LIBERTY UNIVERSITY JOHN W. RAWLINGS SCHOOL OF DIVINITY
Incorporating the Role Religion Plays for a Client into Treatment
A Paper Submitted to
the Faculty of the School of Divinity
in Candidacy for the Degree of
Doctor of Education in Christian Leadership (Ed. D) Department of Christian Leadership and
Church Ministries
By
Mary Gracias
Lynchburg, Virginia
10/2022
Cognitive Behavioral Therapy for Christians with Depression by Michelle Pearce, PhD is a
phenomenal guide to treating religious clients suffering from a depressive episode. It not only
provides an evidence based treatment model, but exemplifies the importance of compassion
and respect for the client and their values and beliefs that they bring to therapy. Although this
book targets mental health professionals, Dr. Pearce includes resources for clergy and spiritual
leaders who may be counseling a member of their church suffering from depression; these
resources and the treatment modality are well articulated and easy to follow for both clergy
and mental health professionals alike.
Dr. Pearce explains that while cultural and religious diversity are necessary ethical and
clinical competencies, few clinicians utilize the healing properties religion has to offer our
clients either because we are too hesitant to integrate religion into therapy and/or because we
have not received adequate training in how to do so. Importantly, Dr. Pearce posits that religion
will (and should) be a part of our therapy if religion is important to our clients, whether or not
the therapist explicitly discusses it. She provides compelling evidence that religion helps clients
to cope with depressive symptoms, instill hope, and buffer against stressful events and,
therefore, should be incorporated into psychotherapy when possible. Additionally, she
emphasizes the importance of conducting in-depth assessment of each individual client’s
religious beliefs, values, and level of religiosity and avoiding assumptions.
As therapists, we cannot assume that each Catholic or Baptist or Protestant are alike; we
must first understand how religion plays into our client’s life before integrating religion into
treatment. She provides helpful questions and examples on how to gather this religious history,
which is extremely useful particularly because religious diversity and considerations are
infrequently taught during our training as mental health professionals.
Another important topic that she raised was how to incorporate religion into treatment
when religious beliefs are part of the problem. This was particularly interesting because so
often clients may be experiencing shame, guilt, despair, and conflict because their religious
affiliation disapproves of a certain behavior or character trait. For example, she explains the
negative psychosocial experience of Christians in relation todivorce, spanking, faith in healing.
This understanding can be applied to Christian clients struggling with sexual orientation,
abortion, or use of contraceptives as these are highly contentious issues within the Christian
faith.
The second part of the book focuses on seven practical CCBT tools to use throughout
therapy. These include: renewing your mind (planting truth), changing your mind (metanoia),
finding God and blessing in suffering (redemptive reframing), reaching out and connecting,
letting go and letting God (acceptance and forgiveness), gratitude, and giving back (service).
These chapters were filled with adequate scientific evidence supporting these tools, case
examples, biblical passages to reference and suggest to clients, example dialogues and
questions to facilitate client reflection. As a clinician, this portion of the book was extremely
pragmatic and informative. Additionally, the plethora of examples may aid in reducing the
clinician’s anxiety about bringing up religion during session or anxiety relating to not having
enough knowledge about passages or values. I was particularly impressed with Figure 5.1 in
which she delineates the 10 common cognitive distortions and provides theological reflections
for each one. This is a useful tool not only for psychoeducation, but for reflection and metanoia.
The only criticism, or rather an observation, was the missed opportunity to elaborate and
explicitly discuss Jesus’ doubt and questioning of God during His crucifixion as the most
impactful example of redemptive reframing; “My God, my God, why have you forsaken me”
(Matthew 27:46). An elaboration may have helped clinicians who are unfamiliar with the Bible
or the Passion of Christ to understand and convey to their clients that even Jesus – the perfect
son of God, whose entire life purpose was to die for the sins of His followers – questioned his
suffering and pain during His torture and death. This example, in my opinion, would have been
more impactful and validating to clients who feel guilty over questioning God, being angry with
God, or blaming God for their suffering because it exemplifies that everyone, including Jesus,
has questioned suffering and that it does not make you a bad person or a bad Christian. In fact,
it is quite liberating to realize that questioning is expected and helps to restore the client’s
relationship to God in finding new meaning and purpose in their trials.
