofar as dominant models of mental health encourage clients to look inside themselves or to a counselor for standards of conduct and principles of morality, using Scripture takes counseling in a different direction by suggesting an external source of truth.

What If This Happened?

Wendy cries softly as she describes her feelings of shame to her therapist, Dr. R. E. Teeguy. Unhappy in her marriage, Wendy agreed to go on a business trip with a coworker. While they were away together, she had sex with him. Since she returned, she has felt overwhelmed with guilt and shame.

Dr. Teeguy interrupts, “I’m wondering why you are upsetting yourself so much about your decision to sleep with Tom.”

“Because what I did was terribly wrong. I cheated on Mike. I betrayed his trust, and now I don’t even know how to act around Tom.”

“I can see this is upsetting for you, but I don’t agree that you have to be upset. Can you prove to me, logically, that what you did was terribly wrong? It sounds as if you’re saying that you have broken the law or something and that you are now a worthless person because of having slept with Tom.”

We can see where Dr. Teeguy is headed. He believes Wendy is upsetting herself unnecessarily with arbitrary standards of morality. By dismissing her “silly” ideas of right and wrong, Wendy might feel great relief after the session. Both Dr. Teeguy and Wendy think of it as a successful counseling session.

Though Dr. Teeguy might say that he holds no religious values, he actually has deified himself by assuming that his values of right and wrong are better and more carefully reasoned than Wendy’s. He encourages Wendy to accept his values and feel greater peace about having slept with Tom.

This is an extreme example, chosen to illustrate the problem of removing external standards of right and wrong from the counseling office. Most counselors, regardless of their religious perspectives, are more sensitive to religious values than Dr. Teeguy. But even religiously sensitive counselors are sometimes guilty of undermining external standards of right and wrong and of encouraging clients to look inside themselves for truth. In his presidential address for the American Psychological Association’s Division of Psychotherapy, Dr. Stanley Graham stated: “Quite early in the treatment process, the patient begins to use words like good and bad, and it is our tendency as therapists to diminish the intensity of these words since they relate to a value system within the individual that has led to the current state of stress. My own personal view of the last thirty years of psychotherapy is that we have collectively done an excellent job of diminishing the demonstration of good and bad and a very poor job of replacing these concepts with acceptable definitions that allow the individual self-acceptance and peace.”172

Though Graham was not arguing for explicitly religious forms of psychotherapy, Christian counselors can resolve his concern by respecting Scripture as an external authority for values and morality. Christian counseling, rooted in a commitment to Scripture, retains words such as right and wrong. Clients can still look inside themselves for feelings, experiences, thoughts, and assumptions, but they do not have to find truth inside themselves. Christian counseling leaves room for external authority: God can still be God.

Of course, we must be careful not to be too strident in our assertions about Scripture in counseling because our interpretations of Scripture are limited by human fallenness and our imperfect hermeneutic strategies. Some clients have unhealthy beliefs that they support with a distorted understanding of Scripture. So do some counselors. We must be humble, submit ourselves to God’s guidance, and learn from one another.

Challenge 5: Establishing a Scientific Base

Unfortunately, the use of Scripture in counseling has received very little scientific attention. The hypothesis, which awaits scientific verification, was stated well by Dr. Siang-Yang Tan: “It is proposed that a biblical approach to counseling . . . that explicitly utilizes Christian religious values or perspectives and interventions (e.g., prayer and the use of Scriptures) and relies on appropriate spiritual gifts and the power and ministry of the Holy Spirit, makes unique contributions to counseling effectiveness, especially with religious, Christian clients. Further research is needed to determine the empirical validity of this proposal.”173

In 1993, when Dr. Brad Johnson reviewed the outcome literature on religious forms of psychotherapy, he found only five studies reporting the effectiveness of Christian forms of therapy.174 Of these, only three used Scripture as a direct intervention. In the best designed of these studies, Johnson and his colleagues used two different forms of Rational-Emotive Therapy (RET) and tested their effectiveness. One form, Christian RET, used Scripture rather than the human reason of the therapist as the source of truth. Clients learned to challenge irrational beliefs with Bible passages. Although the treatment effectively reduced depression, the researchers found no differences between the overall effectiveness of RET and Christian RET among their depressed Christian participants.175 Two other published studies, both using Scripture as a tool to combat irrational beliefs, produced similar results.176 Interestingly, two studies in Johnson’s review showed religious interventions to be more effective than nonreligious interventions, but both of these studies relied on Christian imagery more than Scripture for the religious interventions.177

At this time, the research is so limited that it is premature to draw any conclusions about the effective use of Scripture in counseling. As academicians and clinicians work together to collect additional information and report results, we will be better prepared to use Scripture in effective and sensitive ways in counseling.

