Two Ethical Issues for My Consideration

Introduction

There are two issues within the scope of ethical practice that readily come to my mind as subjects that I desire to consider more and to flesh out how I feel about them. The first is the subject of Christian counseling. As a pastor who is in a counseling program, this is a subject that I want to work out. I feel that much of what is done in the Christian counseling is terrible and should not be allowed to continue. I have some thoughts that I have worked through and past during this class on this issue. The second issue is that of online counseling. I want to talk/think for just a few minutes about this subject. In this technological era there will be more of this happening. I like the ‘e-model’ of hands off communication with people. Let’s dig in and see what we can uncover in my head as we look at the two ethical issues that come to the forefront of my mind of issues that I want to think more on.

 

Christian Counseling

In order to begin my exploration of the topic of Christian counseling I began by looking at two articles from Christian Counseling Today, which is the monthly magazine of the American Association of Christian Counselors. Since these articles and my exploration of them had such an impact on my study, I would like to include my thoughts from those articles here. The first article that I reviewed and gathered my thoughts on was an article that dealt with the treatment of panic attacks. The reason for this interest in Christian counseling is because I have some issues with what is often called ‘Christian counseling.’ I feel like they often will spend much time on the spiritual and little to no time on the mental health aspects of what is going on. I just met a person the other week that told me they used to run a meth clinic to assist addicts to come clean from meth.  They stated their main method of treatment was to pray the meth out of them.  While I will never discount the power of prayer, I was somewhat bothered by this statement and the assessment that for something like meth addiction, the solution is praying the problem away.  I know that Jesus Christ is able to heal in that way, but what happens when he doesn’t.

When I came to read this article, the journal itself, I brought this baggage.  In fact I had this journal for almost two years before I even cracked it open to read it.  When I finally did read it, I found the article (and the journal) to be very refreshing in the fact it was very clinical in nature and offered many suggestions that were not just praying the problem away.

I noted the article realized and admitted that panic attacks affect the entire body and not just the mind.  Since the article acknowledged that panic attacks do affect the entire physiological body, they admit there needs to be some sort of solution other than just prayer.

I also really liked that the article suggested using brief strategic therapy modalities in order to treat the panic attacks.  I really like strategic therapy and feel like this is very appropriate for use with panic attacks.  Using these techniques alongside other techniques can be very effective in the treatment of panic attacks.  Also noted in the article was the need to utilize a healthy lifestyle to treat all mental health disorders, not just panic attacks.

This article and perusing of the journal as a whole began to give me excitement that Christian counseling can in fact be legitimate counseling.  What I hope for is more Christian counselors to realize and accept the mental health aspect of the mental health disorders they treat.  I am beginning to change my mind with regard to Christian counseling.  This was my hope as I began to look at this ethical issue.

The second article that I looked at in order to assist me in feeling out my thoughts and feelings on Christian counseling came from the same journal and was an article about attempting to resolve treatment resistant depression. This article had the potential to go in very good places or in very bad ones for the Christian counseling community.  It started by painting a creative picture of the history of therapy attempting to treat depression from all the major schools of thought, from Freud to Rosenzwig and medical treatments.

It is easy to see how this article could have some bad notions for the Christian counseling community.  I was particularly interested in seeing how the author handled the forefathers of counseling and whether he would discredit them or give them some credence. I was happy to note that the author gave a fair description and was true to the nature of what each theory thought and tried to teach. It was very refreshing to see the author treat the greats of counseling as though they were on to something and not infidels who needed to lead their clients to pray more. I half expected the theories of Freud, Jung, Adler and the like to be discrediting in the name of science and reason needing to give way to faith.

The author then went on to then discuss some of the newer theories available to combat depression.  This is another spot where the article could have gone south in a hurry.  Anytime you begin to talk about electro-shock and anything like that people tend to freak out. The author gave credit to two different varieties, Vagus Nerve Stimulation (VNS) and Transcranial Magnetic Stimulation (TMS), briefly describing how and what they do. Almost more surprising than that was the reference to genomic medicine as an innovative therapy to be used in the treatment of depression.

