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Pastoral Care: From Past to Present

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  • Independent Researcher

Abstract

According to the U.S. National Conference on Mental Health, " Nationally, an estimated 45 million Americans suffer from illnesses like depression, schizophrenia or post-traumatic stress syndrome. " 1 In a speech at this conference, President Obama stated that one out of five Americans experience mental illness in any year. 2 A study published in 2013 surveyed prescription drug use and found that the second most common prescribed drugs were anti-depressants. 3 Obviously there is a great demand for counseling and psychological care in the United States, and both secular and religious approaches to care are available. The purpose of this article is to review briefly how the church provided care in the past, the development of psychology as a science, and the church's intersection with it in present-day contexts. Exploring approaches to pastoral care and the changes it has undergone throughout the centuries is worth considering when preparing to serve the modern day " body of Christ. " Ultimately, the reader will be challenged to consider whether the Church is meeting the needs of its congregants and the greater community. Psychology as a science is considered to have been birthed from the field of philosophy in the 1870s, but some of the questions addressed by psychology have been contemplated since the earliest times. 4 Philosophers like Plato (427-327 B.C.) considered the ways the mind worked and how knowledge is acquired. Plato's " Allegory of the Cave " dealt with perception, cognition, and intelligence, all topics that could be subsumed under the heading of psychology. Aristotle (384-322 B.C.) wrote about perception and the mind in De Anima. 5 The representational theory of mind that is prevalent in
1
Pastoral Care: From Past to Present
by Ann M. Kerlin, Ph.D.
Journal of Biblical Ministries,
Fall 2014, pp. 25-43
http://www.lru.edu/UserFiles/Documents/JBM/Journal%20Fall%202014.pdf
According to the U.S. National Conference on Mental Health, “Nationally, an estimated 45
million Americans suffer from illnesses like depression, schizophrenia or post-traumatic stress
syndrome.”
1
In a speech at this conference, President Obama stated that one out of five Americans
experience mental illness in any year.
2
A study published in 2013 surveyed prescription drug use and
found that the second most common prescribed drugs were anti-depressants.
3
Obviously there is a
great demand for counseling and psychological care in the United States, and both secular and religious
approaches to care are available. The purpose of this article is to review briefly how the church provided
care in the past, the development of psychology as a science, and the church’s intersection with it in
present-day contexts. Exploring approaches to pastoral care and the changes it has undergone
throughout the centuries is worth considering when preparing to serve the modern day “body of
Christ.” Ultimately, the reader will be challenged to consider whether the Church is meeting the needs
of its congregants and the greater community.
Psychology as a science is considered to have been birthed from the field of philosophy in the
1870s, but some of the questions addressed by psychology have been contemplated since the earliest
times.
4
Philosophers like Plato (427-327 B.C.) considered the ways the mind worked and how knowledge
is acquired. Plato’s “Allegory of the Cave” dealt with perception, cognition, and intelligence, all topics
that could be subsumed under the heading of psychology. Aristotle (384-322 B.C.) wrote about
perception and the mind in De Anima.
5
The representational theory of mind that is prevalent in
1
Matt Compton, “National Conference on Mental Health,The White House Blog, June 3, 2013, accessed
January 7, 2014, http://www.whitehouse.gov/blog/2013/06/03/national-conference-mental-health.
2
Barak Obama, “National Conference on Mental Health(video), The White House Blog, posted June 3,
2013, accessed January 7, 2014, http://www.whitehouse.gov/blog/2013/06/03/national-conference-mental-
health.
3
W. Zhong, et al., Age and Sex Patterns of Drug Prescribing in a Defined American Population, Mayo
Clinic Proceedings 88, no. 7 (2013): 697-707, accessed January 7, 2014,
http://search.proquest.com/docview/1401187128?accountid=12085.
4
Charles Stangor, Introduction to Psychology (Washington, D.C: Flat World Knowledge Publishing, 2013).
5
Christopher Shields, "Aristotle's Psychology," The Stanford Encyclopedia of Philosophy (Spring 2011), ed.