Challenge 6: Defining Relevant Ethical Standards

Many of the same ethical issues considered at the end of chapter 3 are relevant here. The principle of competence suggests that counselors should use Scripture only in ways that are consistent with their training. For example, the psychologist who has no training in theology needs to exercise special caution when using Scripture in counseling. The principle of informed consent requires counselors who use Scripture extensively in counseling to tell their clients so near the beginning of the counseling relationship. The counselor should also disclose the client’s alternatives by discussing other models of treatment available elsewhere. Charging fees and filing insurance claims for scripturally based interventions creates the tensions already discussed in chapter 3.

Using Scripture in counseling introduces another risk not discussed previously: the risk of significantly reducing client freedom by imposing the therapist’s values on the client. Religious psychotherapy, in general, introduces the risk of imposing unwanted values or beliefs on a client, and explicitly using Scripture in counseling quickly magnifies this risk.178

What If This Happened?

Ms. Young is seeing a counselor at the Ridge Id Counseling Center. She is facing a difficult decision about her future education and is looking for Christian guidance. Ms. Young has always dreamed of being a pediatrician, but her parents and her fiancé want her to matriculate in a two-year nurses-training program. With nurses training, they tell her, she can more quickly enter the workforce and will have an easier time giving up her career when her children are born. The counselor at Ridge Id joins forces with Ms. Young’s many advisers and, based on a questionable interpretation of Titus 2:5, tells her that Scripture instructs women to stay at home once they have children. Her counselor makes it very clear: Nursing school is the option best supported with Scripture.

Ms. Young leaves counseling feeling confused and frustrated, intent on giving up her long-standing goal in order to do what God wants her to do.

This counselor not only communicated a personal preference for Ms. Young to choose nursing school but also suggested, by referring to Scripture, that God wants her to choose nursing school. Under such circumstances, Ms. Young has lost freedom. In her mind, she can choose only to give up her goal to be a pediatrician or to rebel against God. Using Scripture in counseling magnifies the risk of unethical coercion or inappropriate value imposition. This is not to say that we should always avoid using Scripture in counseling but that we are wise to consider the risks and exercise appropriate caution.

Although the greatest attention has been given to whether or not it is ethical to use explicitly Christian techniques in counseling, one author has turned the question around: Is it ethical for a Christian counselor not to use explicitly religious interventions in therapy? David Holling argues that a pastoral psychotherapist has an obligation to treat patients differently from the way a traditional therapist might, by using Scripture, prayer, rituals, doctrines, and sacraments.179 His point is worth considering. If we claim to be specialists in Christian counseling, then our work with religious clients ought to look different from the work of those who specialize in different forms of counseling.

Summary

Scripture is powerful and can keep us focused on timeless truth in the midst of professions vulnerable to fads and shifting standards of right and wrong. Some Christian counselors have used Scripture to support counseling models or as a specific intervention tool in counseling, but survey research suggests that the explicit use of Scripture is quite rare among Christian counselors.

When counselors choose to use Scripture in counseling, it is important to consider the specific effects it might have on a client, based on a careful assessment of the client’s needs, the therapeutic relationship, and ethical standards. Also, it is important to balance a healthy respect for Scripture as God’s special revelation with personal humility, recognizing that all interpretations of Scripture are limited by our imperfect hermeneutic methods. Our knowledge of God, self, and Scripture are all interrelated, and our capacity to understand any one of these elements will add to our ability to understand the others.

In order for Scripture to effect significant change in the lives of counselors and clients, it must be internalized and personalized outside of counseling sessions. Meditating, contemplating, and praying from Scripture are often helpful in spiritual growth, especially when we discard the notion that more is better. Sometimes thirty minutes are better spent contemplating one or two verses than reading several chapters.

Upon Reflection

Since I wrote the first edition of this book, three humbling events have caused me to think further about the use of Scripture in counseling. First, a colleague at Wheaton College wrote a chapter on hermeneutics, which was published in a book that a theologian colleague, Timothy Phillips, and I edited.180 In his chapter, Richard Schultz gave example after example of Christian counselors misusing Scripture in their written work. Richard’s chapter stopped me short, reminding me of how self-serving we can be when approaching Scripture. It is tempting to go to Scripture to find “proof” for an idea that we already have rather than to form our ideas based on a solid and wise understanding of Scripture. Let me state it even stronger: as a professional movement, we ought to be ashamed of how we have distorted Scripture for our own benefit, sometimes with blatant disregard for the intended meaning of the Bible.

