The practice of unlicensed counseling


The practice of counseling, therapy, psychotherapy and other related terms is restricted to those with proper licensing in most, if not all, US states. Makes sense on most levels, right? You wouldn’t want to go to an unlicensed doctor for your appendectomy. In opposition to Holiday Inn’s ads, you wouldn’t want just anybody doing professional work on you. License control is supposed to protect the public from harm. Bad docs and bad therapists should lose their license and not be allowed to practice.

But with counseling and therapy, it gets a bit sticky. Lots of different professions do similar activities. Unlike surgeons, you have people from widely divergent schools of thought and training doing very similar things. LCSWs, LSWs, LMFTs, Psychologists, Psychiatrists, LPCs all do talk therapy. They all diagnose and intervene per their view of what is wrong and what needs to change (thoughts, behaviors. feelings, etc.).

And it gets stickier. Pastors, clergy, and religiously trained individuals do many of these as well. While they may not give DSM or ICD9 diagnoses and bill insurance companies, they do talk therapy with people who are depressed, anxious, angry, on the verge of divorce–just like all of those licensed people above.  In my world, there are pastoral counselors, biblical counselors, pastors who counsel, christian counselors, etc. Most of these in PA are not licensed by any body. (In PA we don’t have a pastoral counselor license as some states do.)

In an effort to tighten controls, there is a state effort underfoot (HB 1250) to tighten who can practice as a counselor. There were already controls but now the new bill would disallow someone like myself to hire or supervise an unlicensed (but in my opinion competent) person UNLESS they were actively in the process of becoming licensed.

Why does this matter?

1. There are many competent people doing counseling related work that are not licensed (nor could they be since their training is of a religious or pastoral nature). Should the state control these individuals? Right now they haven’t been actively going after these folk. The law will continue to remain vague: Here’s the restriction for LPC practice:

Only individuals who have received licenses as licensed professional counselors under this act may style themselves as licensed professional counselors and use the letters “L.P.C.” in connection with their names. It shall be unlawful for an individual to style oneself as a licensed professional counselor, advertise or offer to engage in the practice of professional counselor or use any words or symbols indicating or tending to indicate that the individual is a licensed professional counselor without holding a license in good standing under this act. [underline indicates new change in this paragraph]

Who decides what “engage in the practice of…or use any words…” constitutes? Obviously, one cannot intentionally lie but does the term therapy indicate a license?

2. There are many who provide pastoral care who are not ordained clergy. They have graduated from seminary-based programs that are not professional counseling programs. Yes, the current standard makes clear that it does not seek to limit the work of those acting under the legal auspices of a religious institution (i.e., are ordained by the church). But, should the state regulate those who provide biblical counsel but are not ordained? As long as these individuals make clear (informed consent) what it is they do and what they do not do, shouldn’t they be able to make a living? Research indicates that lay people can have tremendous success in helping those with depression and anxiety.

I’m all for protecting the public. But while licenses limit who gets to perform certain duties, it does not eliminate unethical or harmful practice. Further, much of psychotherapy is art as well as science. Artists can learn their trade in a variety of locations. What we need to do is to make sure the public can clearly identify the kind of counseling (and limits of) each counselor does. Second, those who provide biblical counseling ought to have some authoritative body. It would be great if they were recognized and “licensed” by denominations or organizations (e.g. the AACC who is trying to do this).

But I would hate to see the many seasoned, unlicensed counselors lose their ability to ply their trade.

That raises a question of analogy. Can anyone make a legal living cutting hair for a fee without a license?

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35 Comments

Filed under christian counseling, christian psychology, counseling, counseling and the law, counseling skills, Psychology

35 responses to “The practice of unlicensed counseling

  1. I found your blog very interesting. I wrote the following a while back and have blogged about this topic as well. Below is the article I wrote.

