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Abstract
In order to arrive at a clearer view of Christian counseling, this paper examines the similarities and differences between secular and Christian counseling. It begins with a biblical word study to establish a basis for Christian counseling. The words counsel, comfort, and wisdom are examined in both the Old and New Testament. The Biblical view of counseling is compared and contrasted with the secular view. Relevant ethical considerations are examined, specifically related to the _Bruff v. North Mississippi Health Services, Inc.,_ 2001 case.
The paper concludes with a discussion regarding future endeavors in professional counseling including how to integrate the best Christian and secular practices.
Christian counseling has been difficult to define because there are two distinct kinds of counseling: spiritual counseling and mental health counseling (Bufford, 1997). Thus, there are many approaches for the practice of Christian counseling that range from the integrationist to the nouthetic position, which has made identifying distinctive features of Christian counseling a complex task. Counselors of the nouthetic approach claim that truth can only be found in the Bible, all counseling models must be exclusively from the Bible, and any integration of psychological theories must be rejected.
The integrationists state that God reveals his truth universally. Hence, they accept and utilize both the techniques and the theories of psychology with Scriptural truth to help their clients heal (Carter, 1999). Realizing the need for both spiritual counseling and mental health counseling, Bufford (1997) defined seven distinctives of Christian counseling. Clinton and Ohlschlager (2002) proposed ideas for Christian counseling that they describe as a paracentric focus that seems to more accurately convey the essence of Christian counseling.
In view of all this effort to define Christian counseling, there is still much diversity of practice among Christian counselors.
In an effort to understand the biblical views of counseling, and create a more distinctive picture of what is and is not biblical counseling, a word study on a variety of counsel terms is presented in this paper. Next, the conclusions from the word study are compared to the professional views of counseling including an examination of relevant ethical considerations. This paper will conclude with a discussion regarding future endeavors in professional counseling.
Biblical Words Related to Counseling
In this section, a word study was conducted to understand the biblical views of counseling. The words counsel, wisdom, and comfort were researched by first using the _Strong's Exhaustive Concordance of the Bible_ (Strong, 1996). The range of situations in which these concepts were used in the Old and New Testaments were researched using Richards' (1985) _Expository Dictionary of Bible Words,_ Vine's (1940) _Expository Dictionary of New Testament Words,_ and the _Baker's Evangelical Dictionary of Biblical Theology_ (Elwell, 1996). Several Bible commentaries were used to illustrate how these concepts were used in the Old and the New Testaments.
_Counsel_
The Hebrew words that best communicate "to counsel" or "to advise" are ya`ats and its derivative `etsah. Both words mean advice, counsel, purpose or plan. In the Old Testament, these words are used to describe both the counsel of God and the counsel of man. Ya`ats is used 80 times in the King James Version (KJV) of the Old Testament and `etsah is used 88 times to convey the concept of counsel or advice (Blue Letter Bible (BLB), 1996-2008). When ya`ats and `etsah are used as human counsel, it is usually in the context of counsel being given to kings (1 Chronicles 13:1; 2 Chronicles 25:17). Proverbs suggests that one should seek the counsel of many (Proverbs 11:14; 15:22) because human beings and their counsel are both fallible. However, God's counsel is infallible, firm, and purposed (Psalms 33:10-11) which is conveyed as such in the Old Testament when ya`ats and `etsah are used. (Richards, 1985).
In the New Testament, boule comes from the root word boulomai which means "to will." Bouleuo is used 8 times in the New Testament and can mean "to take counsel, to resolve" (Vine, 1940). The root word boule translates "to will" or "to purpose" when God is the context. Its derivative, bouleuo, means "to take counsel, to resolve" and together with boule is used 20 times in the New Testament. Like the Old Testament, boule is used both to express the counsel of God (Luke 7:30; Acts 2:23) and the counsel of man (Ephesians 1:11; Hebrews 6:17). The compound symbouleuo refers to counsel taken together (John 11:53). One other word used in the New Testament that communicates "to counsel" is gnome. Whereas boule is counsel as a result of determination, gnome is used as judgment, opinion, or counsel as a result of knowledge (2 Corinthians 8:10). Gnome is used 9 times and symbouleuo is used 5 times (Vine, 1940).