As you may have guessed lastly, the author suggested the use of Jesus Christ as a healing agent in depression.  He suggested it in conjunction with the other treatments though. He closes the article with the line, “Beautifully, through all these combined techniques of the past and present and placing one’s future in Christ, many clients are finding help and hope for dealing with resistant depression.” There is no better way to close the article.

It is easy to see that I have a strong bias against so-called Christian counseling.  I think it stems partly from the bias I have towards the Church/religion as a whole and the atrocities that have been done in the name of God. I also think it stems from Christian’s uninformed and well-meaning yet demeaning and trivializing reactions to some of my own baggage. Christians tend to think that if a person is struggling they must have done something to piss God off. If God is pissed at you, all you have to do is get right with him, pray and God will heal any ailment.  Maybe, but maybe not. Maybe you will suffer this your whole life.  Healing from emotional and mental anguish and pain comes through many avenues and is not exclusive to praying alone. There is validity in the work of the fathers of counseling. I was pleasantly pleased to see their work given the credit that is due them by a Christian counselor.

These articles did very much in building the credibility of Christian counseling for me as I researched and thought more about the process of counseling in the context of a faith system. I believe that it is possible to offer the client faith-based and Christian-based modalities that are equally therapeutic and legitimate in the counseling process. What the Christian counselor has to be aware of and remember is that mental health is legitimately organic in nature. There are chemical imbalances in the brain that causes those suffering from mental health disorders to have more difficulty coping and they need more than to be told to just pray it out.

There does seem to be a new wave in the field of Christian counseling where the pastors are actually being trained as counselors and therefore understand the underlying issues that accompany therapy. If this trend continues and counselors are able to integrate the faith of the client into the therapy process while still understanding and remembering the organic and medical nature of mental health illness then the future for Christian counseling has a very positive outlook. I started this course having a very negative outlook on Christian counseling and through the course of my study and further contemplation of the subject, have to come to appreciate it and value it to a great degree. I have come far enough, that I would not shy away from using the term ‘Christian counselor’ to describe myself. Not only do I see the value of proper Christian counseling, but I think to some degree I find that it could be the most appropriate type of counseling… for me at least. I recognize there are many different people who will use many different methods, but being able to call into attention the client’s faith seems to bring a power to the therapy that can’t be found elsewhere.

Online or e-counseling

The second issue that is of interest to me is that of counseling or therapy in the non-traditional sense of sitting in therapy with the client. This could include anything from text, Facebook, email, Skype, online chatting, group chat rooms or any other method utilizing technology and using it for therapy.

I must start with a sort of disclaimer that I haven’t done any ‘research’ on the subject of e-counseling, but it is something that interests me. What follows is just a few rambling thoughts as I think over what comes to mind as the strengths and needs of e-counseling. Let’s look at the strengths first.

The first strength that comes to mind is the increased availability of the counseling process. Counseling via the internet or other technologies would allow for a wider range of potential clients who may or may not be able to receive services elsewhere. With many people becoming increasingly tech savvy, this would seem to be the wave of the future, just another way for the client to easily get the services they need.

Similarly, it would be possible to get clients who don’t wish to attend traditional counseling due to the perceived stigma attached to being in counseling. Many of us already chat, email or communicate across vast geographical spaces that talking to someone about your problems would almost seem natural in this setting. Many people already use blogs and other online forums as a way to vent and air their frustrations, why not add an another therapeutic aspect to it by allowing there to be a counselor to respond back and help point the client in a proper direction. Being able to access services in a forum or setting that the client already frequents seems to make a lot of sense.

Another potential strength would be the possibility of reaching clients who are willing to try something out of the box. This could potentially set you, as the counselor, up in a way so that you could use some of the more counseling techniques that are less often used like brief strategic therapy. There are some aspects of brief strategic therapy, like paradox, where the client is asked to do something that seems counter-therapeutic. Given the already unique setting with which the client and counselor find themselves, being able to rely on methods like these could lend themselves easily to e-counseling.