    Christian Counseling: A Call for
    Separation of Church and State

    By Ty Weckerly

    The universal Christian Church and state behavioral and mental health boards across America are failing to recognize the fundamental difference that exists between the ideologies of clinical psychotherapy and Christianity, and how this difference relates to licensure restrictions for Christian counselors. The primary difference between the ideologies of psychotherapy and Christianity is that psychotherapy teaches that 1) man heals man and 2) man heals himself, while Christianity teaches that Christ ultimately heals man. Although there are other ideological differences between psychotherapy and Christ-ianity, the source of healing is generally recognized as the most significant difference. For Christians, the source is God, and for psychotherapists, the source is man. This difference is significant within the arena of mental health because the “state” – defined in this article as the political and legislative bodies and/or boards overseeing behavioral/mental health in America – has accepted the secular systems of belief held by psychotherapy and its various humanistic orientations. As a consequence, the state has taken jurisdiction over and regulation of the field of psychotherapy, which includes specific licensure processes directed towards secular counselors. However, this article argues that the state should not impose jurisdiction and licensure restrictions over the field of Christian counseling because of the inherent ideological difference in psychotherapy and Christian counseling, and that the field of Christian counseling should instead be regulated by the Church.
    If the state has accepted the system of beliefs held by psychotherapists, and consequently taken juris-diction over this system, is it possible and morally acceptable for the state to also agree with and take jurisdiction over the system of beliefs held by Christian counselors? I argue that it is not possible. The state cannot have it both ways. If the state agrees with a secular belief system as it pertains to counseling, it cannot at the same time agree with and support a belief system rooted in God. Consequently, I argue that Christian counseling as a practice should not be regulated by the state, but instead by the Church, and that a separation of Church and state should be recognized within both fields – psychotherapy and Christian counseling. Unfortunately, there currently is no separation. This article describes five primary factors preventing this separation from occurring. It should also be noted that this article is written by a member of the Catholic Church and provides suggestions for both Christians in general as well as the Catholic Church specifically regarding alternatives to state regulation within the field of Christian counseling.
    The five primary factors preventing a separation between psychotherapy and Christian counseling by the state and Church are the following: 1) The state, Christian counselors, and Christian counselees fail to recognize that a fundamental difference exists between the “systems of belief” maintained by Christian counseling and psychotherapy. 2) Christians and Christian counselors are largely unaware that the state only has jurisdiction over psychotherapy. The state should not have or accept jurisdiction over Christian counseling, or any other form of religious counseling for that matter. 3) The various terms and lack of clear definitions for Christian, Biblical, and Pastoral counseling prevent unity within the universal Christian Church as it pertains to Christian counseling. 4) The state is infringing upon the Church’s and Christian counselor’s ability to administer Christian counseling through its licensure restrictions. 5) The Chuch has not fully accepted its obligation to regulate the field of Christian Counseling. This article discusses these fac-tors in more detail and provides potential solutions to the challenges mentioned above.
    Many Americans are under the notion that psychotherapy is essentially a science and that it has been validated by science. This is simply not true. Instead, psychotherapeutic orientations are rooted in a “system of beliefs”, just as Christianity is rooted in a system of beliefs. Examples of these psychotherapeutic systems of belief are Cognitive Behavioral Therapy, Client Centered Therapy, and Psychoanalytic Therapy. Each system provides a theory, or explanation, for how a person achieves and maintains mental health. Although science attempts to inform these theories, psychologists admit that science is not equipped to validate or invalidate the systems of belief proposed by any psychotherapeutic orientation. Similarly, science is not equipped to validate or invalidate the system of beliefs held by Christians. Still, it remains a common misconception that psychotherapy has been validated by science, whereas Christianity is based primarily in belief. The truth is that both are systems of belief and these systems are fundamentally at odds with each other.
    As mentioned, these systems are primarily at odds with each other because of their ideological differences regarding the source of man’s healing. Psychotherapy professes that man heals, and is therefore considered secular. Psychotherapy does not rely upon or ac-knowledge God as a healing source within the context of counseling. Rather, psychotherapy is defined by secular psychology, has its origins in secular Freudian psychoanalysis, and is currently secular in practice. Christian counseling, conversely, proclaims that God heals. Its orientation is based in the teachings of the Bible and a belief in the intervention of the Holy Spirit as a healing source. Christian counselors and clients believe that life’s problems, ranging from depression, to marital problems, to anxiety, to crises of faith, deserve at the very least spiritual attention and at the most a spiritual cure. The notion that man heals himself without God, as psychotherapy proclaims, is anti-Christian.
    The universal Christian Church, and the Catholic Church specifically, is not fully aware of and willing to challenge the influence of psychotherapists on their laypeople. It has become a common practice for Catholic priests to refer their struggling laypeople to secular, and sometimes atheistic, psychologists, psychiatrists, and psychotherapists. Catholic priests often make these referrals because they lack a Christian counseling alternative. In addition, many priests will admit that they do not have the time required to meet the needs of many of those struggling within the Church with spiritual brokenness, sinful behaviors, and other problems of life. As a result, they are often forced to make a referral outside the Church.
    Catholic priests do not recognize the spiritually destructive impact their referrals to secular mental health professionals, or even state licensed professionals who do Christian counseling, may have on the collective spirit of the Church. When faced with adversity, many Catholics are sent to secular therapists, and miss out on the opportunity to recognize healing that comes from God, which then strengthens their relationship and dependence upon God. Instead, they are led to believe that their healing came from themselves as taught by their psychotherapists. As a result, they may return to this anti-Christian belief system when faced with adversity again.
    The Evangelical Church has taken a different path, which the Catholic Church should consider. The Evangelical Church is currently certifying its own Biblical counselors, and has separated itself from the certification process of the state. In doing so, they protect their ministries and provide reliable services for their counselees. In short, they are refusing to allow their counselors and Biblical counseling methods to be regulated by the secular state. Instead, they are reg-ulating their own counseling ministries.
    Although Biblical counselors have developed greater autonomy, they are still being challenged by the state. Dr. David Edgington, a certified Biblical coun-selor in Phoenix, Arizona, was recently challenged by the state. The Arizona Board of Behavioral Health Examiners, hereafter referred to as the Board, recently ordered Dr. Edgington to “cease and desist” his Biblical counseling ministry under the charge that he was administering psychotherapy without a license in the state of Arizona. The state initially claimed Dr. Edgington was illegally practicing psychotherapy without a state license. Dr. Edgington was summoned to a meeting before the Board, which he described in his emails to me and others as a generally “hostile, inflammatory, and threatening” meeting. The purpose of this meeting was to determine if he was in fact practicing psychotherapy without a license.
    Dr. Edgington explained to the Board that he was not practicing psychotherapy, but instead was providing Biblical counseling, which is distinctly different from and in many ways opposed to psychotherapy. Dr. Edgington explained that two distinct aspects of Biblical counseling, reliance on the Word as provided in the Bible, and reliance on the Holy Spirit for the purpose of healing and sanctification, make Biblical counseling markedly different from psychotherapy. Furthermore, Dr. Edgington explained that he was protected under the Constitution, which acknowledges a separation between church and state. He explained that the teachings of the Bible are protected by the Church.
    A decision was then made by the Board, which holds enormous significance and is at the crux of this article. The Board voted by unanimous decision that Biblical counseling was not in fact psychotherapy and that the state did not have jurisdiction over Dr. Edgington’s ministry. Dr. Edgington was given per-mission to continue his counseling ministry. This decision is extremely relevant for Christian and Pastoral counselors. If the Board acknowledges that they do not have jurisdiction over individuals practicing Biblical counseling, then the Board must also acknowledge that they do not have jurisdiction over individuals practicing Christian and/or Pastoral counseling. In short, the Board does not have jurisdiction over any form of therapy rooted in the belief that God heals, which is consistent with Biblical, Christian, and Pastoral counseling. However, the definitions of Biblical counseling, Christian counseling, and Pastoral coun-seling are a source of confusion, which detracts from their common purpose and application. The following provides definitions and analysis of these terms.
    Biblical counseling is generally associated with Evangelical Christianity and was largely expanded by Jay E. Adams. Biblical counseling is also referred to as Nouthetic Counseling. Biblical counselors emphasize the teachings of the Bible and healing that occurs through the Holy Spirit. Biblical counselors have their own certifying bodies such as the International Association of Biblical Counselors (IABC) and the National Association of Nouthetic Counselors (NANC). Consequently, Biblical counselors generally do not operate under the licensure of the state.
    Christian counselors attempt to combine the teachings of Christianity with the teachings of psychology, yet maintain that Christ ultimately heals. Similar to Biblical counselors, Christian counselors emphasize the teachings of the Bible and healing by the Holy Spirit. In contrast to Biblical counselors, Christ-ian counselors are generally licensed by the state, which I argue is a contradiction. Christian counselors licensed by the state unknowingly promote two contradicting belief systems – Christianity and psychotherapy. Some have referred to these Christian counselors as State-owned Christian counselors or Secular Christian counselors. Although these titles sound ridiculous and condescending, they demonstrate the glaring contra-diction.
    Finally, Pastoral counselors may be priests, rabbis, ministers or pastors who also attempt to combine the science of psychology with their religious beliefs. Few states acknowledge the license of Pastoral counselor, so many Pastoral counselors believe they must first acquire a traditional state license to practice psy-chotherapy such as an LPC (Licensed Professional Counselor) or LMFT (Licensed Marriage and Family Therapist). Again, I argue that Christian Pastoral counselors do not need to seek licensure by the state, but instead should consider licensure through the Church.
    The contradiction of a State-owned Christian counselor or a Secular Christian counselor could place these Christian counselors and the state in a significant double bind. If Christian counselors continue under the licensure of the state, they demonstrate to themselves and the Christian public that they do not recognize the impossibility of administering both psychotherapy and Christian counseling. Alternatively, they can operate outside of their state license, but may have difficulty locating Church organizations that will certify them. The state will also be in a double bind. The state can give up their jurisdiction over Christian counseling, but doing so requires them to relinquish their authority over Christian counseling. Alternatively, the state can claim they do have jurisdiction over Christian counseling, but by doing do so, the state is essentially saying that they have jurisdiction over the teachings of the Bible and the Holy Spirit.
    This article also argues that the state has per-petuated a lack of appropriate separation between psychotherapy and Christian counseling through its licensure restrictions, and has wronged Christian counselors seeking a license from the state in the process. The state has wronged these Christian counselors in several ways? First, the state has obliged Christian counselors into an implicit agreement in which potential counselors are not fully aware of the agreement made. More specifically, a licensed Christ-ian counselor must make an implicit agreement to accept the system of belief provided by psychotherapy, which is that man heals himself without the assistance of God. This anti-Christian belief is unacceptable to most Christians. Unfortunately, many Christian coun-selors licensed by the state are unaware that they have made this implicit agreement once they acquire a state license to administer psychotherapy. They must make this agreement with the state because the state admits they only have jurisdiction over psychotherapy, and consequently, can only license individuals to do psychotherapy. Thus, once a Christian counselor acquires a state license, an agreement has been made.
    Second, the state requires Christian counselors and Pastoral counselors seeking a license through the state to be educated in and practice a system of beliefs that is markedly different from Christian beliefs before they are given permission to practice Christian counseling. For example, Christian counselors are required to dem-onstrate a proficiency in a belief system which states that God does not heal man before they can practice a belief system which says He does. This is similar to saying that someone can agree to follow their own faith after they first denounce it. The state prescribes that the state-licensed counselor must first be trained in secular belief systems, also called psychotherapeutic orien-tations. This training generally occurs in secular ins-titutions by instructors maintaining secular beliefs. Once the initial education process is complete, Chris-tian counselors must take the state’s licensure test demonstrating their knowledge of secular psycho-therapy before they can move along to the next stage. After secular training and testing, Christian counselors often continue to receive training and guidance at the intern and supervised levels by secular institutions teaching secular belief systems. After all this training and indoctrination has occurred and a license has been issued, the state will then allow Christian counselors to practice Christian counseling independently. The entire process of state licensure, which allows Christian counselors to practice independently, can take four years and sometimes as many as seven or eight years if they want to be licensed as a psychologist or psychiatrist. Christian counselors cannot and should not accept this level of secular indoctrination, and must recognize the impossibility of serving two masters.
    Finally, the state restricts the separation of Christian counseling from regulation through the state’s alliance with insurance companies. Insurance companies will only provide funding for those counselors that are licensed by the state. Consequently, Christians who need or desire to use their insurance to assist in paying for counseling will be required to see a counselor licensed by the state. In other words, insurance comp-anies financially support a secular system of belief, which is not held by Christians. This system drastically limits the decision-making ability of individuals who desire a Christian form of counseling, but cannot afford it.
    Of course there are no easy solutions to the issues mentioned above, but further attempts to resolve these issues must be made. The following provides brief suggestions for the terms, people, and institutions involved.
    Christian counseling, Biblical counseling, and Christian Pastoral counseling
    In order to strengthen and unite Christian forms of counseling, one overarching term for Christian coun-seling, Biblical counseling, and Christian Pastoral counseling should be used. I believe the term Christian counseling adequately summarizes the three forms mentioned above. Christian, Biblical, and Pastoral counselors believe the Bible can and does address all problems people experience. A singular term, Christian counseling, will both better combat secular influences and strengthen the growth of Christian counseling across denominations.
    State
    Do not license Christian counselors. Acknowledge that this is outside your jurisdiction. Inform the public that the state’s jurisdiction is limited to psychotherapy.
    Catholic Church
    The Catholic Church needs to offer a Catholic Christian counseling education and certification process for its counselors in much the same way that the Evangelical Church is doing with NANC and IABC. The Catholic Church needs to keep the certification process separate from the state.
    Catholic priests
    Recognize the potential spiritual hazards of re-ferring your laypeople to secular counselors. Be aware that even those who claim to do “Christian counseling” may actually be performing counseling closer to psychotherapy as a result of their education, training, and licensure process. Promote Christian counseling as an official ministry under the jurisdiction of the Church.
    Christian clients
    Determine if you would prefer a Christian counselor to a secular psychotherapist. Research any counselor you are interested in seeing. Determine if the counselor is licensed through the state, or licensed through the Church. Understand that if the counselor is licensed by the state, then the counselor meets the state’s requirements for practicing psychotherapy. Next, ask your counselor where they were educated. In many cases, the counselor will be educated in state programs that teach belief systems and methods of secular psychotherapy. Also, ask if the counselor has been trained in Christian counseling, and if the counselor has any form of certification in Christian counseling. In addition, ask your state-licensed coun-selor where they did their counseling internship and whether or not the supervision was Christian based. Ask your counselor if he or she is Christian and promotes Christian ideals in counseling. Also, ask about his or her healing orien-tation is. If the counselor tells you he or she does “client centered”, “cognitive behavioral therapy”, “humanistic”, or “psychoanalytic therapy”, then the counselor plans to utilize a secular psychotherapeutic technique. In other words, their healing philosophy is rooted in a secular system of beliefs, not Christianity.
    Potential Catholic Christian counselors/clients
    Urge the Catholic Church to develop a Church-sponsored education and certification process for counseling, which would enable a base of certified Catholic Christian counselors.
    Christian counselors licensed by the state (State-owned Christian counselors/Secular Christian counselors)
    Refuse to make the implicit agreement with the state to do psychotherapy if you want to continue doing Christian counseling. Inform your state licensing boards that they do not have jurisdiction over Christian, Biblical, or Pastoral counseling. Consider becoming licensed by a church-regulated Christian counseling certification agency. Check the statement of faith of that agency first to make sure it is not in violation of your own belief system.