_Old Testament usage_. Both God's counsel and human counsel are reflected through the use of ya`ats and `etsah in the Old Testament. The incidents of Absalom in Samuel 17:11-21 and Rehoboam in 1 Kings 12:1-15 illustrate how ya`ats is used for human counsel and suggests some plan of action to deal with a specific situation. Ultimately, both Rehoboam and Absalom choose a course of action, but there is no certainty in human plans. However, perfect counsel is found in God's plans (Richards, 1985). Psalms 33:10-11 declares, "The Lord foils the plans of the nations; he thwarts the purposes of the peoples. But the plans of the Lord stand firm forever, the purposes of his heart through all generations" (NIV). God's counsel is inerrant, sufficient, and unchangeable and is at the center of Christian counseling.
_New Testament usage._ The New Testament depicts the different ways in which human counsel is given. Symbouleuo is often used when advice is given by one person to another and is usually in reference to plots against Jesus or the early church (Matthew 26:4; Acts 9:23). Gnome is used in an example of sound advice based on maturity and knowledge given by Paul to the Corinth church (2 Corinthians 8:10) and boule is used in the sound advice given by the highly esteemed teacher of the Pharisees, Gamaliel (Acts 5:33-39). Although Gamaliel gave good advice, it was not tested by the standard of God's word. Nonetheless, God used Gamaliel's advice to give a needed respite to the young church (Guzik, 2001, Acts 5, D.2). The inconsistent advice given by man contrasts the immutable counsel of God. His truth is the primary source by which Christian counselors test all counseling methods, techniques, and principles in order to offer sound counsel to their clients.
_Comfort_
Naham is the Hebrew word most often translated "to give comfort" in the Old Testament. It is used 108 times in the Old Testament. Many times naham means "to console" (Psalms 71:21; Isaiah 49:13). Its derivative, tanchuwm, means consolation (Job 15:11; 21:2) and is translated 5 times. Other meanings used in the Old Testament are support, relief, cheer up, and exhort. The last 26 chapters of Isaiah express God's comfort (Isaiah 40:1) and the future promise of the Redeemer (Baker, 1996).
In the New Testament, the words parakaleo (verb) and paraklesis (noun) come from kaleo which means "to call," and para meaning, "alongside of." Parakaleo means "to call to one's side or to summon to one's aid, but this word and its various forms can mean many other things. This word group can be translated as invite, call, exhort, beseech, encourage, summon, instruct, comfort, and console. Parakaleo is found 109 times in the New Testament. Nine of the NIV's 17 translations of this word group meaning "comfort" are found in 2 Corinthians 1:3-7. In these passages, Paul addresses God's comfort during times of trouble.
_Old Testament usage_. Jerusalem is discouraged over the announcement about the coming Babylonian conquest and future exile. In Isaiah 40:1-2, God tells Isaiah to "comfort, comfort my people" (NIV) and speak tenderly as you comfort. The people of Jerusalem were broken-hearted and needed comfort. God offered that comfort through Isaiah by instructing him to speak comfort, literally "speak to the heart" (Guzik, 2006, Isaiah 40, A.1.c.i). The goal of the therapeutic process is to restore the broken-hearted person to a whole life.
Clients must believe that healing is possible, but counselors must first comfort their anxious souls (Clinton & Ohlschlager, 2002). The process of change begins with the Christian counselor speaking tenderly to his or her clients' hearts and reassuring them of God's omnipotence, omniscience, and omnipresence. Healing begins when a sense of comfort and encouragement grows from knowing that God knows everything, is in control of everything, is perfectly good, and is _on my side_ (Johnson, 2003).
_New Testament usage._ Clinton and Ohlschlager (2002) proposed a Paracentric focus that describes the Christian counselor as single-mindedly focused on Christ and the client. In 2 Corinthians 1:3-7, Paul models this idea. Paul's life is not on focused on himself, but on the Lord and on others. Paul opens his letter to the church in Corinth praising God for his mercy and comfort (2 Corinthians 1:3). Paul uses the Greek word paraklesis that expresses a comfort that strengthens, encourages, and helps one deal with distressful times.
