Help for the Hurting

It ’s no fun watching someone struggle. It may be the trauma of divorce, a family bereavement, a battle with singleness, sudden redundancy,an addiction to alcohol, the aftermath of an abortion. In some cases,the person ‘recovers ’relatively quickly, but in many others patterns of behaviour develop which give us concern. The fun-loving relaxed woman becomes tense and prickly, the conscientious faithful guy becomes depressed and apathetic. We realise they are not coping. What do we do?

Chances are we will all face this dilemma at some time or other. If you are in church leadership you definitely will, and according to life study surveys most of us will face situations where we are out of our depth and need a listening ear, wise advice and systematic help at some time during our lives.

But the prospect of finding a good counsellor can seem daunting, especially if images of a stern man or women with steel-rimmed spectacles inviting you to a leather couch, is at the front of your mind. There are too many scare stories of people stuck in ‘therapy ’ to not be wary.

So in lieu of ‘The Which guide to Counselling’ we aim to consider the questions we should be asking as we look for a counsellor. If we are destined to end up on a couch, telling our life story to a complete stranger, we need some guidelines first.

Why counselling?

First off, it ’s important to think through the nature of the problem and whether counselling is the appropriate step. This isn’t always as easy as it seems, as we will see later. Definitions of counselling are of little help if you are hurting but it’s as well to be aware that counselling language means different things to different people.

The Association of Christian Counsellors (ACC) defines counselling as: ‘that activity which seeks to help people towards constructive change in any or every aspect of their lives through a caring relationship and within agreed boundaries’. Most distinguish between ongoing pastoral care which may involve listening, encouragement and advice on an ad hoc basis and the regular systematic counselling whereby a counsellor and counselee meet together with a view to dealing with a specific problem.

Peter Hicks writes in What Could I say? (IVP 2000) ‘Sometimes when people need help they need a trained counsellor. But most times they don’t. My guess is that the proportion is one in ten. That is, 90%of the time they need the kind of love and support and listening ear that any Christian should be able to give. It ’s only 10% of the time, or less that they need a trained counsellor.’

So in some cases a chat with a pastor, vicar,elder or pastorally sensitive friend could be the first port of call. They may not be ‘trained ’, but their loving concern could be all that ’s required.

In other cases of course it is appropriate to seek medical attention. One woman ’s anxiety attacks failed to respond to counselling. But she was given a medical check up and found to have an early menopause. After a course of drugs she was back to normal.

Which counsellor?

Having decided that counselling is the way ahead, there are some key questions we need to think through before signing up with someone.

Alistair Ross, Director of Bridge Pastoral Foundation (formerly Clinical Theology Association) which provides training in pastoral care and counselling is also a member of the British Association for Counselling and Psychotherapy (BAC&P), one of the major bodies of accreditation in this field. He explains the importance of the counsellor, “in study after study the one factor determining the successful outcome of a counselling situation is the relationship between counsellor and counselee”.

1. A friend or a stranger?

For some the thought of seeing a counsellor is very daunting. “I wasn ’t going to spill my guts out to a complete stranger,” says Samantha, who has been seeing a counsellor in her church for the past few months.

However,Sean Gubb, Chairman of the Association of Christian Counsellors and Head of Seminars and Events at Crusade for World Revival CWR which runs a range of counselling courses explains: “It can be awkward for someone to see a counsellor who they also worship with on a Sunday. There’s something to be said for seeing someone you relate to solely as a counsellor.”

So it might be worth checking with the church to see whether someone in the congregation has a good reputation. You might be surprised to discover what goes on and who ’s involved.

2. Does it matter whether the counsellor is a Christian?

Many Christians couldn’t contemplate discussing personal problems with someone who didn ’t share their faith. Richard Goodwin, Executive Editor of The Christian Counsellor says: “Secular counselling is limited. It can patch people up – but where does God come in? Without working on the heart, we are merely making people good Pharisees.”

Sean Gubb of CWR agrees: “We believe in a God who reveals his will through His Word. Someone seeking to counsel without this element can only be working at a superficial level.”

For those insisting that the counsellor must be a believer, there are 1,800 counsellors who are part of the Association of Accredited Christian Counsellors (ACC). Christian counselling is defined by them as ‘counselling whose assumptions, aims and methods are under girded by Christian commitment, insight and values.’

