Do we understand what a safe counselling situation looks like?
Last week I wrote a post on 10 questions you should ask your biblical counsellor before counselling. It was a controversial one to write, and I said pretty much all I wanted to say. But this week two things happened. I’ve had a ton of people contact me about that post, including biblical counsellors; and then Rachael Denhollander spoke at a conference echoing my themes. So I thought I could clarify a little bit.
Note: I was supposed to get a podcast out today, but my team has suffered from health issues this week, so we’re a day behind. Look for the podcast tomorrow!
“Biblical counsellors” are not the only Christian counsellors
Biblical counselling is a particular type of counselling, one where they believe their interpretation of the Bible is all-sufficient for counseling, and where they are not licensed by any government or professional entity. They are not, however, the only counsellors who follow Jesus.
Christian, licensed therapists also believe the Bible. Many studied at seminaries and were taught what the Bible teaches about bitterness, and anger, and forgiveness, and hurt, and healing. They were taught about the role of the Holy Spirit in our lives. But they were also trained more in-depth about treating trauma, anxiety, and depression using evidence-based therapies.
Safe counselors recognize that complex psychological issues such as trauma require specialized training
Licensed counselors and psychologists go through years of such training, much of it supervised. Psychologists take different training courses for treating different psychological illnesses with treatments backed up by evidence-based research. If you are seeking help for a mental health issue outside of your counselor’s training, they will often refer you to a colleague who is better equipped. A general practitioner wouldn’t operate on your brain tumour, but would refer you to a neurosurgeon or an oncologist. Similarly, a safe counselor will refer when it’s beyond their expertise. And this goes both ways! My uncle, who was a Christian psychiatrist, would occasionally refer Christian patients (with their consent) with particularly entrenched spiritual issues to pastors.
Last weekend, Rachael Denhollander, the brave woman who led the charge against Larry Nassar, the doctor who sexually abused hundreds of girls, spoke at the Valued Conference. Rachael has become an advocate for sexual abuse survivors, and become very outspoken about sexual abuse in the church. This is part of what she said about acknowledging our limitations in counseling:
Please know your limitations. Realize how deep the damage is, and how much specialty is required in helping heal that injury. Just like if you have a parishioner who was in a car accident with a spinal cord injury, you would not try to be their pastor and physiotherapist…In the same way, please don’t try to take on the role of both pastor and …trauma specialist. Your role is vital but it’s not all-encompassing.”
She was then asked a follow-up question: “How would you go about finding a good counsellor?”
She responded with this:
She went on to talk about the benefits of finding a counsellor who is also a Christian:
“The gospel is our ultimate hope; to be able to find a counsellor who understands trauma but also understands where the ultimate hope is found can be very helpful. That being said, there are a lot of secular methodologies that are in line with Scriptural principles.”
Why was she so adamant about licensed therapists? For deep hurts, you need training in treatments that have been shown to work. Most psychologists and licensed counselors use the same protocols for dealing with certain mental illnesses because those treatments have been successful. Happily, those methods are not in conflict with God’s word. In fact, many of them revolve around biblical principles like freeing yourself of lies (John 14:6) and taking every thought captive (2 Corinthians 10:5).
One of the problems with biblical counsellors, though, is that many don’t understand that they aren’t qualified to counsel in all types of cases, because they don’t tend to be trained in evidence-based treatments.
That’s what Rachael’s questioner was getting at. She followed up, asking about a sexual abuse survivor who had been so hurt by Christian counsellors. Rachael responded:
The Bible is a great source of wisdom and a gift from God that should show us how to live. But it is not the same thing as a doctor’s prescription pad or specialized training in trauma–and it doesn’t try to be. You can believe in the all-sufficiency of the Bible without believing that it is the only tool we should use in life. Just because you seek trained professionals in your area of need does not mean you have less faith.
Safe counselors acknowledge this need for extra training, and will immediately refer any client who is dealing with complex psychological issues.