    In summary, the purpose of this article is to demonstrate that the state does not have authority over the field of Christian counseling and therefore should not regulate Christian counseling. Christians do not give licenses to state authorities on secular matters, and there would be a massive uproar if the Church were to license and regulate secular psychotherapists regarding their methods and practices. Even the hint of such a Church-regulated licensing board for psychotherapists would incite mass resistance from state authorities and secular counselors on grounds of the necessity for separation of church and state. Yet, this form of regulation is occurring in the opposite fashion. As mentioned, state authorities are restricting the belief systems of Christian counselors, which is a violation of their religious rights. Christian counselors need to recognize their religious freedom to counsel as proclaimed by the Gospel.
    As things stand, it is unclear where the jurisdiction of the state ends and the rights of the Christian counselor begin. This ambiguity must be clarified by making clear divisions between the counseling jurisdictions of state and church. There must be serious institutional changes that take place if there is to be a future for Christian counseling as a vibrant and effective ministry of the Church. The state must have no part in the counseling ministries of the Church. The Church and its members must explicitly state that any infringement is nothing short of religious persecution. Also, the Church must begin to institute its own educational systems and licensure processes for regulating its own counselors. The lines must be drawn, and the ignorance and indifference must be addressed. All of these important steps must be taken before Christians can enter a new era of counseling. This new era of counseling ensures that Christians are guided by the timeless truth that God is the source of all healing.

