Author Bios
Tim Stauffer, PhD, is a licensed professional clinical counselor-supervisor in
Ohio, a certified sexual recovery therapist, and an adjunct professor at Liberty University. He
works in private practice in the greater Columbus area. He has specialized in the treatment of
sexual addictions and marriage counseling for over 10 years. Dr. Stauffer is married to his lovely
bride of 26 years and has three children. He has a deep love for Jesus and the scriptures, and a
passion for the ethical integration of faith and counseling.
Brittany Lashua, PhD, NCC, is a licensed professional counselor supervisor in Texas who has
practiced sex therapy, with a focus on trauma and couples, for over 10 years. She is also an
associate professor at Liberty University. She is the owner of a group private practice in the
Dallas area. She is married to the love of her life and has one child. Dr. Lashua believes that the
integration of faith with sexuality is deeply important in counseling work and the ability of the
clinician to be present and attuned is powerful.
LEARNING OBJECTIVES
After reading this chapter, students will be able to: 1.
Understand the role of values in issues of sexuality, 2.
Describe a Biblical perspective of sexuality and gender, and 3.
Explain how to ethically approach issues of sexuality and gender.
Introduction
The primary task of this chapter is to help Christian counseling students think critically about
the integration of faith and values when addressing a client’s sexuality and/or gender concerns.
It is important to note that the focus of treatment must always center around the client’s
concerns and not the counselor’s moral concerns related to their client’s sexual behaviors or
sexual/gender identities. The moment a counselor makes the focus of counseling about their
moral concerns, it’s no longer a counseling relationship. That said, clients regularly ask
counselors to help them sort through the challenges they face regarding sexual behavior and
identity concerns. Herein lies the challenge facing the therapist: to ethically help their clients
with sexuality/gender issues when they tie back to religious, philosophical, or ideological
valuing systems. Counselors often wonder if this can be done without violating the ethical
mandate to avoid the imposition of values on a client (American Counseling Association, 2014).
This chapter will propose a way forward for Christian counselors to ethically integrate faith and
values conversation when addressing issues of sexuality and gender.
Furthermore, it is critical for counselors to be aware that issues of sexuality and gender are
often polarizing within the current religious, cultural, and political landscape. This is because
sexuality and gender are values-laden constructs that can be intense and divisive. Therefore,
counselors need to be prepared for clients to present in therapy with conflicts related to
sexuality and gender; these issues spill over into the clinical concerns a client brings into the
therapy office, even when they are not the presenting concern. Christ living in us has equipped
us with the ability to show love, patience, and self-control. Therefore, in order to best care for
clients, Christian counselors must be equipped to face these concerns and choose to not engage
in religious, cultural, or political battles with their clients regardless of the differences between
the client’s and counselor’s values.
Moreover, sexuality and gender are inextricably tied to a person’s values system (Yarhouse,
2001), which includes both structural and functional elements. These structural elements refer
to the philosophical, theological, or religious underpinnings of the person’s worldview or
ideology. In short, the structure is about values, beliefs, identity, and understanding of what is
moral, right, and good. The functional elements refer to the way a person operationalizes the
structure of their identity and values. In short, the function is about the outworking or
expression of values through choices, attitudes, and behavior.
For example, Sarah is a 32-year-old client who grew up in the South and has structural issues
related to her Pentecostal Christian background and what she learned growing up about God,
sexuality, and how she’s supposed to exist as a woman. She went to a liberal arts college outside
of New York City and was exposed to different beliefs about spirituality and sexuality, along with
feminine expression. From a functional perspective, Sarah, who is recently married, struggles
with shame around being a sexual being with her husband even though she experimented with
casual sexual experiences in college.
It is common for clients to seek counseling for both structural and functional issues related to
sexuality and gender. There are various sexual and gender challenges that cause difficulty and
lead people to ask for help. Many common sexual and gender concerns include sexual
performance and desire issues, sexual relationship issues, sexual trauma and abuse, sexual
addictions, sexual and gender identity concerns, sexual offending, and paraphilias (Yarhouse &
Tan, 2014). In order to best meet the needs of our clients, Christian counselors must be willing
and equipped to face both structural and functional issues related to sexuality and gender.
Purpose Statement
As previously noted, the purpose of this chapter is to propose a framework for Christian
counselors to ethically integrate their faith and interact with their client’s faith in the counseling
process. The purpose of this chapter does not include a proposition of a particular viewpoint or
theology of sexuality and gender despite the authors having clear convictions, beliefs, and
values about sexuality and gender rooted in Christian orthodoxy. The authors would like the
reader to engage the material from their own vantage point and consider how their faith and
values will inform their counseling work with clients who may or may not espouse the same
sexual or gender values and perspectives they do. In reality, no matter how integrated and
regulated counselors believe they are, there will eventually be something that forces the
counselor to face the intersection of personal values and the client’s values (Francis & Dugger,
2014).
Theology of Sex and Gender
Christians and secular cultures share many common values related to sexuality. For example,
Christians and many non-Christians share the belief that sex should be a consensual act
(Balswick & Balswick, 2008).