In verse four, Paul explains that God "comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves have received from God" (NIV). Paul is thankful that he can experience God's comfort during times of trouble and use that experience to help and comfort those in similar circumstances (Guzik, 2001, 2 Corinthians, A.2.a.i). In the same way, the Christian counselor, yielded to the Holy Spirit, can meet the client at his or her point of need, and begin to create a strong working alliance (Clinton & Ohlschlager, 2002). The broken-hearted can be comforted, the weak can be supported, the discouraged can be encouraged, and the misdirected can be guided (1 Thessalonians 5:14).
_Wisdom_
The basic word group expressing the idea of wisdom includes chakam and its derivatives chokmah and chokmowth. Together they occur over 150 times in the Old Testament. This word group can mean to be skillful, to instruct, or to be prudent. Biyn and sekel are also closely related and usually means understanding or discernment. Biyn is used 170 times and sekel is used 16 times in the Old Testament. Throughout the Old Testament, wisdom is expressed in godly living that is most represented in the book of Proverbs (Proverbs 2:6, 9-10, 12). Wisdom can fit into two categories. Practical wisdom, which is usually found in Proverbs, deals with the issues of an individual's life, such as family relations (Proverbs 22:6) and personal industry (Proverbs 8:15). Reflective wisdom focuses on theological issues, such as the suffering of the innocent Job and the meaning of life in Ecclesiastes (Elwell, 1996).
The Greek word sophia is the word that expresses wisdom in the New Testament. Sophia is translated 51 times, and focuses on the same practice of godly living as described in the Old Testament. The exception is in 1 Corinthians 1-3 where Paul compares the wisdom of men to the "hidden wisdom of God" or God's plan of salvation. Other words used are sunesis which means knowledge or understanding (Mark 12:33) and phronesis which can mean wisdom or prudence (Luke 1:17; Ephesians 1:8). Sunesis is used seven times and phronesis is used twice in the New Testament (BLB).
_Old Testament Usage._ In Ecclesiastes, Solomon demonstrates how wisdom must be used when teaching or counseling those who are suffering. In Ecclesiastes 12:8-14, Solomon focused on the immediate needs of the people (vs. 8). He "sought to find out acceptable words: and that which was written was upright, even words of truth" (Ecclesiastes 12:9-10; KJV). Solomon understood that divine wisdom would be required to respond to the needs of the people (1 Kings 3:5-14). He also knew that he must offer truth found in Scriptures to direct them towards wellness (Ecclesiastes 12:10) for "what good will acceptable words do us if they be not upright and words of truth?" (Henry, 1996). Solomon pondered, sought, and used God's Word to meet the immediate needs of the individual. This is the essence of Christian counseling.
_New Testament usage._ James reflects Old Testament sentiments in his advice to appeal to God when one lacks wisdom (James 1:5-7). James is not just talking about knowledge, but about the ability to discern right from wrong. Later, James contrasts personal character that comes from divine wisdom and traits that are destructive and not of God (James 3:13-18). Wisdom that comes from God is "peace-loving, considerate, submissive, full of mercy and good fruit, impartial and sincere" (James 3:17). These traits should define competent Christian counselors. Both the Old Testament and the New Testament emphasize the importance to appeal to God for his divine wisdom.
Comparison of Biblical Views with Professional Views
This section begins by identifying similarities in function and approach between Christian and secular counseling. Differences are defined by examining three different areas: Philosophy of life, counseling goals, and source of truth. In the final section, conclusions are drawn regarding the implications to future counseling endeavors based on the conclusions from the word study, comparisons to professional counseling, and relevant ethical considerations.