If a client were to utilize e-counseling it could be possible for the counselor to keep a better handle on how the client is doing daily. With access to the client’s Twitter, Facebook and blog the counselor would be able to get a more holistic idea of how the client is doing actually in between the therapy sessions. This has great potential as a strength because the counselor can then use the information gleaned by perusing the online profile of the client to tailor the therapy to discuss and cover the issues most needed by the client. The better the counselor can match the therapy to actual needs of the client, the greater the likelihood the therapy will hold and be successful.

There are many potential strengths to e-counseling.  However, there are potential needs, downfalls or weaknesses of utilizing that form of counseling. It seems only fair to consider possible needs to this approach.

The first one that comes to mind is that it leaves no face to face interaction with the client. There is much therapeutic gain to be had from the face to face contact the therapist has with the client. Unless, you using methods that allow you to video chat or Skype you will not be able to read the facial cues of the client. Even when using these methods, there is still something ‘lost in the translation’ when comparing it to seeing the client face to face. Not just the facial cues and reads of the client but also the body language will be difficult, if not impossible to read. So much of what the counselor does in therapy relies on their ability to read the client and gauge the effectiveness and the need to explore further while sitting across from the client. If you remove this face to face then it becomes harder to use these cues and skills in the course of therapy. It is very easy to see how this method of counseling has many needs to it.

The next need that comes to mind is that this method for counseling isn’t going to be for everyone. This method seems to be a great fit for those that are tech savvy and willing to try something that is way out of the box and very different from the traditional approach to counseling. There are still many people today who don’t rely on or use technology enough that it would make sense for them to attempt to use this method. If a person is not familiar or comfortable with technology, then they will not only get nothing out of this method they could be pushed further into their mental health concerns by not seeking a counselor or by failing to realize there are other methods of counseling. Aside, from those not tech savvy not everyone will be willing to give up the traditional methods of counseling. For those clients that are more traditional in the sense that they would prefer to sit in a room with a counselor, this method will not work at all.

Another big concern is for the legitimacy of those conducting the therapy. The information in the website bio has no way of being verified that they are for the person who is providing the therapy. It would be very easy to claim to be something that you are not in an online setting.  This is done is almost every aspect of usage the internet gets. It would be very hard to ensure the counselor and not only their methods but their skill level follows the legal requirement. With the internet came an ability to remain anonymous in many ways, and having your therapist to remain anonymous to the point of not being able to verify who they are is not something that you want. This may on the surface seem like a concern that doesn’t hold much water, but it boils down to the competency of the counselor offering the services. This is dangerous not just for the client but for the profession as a whole. As an example, Florida has many strict laws regulating the mental health profession due to shady dealings by the so-called professionals in the field who abused not only the system but their own clients.

There can be many good and useful strengths to the idea of online or e-counseling, but the other side of that coin is that there are just as many or more needs or negatives that can come from trying to implement this method of counseling. For me, I think there is a lot that can be gained from this however would only see myself offering it to a select number of clients that seem to be really a good fit for it. This is unique for me because I thought that I would want to offer this to everyone and make use of it heavily. I still think that I could utilize it well, however I don’t think that it would work for everyone or even in every situation. The bottom line here is that it will have to be taken on a case by case scenario.

Wrap Up Thoughts

This trip of self-discovery has been interesting for me. I have found myself questioning and re-deciding decisions and positions that I once thought I held strongly. The first example is that of Christian counseling. When I started this class and began this exploration I was ready to throw it out and never turn to it ever again. After more thought and reading of a few articles, a magazine’s worth, I find that I am not only open to it but very interested in utilizing it in my counseling practice in the future. I found that biases were held because of a few bad experiences and I was not allowing there to be a chance that things had changed for the profession as a whole. I believe myself to be wrong in this. There is much good that comes under the guise and name of Christian counseling and to discredit it is doing counseling as a whole a disservice. Additionally, online or e-counseling is a service that ought to be reserved for a select demographic within a counselor’s clients. This is not a service that everyone will be able to utilize or would even be interested in utilizing. As with any ethical issue or counseling method, the counselor must evaluate their own bias, skill level and implement only what they are skilled and competent enough to appropriately use.

 

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