The second humbling experience occurred in a recording studio. As I mentioned in the previous chapter update, on prayer, several years ago the American Psychological Association (APA) asked me to record a psychotherapy video demonstrating Christian counseling. This involved seeing four clients in one evening, with sessions at six, seven, eight, and nine, in each case surrounded by three cameras and their operators. For a morning person, this was a bit of a challenge, especially when nine o’clock rolled around. After the evening of the taping, I slept lightly and then went back to the studio the following morning to review the sessions and select a recording for the published DVD. Frankly, I was appalled to see my counseling approach with the nine o’clock client from the evening before. The session began with the client telling me that he had memorized Romans 8, while also describing his desire to live a pure and godly life. Rather than follow the emotional cues and dig deeper into the conflict he was feeling about temptations and struggles, I began to talk with him about the end of Romans 7. Biblically speaking, it is an important prelude to Romans 8, but our conversation seemed to be more about impressing each other with our knowledge of Scripture than about me listening—really listening—to the client’s presenting concerns. The host of the APA psychotherapy series smiled when I told him I didn’t like how the session started. He replied, “Yes, it sounds as if you were playing Bible Bowl.” I passed over that session and chose the seven o’clock session for the published APA video.

I’ll describe the third humbling event at the end of this update. But the first two experiences remind me that Scripture is critically important in shaping our understanding of God, self, one another, and the world around us, but this does not mean that using Scripture more often or more explicitly in counseling is always a good idea. Should we give up on using the Bible explicitly in Christian counseling? No. But we need to be wise and discerning. In this update I offer two cautions for the use of Scripture, both illustrated by the humbling experiences I have just described: (1) counselors might unwittingly go beyond their knowledge and misuse Scripture in the process, and (2) the use of Scripture can have an intellectualizing effect on conversations. Then I affirm that Scripture can indeed be used explicitly in Christian counseling and give two examples from the recent literature. Finally, I conclude with my third event—a story about Dallas Willard that moves me every time I recall it.

Caution 1: Maintaining a Humble Awareness of Our Limited Knowledge

One of the basic ethical principles of every counseling profession is that we not go beyond the boundaries of our competence. If we don’t know how to use a particular type of treatment or technique, then we get supervised training before offering these services in counseling. I remember back in the early 1990s when counselors were starting to talk about Eye Movement Desensitization and Reprocessing (EMDR). It seemed fairly simple, which tempted me to start waving my finger back and forth in front of my clients’ eyes to see what happened. Fortunately I resisted the temptation because I was not trained to use EMDR. A few years later many Christian counselors were talking about Theophostic Ministry. Again, the methods seemed fairly straightforward, and I was tempted to try the inner-healing-prayer methods that I saw on a training video. But I had not received adequate training, and I resisted the urge. I don’t regret passing up either of these opportunities, holding firm to my ethical commitment to provide only those services I am competent to provide.

We ought to hold to similar principles when it comes to biblical hermeneutics. Having a cursory understanding of the Bible may not be sufficient even if a passage seems fairly straightforward and easy to understand. Scripture is a grand and beautiful narrative of God’s dealing with broken humanity, but we cannot take one verse from a portion of Scripture and assume it applies however we may want it to apply. There are guidelines and principles for biblical interpretation, just as there are for EMDR or Theophostic Ministry. One excellent source for getting started is Fee and Stuart’s How to Read the Bible for All Its Worth.181

Imagine a client who has just been diagnosed with cancer sitting in your office. You comfort the client with Jeremiah 29:11: “‘I know the plans I have for you,’ says the LORD. ‘They are plans for good and not for disaster, to give you a future and a hope’” (NLT). Your client feels hope and comfort from these words, and rightly so. Indeed, these words show the character of a God who longs to save and redeem us from disaster, and it may well be that this client will be successfully treated for cancer. But it is also true that these are specific words, written by Jeremiah, to the southern kingdom of Israel to provide comfort for a nation that was to spend seventy years in captivity in Babylon. While Jeremiah’s words still reveal the general character of a gracious and redemptive God, they cannot be taken as God’s promise for every troubling situation we face in contemporary life. If this verse from Scripture is used at all in the counseling situation just described, perhaps it would be good to add, “Jeremiah wrote these words for a different situation than what you face, but they still tell us something important about God’s nature.”

Richard Schultz’s chapter has caused me to think twice before mentioning Bible verses in my counseling and my writing. Scripture is powerful and life changing, deserving proper respect and thoughtful interpretation.

Caution 2: The Intellectualizing Effects of Using Scripture

My Bible Bowl experience has taught me how easy it is to use Scripture to avoid the more difficult task of sitting with pain and struggle. Using Scripture often moves conversations to an intellectual level, and if we are not cautious, we may unwittingly use it to ease our own anxiety about our clients’ pain. For example:

Client: The test came back positive. It’s a stage III cancer, which is treatable, but it’s hard to know what will happen.

Counselor: Oh my, I’m so sorry to hear it. That’s such hard news.

Client: Yes (sobs quietly).