Additionally, many non-Christians will agree with Christians about the value of monogamy in
marriage. However, differences in sexual values between Christians and secular culture are
often very stark and distinct such as the definition of marriage, the use of pornography,
premarital sex, and perspectives on sexual and gender identity, to name a few (Yarhouse & Tan,
2014). Additionally, those who identify as Christian have often been influenced by secular sexual
values. Therefore, it would behoove the Christian counselor to not assume that any identifying
Christian believes a certain set of values.
Furthermore, it is crucial that counselors who are Christian take time to process the concepts of
sexuality, gender, and God. Counselor education and training in issues of sexuality increase the
likelihood that a counselor will discuss sexual issues with their clients (Zeglin et al., 2018).
Training and preparation set the framework for what models and treatments are utilized and
applied in a way that honors our clients. Christian counselors must respect their clients by
preparing to interface with those who are experiencing the impact of sexual abuse/trauma,
sexual desire and performance issues, sexually addictive behaviors, sexual and gender identity
concerns, and more. As mentioned previously, sexual and gender issues often involve a complex
mix of values-laden variables, and the current social and political climate related to sexuality
and gender can be polarizing, contentious, and full of pitfalls. These complexities require
wisdom (James 1:5), sensitivity, compassion, extensive training (Romans
12:2), and ongoing professional peer consultation (Proverbs 15:22) from the Christian counselor.
For the sake of clarity and as a reminder, it is not the authors’ intent or purpose to advance a
particular theological or ideological perspective related to the topic of sexuality and gender. It is
the authors’ hope that the integrative framework suggested in this chapter will be useful to all
counselors regardless of where one stands on the particulars of theology or ideological
expression. While a comprehensive theology is beyond the scope of this chapter, readers are
encouraged to expand their knowledge in this critical area. The following section is a brief
review of some important theological concepts.
Intention
God created gender to mirror himself—He created both male and female and blessed them to
be fruitful and multiply (Gen. 1:27-28). Additionally, Genesis 2 indicates that God created
woman for man because He realized man needed a “suitable helper,” signifying we weren’t
intended to do life alone (Balswick & Balswick, 2008). Furthermore, the relationship is more
profound than simply not being alone; we were created for intimacy because God is a relational
God. So, both husband and wife leave their families and become one flesh, naked and without
shame (Genesis 2:24-25).
God intended for couples to connect without shame, with full intimacy and vulnerability. This is
the depth of intimacy that is implied in Isaiah 43:1b (New International Version Bible [NIV],
2011): “I have summoned you by name; you are mine.” To use the phrase “called you by name”
suggests that there is an intimate relationship (Walvoord & Zuck, 1985). The intimacy we have
with Christ is a mirror image of the relationship described between Christ and the church
(Chapman, 2003). Therefore, when we understand Christ and the church, we can understand
the role of gender, sexuality, and our body. He created our sexuality to be enjoyable, without
both physical and emotional pain, and as the means of procreation (Chapman, 2003; Penner &
Penner, 2003). However, there is evidence through the Fall that sex does not always look this
way.
Fall
As a result of the Fall sin entered our existence, and from a theological perspective our bodies
and minds do not function as originally intended (Chapman, 2003; Penner & Penner, 2003;
Yarhouse & Tan, 2014). Unfortunately, this includes our physical body, sexual behaviors, and
gender identity. We are so deeply impacted by sin that Colossians 3:5 says, “Put to death,
therefore, whatever belongs to your earthly nature: sexual immorality, impurity, lust, and evil
desire” (NIV, 2011). Again, because sin has entered the world, we take what was meant for
connection and disconnect it. We take what is meant for intimacy and safety and use it to meet
our own ends at best and cause intentional harm at worst. We remove the soul and spirit from
the body and engage in sexuality that involves just the body (Smedes, 1994). Think about it like
this:
[The] “paradox of the body is that the body is a temple, but the temple is in ruins. The
incarnation of Jesus affirms the body’s original goodness. The death of Jesus reminds us of the
need for redemption. And the resurrection of Jesus gives us hope for its restoration.”
(Anderson, 2011, p. 31)
Through the restoration, God also gave humans the ability to face temptation and to get out of
it (1 Cor 10:13). Unfortunately, humans do not always take that way out and play into Satan’s
role in sexuality—to take what God created and distort it (Glahn & Barnes, 2020). Yet, the need
for redemption takes what was distorted and makes the picture clear, offers restoration, and
recovers the original intent.
Restoration
Without a doubt, Christ came to redeem what has been broken and restore it. Joel 2:25 (NIV,
2011) says, “I will restore to you the years that the swarming locusts ate.” When we mess up,
feel unworthy or dirty, or carry shame, or do the things we don’t want to do (Rom. 7:14-20),
Philippians 1:6 (NIV, 2011) serves to remind us that “He who began a good work in you will
bring it to completion at the day of Christ.” In spite of imperfection and sexual sin, we can find
comfort that there is a restoration plan in place. Matthew 11:28 tells us to come to God with
our burdens and He will give us rest.
As a counselor, it is imperative that we are aware of how God created sexuality and that he had
an original intent for our beliefs and behaviors. We have to be able to see that our clients
experience brokenness in this area due to the Fall and that there is a God who loves and cares
for them. We must be diligent to not impose values, and having an understanding of Biblical
sexuality helps us navigate these waters with care and honor. Ethical counseling proceeds from
understanding the necessity, pitfalls, and process of integration.