_Similarities between Biblical and Professional Views of Counseling_
_Code of Ethics._ Christian counseling and secular counseling have much in common, more so in the process than in the content. One area of commonality is illustrated in the American Counseling Association's (2005) _ACA Code of Ethics_ and the American Association of Christian Counselors' (2004) _AACC Code of Ethics._ Both ethics codes address basic moral principles - nonmaleficence, beneficence, justice, fidelity - that form the framework for ethical behavior and decision making for the professional counselor (Meara, Schmidt, & Day, 1996). Both ethics codes begin by addressing the primary responsibility of the counselor to _do no harm_ to those they serve (ACA, 2005, A.4.a; AACC, 2004, 1-102). Both ethics codes also address the counselor's responsibility to "respect the dignity and to promote the welfare of clients" (ACA, 2005, A.1.a). Providing verbal and written informed consent, ensuring that "the client reasonably understands the nature and process of counseling" (AACC, 2004, 1-310), as well as respecting client diversity (ACA, 2005, C.5; AACC, 2004, 1-101) are included in both ethics codes to protect the welfare of the client.
_Common elements._ Christian counseling and secular counseling also share many common elements in their approach. First, both counseling systems are goal-oriented. Although goals such as spiritual maturity and discipleship are clearly distinctive to Christian counseling, many of the immediate goals, such as alleviation of depression, reduction of anxiety, and control over substance abuse are common goals in both secular and Christian counseling. Second, Christian and secular counselors use many of the same strategies, techniques, and methods to offer hope to the counselee, build a strong therapeutic relationship, develop competencies in social living, provide support, and change destructive cognitive or behavioral patterns (Bufford, 1997). Lastly, effective counselors in both Christian and secular counseling are characterized by warmth, sensitivity, understanding, genuine concern, trustworthiness, and competence (Clinton & Ohlschlager, 2002).
_Differences between Biblical and Professional Views of Counseling_
_Philosophies of life (View of man)._ Everyone has a philosophy of life, a way in which one views the world. Generally, secular counseling views are man-centered (anthropocentric) and biblical counseling views are God-centered (theocentric). The worldview of a counselor determines how he or she thinks about human nature, evaluates and assesses the client, and decides on treatment strategies (Clinton & Ohlschlager, 2002).
In secular counseling, the reason for man's existence and the goals to be achieved are centered upon, and revolve around man. Secular counseling relies on theories influenced by behavioral, humanistic, and existential thought, but those theories have little to offer the client except the advice that they should care about and love themselves (Carter, 1999). These theories emphasize a basic goodness or a basic depravity in the soul, and focuses on what will make the individual happy, adaptive, and successful. This is their basis for self-evaluation. "Humanistic psychotherapy has always been hampered by the contradiction of encouraging unlovable selves to love themselves" (Johnson, 2003, p. 84).
In contrast, biblical counseling is God-centered. Christian counseling does not place humans at the center of the universe as humanism does. In Genesis, it states that God is the creator, and he created man in his image and likeness to live and rule in a perfect world (1:26-2:25). In spite of the corruption of the fall, man still bears the image and likeness of God and still has authority in the world as dependent creatures who desire to have a relationship with God and other people (Averbeck, 2006).
It is this God-revealed concept of the nature of man that biblical counseling, both as a system and as a process of doing counseling, bases its work. Christian counselors understand that all biblical care giving falls within the larger plans and purposes of the Creator. It is comforting to know that in the midst of a contingent, unpredictable life, God, the creator, is always there to meet every need and pour out his comfort to all who seek him (Johnson, 1997). Christian counseling offers what secular counseling cannot: "the father of compassion and the God of all comfort" (2 Corinthians 1:3; NIV). As man searches for meaning and contentment, God comforts and heals.
_Goals._ Though easing the suffering of the client is a goal in both Christian and secular counseling, it is not the ultimate goal of the Christian counselor. All counseling systems have goals of bringing about changes in the counselee, whether they are changes in feelings, beliefs, thinking or behavior. The goals of a counseling system are largely determined by the philosophy of life held. A man-centered viewpoint will yield goals that focus on the relief of suffering and the fulfillment of personal happiness. Secular counseling holds such views. The main goals of secular counseling in treating clients are to help the client alleviate anxiety, guilt, depression, anger and to achieve personal happiness, contentment and self-fulfillment. Secular counselors also give counselees methods of self-assessment to help them continue to live life with minimal anxiety and hostility (Clinton & Ohlschlager, 2002).