    • Sandra

      Hi,
      I appreciate the information you provided in this article. I am a Psychology major who wanted to become a Christian counselor. Now that I have read your article, I will pursue this through a Christian organization that will allow me to operate with Christian beliefs. I am so grateful that I read this. I did not know the difference in being licensed as a counselor and a christian counselor. I believed you just help me make up my mind about going to school for my masters degree!! I now have other options.

  2. I forgot to leave my email as well if you would like to comment. My email is tweckerl@hotmail.com. Again my name is Ty Weckerly. Thanks!

  3. Phil,

    I believe this will become an even more “delicate issue.” However, reading the portion of the law you quote, I’m not sure it needs to be an “issue” at this point. A “pastoral counselor” has no reason to claim the title “licensed professional counselor.”

    The key, I believe, is what someone calls them self and whether their training and experience qualifies them for that label/title.

    A lay personal with biblical equipping in one another ministry might be wise to use terms like “lay encourager” or “lay discipler” or “spiritual friend” or “spiritual director,” or “soul care-giver” that accurately and aptly and biblically and historically describe the ministry being done.

    A pastor with training in pastoral care and biblical counseling might be wise to use labels like “pastoral care and biblical counseling,” “soul phyisician,” “spiritual friend,” “spiritual director,” or “soul care-giver,” etc.

    What do other people think?

    Bob

    • Dear Bob,

      I know that I can not call myself a Psychologist or Psychotherapist. But what would or could happen if I call myself a Biblical Counselor?
      What can anybody do about it? Afterall, I am a Christian so I can counsel. I counsel from Scripture alone, so am I not a Biblical Counselor?

      fyi, I did a film documentary entitled: MAKING MERCHANDISE OF MEN’S SOULS, PART I PSYCHOTHERAPY VS. SCRIPTURE. Trailer available on our site.
      Kindest regards in Christ,
      James Sundquist
      http://www.perfectpeaceplan.com
      rock.salt@verizon.net

      • James, happy you stopped by. I think there is room for a wide variety of believers bringing all sorts of mercy (that’s what I see counseling and pastoral care as). I do think that someone who is Christian and practiced helping others apply biblical concepts to their lives could well be called a biblical counselor. And yet, there are some consistencies in how that term has been used (kinds of training may vary some but usually includes a core set of classes/supervised practice).

        It is not clear, but from the title you liste above I am concerned about smearing all who charge for their counsel. I encourage you not to lump all who might use psychotherapeutic techniques as against Scripture. That slanders a large group of Christian counselors in an unjust manner. In addition, assuming that those who charge for counsel are only merchandising the soul is offensive and also slanderous, just as it would be if you accused your pastor of only preaching the Word to get a paycheck. While I concur that there are those who are only in it for the money (preaching that is), to smear all pastors and paid ministry leaders violates the 9th commandment. Not accusing you of doing so but it has that appearance from your comments above.