The Necessity of Integration
Counseling is a values-informed process that is ruptured at best and damaged at worst if there
is not genuine interaction between the client and the counselor (Rogers, 1957). The alliance
between client and counselor is a mediator for change and has a significant role in the
effectiveness of psychotherapy (Baier et al., 2020). This interaction, by necessity, must include a
deep understanding of the values guiding the therapeutic conversations and be monitored from
session to session throughout treatment to obtain continued effectiveness (Falkenstrom et al.,
2013). The ACA Code of Ethics is predicated on a set of values designed to promote human
flourishing. These counseling values undergird the counseling principles of autonomy,
nonmaleficence, beneficence, justice, fidelity, and veracity (ACA, 2014). Ethical counselors are
mandated, by virtue of the law in many states, to inculcate these values and principles into the
therapeutic relationship (Ohio Administrative Code, 2022, 4754-5-01). This is why it’s so
important to stay up to date with the ACA Code of Ethics and state laws regarding values.
Counselors in training often wonder where values come from and who decides how they are
codified or expressed. These questions are beyond the scope of this chapter but are lodged
within scientific, philosophical, theological, and religious domains. Science serves as a tool for
developing knowledge on sex and sexuality but is woefully inadequate for answering the
philosophical questions of meaning, purpose, and proper values. Science has great utility for
addressing the functional domain and for evaluating the functionality of structural claims but is
anemic for answering deep structural belief and worldview questions (Volf, 2011).
By nature of being human and having a wide variety of experiences, people are at risk of
imposing their values on others. This is elevated when a person’s values are operating beneath
conscious awareness (Oberai & Anand, 2018), which is likely considering 95% of our mind is
unconscious and only 5% is conscious (Zaltman, 2003). For this reason, the American Counseling
Association (ACA, 2014) Code of Ethics promotes the idea that counselors develop an
awareness of the values that are guiding their work and take steps to avoid imposition. It is
critical to recognize that avoiding imposition does not mean that the counselor’s values must be
eliminated or dismissed from the process. On the contrary, maintaining your own values while
holding the values of your clients is critical to the personhood of the counselor. Therefore,
counselors must understand that the significant power differential inherent in the counseling
process must be constantly attended to in order to be beneficent and avoid harming the client
(McWhirter, 1991).
Counseling issues related to sexuality and gender require attention to the values of both the
client and the therapist. This author, Tim, had a client who came to see him for sexual addiction
issues and, very early in the assessment process, identified as an atheist. He proceeded to
describe that he came to see Tim because he identified as a Christian and clearly stated on his
website that he holds a Christian worldview. The client stated that he wanted a therapist who
worked from that valuing system because his valuing system was inadequate for his needs.
This genuine request from the client was not a license for Tim to impose his values. Rather,
within the dialog, a Christian understanding of sexuality was incorporated into the session to
facilitate the client’s exploration and articulation of values and to seek congruence between his
values and behavior. Tim took great care to avoid coercion and imposition on the client’s valuing
system. He affirmed the client’s autonomy of choice because the responsibility for the client’s
values formation is solely with the client. The choices that a client makes are uniquely their own
and the counselor is under no requirement to affirm decisions that are in contradiction to their
own personal values, nor should they try to convince a client to embrace their own particular
viewpoint. The ethical mandate to avoid imposition is in alignment with Christian theology and
is also noncoercive and prohibits imposition on others (ACA, 2014; Volf, 2011). The Christian
counselor must respect the autonomy of the client just as God affirms the free will of people to
choose for or against him (Joshua 24:15). As aforementioned, this is especially important with
issues of sexuality as those tend to be particularly values-laden.
After a year of therapy, the client came to a session and announced that he now believed in
God. He was participating in an addiction support group and was listening to discuss their
prayers and the subsequent answers to prayers they received. This was the evidence that he
needed. He reported that it would be intellectually dishonest to insist that there was no God
after hearing the stories of answered prayer. The transformation this client experienced was
awe-inspiring. He sustained recovery over time, the depression remitted, and he found a new
sense of purpose in his life.
Jesus invited people to follow him but honored the autonomy of people to make their own
choices. This is clearly seen in the story of the rich young ruler (Mark 10:17-27) who came to
Jesus asking about how to gain eternal life. Jesus provided a response that was in sync with the
purposes of God but did not cajole or impose on the young man’s autonomy. At the same time,
however, Jesus did not change his message because the young man was sad and walked away
deeply dismayed. It is important for a Christian counselor to know where they stand on issues
and to stand there without compromise all the while loving the person and respecting the value
choices a person may make (Volf, 1996).
Christian counselors trust the work of the Holy Spirit who hovers over the dark waters of chaos
waiting for the creative word of God to pierce the darkness with light (Genesis 1:2). By way of
the counselor’s confession of Jesus Christ as Lord and Savior, their bodies become a dwelling
place of the Holy Spirit acceptable to be used by God (1 Corinthians 3:16, 6:19). Christian
counselors are privileged to join with God in the creative work of bringing order to chaos.
Proverb 18:21 (NIV, 2011) notes the words have the power of life and death. Counselors have
the ethical mandate to speak life and light to their clients. This kind of speech is beneficence at
work (ACA, 2014). The counselor trusts the work of the Holy Spirit in the life of that client
knowing that beneficent speech will bless the client regardless of the client’s choices.
Imposition on the client is a violation of clinical and Christian ethics.