But some counsellors who are Christians say non-believing counsellors can be valuable. Trevor Waldock is a BAC&P accredited counsellor who has worked in Christian contexts, private practice and the NHS: “A well trained therapist is not there to attack your beliefs and shouldn’t promote their belief system. When I need a professional GP or lawyer, their Christian standing is generally unimportant. It ’s the same with a therapist.” “The faith element can prevent problems being seen clearly. The client and counsellor are tempted to ‘collude’. The Christian language can mask what is actually going on, ”Ross adds.

Furthermore, in some cases it may be difficult to discover where the counsellor stands. Jane Collins, person-centred Counsellor and Editor of Wholeness says: “Some professional counsellors won’t answer the question, ‘Are you a Christian!’ They see their own beliefs as irrelevant.” If a Pastor is uncertain about sending a church member to a ‘secular counsellor, Waldock says, “Pastors could spend some time at local counselling centres, meeting Relate therapists and other specialists so that when they face a counselling situation which they can not handle, they have a network of contacts to whom they can refer people.”

3. What level of training do they have?

There is an increasing concern that people who claim to be counsellors should be part of an accredited body. Dr Ruth Fowke,retired psychiatrist says: “We must be aware that counselling is a profession in its own right.”

Organisations such as the British Association for Counselling & Psychotherapy (BAC&P) and the Association for Pastoral Care and Counselling set high standards in terms of accreditation, training, ethics and supervision in counselling. It is a requirement that someone in practise is seeing a supervisor regularly.

Recognising the need for professionalism,the Association of Christian Counsellors (ACC) was set up in 1992 to become a recognised accrediting body for Christian counsellors, whether they work within a pastoral setting, the wider community or both. This means considerable time spend learning the trade. To qualify as a level one counsellor with the ACC, requires a minimum of 100 hours of training and 150 hours of supervised counselling practice.

Those in the profession argue that such levels of training are vital given the nature of the problems faced. The client ’s ‘presenting problem’ may be just a small part of the overall picture. For example, imagine that a client sees a counsellor because he finds it hard to make friends. Most ‘counsellors’ would be able to empathise and suggest strategies to cope or overcome the problem. But what if further conversation reveals a past involving sexual abuse, which has led to a defensive style of relating and leads to the failure to make friends? Suddenly the ‘problem’ has changed. It ’s like taking your car to the mechanic thinking the noise was a caused by a faulty wheel, only to discover that there are major problems with the engine. The point is this,a mechanic can help, but a tyre fitter can’t.

An appropriately trained counsellor will know their limits and either deal with the ‘new area ’or refer to someone better able to help. An untrained counsellor may seek to fix the wheel and wonder why the client still isn ’t happy.

4. Which model does the counsellor use?

Each Counsellor will have their own approach and assumptions regarding the human personality and the appropriate techniques to assist someone.
Analysts of counselling divide the methodologies in a variety of ways. A simple distinction is to distinguish between those which focus on a person’s thinking (cognitive therapy) and those on that focus on the person’s relationship. Others focus on the degree of direction the counsellor gives. In directive counselling you might expect the counsellor to diagnose ‘the problem’ and suggest a response. Non-directive counselling focuses more on the counsellor assisting the counselee to come to a solution.

Directive and non-directive have their strengths and weaknesses. Ruth says:“I went to a Christian counsellor who was so non-directive she barely spoke to me: it was hopeless. Now,with a new counsellor, we are gently exploring together and I feel my life opening up and my depression lifting.”
While Penny struggled with a more directive approach: “I spent three hours with three very well-meaning people who had me visualising Jesus leaning over my incubator, casting out spirits of fear and giving me prophecies. It was very emotional and exhausting, but the long-term effect was minimal.”

It ’s been said that he whose tool is a hammer, sees every problem as a nail, so if the counsellor has a limited methodology don’t be surprised if your ‘problem’ is re-defined to fit their particular model. This may of course be appropriate, but it ’s at least good to know what is going on. See table on page 15 to see some of the vast array of counselling models used.