Like the secular counselor, Christian counselors seek to change behaviors and attitudes that will bring about happiness, contentment, and greater well-being; however, Christian counseling goes much deeper than changing behavior and helping clients find happiness (Bufford, 1997). The ultimate goals of Christian counseling are to help the counselee experience intimacy with God and maturity in Christ (Ephesians 4:20-24). Placing an emphasis on discipleship and introducing spiritual disciplines in the Christian counseling practice helps achieve these goals.
Although both share similar thoughts in techniques and theories, the practice of spiritual disciplines is uniquely Christian and is an important factor in achieving the goals of intimacy and maturity (Willard, 2000). Collins (1996) states, "Helping that leaves out the spiritual dimension ultimately has something missing. It may stimulate good feelings and help people cope with stress, but it does nothing to prepare people for eternity or help them experience the abundant life here on earth" (p. 15).
Though the ultimate goals of Christian counseling are intimacy with God and maturity in Christ, the heart of Christian counseling is the good news of Jesus Christ (Colossians 1:26-27). The power of Jesus makes change, redemption, and new life possible. In the Great Commission, Jesus commands Christians to make disciples and to teach them to how to live as disciples and experience abundant life. The Great Commission differentiates Christian counseling from secular counseling. The work of Christian counselors is incomplete until they have helped the counselee put off the old self and put on the new by teaching and training them to live like Christ (Willard, 2000).
_Source of truth_. There are more than 400 different therapy models available today. "Effective counselors scrutinize theories for proven effectiveness and match them to personal beliefs and realities about the nature of people and change" (Gladding, 2007, p. 190). Never before has it been so important to have a source of absolute truth. Christian counselors believe that the Bible is the authoritative word of God against which they can assess their beliefs, practices, ideas, and actions. They believe that "all Scripture is God-breathed" (2 Timothy 2:16-17, NIV) and fully equips them for every good work. Thus, although both Christian counselors and secular counselors use many of the same counseling techniques, the Christian counselor does not use counseling techniques that are inconsistent with biblical teaching.
Recent studies on therapeutic outcome encouraged the present emphasis on an eclectic approach in professional counseling. That is, most counselors today are using various theories and techniques to meet their clients' unique needs. Whiston and Sexton (1993) concluded that a strong therapeutic relationship is significantly related to positive client outcome. Tan (2003a) reported that empirically supported treatments (ESRs) and empirically supported therapy relationships (ESTs) that are specifically tailored to a client's needs produced the best therapeutic outcomes.
Like Solomon (1 Kings 3:5-14), it is crucial that a Christian counselor be a biblically informed and responsible eclectic who prays for the discernment needed to "fit the right therapy with the right client at the right time and the right stage of living" (Clinton and Ohlschlager, 2002, p. 176). However, the Bible is the authoritative source of truth, and an effective Christian counselor will evaluate the moral and spiritual quality of every theory and method they use in his or her clinical practice.
_Ethical Considerations_
Value conflicts between clients and therapists are inevitable, especially for Christian counselors working within a secular environment. Although Christian counselors may not always agree with the values of their clients, it is essential that they respect the rights of their clients to hold a different set of values (Hermann & Herlihy, 2006). It is also essential for Christian counselors to inform potential clients in writing, as part of the informed consent document, about their religious beliefs and values to avoid certain ethical and legal issues as described in the following court case.
_Bruff v. North Mississippi Health Services, Inc., 2001_ is an interesting case that illustrates the complexity counselors confront when their value system and religious beliefs conflict with the client's presenting problem. In 2001, the United States Court of Appeals "upheld the job termination of a counselor who requested being excused from counseling a lesbian client on relationship issues because homosexuality conflicted with the counselor's religious beliefs" (Hermann & Herlihy, 2006, p. 414).
This case illustrates both legal and ethical issues related to value imposition and conflict of values between client and counselor. The American Counseling Association's (ACA, 2005) _ACA_ _Code of Ethics_ states that counselors need to be "aware of their own values, attitudes, beliefs, and behaviors and avoid imposing values that are inconsistent with counseling goals" (A.4.b). Working with clients who hold different values can be challenging for counselors. It can be especially difficult for Christian counselors if those values challenge their religious values and beliefs. However, counselors must respect these differing values of clients and take care not to impose their values in the counseling relationship (Hermann & Herlihy, 2006).