  4. D. Stevenson

    fyi- The New Jersey Professional Counselors Committee adopted new regulations for counselor licensure on October 5, 2009. Effective 2012, applicants for licensure will be required to have graduated from a counseling program accredited by CACREP.

  5. Thank you for writing about this, Phil. I’m an LLPC in Michigan and am always interested in how other states are handling this.

    Like Bob, I interpret the wording to mean that a person cannot call him/herself “licensed” without being actually licensed. That seems to afford some degree of freedom, if a counselor selects another type of title.

    I’m always curious who’s behind movements like this. Is it a group of LPCs looking to protect their interests?

  6. I’m a huge advocate of the state staying out of the church’s business. That being said, there simply needs to be some kind of “truth in advertising” as to who can claim the various titles of “therapist”, “counselor”, etc. etc. When you go to a doctor who claims to be a “neurologist” you’d like to know that he’s a board certified physician with the requisite medical school training and not a graduate of the Billy Bob’s Holistic Spiritual School of Neurology.

    To give some sense of how different the practice of counseling is from a standard psychologist to some pastoral “nouthetic” counselors, I wrote a compare and contrast paper of two classes that I audited. One is an basic Intro to Psych course from MIT the other is a Pastoral Counseling class from Reformed Theological Seminary. The differences between the two approaches are stark. Yet people from both these schools of thought may claim the title of “counselor.” caveat emptor

  7. Carmella

    Hey Phil!

    I think this is a critical issue, as I am in the process of applying for my LPC now and finishing my first semester of a doctoral program.

    I think the main issue is that of informed consent, making sure people really know what they are signing up for. In terms of pastoral work, often the term counselor isn’t even necessary for the pastor to provide the services. To say the relationship is pastor-congregant instead of counselor-client doesn’t negate privilege/confidentiality, but may nore clearly delineate what the perspective is, what amount of advise-giving can be expected, even some other dual relationship and boundary issues which are so different in the church versus in the counseling relationship!

    I think that if we respond as the church by embracing the changes in semantics and responding accordingly, very few negatives can occur.

    On the other hand, the positives will be that an individual now knows what to expect, understands that the pastor doesn’t have to operate the same way as a counselor, and can have a clearer perspective of why certain things are said. I believe this is in the best interest of the client, who can experience extra confusion when not knowing what to expect in the role of pastor-client vs. counselor-client (which can be, appropriately, SO different!)

    I’ll be interested to hear ongoing thoughts…..

  8. Louie Buses

    Informed consent should be the answer. However, the secular counseling system holds enough antipathy toward Biblical/nouthetic counseling that they will continue to press to eradicate us under the guise of protecting the public from “unqualified” and “superstitious” practitioners. We will have to fight to stay free of the state. I have a BA in psychology, an M.Div. and certification from three biblical counseling organizations, but my psychologist acquaintances despise what I do.

    The article concerning separation of church and state was good. He only made one mistake. When it comes to separation of state secular counseling from church Biblical counseling, the state licensure will have it both ways.

    What effect do you think the “Hate Crimes” legislation, which just passed the senate, will have on these issues?

  9. Carmella

    (I’m not intending to direct this right to Louie, but he makes a great point…)

    Louie-
    I think your point of the legitimacy of the M.Div. education/credentialing in the practice of counseling is important.

    I’ll give an example from my work. I work at a professional/faith-based agency, which functions from a multi-disciplinary perspective. (www.fracc.org if anyone is interested) At Intake/assessment, we identify a person’s goals, problems, and focus of counseling. We then align those goals with the particular theoretical orientation that suits their needs (as well as the experience of the therapist)- LPC, LSW, LCSW, LMFT, MDiv, Spiritual Direction, Prayer, etc.
    THIS is what enables the informed consent process to provide for the need of faith-based services or purely professional services (which happen to be delivered by Christians… which is another conversation in and of itself).

    The point is not to blame MDiv’s for not being qualified, to stifle the ability of people to integrate their faith into their practice, or for people to seek out spiritual counseling. The point is that certain people are not trained in certain things. A prayer counselor might not know what to do with major symptoms of Bipolar I, which is harmful to that person seeking help and possibly not knowing where to find it. I know I am outside my competency with certain severe and pervasive mental illnesses, such as schizophrenia, and would want to help that person best by connecting them with a provider who can actually help them (because of my ignorance, I can’t).

    There are many seminaries and Biblical universities that are APA accredited in Psychology- which certainly incorporate spirituality into conceptualization and practice. I just don’t want you to fear that the motivation is to “erradicate” Christianity, when I think it is actually to ensure competent practice.

    • Interesting discussion. Bias exists on all sides. I remember that APA wanted to remove “footnote 3″ which enabled faith-based accredited programs to discriminate on the basis of faith. This was about the time Wheaton College was going for its accreditation. The change was not approved or was withdrawn but was later brought up again and withdrawn (I think they realize that they can overstep their powers and have their accrediting privilege revoked should they have messed with the constitution).

      So, there are some in power who do not like to give any power to those in the biblically oriented counseling movement. That said, I don’t think there is a vast conspiracy to do this. Carmella, you are right, mostly there is an interest in competency. Unfortunately, we have yet to have an agreed upon definition. Psychiatric diagnosis competency? Client satisfaction competency? Ethical competency? Biblical competency? Lacking that, it seems your work place has figured out how to match people up. That sounds good.

    • Louie Buses

      Thank you, Carmella.
      My error was attributing the “eradication” motive to the “secular counseling system”. These men and women are simply blinded tools of the great deceiver, who attacks the work of Christ from all directions. I obviously believe training and credentialing are very important. Let’s simply be “wise as serpents and innocent as doves”, as we deal with the state on licensure. How many laws have been enacted with wonderful intentions and then perverted to the purposes of the liar. For instance, do you want to equate freedom of speech with pornography ?

  10. Carmella

    Ooooh- this is great stuff.