Faith in the Public Square
Miroslav Volf, a Christian theologian, persuasively argues in the introduction of A Public Faith
that “religious people ought to be free to bring their visions of the good life into the public
sphere … and that it would be oppressive to prohibit them from doing so” (Volf, 2011, p. x).
However, the risks of secular philosophical and/or religious coercion and imposition of values
are always present and must be managed carefully. Volf proposed six decidedly Christian
principles for engaging the broader culture with its noncoercive ethic. First, faith should be
active in all spheres of life and seek to mend that which is broken. Secondly, Christ’s redemptive
mission was rooted in the gift of grace. Therefore, a faith that imposes its values is coercive and
malfunctioning. Thirdly, Christlike caring for others means working for the human flourishing of
all people regardless of the person’s values or behavior. Fourthly, a Christian’s stance toward the
broader culture must be nuanced and complex and “cannot be that of unmitigated opposition
or whole-scale transformation” (p. xvi). Fifthly, Christians avoid imposition on the broader
culture, choosing instead to model Christlikeness as he embodies the good life. Finally, Volf
notes that even Christians who are exclusivists in their own personal religious views ought to
extend to others the same freedom of thought and perspective they enjoy to those who differ
from them. Inculcating these six points serves as a protective function from those who may
otherwise seek to impose their values on others. This roadmap gives guidance for people of
faith to bring their full selves and values into the public square in a noncoercive, yet influential
way.
A modern-day exemplar of Volf’s (2011) vision is Dr. Mark Yarhouse, a clinical psychologist,
sexual/gender identity researcher, and prolific author. He wisely states that humility is in order
when trying to answer questions about what God thinks about an issue and when we try to
answer these questions, “we don’t want to lose sight of the person behind the experience”
(Yarhouse, 2010, p. 18). Any counselor helping clients with issues of sexuality and gender will be
enriched by his work.
The Christian faith provides guidance and a clear vision for human sexual thriving. In their
seminal work, Balswick and Balswick propose “that God intends for our sexuality to be a
genuine, believable, and trustworthy part of ourselves” (2008, p. 14). Sadly, as aforementioned,
the human experience of sexual inauthenticity robs people of joy and true intimacy. In the
Christian tradition, the theology of sin and the Fall provides a backdrop for an understanding
that all people grapple with and fall short of God’s creative intention for human sexuality
(Erickson, 1998). Christian counselors are on the front lines of promoting sexual thriving
through the alignment of sexuality with God’s stated design in the Bible.
But how can a Christian counselor advocate for the good of the client through the alignment of
sexuality with God’s design without imposing values onto the client? This critical question is
complex and needs to be nuanced. One, it is impossible for a counselor to be values-free, no
matter which value system from which they work (Kocet & Herlihy, 2014). The very questions
that a therapist asks emerge from a system of values that makes judgments about what to
attend to or not attend to in a client’s narrative. This is no different than the way a counselor
asks questions through a specific theoretical lens. We must recognize that our values do
influence our behavior. This is why the ACA Code of Ethics (2014) mandates counselors to know
and understand their values so as to avoid imposition. Intentionally bracketing of personal
values, a skill extensively covered in Chapter 3, honors and dignifies the counselor’s valuing
system while simultaneously helping to avoid values imposition on the client.
Guide Rails for Integration
There are three professional bodies that oversee or govern the practice of counseling and by
extension the integration of faith into the counseling process. The Council for Accreditation of
Counseling and Related Educational Programs (CACREP, 2016) is the gold standard of counseling
program accreditation. The Association for Spiritual, Ethical, and Religious Values in Counseling
(ASERVIC, 2023), a division of the ACA, advocates for the integration of spiritual, ethical, and
religious values into the counseling process. Lastly, counseling is governed by state licensure
boards and state law.
CACREP
We want to note how CACREP (2016) standards are connected to our understanding of sexuality
and gender. As counselors, we need to be able to understand models related to sexuality and
view gender and sexuality through an overall biopsychosocial-spiritual lens along with how to
apply these models to treatment (5.C.1.c; 5.C.3.a). Additionally, working with those who have
gender or sexuality issues tends to involve a specific set of nomenclature, understanding of
etiology, and often having great referral sources (5.C.2.b) because of the biological and other
neurological mechanisms that impact mental health (5.C.2.e). Additionally, advocacy is often a
part of caring well for clients with gender and sexuality issues (5.C.3.e).
ACA Code of Ethics and ASERVIC
The counseling industry relies on the ACA Code of Ethics to assist
“members in constructing a course of action that best serves those utilizing counseling services
and establishes expectations of conduct with a primary emphasis on the role of the professional
counselor” (ACA, 2014, p. 3). The following ethical codes have particular relevance to the topic
of sexuality and gender.
Sexuality and gender are strongly influenced by cultural or religious norms, beliefs, and dogma.
The ACA (2014) code A.2.c., Developmental and Cultural Sensitivity, mandates counselors to
attend to adjust their work to be both developmentally and culturally appropriate.
As previously mentioned, sexuality and gender issues are often connected to the client’s values
and beliefs. Additionally, the counselor also has a developmental history, culture, and beliefs
that inform their life. Code A.4.b.
instructs the counselor to have awareness and avoid imposition of their values on the client
(ACA, 2014). This is particularly salient when the counselor’s personal values and beliefs are
inconsistent with the client’s goals or are discriminatory in nature.
