Tag: Psychiatrist

Jay Adams, and the Dangers of Biblical Counseling

Almost fifty years ago, in 1970, Jay Adams wrote his controversial book, Competent to Counsel, insisting that Christians reclaim counseling from psychologists and psychiatrists and redistribute humanity’s problems into categories using labels that maintained a theological tone: sin, disobedience, and rebellion. The Biblical Counseling movement, ushered into Christian culture by Adams and his followers, declares that humanism (secular ideals and philosophy) establishes the foundation of professional counseling, creating blueprints for unstable soul repair.  For present day professional counselors this idea, aside from the obvious affront to psychology as a field of study, may seem dubious since the field of counseling is more complex than simply lumping all who counsel professionally into the field of psychology, or even psychiatry.  Regardless, Biblical Counselors see counseling belonging to a different authority altogether:  “Central to his [Adams] vision was the notion that human life is meant to be lived under benign authority—parental, pastoral, ecclesiastical, and, ultimately, immediate theocratic authority as articulated in the Bible—whose purposes were to transform human nature, not actualize it.” [1]  What is interesting here is that the line being drawn in the sand is over human nature—who gets to define it, have its say over it, and counsel in relation to it.  

Undoubtedly to the dismay of the American Psychological Association, modern day professional counselors are not required to study large quantities of psychology, nor are they mandated to specialize or equip themselves with a particular psychological model (i.e. Freudian Psycho-analysis).  Rather, modern day counselors study evidenced based practices for recognizing mental health disorders [2] (assessments) and evidenced based interventions (methods for treatment).  What is important to understand is there is a division in the secular world between professional counseling as underscored by the American Counseling Association and psychology as indicated by the American Psychological Association.  The American Counseling Association (ACA) describes the purpose of counseling in the following statement: “Counseling is a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals.  The American Counseling Association (ACA) is an educational, scientific, and professional organization whose members work in a variety of settings and service in multiple capacities.” [3]

The problem, aside from the various idealistic approaches to counseling—or, even defining the objective of counseling itself, is that at this very moment there are individuals who are suffering from mental health related issues (autism, bipolar disorder, trauma, PTSD, abuse (sexual, physical, emotional, and psychological, etc).  These individuals have grown up to believe that pastors, elders, and Sunday school teachers have been equipped with enough training to provide counseling on these matters.  Most mainline seminaries only provide one or two required classes in pastoral counseling.  Some pastors and teachers in the church have become certified in Biblical Counseling, but that is not particularly impressive.  One website I perused recently proudly offers a Biblical Counseling certificate to individuals who can part with $100 and attend 30 hours of training.  

On the contrary, a professional counselor who is licensed with the ACA is required to have a Masters Degree in counseling and included in the masters degree education a minimum of 700 hours of practicum and internship training is required. After an individual graduates with his or her masters degree in counseling an additional 3000 hours of supervision are required before one can be fully licensed. Built into a masters in counseling are classes that teach counselors about assessments, research studies, diagnosis, and evidence based practices and interventions.

The licensed counselor will not be surprised or overwhelmed by trauma because he or she will have had the training needed to meet you where you are.

However, what is even more shocking, is that the Biblical counselor will first, want to convert you or your son or daughter to Christianity prior to treatment—since treatment at its very start includes conversion. “Adams did not think that either peace of mind or socially acceptable behavior prescribed an adequate goal for the “cure of souls.” He asserted instead that the church should understand the vast majority of problems in living in terms of an explicitly moral model. Given this diagnostic framework, he established goals for the church’s counseling that employed the ingredients of the traditional Christian message. First, because “man’s greatest need is forgiveness,” the forgiving grace of Jesus Christ was essential to solving problems in living.” [4]

The Biblical counselor will set the agenda, drive the conversation, shaping it into whatever he or she thinks is best for the moment. The licensed counselor will avoid imposing his or her values onto the counseling session [5], having unconditional positive regard for the client (regardless of what he or she believes) and allow the client to bring up what he or she is struggling with and address it, in tandem with the client. The client and the professional licensed counselor work together on setting the goals, the client and the professional licensed counselor work together through the issues—and together they find hope and healing.

