Sunday, January 18, 2015

Should Christians get counseling from Christians?

Christian Therapist – Christian Client Matching:
 Is it important?

Answer #1: Yes. Matching is probably important.

Seven reasons why matching Christian clients to Christian therapists might be important. (Gleanings from Stegman and colleagues, 2013).

1. Psychotherapists know little about religion and spirituality.

2. A large number of Psychotherapists associated with Christian counseling professional groups graduated from non-Christian programs.

3. The spiritual beliefs of Christians can seem like psychopathology to non-Christian clinicians. This is especially true when the beliefs are different from the typical beliefs in a culture.

4. Christian clients consider religious and spiritual issues important to psychotherapy and many wish to talk about these matters.

5. Conservative Christian clients expect their beliefs to be a part of psychotherapy.

6. Not addressing Christian beliefs can lead to early termination.

7. There is a general consensus that accommodating a client’s religious and spiritual beliefs can be helpful. For example, the American Psychological Association endorses the importance of recognizing spirituality as important in psychotherapy.

Answer #2: Matching is complicated.

1. The evidence suggests Christian clients will likely feel more affinity for Christian clinicians. But, the evidence does not indicate what beliefs might make a positive or negative difference in treatment outcomes.

2. The emphasis is on beliefs; but what about religious or spiritual experiences? How will a clinician respond if a client wants to discuss experiences with supernatural beings, encounters with God, or the importance of visions or dreams? Christians experience God in many ways but some may be viewed as evidence of pathology.

3. The emphasis on religious beliefs does not address divisive values among Christians. Several moral issues divide Christians into tribes but these issues can be focal or important to clients. How well can Christian clinicians accommodate the moral values or challenges of their clients? The cultural divisions occur over such matters as abortion, birth control, cohabitation, marijuana usage, same-sex relationships and marriage, sex education, pacifism, and gender roles within society and the church.

How can clinicians learn more about client religiosity or spirituality?

My colleague, Chris Arnzen, and I conducted a survey of Christian Counselors in 2014. We have begun to look at background information related to the questions we asked and hope to analyze most of the data in the next few weeks before we make our first presentation.

Both of us are experienced clinicians and we are familiar with the religious beliefs of people who seek help. It’s no surprise to anyone that the beliefs and behavior patterns of religious persons do not match the official beliefs and expected behaviors associated with a particular Christian group. By group I mean Catholic, Orthodox, Anglican, Protestant, Pentecostal/charismatic and so forth.

Anyone can find the official teaching of various groups on their websites. But what do the clients really believe, practice, and value? Fortunately for us, the beliefs and practices of U.S. Christians have been studied by major research sources. So this week I’m gathering some facts that might be important to matching Christian psychotherapists and clients. After we analyze the survey data we should have some idea of what a sample of Christian clinicians believe and practice.

What is the religious identity of most Christians?

According to Pew, 78.4% of U S adults are Christian. And for perspective, there are about 2.2 billion Christians in the world. The three major grouping of Christians are Catholics, Protestants, and Orthodox.

  Protestant 51.3%
            Evangelical 26.3
            Mainline 18.1
            Historically black churches 6.9
  Catholic 23.9
  Mormon 1.7
  Jehovah’s Witness 0.7
  Orthodox 0.6 (Greek and Russian each < .03)
  Other Christian 0.3

If official belief matching is important, then most counselors ought to know the most about Catholic and Evangelical traditions.

And focus on the Baptists—about 20% of the U S adult population are Baptists. They are about 1/3 of U S Protestants.

Important research note- Pew relies on the self-report of the respondents to classify people in terms of their religious affiliation.

An aside: Are Anglicans Protestants? This is a bit tricky. Some see themselves as catholic but not Roman Catholic. Others so see that the protested against the Church of Rome but they were not part of the general Protestant Reformation groups. Read more. When it comes to surveys, people may not always know their heritage. The devil may be in how you ask the questions.

What can we assume about the religious faith of couples?

It turns out we cannot assume anything. More than one-third (37%) of married persons are married to someone from a different religious group—that includes different denominations for Christians.

Does it matter where people live?
Actually it does. One of the questions we asked on the survey was the geographic location of the clinician. The Midwestern states closely match the national averages but other regions have faith clusters:

South- highest percentage of Evangelical Protestants
Northeast- highest percentage of Catholics
West- highest percentage of atheists, agnostics and unaffiliated persons.