Code A.5.a prohibits sexual or romantic relationships with clients or their family members.
Counselors are also prohibited from forming a counseling relationship with previous romantic or
sexual partners (ACA, 2014).
Providing counseling for sexual and gender issues often requires specialized training. The ethic
of professional competence (C.2.) mandates counselors to only work within the confines of
competence (C.2.a.) and to seek additional training so as to prevent causing harm (C.2.b).
Advocacy is an important value of the counseling field (ACA, 2014). Christian counselors need to
be prepared to advocate for child sexual abuse victims, adult sexual violence victims, and sexual
minorities. Code A.7.a instructs counselors to advocate for their clients when there are barriers
and obstacles that inhibit growth and development (ACA, 2014).
Christian counselors, in conjunction with the ACA code, should read and inculcate the 14
ASERVIC (2023) competencies and then confidently integrate faith and values into the
counseling process as it relates to sexuality and gender. In the following section, there will be an
application of specific ASERVIC competencies in the integration of faith in counseling. We highly
encourage our readers to visit ASERVIC’s website at www.aservic.org, bookmark the site on your
browser, and review these 14 spiritual competencies before continuing your reading.
State Law
The practice of counseling is governed by state law and licensure boards. It is common for many
states to adhere to the ACA Code of Ethics and guide counselors to default to the state law
should there be a conflict. For example, the Ohio Administrative Code states:
The board subscribes to codes of ethics and practice standards for counselors, social workers,
and marriage and family therapists promulgated by the “American Counseling Association.” …
These association standards shall be used as aids in resolving ambiguities which may arise in the
interpretation of the rules of professional ethics and conduct, except that the board’s rules of
standards of ethical practice and professional conduct shall prevail whenever any conflict exists
between these rules and the professional association standards. (Ohio Administrative Code,
2022, 47575-01)
Christian counselors honor the authority of these regulatory bodies and respect the boundaries
and limits contained therein.
Process of Integration
Christian counselors integrate faith and values related to sexuality and gender in the following
ways:
1.
Knowing where you stand 2.
Integration through presence
3.
Integration through articulation of values 4.
Integration through facilitation of congruence
Knowing Where You Stand
In the Old Testament, Joshua made his famous declaration, “Choose for yourselves this day
whom you will serve. … But as for me and my household, we will serve the Lord” (Joshua 24:15).
If Joshua was a professional counselor, he could have lauded his grasp on the third ASERVIC
competency: “The professional counselor actively explores his or her own attitudes, beliefs, and
values about spirituality and/or religion” (2023, para. 3). Counselors need to know where they
stand on issues of sexuality and gender. It is wise for Christian counselors to expand their
knowledge by reading a wide variety of material and thoughtfully exploring their theology,
beliefs, and values related to these issues. Knowing where one stands is critical to even being
able to employ the skill of bracketing. Counselors cannot avoid the imposition of their beliefs
and values without first knowing what they are (ACA, 2014). Additionally, from a personal
standpoint, knowing what you believe and why will help you hold true to what you believe in
the face of differing value systems.
There are a multiplicity of resources that a counselor can use to deepen their own awareness of
values and to solidify their beliefs about sexuality and gender. The process of self-awareness will
include exploring a wide range of perspectives and beliefs related to the topic. This exploration
lays the groundwork for honoring ASERVIC competency number five:
The professional counselor can identify the limits of his or her understanding of the client’s
spiritual and/or religious perspective and is acquainted with religious and spiritual resources,
including leaders, who can be avenues for consultation and to whom the counselor can refer.
(2023, para. 3)
It is critical to emphasize again that a counselor’s values and beliefs are important to the
counseling process and that the counselor has the ethical mandate to know where they stand
on issues of values and beliefs.
Consider the following to deepen your awareness in knowing where you stand:
1.
Describe the influences, attitudes, and beliefs that shaped your understanding of sexuality and
gender.
2.
How did your own sexual development and experiences influence what you believe in issues of
sexuality and gender?
3.
What are your current beliefs and attitudes related to sexuality and gender? How will this
influence your work with clients about these issues?
Integration Through Presence
The counselor’s Christlike presence is the heartbeat of integration. Jesus said the world will
know that you are my disciples by your love for one another (John 13:35). There is no law or
ethical mandate that prohibits or limits a counselor from being Christ-like to a client. Scripture
even states that there is no law against inculcating the fruit of the Spirit in the life of the
believer (Galatians 5:23). Christian counselors do well to align themselves with the same
attitude as Christ (Philippians 2:5).
Jesus modeled a gentle posture toward vulnerable and broken people, and Christian counselors
should do the same. The prophet Isaiah said these words about Jesus: “A bruised reed he will
not break and a smoldering wick he will not snuff out, in faithfulness, he will bring forth justice”
(42:3, NIV). Clients experience a broad range of sexual issues that compromise their ability to
live full, productive, and satisfying lives. It is very common for a person to walk through the
counseling door full of shame, embarrassment, or deep guilt for their sexual struggles. For
instance, the conversation between Jesus and the woman at the well. Jesus did not condemn
her for her gender, sexual behavior, or relationship history; instead, Jesus welcomed her to
salvation (John 4:1-26). This is why it’s necessary to meet people exactly where they’re at,
regardless of presentation or particular struggle.