    Phil- I appreciate the note on biases. I think mine comes from fear- mostly fear that I would hurt someone out of ignorance to their issue or an aspect of it. That’s why I read things like this blog, enjoy talking to people who are Biblically oriented (so we can figure this thing out together) and continue to be educated, praying that the Spirit gives discernment through accountability, supervision by Christians, and peer consultation with Christian professionals.

    Louie- I appreciate the “wise as serpants, innocent as doves” tie in. I believe that as Christian professionals, we seek together to pursue God in how to do that.And I pray that we keep talking and working through ways to do that.

  11. Louie Buses

    Licensure obviously does not equal competence.

    I have a couple that recently came to me trying to put their marriage back together. She had run off with another man and filed for divorce. In the court proceedings which followed the judge required a psychiatric evaluation. The psychiatrist labeled her “bipolar”. After two counseling sessions, I came to believe that she was not bipolar. I asked her what testing the psychiatrist had done to determine his diagnosis. She said, “None. He said he was bipolar himself and could tell from interviewing me.” He put her on an antidepressant.

    I told her that I was not a licensed psychologist but asked her to take a screening test so I could better understand what she was experiencing. I gave her the HCL-32 test for bipolar disorder. High score possible is 32, at 13 there is a 70% chance of bipolar disorder, she scored a 4. When she asked about the results, I told her that we were going to work on the depression she was experiencing, keep on her meds, and do what the doctor told her about the bipolar side. [What else should I have done or said?]

    As a result of the psychiatric diagnosis, she has been court ordered to undergo a evaluation requiring a bank of tests including MMPI, Rorschach, TAT, etc. costing many dollars that the couple can not afford. In God’s grace, there has been repentance, forgiveness and reconciliation (in both partners). They are studying and working on knowing and applying God’s word to their marriage and lives. Her depression has become a minor issue (at this time). They are planning to remarry at the end of the year.

    • Good points Lou. While Psychiatrists rarely use tests and usually use indepth history taking, I’m pretty sure that diagnosing someone because it is what you struggle with is NOT one of their preferred techniques.

      Of the listed tests, the MMPI might be the only one that really gets at mania or hypomania. I personally like to give the Rorschach but it isn’t helpful in this situation.

      Glad to hear of good results.

  12. Carmella

    oh man, Louie.

    Phil- maybe at some point you can do something on the importance of proper assessment utilizing the actual criteria to determine a disorder. sheesh.

    Honestly, I think you did the right thing- not totally dis’ the other professional, not have her change her meds, and after that… I would have had a release signed for the psychiatrist, and contacted him noting that I was not sure what I was treating because I wasn’t seeing the same symptoms. Maybe she had 1 previous hypomanic episode, qualified for Bipolar II, and was asymptomatic or in a depressive episode at the time. Patients don’t always understand their diagnosis- WHICH IS THE RESPONSIBILITY OF THE PROFESSIONAL!

    I know a lot of MD’s who struggle with explaining diagnostic stuff. I also have a major pet peeve with mis-diagnosis, and even quick diagnosis.

    I think, sadly, the MMPI and other batteries can at least clarify. I know they are expensive, but at least they can clear her record if she was misdiagnosed.

    Also- you did a great job of treating the marriage, when that was your role. Sounds like you did the best you could given the circumstances… but that’s my take on it.

  13. Bobby Eaton

    On the other hand, there are things not taught in schools or mainstream psychology that are the fundamentals of life for every person with the capacity to learn concepts.

    Learning unconditional love, discernment, and responsibility of thoughts, emotions and actions are things that are discouraged in society and even Christian religion, that can be shown to fundamental for all persons who have moral responsibility in a social environment who understand the need for interdependence.

    How can you reconcile the duty to teach people to be responsible for their thoughts, emotions and actions, when Christianity teaches people to blame outside sources? Do you know why people get addicted to drugs, alcohol, religious delusions, etc? It’s because when you blame outside sources for your thoughts, emotions and actions, you look for outside sources to save, change or distract you.

    Earlier this week, a Greek Orthodox priest who is a Doctor in Psychology at a childrens’ mental hospital had such a problem debating religion with me that he gave up and resorted to personal attacks, claiming Satan was my master and using threats that I would wake up in my last breath in the face of demons. He even resorted to claiming that I had a God complex due to my father abandoning me and that I was projecting.

    Unfortunately, he had no family history or confessions from anyone I know to prove this claim and the last counselor I want to listen to is one who has symptoms of delusional schizophrenia. I question his ability to be capable of helping any child learn moral and social confidence and structure. I question any pastor/priests ability to do so.

    Psychology and Christian belief do not mix. Even God is schizophrenic in the OT. This god is jealous, angry, vengeful, biased, and can easily be shown to be malevolent, unjust and not omnipotent or omniscient using Scripture. This alone can confusion in an individual who is also taught that Satan has these same attributes and wants to be like God.

  14. D. Stevenson

    A little late here for the conversation, but I’ll make a comment anyway.

    An advantage of requiring a license (of some sort) is that then there is some form of accountability. Otherwise a person could pose as a Christian counselor and be really a rogue.

  15. Jackie

    i just found this article. is someone still out there who wants to talk about this?
    please check with the National Christian Counseling Association. They are a good organization who have accountability requirements for their counselors, help with questions and lots and lots of information about informed consent. it’s a treasure for commissioned or ordained people who choose counseling as their way of serving God.
    pastoral counseling is distinct and markedly different from psychotherapy/psychology, though some of the same cognitive techniques can be used. the ultimate source of healing is the Lord Jesus. when you counsel from that perspective, there is a distinct separation from state-licensed counselors who, usually, cannot share their faith with clients.
    do some research!

    • Jackie, thanks for stopping by. Organizations like NCCA do help with the accountability but of course they do not have much teeth. They cannot levy fines, they cannot publish the names of unethical or immoral licensees. State licensing bodies can do this. It is false to say that licensed counselors cannot share their faith. I am. I do. What is not ethical is coercion, manipulation, etc.

  16. Jerry Ricks

    My life was destroyed and my child ended up dead because of an unlicensed counselor. When you are unlicensed there are no formal standards of practice, no formal accountability, no protection for inncoent consumers.