A safe counseling situation will protect the client’s confidentiality
Psychologists and licensed counselors have a clear ethical code they must follow. If they do not, they can be sued and lose their license to practice. One of the fundamental rights of a client is confidentiality. Licensed counselors and psychologists can only break confidentiality if harm is involved or if there is a reportable crime. Unfortunately, biblical counselors make other exceptions for breaking confidentiality, as I talked about last week.
Not holding the counselor to ethical standards of confidentiality distorts the counselor/client relationship
A teacher of biblical counseling, in a Twitter conversation, asked me to defend confidentiality biblically. He did not believe that confidentiality was necessarily a biblical concept, since it must be broken if a person was in persistent sin. The problem here, as I tried to outline in my post last week, is twofold.
First, who gets to define persistent sin?
If you go to a church that feels that divorce for any reason, other than adultery, is a sin, then if a wife decides to initiate a divorce against her abusive husband, is she in “persistent sin”? Will she be put under church discipline? (The answer, all too often, is yes.)
But then there’s a more fundamental problem that I didn’t mention last week: When we do away with confidentiality, we create a power imbalance.
Confidentiality in a counselling situation means that there can be trust between the client and the counselor. The client can be vulnerable, something which is very, very difficult for many trauma or abuse survivors, because they know their information is safe with the counselor. It’s that vulnerability, too, which is often necessary for healing to occur.
If, on the other hand, confidentiality can be broken for a number of reasons, there can no longer be trust. You’ve replaced trust with a power imbalance. The counselor has the power to destroy your most intimate relationships. They can talk about your issues with church leadership. They can bring church discipline down on you. They can take your spouse’s side, or your abuser’s side, and you have no recourse, because you have signed a biblical counselling consent form saying that if the counsellor does something you disagree with, the church leadership will mediate. You are powerless.
In the church, when there are power imbalances, bad things have happened. Just Google Harvest Bible Chapel, Mars Hill, Bill Hybels, the Catholic sexual abuse scandal, the Southern Baptist sexual abuse scandal, and see what I mean. Recently, at Harvest Bible Chapel, former Executive Leadership Team member Dean Butters, in a letter to the elders’ board encouraging them to fire James MacDonald (which they did), reported:
Dean Butters is saying that former megachurch Pastor James MacDonald used the biblical counseling program to manipulate people. That’s heinous. Licensed therapists, if they shared information with the pastor in this way, would lose their credentials.
Safe biblical counselors will understand the importance of holding themselves to the same ethical standards as other mental health professionals.
My prayer is that biblical counsellors will rediscover the imperative of confidentiality, and will recognize that there are some things that they are not “competent to counsel”
If those two things happened, I think biblical counseling would be much improved and much safer. And I am heartened that some Biblical counselling schools are beginning to acknowledge the biological sides of many mental illnesses. I still think licensing is crucial, because it’s the only way to enforce ethical standards, but these two changes would at least be a good start.
I love the Bible. I believe the Bible. I live by the Bible. But the Bible does not speak in-depth to all the different ways that trauma, anxiety or depression can manifest themselves, and all the different ways they should be treated.
If you are a biblical counsellor who agrees that what I wrote is important, please speak up. Defend confidentiality. Refer out to experts, doctors, and psychologists when necessary. And please, lobby for your colleagues to practice the same ethical, moral code as other mental health and medical professionals. It’s awful when the secular world does this better than some elements of the Christian world. As Rachael intimated, she would prefer a secular, trained therapist or psychologist than a biblical counsellor to help with sexual abuse trauma. When someone of her stature says that, the response should be to ask, “what are we doing wrong?”
The Christian world simply must get this right. God isn’t just concerned with our salvation; He wants our healing and growth, and Christian counseling is a huge, huge part of that. So let’s do it properly, and let’s do it safely, because the church needs awesome counselors.
What do you think? Why is stating that sometimes we need expert help considered so controversial? Do you think confidentiality in counseling is important? Let’s talk in the comments!