Counselor: At times like this I often think of Jeremiah’s words, “‘I know the plans I have for you,’ says the LORD. ‘They are plans for good and not for disaster, to give you a future and a hope.’”

Client: Yes, thank you.

At first glance this intervention may appear to be wise and spiritually mature, but it may be neither. This use of Scripture moves the client away from exploring the pain associated with this shocking and painful diagnosis, and back to some theoretical, intellectual level that distances the counseling and client from the angst of the moment. While the Jeremiah passage might be helpful later in the session, for now the counselor’s task is to sit with the client in the midst of this pain, using words of empathy, if words are to be used at all. Perhaps sitting silently is the wisest and most spiritually mature option at this moment. There will be time for words later.

Scripture Can Be Used Well in Counseling

Having highlighted these cautions, let me again emphasize the fact that Scripture can be used well in counseling, both implicitly and explicitly. The implicit use of Scripture is a given for Christian counselors. The Bible helps us understand human nature—what we strive for, how we fall short, how we long for healing and redemption. Without Scripture we would be left only with the prominent counseling and personality theories of our time, and as useful as these may be, they cannot possibly provide a comprehensive Christian understanding of our diseases and our healing.

Scripture can also be used explicitly as the counselor offers words of hope and perspective at timely moments. I could give many examples of this, but I will focus on two that have recently been described in the integration literature.

Dr. Fernando Garzon182 discusses the use of Scripture in therapy in a recent article that has two specific aims. The first is to increase Christian counselors’ awareness of the myriad types of Scripture interventions that can be used in treatment, and the second is to stimulate creativity about ways Scripture can be integrated in counseling. Garzon begins by highlighting the importance of considering ethical, cultural, and assessment issues when making decisions about the use of Scripture interventions; then he goes on to give examples of various ways Scripture can be used within the context of different therapeutic approaches. The article offers an encouraging and thoughtful presentation of how Scripture, applied ethically and creatively, can facilitate growth and healing in clients.

Another recent article, by Dr. Donald Walker,183 focuses on the explicit use of Scripture in parenting training. The article discusses biblical and behavioral perspectives on parenting roles and practices, with an emphasis on the ways these two perspectives both correspond and diverge from one another in terms of basic assumptions. Walker illustrates various ways that Scripture can be incorporated into a behavioral training model for parents and describes the specific conditions in which the explicit integration of Scripture into parenting training can be most effective.

Final Thoughts

I mentioned at the beginning of this chapter update that I had three humbling stories to share. The third occurred in the late 1990s when I taught at Wheaton College. Well-known Christian author and philosopher Dallas Willard came to the campus to speak in chapel. He also graciously agreed to speak to one of my doctoral classes in clinical psychology. I can’t remember what he talked about, but I do remember this: at the end of our time, one of the students asked him what brings him hope and encouragement in life.

Dallas answered quickly, as if he had known the answer for many years. “I love the Bible,” he said. He went on to describe how much he enjoys reading the Bible, how many Bibles he has worn out over the years, and how precious he finds the words of Scripture.

I don’t think my students could see it, but I was sitting close to Dallas as he answered the student’s question, and I saw tears welling in his eyes. His answer, so vivid to me after all these years, struck me as beautiful and true. Oh, how I long to love Scripture as Dallas Willard does. How beautiful the lives of those who cherish God’s Word. I find Dr. Willard’s example inspiring as I do the work of Christian counseling.

Lord, help me to love Scripture as Dallas Willard does. Let it shape my life for good so that I sit in wisdom and kindness with those who face pain and struggle.

Acknowledgment

Thanks to Ryan C. Staley for helping me with this chapter update. When Ryan served as my research assistant, he helped me find current research for a number of the chapter updates. Ryan is currently doing his dissertation on social support among pastors and their spouses and hopes to work with pastors and their families after finishing his doctoral degree.

Additional Reading

Gordon D. Fee and Douglas Stuart, How to Read the Bible for All Its Worth, 3rd ed. (Grand Rapids: Zondervan, 2003).

Bibliography

Fee, Gordon D., and Douglas Stuart. How to Read the Bible for All Its Worth, 3rd ed. Grand Rapids: Zondervan, 2003.

Garzon, Fernando. “Interventions that Apply Scripture in Psychotherapy.” Journal of Psychology and Theology 33 (2005): 113–121.

Schultz, Richard. “Responsible Hermeneutics for Wisdom Literature.” In Care for the Soul: Exploring the Intersection of Psychology and Theology, edited by Mark R. McMinn and Timothy R. Phillips, 254–275. Downers Grove, Ill.: InterVarsity Press, 2001.

Walker, Donald F. “Integrating Scripture with Parent Training in Behavioral Interventions.” Journal of Psychology and Christianity 26 (2007): 122–131.