    I can maybe be okay with unlicensed counselors as long as they

    1) Have a sign on their door that explains that they are not licensed.

    2) Charge no money for their services. Charging money lends an aura of “professionalism” to the practice.

    • Sorry for your loss. It is all in the consent process as well as being honest. As a counselor, I have a consent form for counseling services which explains my credentials and expectiations. It says that I don’t replace medical or psychiatric advice. At the end it says that counseling through the XXX agency may not be successful with everyone.
      The more regulated we become as a nation is less opportunities people have to make an income. I have my master’s degree in counseling from Biblical Seminary. I was recently laid off from a job with the state. Although I have applied for jobs, i haven’t found one yet and so I am counseling privately as a christian professional counselor.
      A license doesn’t determine whether or not someone is a good counselor.
      To get your license takes about 3000 hours and more than 10000 dollars . After you graduate in order for you meet licensure requirments, you may have to take additional classes and you have to pay a licenses counselor which averages between 30-100 dollars for every 20 hours you counsel. Not everyone can afford this therefore it is not fair to stop someone from making a living as long as they are ethical in their practice.
      Counseling is an art and takes time to master. Even counselors with 10-20 years under their belt have trouble with helping certain clients. The lesson learned is that as a professional you have to learn when an issue is beyond your scope of practice. In nursing school, I learned that if you are not sure than don’t do it. The example we were given is that if you are asked to do an IV push but never did one before get an experiened nurse to do it or guide you along. It is the same with other professions or counseling. At this time I would counsel someone with severe depression and if I do I was ensure that I have a mentor or refer the person to see a psychologist. I believe that what happens is that pride and greed gets in the way and we take on more that we can handle.

  17. Some simple criteria I have learned to consider are personality, theoretical approach, experience with my specific situation, and license.

    A little online research yields plenty of information on the theoretical approach options. Personality differences that interfere with treatment can (and should) be discussed prior to a therapist/client relationship starting. It is very painful and discouraging to have spent a few sessions only to discover this is not going to help. Searching for therapist number 2 or 3, requires energy many struggling people do not have.

    Experience is vital. While students and beginners in the field are good people with great intentions, just like one wouldn’t ask an inexperienced driver to tackle ice road trucking, those who deal with serious mental illnesses need to seek out professionals with experience in that specific area. This is too important to trust to a novice.

    State licensing is also crucial, as it requires experience to achieve it, and shows that this counselor has more than good intentions. Unfortunately, as thoughtful and talented as pastors and other church leaders may be, they do not usually have any or much training in this regard. The wisest potential spiritual counselors will admit this and send any of us with deeper mental issues to a more specialized professional, especially if we are in need of a crisis counselor or crisis intervention. Having someone kind to talk to is a key ingredient to feeling supported, and I am not in any way dismissing anyone as viable listeners, encouragers, or reinforcements. Nonetheless, being able to apply truth to specific and extreme emotional needs requires more than a theological degree.

  18. shell

    Ty, not sure if you’ll see this (over 3 years later) but I want to thank you for putting in words so clearly what I’ve experienced in the real world. Ironically, i found this site while checking out the pros & cons on licensure, as I totally realize I would be more easily received as a ‘licensed counselor.’ I have been a student of the Word of God for almost 34 years, I was completely set free from the effects of sexual assault and emotional abuse, simply from studying God’s Word and believing what He says about Himself and about me.
    I call myself a ‘biblical tutor’ to avoid the entire licensing issue…
    I minister to many women from all walks of life (including agnostics and atheists) by showing them what God says about them. I witness miracles on a regular basis. I receive many comments regarding how 30 minutes changed a perspective (and behavior) that years of couseling couldn’t- including Christian counseling.
    Nancy’s right- a theological degree doesn’t necessarily mean one’s able to apply truth. But knowing God’s Word and being filled with His Spirit does… God’s Word is TRUTH. Man’s wisdom is just a counterfeit…

    • Shell, this topic needs to be discussed, and I hope more people find this site. I too have been a student of the Word since a child. Of course, back then it was Bible stories which implanted into my heart a faith in the most amazing and powerful God, and the inerrancy of the Bible. The Word is living and active, and never will it cease to strike me with awe at how vital and irreplacable it is as the source of wisdom and faith.

      However, as I grew in knowledge and the Holy Spirit taught me, a sense of clarity on some scriptures did not occur until I heard them in the context of professional counseling. I will give you one example, 2 Corinthians 10:3-6 ESV: “We destroy arguments and every lofty opinion raised against the knowledge of God, and take every thought captive to obey Christ…” From unlicensed counselors and pastors and Bible teachers over the years, this scripture has been approached as a command, and an example (St. Paul’s) to emulate. I do not remember anyone telling me how to accomplish this. I’ve been told what to believe, and how to act if I do believe it. I’ve been told what to think, and I have taught these concepts.

      It is the application of that truth I haven’t been able to grasp until a professional Cognitive Behavioral Therapist explained negative core beliefs and in prayer I was able to uncover many of them. It wasn’t until he taught me how to challenge them using the Word and diligence that I realized what taking thoughts captive really looks like. To continue this example, I know now that I think in black and white terms and can better “hear” what God is expressing in the Bible.

      I’m glad you have been used of the Lord to help so many people. Some unlicensed counselors are talented. I would expect, however, that you are a better counselor now than you were when you were younger. Experience has taught you much. If you had worked toward a license back then, you would have had more of the knowledge immediately that it has taken you awhile to discover. As for the 30-minute lessons, of course much of what has changed my approach to life has been offered to me in 30 minutes or less. It doesn’t take long to hear truth. Behavioral changes take longer, however, and as I grow and practice CBT in light of the Word, I see more and more areas in which I can apply it.

      The counselors who have helped me have earned their licenses through hard work, achievement, and knowledge. by the way, it is the patient’s responsibilty to know the Word- to compare it to any teaching.

