Yet studies show that people prefer counselors who share their religious beliefs and support, rather than challenge, their faith. Religious people often complain that secular therapists see their faith as a problem or a symptom, rather than as a conviction to be respected and incorporated into the therapeutic dialogue, a concern that is especially pronounced among the elderly and twentysomethings. According to a nationwide survey by the American Association of Pastoral Counselors (AAPC), 83 percent of Americans believe their spiritual faith and religious beliefs are closely tied to their state of mental and emotional health. Three-fourths say it's important for them to see a professional counselor who integrates their values and beliefs into the counseling process. More people said they would prefer to see a religious counselor (29 percent) than a psychiatrist (27), psychologist (17) or family doctor (13).
Women are more likely to favor religious counseling than men, and African-Americans strongly embrace faith-based counseling. The AAPC survey found that African-Americans, devout evangelicals, people without a college degree, the elderly and people age 18 to 29 are most likely to fear that a professional counselor won't take their religious beliefs into serious consideration when treating them.
"People come to Christian counselors for two reasons," says Randolph Sanders, executive director of the Christian Association for Psychological Studies, an association of Christians in mental health and behavioral sciences. "One is faith perspective; they want a therapist who resonates with their worldview. The second is moral ethics; they want a counselor who understands what guides their decisions."
The origins of Christian counseling lie with the clergy, whom parishioners traditionally consulted about emotional and spiritual well-being. The progenitors of faith-based counseling may well be psychologist William James, Freudian psychiatrist Smiley Blanton and Norman Vincent Peale, the New York preacher and apostle of self-esteem whose widely broadcast sermons and 1952 best seller, The Power of Positive Thinking, urged people to realize their psychological potential.
In 1957, some 42 percent of Americans sought counseling for their personal problems from the clergy. Even today, the amount of time clergy spend counseling parishioners is equal to that of all members of the American Psychological Association practicing 35 to 40 hours per week.
But pastors are not always trained to treat those who consult them. "When I was a Presbyterian minister, people from my congregation would come see me, but I wasn't a counselor," says R.J. Ross. So in 1972 he started the Samaritan Ministry and ran the Denver-based Samaritan Institute, a professional association of 500 faith-based counseling centers, to equip pastors with therapeutic training. "We needed to find a way to be sensitive to people's physical and psychological needs as well as their spiritual centers."
Today, pastoral counselors increasingly come from the laity. While that opens the field to licensed practicing counselors, clinical social workers and psychologists, it may open it too wide; some people adopt the title "counselor" with little or no professional training.
Generally, those who call themselves "Christian counselors" or "Bible counselors" tend to be more evangelical and fundamentalist than those who call themselves pastoral counselors. Their therapy typically includes prayer and proselytizing and relies heavily on Scripture. Virginia's John Portmann is wary of what sometimes passes as therapy among Christian counselors. "Many people doing Christian counseling are not equipped to deal with major issues like depression," he says. "There's this faith that the Scriptures can provide all the answers you need."
Services are either free or paid out-of-pocket, and counselors are similarly free to offer "therapy" however they like, without regard to any professional guidelines. "Because there are so many approaches to Christian counseling and no standard of care in the faith-based counseling world, anyone can say they're a Christian counselor," laments Anne McWilliams, assistant professor of pastoral care and counseling at the United Theological Seminary in Dayton, Ohio. McWilliams often fields inquiries from students who tell her they feel called to be a counselor. Such students are typically fundamentalists who view biblical text as the only answer. "The difficulty is, you can find anything you want in the Bible," McWilliams says.
She poses a hypothetical case involving domestic violence and divorce. A literal interpretation of Jesus' teaching: Divorce is wrong, period. The Bible supports that. It also supports the idea that suffering itself is salvation. "So a strict Bible-based counselor might tell that client to endure the violence because that's God's will," McWilliams explains. Of course, she observes, the Bible could also tell a client to leave her marriage because Jesus abhorred violence and held matrimony to be sacred; domestic abuse is a violation of that sanctity. In Christian counseling, she says, what you hear depends on the belief system of the counselor.
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