Friday, June 6, 2014

What in heaven’s name do Christian psychotherapists do?

What on earth are Christian psychotherapists doing?

What in heaven’s name do Christian psychotherapists do?

A Christian woman follows the recommendation of her doctor to see a counselor. Her friends advise her to see a Christian therapist. She shows up in the waiting area. What should she expect?

Most of us who work or have worked as psychotherapists are familiar with the fact that in the U.S. most people believe in God and most of them identify as Christian. A significant part of those prefer to obtain counseling or psychotherapy from a Christian psychotherapist. And they have many to choose from. But Christian psychotherapists are as diverse as people who identify as Christian.

Christian counselors range the full spectrum from conservative to liberal based on their church affiliation and their social values. Add to that conservative-liberal spectrum differences in faith practice by Catholics and Protestants. And if you consider Pentecostals and charismatics you can get an interesting mix of spiritual beliefs. Then there’s the Mormons—still suspect by some conservative groups but certainly invested in psychological research and interventions that integrate Christian spirituality.

The above mentioned variation in Christian faith should be enough to make clients wonder what they might experience when they get a Christian counselor or psychotherapist. But there’s more. So what if the therapist identifies as a Christian, what exactly will that Christian psychotherapist do in psychotherapy that’s different from what a secular psychotherapist does? And what if they were to be assigned to a psychotherapist from another faith—say Islam or Buddhist for example? Does faith make a difference when it comes to treating depression or anxiety?


There is not much research out there. In a book published last year, I came across a startling quote from the editors (Eric Johnson, Everett L. Worthington, Jr., Joshua N. Hook, and Jamie D. Aten) in a summary chapter:

 “…there is a good deal of confusion and little agreement in the field today regarding what exactly constitutes Christian psychotherapy and counseling (p. 337).”

The editors referred to a previous study from 2007. I looked up the article and found that the researchers looked at the effectiveness of Christian therapy in a sample of 51 therapists and 220 clients.

That’s not a lot of Christian therapists or clients but it is a start. And as an agency based field study the team was able to look at some detailed comparisons. Of course these scholars recognized the problems in identifying exactly what is Christian therapy. For the purposes of the study they considered two minimal criteria. The therapy was identified as Christian by the therapist or the agency and there was an intent to provide the client with a Christian therapist who shared a similar commitment to Christian beliefs.

Some findings
From the discussion on page 102:

“The results of the current study suggest that clients who seek and receive explicitly labeled Christian therapy, as well as those who seek and receive secular therapy, tend to feel close to their therapists and perceive therapy to be effective. Those clients who have strong religious commitments respond particularly well when therapists use discernible religious interventions.

But what did they do?

Well, the researchers asked about six interventions. Most agreed that knowing a client’s religious background was appropriate. The other five occurred less frequently for a secular counseling center compared to therapists at Christian Centers. But the interventions were broadly stated: Pray with a client, Pray privately for a client, Use religious language or concepts, recommend religious or spiritual books, and recommend clients participate in religion.


As I mentioned above, the study published in 2007 was referenced in the book of empirically based practice that was published near the end of 2013. The book contains several interventions that could be called Christian. But who uses them? Perhaps more important, who even knows about them? And how would psychotherapists learn about such interventions if they went to secular graduate programs?

The authors of the 2007 study note the value of religious commitment. That seems important to developing rapport. And religious commitment can be measured. Likely that would not be unique to Christian counselors though. I suspect highly committed Christians, Muslims, and Jews would also feel a closer connection to therapists who demonstrate a high commitment to their respective faith traditions.

Christian counseling just means you pray together and consult the Bible. Right?

I know there is more.

 But what on earth are Christian counselors doing?

Clearly it’s time for a lot more research. I and my colleague Chris Arnzen are in the process of collecting data from Christian Counselors and Psychotherapists (all related professions). We want to know what these therapists do and what they believe. We also want to know how they were educated – where did they get their degree and how did they learn about the Christian faith? A survey won’t answer all the questions but we think it’s a start.

Although many clinicians identify themselves as Christian, many are graduates from secular universities and professional schools. It is not clear how much they know about Christianity or explicitly Christian interventions. Also, many enter two-year Master’s Degree Christian counselor preparation programs with little or no coursework in biblical studies yet they are expected to integrate their faith with their counseling practice.

If Christian counseling means something unique, then people need to know what that is.

For those of you who do not know the mental health professions, I’ll offer a quick overview. A Master’s degree is the basic entry degree for counselors and psychotherapists, including Social Workers. Those degrees often take up to two years and students take somewhere between 50 and 65 credit hours, which includes supervised experiences. Before getting a license for independent practice, they must pass a national test and have post-degree supervision from an approved supervisor. A common minimal standard to become a professional counselor in the U.S. is 60 graduate hours covering a defined set of objectives. Psychologists usually have some 120 graduate hours and usually have two years of supervised experience.

In future posts, I will cover some of the strategies that might be considered Christian. So, stay tuned. For now, if you plan to see a Christian Counselor or Psychotherapist because you have specific expectations, it might be good to find out what that person believes and how she/he understands Christian counseling.

Meanwhile, if you know of a Christian Counselor, Social Worker, or Psychologist do refer them to me to complete our survey so we can better understand what it means to be a Christian Counselor or Psychotherapist.

Research Contact for the counselor survey:
Provide an email in the comment section;
by email or on

Related post


Johnson, E.L., Worthington, E.L. Jr., Hook, J.N., & Aten, J.D. (2013). Evidenced-based practice in light of the Christian traditions: Reflections and future directions. E. L. Worthington Jr., E. L. Johnson, J.N. Hook, & J.D. Aten (Eds.), Evidenced-based practices for Christian counseling and psychotherapy (pp. 325-346). Downers Grove, IL: CAPS/IVP Academic.

Wade, N.G., Worthington, E.L., Jr., & Vogel, D.L. (2007). Effectiveness of religiously-tailored
interventions in Christian therapy. Psychotherapy Research, 17, 91-105.


  1. Whereas I affiliate myself with an atheistic perspective, I have extensive training in Christian theology and have no small level of success integrating it into my practice for those who are heavily entrenched in their faith. I feel it becomes much more about speaking a different language to the client to meet them where they are; that language is scripture. I can utilize evolutionary principles to explain the brains propensity to be a meaning making machine, or I can state that "God" has created you for a purpose. Either way, I am communicating Victor Frankl's ideology of logotherapy, but I am doing it in such a way that the client is able to digest the information without resistance. Ellis encouraged REBT practitioners to utilize scriptures and faiths as a way of communicating the scientific in a way that is palatable to the religious. Even Frued viewed religion as useful in treatment, if for no other reason than as a defense mechanism. In modern times, it is my opinion that Christian methods can be used to communicate scientific truths for populations which would be otherwise distanced by science in psychoeducation, and used to communicate other coping skills in a way that allows for the individual to feel safe practicing it (mindfulness meditation turned into "mindful prayer" comes to mind specifically, where some extreme groups see such practices as yoga to be demonic, even.)

  2. Thanks for sharing your atheistic perspective and illustrating how you accommodate Christian clients. I do think it interesting that the researchers in the 2007 article referred to religious language as an intervention. I hope someone conducts a study on how effective that would be.