Saturday, April 26, 2014

Unprofessional Christian Counseling: Helpful or Harmful?

Christian Counseling- by unlicensed persons

Can people with mental illness find help from counselors without professional training at a church or a Christian ministry? 

Certainly, there is a need for help. Rick and Kay Warren  recently wrote about the need for churches to do more for people with mental illness. They quote the National Alliance on Mental Illness statistic that 60 million Americans experience a mental health condition each year. But what can churches and Christian ministries do?

I’ve been reading a book titled Evidenced-Based Practices for Christian Counseling and Psychotherapy. It’s an edited volume with chapters by many leaders in Christian counseling and psychotherapy. One chapter (3) by Siang-Yang Tan of Fuller Theological Seminary takes a look at “Lay Christian counseling for General Psychological Problems.”

What is lay counseling?
The definition is a problem because we need to define both counseling and the attributes of the person providing the counseling. Here’s Tan’s definition of lay counselors from page 40: “those who lack the formal training, experience, or credentials to be professional psychotherapists, but who are nevertheless involved in helping people cope with personal problems…”

What evidence supports the value of lay counseling?
Some years ago, Tan found some positive results from research on the benefits of lay counseling. As he admits, most studies did not include an important ingredient in research-- a valid control or comparison group. Some studies offered evidence that lay counselors improved in target skills. But the key question is: How well do clients fare after being seen by a lay Christian counselor? There is one controlled outcome study. Those in the treatment group improved significantly on four outcomes: Target complaints, symptoms, spiritual well-being, and a global rating of psychological adjustment. And importantly, the clients maintained these gains at a one-month follow-up (Toh & Tan, 1997 in Tan, 2013).

What should organizations do?
At this time, the evidence is scanty but Dr. Tan appears hopeful that future research will support the value of lay counseling. In fact, near the end of the chapter he offers 10 guidelines for setting up a Christian counseling center. Guideline number three advises organizers to “Carefully select, train and supervise the lay counselors.” So it seems, at least in Tan's approach, lay counselors are not just ordinary church workers but people who have some personal attributes, relevant knowledge, counseling skills, and some level of supervision.


What is Christian counseling?
A few approaches are common among those who purport to provide Christian counseling. One general approach is to rely heavily on the Bible and can be called biblical counseling. Professional counselors have difficulty with this restrictive sense of Christian counseling because the Bible does not cover all aspects of human functioning. Another problem is what constitutes Christian in the phrase Christian Counseling? With over 2-billion Christians in the world, the variety of Christian beliefs is considerable. In reality, most of the articles I have read about Christian counseling focus on what may be called American Protestant Evangelical Christianity. It’s probably time for American Christians to broaden their perspective. Maybe some have. So, please add some comments and links if you know of broader perspectives. Here’s one link to a Catholic perspective.

Reasonable Expectations.
Drawing on my own experience, I found a lot of Christians expected prayer and scripture to be a part of the counseling process. Christians also expect counselors to share their moral and social values. I think it reasonable for Christian lay counselors to learn to listen, show support, and lead prepared programs on topics such as relationship skills, forgiveness, and marriage enrichment activities. But I think it is up to the counselor and organization to be clear about expectations.

Truth in advertising.
If a church or ministry offers Christian counseling services, how can the public know if the counseling services are provided by someone with a few hours of workshop training and experience vs. a Professional Counselor with some 60-university hours of education plus thousands of hours of supervision vs. a Psychologist with some 120 hours of coursework plus thousands of hours of supervision? As a matter of integrity, clients should know the credentials of people providing services. Other providers of Christian counseling or psychotherapy include Social Workers, Psychiatrists, Chaplains, Pastoral Counselors, Marriage and Family Therapists, and Psychiatric Nurses.

How much training is needed?
If education, supervision, and experience are important in the assessment and treatment of mental illness, how much of each is necessary? At this point lay counseling is an unregulated movement. People are going to help people. And churches and ministries can play an important part in the helping process. Tan’s chapter offers some good ideas—a starting place to build knowledge and skills.

Good and evil.
Helping can be a good thing. People often feel better just telling their story or confessing their sins. (Hint- protestants should consider the value of confession—a part of Catholic tradition). But counseling can also cause harm. The harm can be due to failure to recognize the need to refer a client for more intensive services. And the harm can come from violating appropriate boundaries between a counselor and a client. There's much more to this topic, which is one reason the licensed professions have ethical guidelines and encourage professionals to take annual risk management workshops. So, let the client and ministries beware.

Related posts


Tan, S. (2013). Lay counseling for general psychological problems. In E. Worthington Jr., E. L. Johnson, J. N. Hook, & J. D. Aten (eds.). Evidence-based practices for Christian counseling and psychotherapy. Downers Grove, IL: IVP Academic/ CAPS books.

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