This case has particular implications for Christian counselors who find it difficult to reconcile their religious values regarding certain client issues. It is important for Christian counselors to include Christ and to incorporate Christian principles into the therapy process. However, Christian counselors' primary responsibility is to "uphold the inherent, God-given dignity of every human person" (AACC, 2004, 1-101). Because it is unrealistic to assume that counselors will not incorporate certain value orientations into their therapeutic approaches and methods, Christian counselors have an ethical duty to clarify their assumptions, core beliefs, and values with the client during the intake session. "It is vital to be open about values but not coercive, to be a competent professional and not a missionary for a particular belief, and at the same time to be honest enough to recognize how one's value commitments may not promote health" (Bergin, 1991, p. 399).
Personal Applications
Current data indicates that no single theory or model adequately accounts for the complexity of human behavior. Counselors will have to learn and apply an eclectic mix of therapy models and techniques to accommodate the complexity of these modern times. Christian counselors will need to consider biological, psychological, spiritual, social, cultural, economic, and environmental factors when assessing, diagnosing, and treating the unique needs of the client (Clinton & Ohlschlager, 2002). Integrating spiritual direction into psychotherapy and counseling enables the counselee to focus on increasing awareness of God and facilitating surrender to God's will (Willard, 2000).
The conclusions I have made from what I have learned about the biblical views and professional views of counseling are that there is a place for employing both psychotherapeutic techniques and spiritual direction in the counseling process, but it is essential to practice such integration in a ethical, helpful, and wise manner. Christian counselors must use discernment when incorporating secular theories and techniques into their practice and they must be wise when incorporating spiritual disciplines into the therapy relationship. The Bible is our resource, it is the foundation for truth by which everything else is evaluated, and it is sufficient in what we need to instruct one another on how to live an abundant life (2 Timothy 3:16-17; 1 Thessalonians 5:13).
Christian counselors must refer to the Bible to distinguish good counseling from bad counseling. Both appropriate and inappropriate counsel is illustrated in the story of Rehoboam, who chose to ignore the advice (etsah) of the older counselors, and instead listened to his young and immature peers. Their counsel lacked a careful examination of the situation, and resulted in disastrous consequences (1 Kings 12:1-15). Wise Christian counselors are careful to gather information and examine a situation as they help their clients. It is imperative that Christian counselors consistently ask God for the wisdom (James 1:5) to choose the godly path (Proverbs (19:21).
The ultimate goal of Christian counseling is to facilitate the spiritual growth of clients, rather than simply alleviating symptoms and finding a resolution to problems. Integrating spiritual disciplines into psychotherapy can be an effective tool in achieving these goals in the therapy process (Tan, 2003b). However, as seen in the _Bruff_ case, counselors must take care not to impose their religious beliefs or values on the client. The client's autonomy must be respected. Counselors must provide sufficient information regarding therapy to the client, and should include spiritual religious goals and interventions only when proper informed consent is obtained from clients who have expressed interest in pursuing and participating in such goals and interventions.
Effective Christian counselors must keep informed of the latest and best information on ESRs and ESTs in order to provide the most effective and efficient forms of psychotherapy and spiritual direction to the client (Tan, 2003a). In addition, Christian counselors should, with the consent of the client, integrate spiritual disciplines into psychotherapy. Effective Christian counselors' primary focus is on meeting the needs of the client. To meet these needs Christian counselors must first comfort the broken-hearted with a comfort (nacham, parakeleo) that consoles while imparting strength, to encourage while offering a hope for a future (Isaiah 61:1-2).
According to Grencavage and Norcross (1990), "the therapist's ability to cultivate hope and enhance positive expectancies within the client" (p.374) was one commonality found in the qualities of effective therapists. Recent emphasis on ESRs shows the importance of a strong therapy relationship and is in line with the conclusion that healing occurs when we model the God of comfort and love. "It is ultimately God who is love who brings wholeness and healing to the hurting people that we minister to through psychotherapy and counseling, using the best ESRs and ESTs available, as long as they are consistent with biblical, Christian truth, ethics, and morality" (Tan, 2003a, 2003).
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