The religious leaders of Jesus’ day brought a woman to him caught in the act of sexual infidelity.
Their religious zeal, hypocrisy, and effort to trap Jesus backfired as he postured himself with
humility, mercy, and grace to this vulnerable woman. Rather than condemnation, Jesus freed
her to live a life of joy and freedom instead of sexual compromise. Simultaneously, his posture
toward the woman and his mysterious writing in the dirt humbled and dispersed the murderous
mob about to stone her (John 8). The importance of a counselor’s posture toward broken
sexuality has lifechanging and life-saving potential. There is nowhere in the Bible where
someone was moved to repentance by judgment but by way of love and acceptance. The
integrative Christian counselor will model the posture of Jesus as he fulfills the Biblical mandate
of being an ambassador of reconciliation to his clients (2 Corinthians 5:20).
This posture toward the sexually broken is consonant with Rogers’s (1957) person-centered
therapeutic conditions of empathy, congruence, and unconditional positive regard. A Christ-like
posture is also in sync with motivational interviewing’s underlying spirit of collaboration,
compassion, acceptance, and evocation (Miller & Rollnick, 2013). It also honors the ACA (2014)
ethical values of nonmaleficence, beneficence, and justice. It is critical that Christian counselors
prepare themselves to be present with their clients in a Christ-like way that honors the
vulnerability and complexity of sexual and gender concerns.
Presence Applied
Greg slunk into the counseling office filled with shame, regret, and deep self-loathing. His
depression and anxiety scores were off the charts and his marriage seemed doomed for divorce.
His intake paper indicated that he grew up in a harsh, religious, “military” family. He stated that
he was agnostic and that if there was a God “he or it” could not be trusted. Greg clenched a
decorative couch pillow and stared at the floor as he described his abuse as an altar boy, and his
subsequent porn use that culminated in paying for sex multiple times over the past two years.
He said his wife discovered his acting out a few days ago and kicked him out of the house. He
told her the truth about paying for sex but still did not disclose his periodic hookups with men
and his recent diagnosis of gonorrhea. Greg feels desperate for help and wants to save his
marriage because she is the love of his life. He is also terrified that he may have infected her
with a sexually transmitted infection.
1.
What Biblical examples inform how the counselor should be present with Greg at this point of
the counseling process?
2.
Describe pitfalls the mindful Christian counselor will avoid early in their work with Greg.
3.
Enumerate the relevant ACA ethical codes and ASERVIC competencies the Christian counselors
would consider in their work with Greg.
4.
If this were your client, what are your values that would be in the background? How would you
work with Greg in spite of your values?
Integration Through Articulation of Values
A clear integrative counseling strategy is to help people articulate their own values and to live in
congruence with them. Within the articulation of values, a client will deeply consider the
tapestry of their foundational beliefs, the source of their values, mental schemas, experiences,
cultural norms, family expectations, and sense of self. This articulation parallels what is called
change talk and will bring increased clarity to the valuing system to which they wish to align
(Miller & Rollnick, 2013).
The work of articulating sexual values occurs within dialog between client and counselor and is
consistent with the ASERVIC competencies. Competency seven states, “The professional
counselor responds to client communications about spirituality and/or religion with acceptance
and sensitivity” (ASERVIC, 2023, para. 5). During the dialog, the counselor maintains a Christ-like
posture toward the client as they listen and ask questions that help the client explore relevant
information.
As the therapeutic relationship with the client develops, the counselor will learn about spiritual
resources or concepts useful to the client’s goals. ASERVIC competency eight states, “The
professional counselor uses spiritual and/or religious concepts that are consistent with the
client’s spiritual and/or religious perspectives and that are acceptable to the client” (ASERVIC,
2023, para. 5). For example, if a client discusses their belief that the Bible is the foundational
text upon which they orient their lives, then the counselor should converse with the client
related to what the Bible says about the topics at hand. This needs to be done with caution. It is
easy for the therapist to impose a particular interpretation of Scripture onto the client, but this
must be avoided (ACA, 2014). We must not assume that just because someone identifies as
Christian, they believe the same things that we do. Additionally, the ACA code and the ASERVIC
competencies mandate that counselors avoid providing treatment beyond their scope of
practice (ACA, 2014, A.11.a.) and consult with or provide referrals to religious leaders within the
client’s faith tradition (ASERVIC, 2023, para. 3).
As a client explores their valuing system, they will encounter intrinsic contradictions that
produce feelings of incongruence and cognitive dissonance. In other words, a client may hold
two cherished values despite those values being mutually exclusive to one another. Think about
the example of Greg—he considered his wife the love of his life even though he had behaviors
that were incongruent and inconsistent with that claim. In the Bible, James 1:8 (NIV, 2011)
describes this as being “double-minded” and indicates that this will lead to a person’s instability.
This instability or incongruence can often be noted in sexual attitudes, unhealthy sexual
behavior, sexual performance, desire issues, and sexual/gender identity struggles. Congruence
occurs when there is an alignment between values, identity, and behavior (Ryan & Ryan, 2019).
In working with Greg, the ultimate goal would be to help him live in congruence with values,
identity, and behaviors.