  19. Dear Phil and Bob,
    In response the “lumping” Christian counselor with Psychotherapists, I encourage you to consider this article on Simony and Scripture:

    http://www.rapidnet.com/~jbeard/bdm/Psychology/simony.htm

    Charging for spiritual counseling is simony whether or not the counselor is a Christian.

    • James,
      Respectfully, licensed therapists have invested a great number of years and money into their training, not to mention school loans. They should not receive recompense for that? Simon was greedy, missing the whole point about the Holy Spirit, and had no intention of doing good works with the gift he wished to purchase. This does not describe most (maybe 1) pastors, evangelists, Bible teachers, counselors, therapists, psychologists, or psychiatrists, Christian or non-christian, that I have met and/or worked with.

      It is interesting to me that the article you posted ends with an insinuation that people who ACTUALLY read the Bible will agree with the author. It is difficult to take such an argument seriously. However, bypassing the author’s not-so-great wording, and giving him the benefit of the doubt per his attitiude, I would suggest everyone is responsible for knowing the Word.

      By the way, did that author get paid? I don’t know, just curious.

  20. Lee T.

    Thank you for the article. I am a believer and have been counseled by Christian therapists (mainly unlicensed). As someone who has suffered a tremendous amount of trauma by a Christian counselor, I am HIGHLY in favor of someone getting their license and or proper training. It’s one thing to sit and minister to a friend, it’s another to put yourself out there with the label of “Therapist” or “Counselor” or “Doctor”. It leaves those of us in need of actual wise counsel very vulnerable. I do agree that Jesus is the best wise counsel, but for some reason, people have very “shady” ideas of what that looks like. It can be very dangerous if you are someone who is in a position of power, yet you are not licensed to use that power. You can desire to do good and end up doing more harm. That’s why licenses and or proper training are put there as a guide. Sometimes guides like proper boundaries, confidentiality, etc… can be overlooked.

    In short, I really am in favor of people counselors/therapists, etc, being licensed. It gives me peace of mind that I am putting my care in the hands of someone that did the work and went the extra mile to get that license. But that’s just me. Thanks again for the article!!!

  21. Christy

    What are your thoughts about a licensed counselor practicing in a church? I feel like the ethics are a bit blurry…but it is needed!

  22. John Goddard

    Lee..as a child of God practicing under supervision in the secular world, I would say you can’t license wisdom. I have awful things done by licensed pros and incredible service by the unlicensed. Informed consent is the answer I think. People have a right to know what they are getting (and not getting) and then make their own decision who they want to work with.

  23. Wisdom cannot be licensed, but experience can be. And education can be. And ethics can be. Those are important, wouldn’t you agree?
    Christy, what ethics are blurred? Because the licensed counselor has secular training? Most of our studies of human behavior have been done by secular scientists. Christians have to know right from wrong and discern.

  24. Not quite there

    This post is important to me because of my own experiences. I grew up inr a tightly controlled, very conservative religious environment. They had their own brand of “counseling” and it was considered sin to not submit completely to what they taught. Going to a licensed counselor would be grounds for church discipline.
    ALL counseling was solely based on the Bible and every struggle was considered sin. The counseling teaches that anxiety, fear, anger, flashbacks, etc. are all sin and simply need to be confessed to find freedom.
    In this system, this is how a case of sexual abuse would play out. For the offender, the counselor would require that he “repent” of his sin. Once he stated that he repented and asked God for forgiveness, that was the end of the matter.
    For the victim, he or she would be told to confess any bitterness, anger, fear, nightmares, flashbacks, etc. IF the victim continued to struggle after confessing these “sins”, then she is considered living in unrepentant sin. If she tells anyone about the abuse, then she is not truly forgiving, so God will also not forgive her for her own sin.
    I have gone through that type of counseling and was left hopeless and suicidal. Victims of abuse didn’t really stand any chance of healing. We were not free to talk through any of what actually happened. We were not free to grieve. The only option of being accepted again into those religious communities was to completely disconnect from the abuse and block it out. Victims were often required to “confess” their sin to their abusers and resume friendly interaction with the abuser to prove that forgiveness had taken place.
    I was locked in that world for many years doing all I could to block out the past. I lived my adult life pretty much blocking out everything from my childhood, teenage, and early adult years. There was no other option. God would condemn me if I ever spoke of anything from the past.
    A couple of years ago, it all crumbled apart for me. All that I had worked so hard to block out and forgive, came crashing in all at once. At the time, I had no understanding of what was happening. I was “sure” I had forgiven, so why was my brain feeling like it had exploded into fragments? I couldn’t eat, couldn’t sleep. I had nightmares, flashbacks, began dissociating, and struggled through every moment.
    Through a series of events, I finally ended up in counseling with a licensed trauma counselor and have been seeing her for awhile now. For months, I sat in her office with no ability to put anything into words. I was terrified I would be sent to hell if she found out any of the abuse I had experienced. I sat there hoping for her to somehow help “fix” me, but had no words to share anything that had happened. The past “counseling” had successfully silenced me.
    My experience with unlicensed / nouthetic style counseling caused as much harm as the abuse did – from my perspective. The only way I can describe it is it felt like I had a gaping wound that the unlicensed counselor covered up, wrapping it tightly so that no evidence of the wound could be seen, however, under the surface, infection grew until it almost destroyed me completely.
    With that being said, I personally have found support through a licensed counselor and from another who is trained as a counselor, but is not licensed. Both have been an incredibly part of me finding healing. My pastor has also provided support that has been healing.
    My experiences color my perspective strongly. I very much want limitations placed on those whose counsel is so horrific and damaging, yet I also realize that there are those who are very gifted and competent to counsel who are not licensed.
    I don’t know what the answer is. I’m not sure that it can come from government restrictions, but I also see the harm that has been done by “counselors” who think they are qualified, but are not. I suppose that has to be included in freedom of religion. All religions hold specific views that would be contrary to what others would agree with. I value freedom. If freedoms are continually taken away because of those who use it to abuse, it is also taken from those who are full of love and kindness – those who spend their time helping to free those who are hurting.

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