What do Americans believe about common faith issues?

God exists (Harris 74%; 81%)
Jesus is the Son of God (Harris 68%)  
Devil exists (Harris 58%)
Angels exist (Harris 68%)
Soul lives on after death (Harris 64%)
Heaven exists (Harris 68%; Baylor 62%)
Hell exists (Harris 58%; Baylor 51 %)
Bible is God’s Word (about half for Old and New Testaments)
Miracles happen (Harris 72%)

            Links Harris 2013;   Baylor, 2011

What are common spiritual practices?

Church attendance (40% according to Gallup)
Prayer is common- Almost 60% of U S adults pray at least one a day (pewforum)

What are common social/ moral values?

Abortion: 29% would like to see the U S Supreme Court overturn Roe v Wade (Pewforum, 2013). How well can a conservative Christian counselor show empathy to a woman discussing a planned abortion?
Birth control: 89% find it morally acceptable and 8% think it wrong. Although official  Catholic teaching opposed birth control, U S Catholics find it acceptable at high rates (82%); 15% find the use morally wrong. Gallup poll.
Christian nation: 32% favor establishing Christianity as the official religion of the USA (opposed 52%). 34% support having Christianity as the official religion of their specific state (47% oppose) 
Marijuana use: 51% of U S support legalization but it is not clear what percentage are Christian. 
Same-sex marriage: 52% of US support same-sex marriage and 40% oppose. (Pewforum, September 9, 2014). I did not find data for a national Christian sample. How will conservative Christian clinicians deal with the issue when so many religious groups oppose same-sex relationships?
War is just: 72% of Americans believe war can be justified but only 58% are willing to fight  (Slavin, 2014). How would pacifists fare with psychotherapists valuing a strong military presence?
 Why do people oppose same-sex marriage? (Gallup,2012)
   Religion/Bible says it is wrong 47%
   Marriage should be between a man and a woman 20%
 An aside: Last week the U S Supreme Court decided to hear cases from four states involving legalization of same-sex marriage. The U S states are divided, which obviously causes difficulties for recognition of marital status and any marriage-related benefits. Key issue in same-sex debate might be choice vs. genetics. Here’s a quote with data from a recent Baylor survey.
 The extent to which Americans support same-sex marriage, civil unions and same-sex adoption is closely tied to whether they believe homosexuality is genetic or a choice. The survey shows that less than half (41 percent) believe it is a choice; more than half (57 percent) believe it is genetic. Individuals who believe it is a choice are much more likely to label it "always wrong" and less likely to have a favorable opinion on same-sex marriage, civil unions and same-sex adoption. Those who think sexual orientation is determined by genetics are much more likely to deem homosexuality as morally acceptable and to support same sex-marriage, civil unions and same-sex adoptions. (Baylor, 2011)

How much does religion matter to people? A lot – highest for Muslims though (2011)

Some thoughts

1. Any psychotherapist seeing a client in the United States will likely be interacting with a Christian who believes that God exists and Jesus is his Son. Many will attend church and pray. Many believe they will live on after death and a substantial portion believe in heaven or hell. And most believe in miracles.

2. A significant number of Americans do not share the beliefs, practices, and values of the majority so if religious and spiritual factors matter, clinicians will have to assess them. And this means clinicians need to know the questions to ask or the scales to use.

3. People tend to trust people who share similar beliefs and values. Trust is important to rapport. It might be difficult for a small percentage of people with atypical beliefs to find supportive and experienced clinicians.

4. Hypothesis: Conservative Christian counselors will be more effective with conservative Christian clients even when religious or spiritual issues are primarily linked to rapport than the focal treatment issue.

5. Hypothesis: Progressive and mainline Christians, atheists, and agnostics will find it difficult to establish rapport with conservative Christian clinicians.

6. Hypothesis: Same-sex couples will find it difficult if not impossible to obtain couples counseling from Christian clinicians who strongly believe same-sex relationships as sinful.

What are your thoughts?



Stegman, R. S., Kelly, S.L., & Harwood, T.M. (2013). Evidence-based relationship and therapist factors in Christian counseling and psychotherapy. In E. L. Worthington Jr., E. L. Johnson, J.N. Hook, & J.D. Aten (Eds.), Evidenced-based practices for Christian counseling and psychotherapy (pp. 25-39). Downers Grove, IL: CAPS/IVP Academic.

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