Rather than imposing on the client, the counselor becomes a redemptive influence by asking
questions, encouraging the articulation of values, challenging contradictions, and promoting
congruence. The Apostle Paul noted that Christians will play various roles in the lives of people:
some plant seeds, some water, but God brings about the harvest (1 Corinthians 3:6). Therapists
will have a multiplicity of experiences where their clients will differ in values about sexuality,
gender, or sexual behavior that they hold. Christian counselors can trust that the same Holy
Spirit that is at work in their lives will be active in the lives of their clients. The Scriptures clearly
state, “But when he, the Spirit of truth, comes, he will guide you into all the truth” (NIV, 2011,
John 16:13). Christian counselors are often privileged to a front-row seat as the Holy Spirit
works in the lives of all their clients as they articulate their values and consider how to live
congruently with them. This is why we can trust the noncoercive work of the Holy Spirit in the
lives of our clients and follow that example to honor the client’s autonomy.
Integration Through Facilitation of Congruence
Furthermore, when we honor autonomy we take one of the first steps to foster client
congruence. The professional literature is robust in supporting the importance of congruence of
values and sexual/gender identity or behaviors (Yarhouse, 2001; Yarhouse & Tan, 2014; Hook et
al., 2015). Conversely, the impact of sexual incongruence is psychologically untenable and
predictive of “guilt, shame, unforgiveness and struggle in one’s relationship with God” (Hook et
al., 2015, p. 185).
Sexuality and gender struggles cannot be divorced from a client’s values. It is very common that
the very reason someone is seeking therapy is due to incongruence related to a conflict
between values, behavior, thoughts, and feelings. This incongruence is particularly powerful
because our sexuality is often closely interwoven with religious commitments (Hook et al.,
2015). In fact, 1 Corinthians 6:18 asserts that sexual sin is a sin against our own body. This is
why the weight of incongruence can feel incredibly heavy.
There is a two-tiered approach to integration that Christian counselors need to consider. The
first relates to the content of the counselor’s beliefs and values that they wish to bring into the
counseling process. This is the location where imposition is most likely to occur. This is where
we are mindful of the power differential in our position with our clients and meet them exactly
where they are with what they come in with. This helps the counselor stay in alignment with
the ACA Code of Ethics. The second tier of integration is about how a counselor holds their
beliefs and values. Counselors reflect and understand their own beliefs and values, so they are
able to avoid imposition (ACA, 2014). This ethical mandate validates a counselor’s values as
important to the identity of the counselor while simultaneously protecting the client. Since the
values and beliefs of the counselor are vital to the counselor’s identity, it behooves the
counselor to integrate carefully without coercion or imposition.
Summary
We count it a privilege and honor to help clients who are dealing with sexual and gender issues.
It takes a lot of courage for a client to address their sexual or gender concerns and we admire
them for doing so. We are also grateful to you, our reader, for investing your time and energy in
exploring this topic. We hope that it has generated critical thought about how to ethically
integrate faith into the counseling process related to issues of sex and gender.
It is important for Christian counselors to clearly articulate their own values and beliefs so they
can avoid imposition on their clients. This can best be done by learning about the theology of
sexuality and gender by engaging a multiplicity of thinkers and writers on the topic. Additionally,
counselors need to honor the ACA Code of Ethics (2014), inculcate the 14 ASERVIC
competencies, and know and follow the licensure laws of their state.
Faith and values are often embedded within issues of sexuality and gender. Science, while a very
useful clinical tool, is anemic in defining values or moral beliefs, so clients and counselors need
to explore philosophical, theological, and religious domains when articulating values and beliefs
about the topic. Volf (2011) provided a powerful roadmap for navigating and integrating faith
into the public square while emphasizing the importance of being noncoercive and avoiding
imposition on others.
The process of integration has four critical components. One, counselors need to know where
they stand on issues of sexuality and gender. Secondly, counselors integrate faith into the
counseling process by taking the posture of Christ with their clients. Thirdly, counselors help
their clients explore and articulate their values. And finally, counselors help their clients live in
congruence with their valuing system.
Integrative Case Studies
In this section, five common sexual/gender issues will be discussed through a Biblical lens and
how faith can be ethically integrated particularly with clients expressing a desire to integrate
their faith into the counseling process. The four case studies are diverse but common
sexual/gender issues that Christian counselors are nearly certain to encounter: sexual
desire/performance issues, sexual addiction, marital infidelity, and sexual/gender identity
concerns.
The following cases represent real stories of real clients. These composite stories maintain the
essence of the cases, but many details have been changed to protect confidentiality.
Affair
Frank and Julie were married seven years and had two young children, ages 5 and 2. Their
relationship was happy and satisfying but was starting to stagnate as they managed blossoming
careers, a growing family, and the flagging health of Julie’s dad. Two years ago, when baby
number two was about to arrive, they made the decision that Julie would quit her job to stay
home with the kids and help attend to her dad’s medical needs. They were both on board with
this decision and felt confident that it was the best route forward for their current life needs.
However, over the two years, sex became increasingly more sporadic and seeds of resentment
began to develop for Frank. He felt overwhelmed with the financial weight he was carrying but
soldiered on while rarely discussing his fears, loneliness, and growing resentments. His career
continued to grow, and he received a significant promotion that required more travel time.