[1]  Powlison, David. The Biblical Counseling Movement. Greensboro, New Grow Press: 2010. p. 3. 

[2]  I am aware that there are many in the Christian community who do not believe that mental health disorders exist.  This warrants a separate post on the matter, but for now you may want to consider my post on the making of the DSM-V 

[3] https://www.counseling.org/about-us/about-aca/our-mission

[4]  Powlison, David. The Biblical Counseling Movement. Greensboro, New Grow Press: 2010. p. 2

[5]  Standard A.4.b of the ACA Code of Ethics 

Regarding Some Misconceptions Regarding the DSM-5

Introduction

As a professional counselor in training, I have heard and seen some disconcerting assumptions asserted about the Diagnostic and Statistical Manual of Mental Disorders (5th Edition). I have encountered Christian professionals, both counselors and pastors, who argue with some contempt, that the DSM-5 does not offer “Christian” solutions to mental health issues. I use the term “mental health” lightly here, because I know that many pastors and Biblical Counselors reject the idea that there are “actual” mental health problems, preferring to use words like soul problems, human problems, sin problems, martial conflict, and so forth. In any case, this post is dedicated to the making of the DSM-5 and what the DSM-5 is designed to do.

Before I address the history, it is first necessary to recognize what the DSM-5 is designed to do. If a psychologist in Sweden, a licensed counselor in Germany, a medical doctor in Montana, and a psychiatrist in Canada were to sit in a room and discuss particular clients that all share the same symptoms they would use the DSM-5 as a point-of-reference, since the DSM-5 is internationally recognized as a reference and diagnostic tool. For example, a person diagnosed with Post-Traumatic-Stress Disorder from the DSM-5 will have either the same or very similar symptomatology of any other person (regardless of where they are in the world) as long as that other person has also been diagnosed with the DSM-5. They key point that I am trying to get at here, is that the DSM-5 is a diagnostic tool, listing certain sets of criteria that have to be met before someone can receive a particular diagnosis.

History of the DSM-5

The history of the DSM-5 began in 1999, which was initiated by the American Psychological Association (APA). The APA wanted a significant amount of collaboration on this project, so they recruited professionals from many different fields: internationally recognized clinicians, scientific researchers, and professional organizations. “Through this wide scale collaboration, the DSM-5 development process has involved not only psychiatrists, but also experts with backgrounds in psychology, social work, psychiatric nursing, pediatrics, and neurology” (APA, 2013).

A task force was created that included over 160 mental health and medical professionals who were leaders in their fields. From these 160 professionals, 13 work groups were created which comprised over 90 academic and mental institutions around the world. More specifically, within the 160 professionals collaborating on this project: “Nearly 100 are psychiatrists, 47 are psychologists, two are pediatric neurologists and three are statisticians/epidemiologists. In addition, also included are a pediatrician, speech and hearing specialist, social worker, psychiatric nurse and consumer and family representative” (APA, 2013).

In addition to the 160 mental health and professionals who were collaborating on this project, an additional 300 advisors came along side the project to help inform specific areas requiring additional expertise.

The American Psychological Association partnered with the World Health Organization as well as the World Psychiatric Association to help with the organization of the DSM-5. “From 2004-2008, APA, WHO and the National Institutes of Health supported 13 additional conferences involving nearly 400 participants from 39 countries, including 16 developing nations. The work resulted in 10 monographs, hundreds of published articles regarding the current state of knowledge and recommendations for additional research in many fields” (APA, 2013).

Committees also helped in the process, such as the APA Board of Trustees, which overviewed the content for the DSM-5 along with A Scientific Review Committee and A Clinical and Public Health Committee.

Additionally, public feedback was also requested, which brought in about 11,000 comments which impacted changes. Lastly, thousands of additional clinicians and professionals volunteered their time to over up their expertise, contributing to the making of the DSM-5.

Final Remarks

It is important to understand that the DSM-5 is not a “Christian” document. It’s purpose is to function as a diagnostic tool. It is it true that the DSM-5 does not offer Christian advice for how to address mental health issues, however the DSM-5 does not offer any advice on how to treat or medicate mental health issues. It is not designed to do that.

Reference

American Psychological Association (2013). The People Behind the DSM-5. PP 1-2. Click here for page location.