5. What role does the Bible play?

Modern day counselling theory has its roots in analysis of the inner and outer aspects of human nature in the 19th century. Freud ’s psycho-analysis is perhaps the best known, but a multitude of other methodologies have also developed. One analyst identified 460 approaches.

According to Roger Altman, in Through the Counselling Maze, (Kingsway 1996) ‘Parts of secular theories are acceptable to most Christians whereas, for others the unbiblical view of man is so integral to the approach as to make it impossible for the believer to usefully use the concepts’.

So some Christians will operate using secular methodology which they have critiqued from a Biblical viewpoint. Ross explains: “They take the view that all truth is God ’s truth. Every methodology has some insights about relationships that are helpful and point to someone beyond ourselves.”

Other Christian counsellors use methodologies they claim to be specifically Biblical in their orientation. Some are happy to incorporate the insights of psychology, some claim not to. But these methodologies say that their practise is grounded on Biblical concepts.

One of the better known is nouthetic counselling which has come to prominence under Dr Jay Adams. This method believes counselling involves the confrontation of the client with the moral demands of the biblical text. The counsellor will call for repentance and a recognition on the sufferer’s part that their personal choices play a major part in the therapy.

The approach taught by Crusade for World Revival (CWR) is also known as ‘Biblical counselling’ and has similarities to the methodology developed by

American Dr Larry Crabb. Gubb says, “Our methodology is founded on the understanding that God has given us absolute truth through the Bible about who we are -as image bearers, but in rebellion with God. Our commitment to seek to satisfy the hunger of our hearts in ways outside God’s boundaries is our central problem. A Biblical approach is not just about identifying sin to confess, but asking why? A person addicted to drink can be told ‘Don ’t drink to excess’,but also needs to be helped to understand why he/she is seeking to satisfy legitimate longings in this way.”

Others claiming the Biblical tag, but focus on different areas. Ken Hepworth teaches at Ellel Grange, a healing and counselling ministry with four centres in the UK. He says: “We use what we call the ‘Jesus model ’ which seeks to help individuals come to the place where they receive all they need from God. We believe we need to listen to the Lord and the person. Ministry (using spiritual gifts) and counselling go together.”

Ruth Carter Stapleton uses guided imagination in which Jesus is invited in prayer to go back into a person’s past life to heal traumatic episodes. Francis Macnutt, who has further developed this approach, writes: ‘I believe that it is always God’s desire to heal us of those psychological hurts that are unredemptive and that prevent us from living with the inner freedom that belongs to the children of God’.

Those part of the ‘Wholeness through Christ’ school act on the presumption that if you pray at the start God will reveal the place that requires Biblical input. There are many more that we could consider, but the point is clear. We need to be aware of the methodology of the counsellor, not least because it may govern the way they perceive our ‘presenting problem.’ If you expect a certain approach you may be disappointed if you don’t ask first. Ross says:“One client gave up after one session. We spent 55 minutes talking and five minutes in prayer, whereas she was expecting the reverse.”

6. How does the counsellor see change?

Whatever the model,you need to know where you may be heading. One counselee described the process thus: “it is a bit like a surgeon opening up the body to do surgery. This is all very well, but you need to know that they can sew you back up again.” Most counsellors have an ‘intake ’ interview with prospective clients. So ask how the counsellor envisages the sessions will go.

Richard Goodwin says: “It is worth being wary and asking the counsellor what his/her stance is. How do you envisage change? What will it mean? It is good not to rely on a quick fix, but some therapists can take years!” Collins advice is to “stay in control. If you don’t feel there ’s any improvement – say so.” Even if you don ’t understand the full implications of the approach, you ought to be able to understand in layperson ’s terms what is going on. If you don’t, chances are they don ’t know either.

Get moving!

Researching a purchase can seem mighty dull, compared to actually owning a product. Our analysis has necessarily raised queries and questions, but the testimony of many thousands is that counselling does have significant and sometimes life-changing benefits. Collins says: “Counselling hasn’t necessarily made my life easier but under God’s hand, it has made it richer.” So it is wise to proceed with caution, but the main thing is to proceed. There are plenty of reasons why we may want to stay in a rut, or say nothing to a friend in need. But on the other hand it just may be that God has allowed the situation because he intends that a time of hurting may become a time for growth.