Julie was devastated when she learned about Frank’s affair with a coworker. Looking back she
could see him withdrawing and becoming more distant, but she never thought he would be
capable of cheating on her. They both decided to try counseling to see if the marriage could be
saved. They identified as Christians and chose a Christian counselor, but they rarely attended
church and had no spiritual disciplines or practices that played an important part in their daily
lives.
How will your faith and view of marriage influence your work with this couple?
1.
The couple identifies as Christian but does not include spiritual or religious traditions in their
home or relationship. How can you advise them related to this important area of life without
imposing your values on them?
2.
What ACA ethical and ASERVIC principles are relevant to this case study?
Pornography
Joel was 27 when he first came for counseling. He was a committed Christian and specifically
chose a Christian counselor to help him stop his pornography and masturbation addiction.
During the assessment process, he noted looking at porn and masturbating every day. He
started using porn at age 13 and began frequently masturbating soon thereafter. His porn use
started with a developmentally normal curiosity about the opposite sex. He reported
experiencing tremendous amounts of guilt and shame but kept his behavior a secret because he
knew his parents and God would be “displeased with him.” He kept his porn use secret for many
years and would engage in cycles of confession to God, promises to stop, and inevitably act out
again within a few weeks.
Once he started dating his now-wife the struggle eased for a bit. He was confident that once he
was married, giving up porn and masturbation would be easy. He was wrong. His struggle with
porn and masturbation persisted into marriage. He came for counseling because his wife
discovered his porn use on the computer as he forgot to delete the browsing history. He was full
of remorse and desperate for help. He professed a strong faith in God and wanted a Christian
counselor who could help him.
1.
What precautions should the counselor take when choosing how to integrate faith into the
counseling process?
2.
Which ASERVIC competencies are particularly relevant for the counselor to consider?
3.
What are some ways a Christian counselor could inadvertently impose their values on this
particular client?
Open Marriage
Stephen and Amanda had been married for 15 years. Amanda grew up in a Christian school and
attended Christian private schools her entire life.
Stephen became a Christian in high school and that’s where he met Amanda. They attend
church a couple of times a month and their two elementary school-age daughters attend a
private, Christian school. About 10 years into their marriage, Stephen and Amanda began having
conversations about adding another woman into their marriage. They believed it would add
some excitement and satisfy their desire for variety.
Amanda worked with Riley, a college student more than 10 years her junior, and one thing led to
another. Eventually, Riley moved in with this family as a “girl they were helping out” and the
relationship a secret to the family. Riley has now lived with the family for four years—they have
had volatile fights that led to tumultuous breakups. Riley lives in her own part of the house and
has been locked in her room when she gets “too crazy” to protect the kids from her rage. She
feels abandoned when Stephen and Amanda want to have their own time without her. Amanda
gets cold from time to time when she feels guilty about their relationship with Riley from a
religious perspective. They want to make their relationship work and yet Riley often feels like
she gets the short end of the stick, but she really loves them, especially Amanda. Riley has seen
a handful of counselors on her own but always leaves when it seems like they make the
relationship a problem.
1.
Honoring their model of the world, how do you help this relationship?
2.
What codes of ethics apply here?
3.
How do you dance between religious guilt (or conviction) and their relationship dynamics?
Gender dysphoria (Britt)
Cameron was a 20-year-old trans male when he started therapy. He had always been very
interested in sports, but not at all interested in men. Before transition, he even thought that
maybe, she at the time, was simply gay. Eventually, Cameron enlisted in the military and it was
during this time period that he truly came to understand that he was a male in a female body.
The first thing that Cameron changed was his look, followed by his legal name—changing his
given last name also.
During this period, his relationship with his parents became very distant, and his then-
girlfriend’s parents were prominent pastors in the community, creating a greater challenge for
their relationship. While Cameron did not have any faith conflicts, his girlfriend did. There was a
fear of her ending the relationship to appease her family and God. Cameron struggled deeply
with the familial distance and isolation. He wanted to pursue hormone treatments and
ultimately have a breast removal, but that seemed to have many hurdles to achieve.
1.
What ACA codes and ASERVIC competencies apply to this case?
2.
How do you best support your client?
3.
Where would you need to seek consultation on this case?
Desire Issues (Britt)
Cynthia is a 32-year-old female who is no longer interested in sex with her husband of seven
years. They have three children under 5 and she is a stayat-home mom. She reported that
before her last child, they still had sex multiple times a week—with her initiating often. She is
unsure of what has changed, but since her last child was born she doesn’t want sex. Her
husband, whom she loves, will touch her and she cringes. She is becoming increasingly
disturbed because she feels confused and it’s creating a lot of problems in her marriage. She
reports being deeply in love with her husband. While her husband loves her, he also has
questions if she is having an affair. This also causes her distress because she also feels like her
lack of desire is hurting him too.
1.
What ACA codes and ASERVIC competencies apply to this case?
2.
What are some good things to be curious about in the case?
3.
What other practitioners would be good referral sources?
References
American Counseling Association. (2014). 2014 ACA code of ethics.
https://www.counseling.org/docs/default-source/default-document-library/ 2014-code-of-
ethics-finaladdress.pdf
Anderson, M. L. (2011). Earthen vessels: Why our bodies matter to our faith. Bethany House.
Association for Spiritual, Ethical, and Religious Values in Counseling. (2023).
https://aservic.org/spiritual-and-religious-competencies/