Edward N. Zalta, accessed January 7, 2014, http://plato.stanford.edu/archives/spr2011/entries/aristotle-
psychology/.
2
cognitive psychology can be traced to his writings.
6
And the Bible, while not a treatise on psychology,
does contain information about people and their behavior, and provides its reader with guidance for
living. Sections of the Bible are believed to have been written about 1000 years before Plato began his
contemplations.
A Brief History of Pastoral Care
From the inception of the church as the body of Christ, its members have been called to help
one another. In fact, 80% of the verses found in the New Testament using the phrase “one another”
refer to supporting and affirming people.
7
Indeed, as the New Testament interprets the Old, the second
greatest commandment is to “love your neighbor as yourself,” (Matt 22:39, NIV).
8
The early church
provided for the physical needs of its members along with spiritual care. In addition to Scripture, in
particular the Pauline epistles, there are some extant writings addressing the topic of pastoral care, at
least in general form, dating back to the early centuries of the church.
6
David Pitt, "Mental Representation," The Stanford Encyclopedia of Philosophy (Fall 2013), ed. Edward N.
Zalta, accessed January 7, 2014, http://plato.stanford.edu/archives/fall2013/entries/mental-representation/
7 Ian F. Jones, The Counsel of Heaven on Earth (Nashville, TN: B&H Publishing Group, 2006).
8 Unless otherwise mentioned, all Scripture references in this paper will be taken from the New
International Version.
3
The First Century Through the Middle Ages
Classical Pastoral Care, by Thomas Oden, is a compendium of quotations related to the care of
souls from the early church.
9
Using a revisionist approach from a modern day Rogerian psychological
perspective, he searched for passages related to pastoral care from the early centuries. Oden’s
compilation included passages from Augustine, Irenaeus, Athanasius, Tertullian, Ambrose, Aquinas,
Aelred of Reivaulx, Catherine of Siena, and many others, which he described as embryonic theories of
psychotherapeutic effectiveness.”
10
One notable passage was partially quoted from the Constitutions of
the Holy Apostles. The Constitutions are a 4th century, pseudo-Apostolic writing composed of eight books
that address Christian discipline, worship, and doctrine, and contain the qualifications and
responsibilities of priests, bishops and deacons.
11
A passage from Book II, named, “After What Manner
We Ought To Receive A Penitent; How We Ought To Deal With Offenders, And When They Are To Be Cut
Off From The Church," includes instructions that blend pastoral care with church discipline in quite
dramatic phrasing. The entire passage from Book II, Section V, XLI is included below:
Do thou therefore, as a compassionate physician, heal all that have sinned, making use of
saving methods of cure; not only cutting and searing, or using corrosives, but binding up,
and putting in tents, and using gentle healing medicines, and sprinkling comfortable words.
If it be an hollow wound, or great gash, nourish it with a suitable plaister, that it may be filled up, and
become even with the rest of the whole flesh. If it be foul, cleanse it with corrosive powder, that is,
with the words of reproof. If it have proud flesh, eat it down with a sharp plaisterthe threats of
judgment. If it spreads further, sear it, and cut off the putrid flesh, mortifying him with fastings. But if,
after all that thou hast done, thou perceivest that from the feet to the head there is no room for a
fomentation, or oil, or bandage, but that the malady spreads and prevents all cure, as a gangrene
which corrupts the entire member; then, with a great deal of consideration, and the advice of other
skilful physicians, cut off the putrefied member, that the whole body of the Church be not
corrupted. Be not therefore ready and hasty to cut off, nor do thou easily have recourse to
the saw, with its many teeth; but first use a lancet to lay open the wound, that the inward
cause whence the pain is derived being drawn out, may keep the body free from pain. But
if thou seest any one past repentance, and he is become insensible, then cut off the
incurable from the Church with sorrow and lamentation. For: “Take out from among
yourselves that wicked person.” And: “Ye shall make the children of Israel to fear.” And again:
“Thou shalt not accept the persons of the rich in judgment. And: “Thou shalt not pity a poor man
in his cause: for the judgment is the Lord’s.”
12
9 Thomas C. Oden, Classical Pastoral Care, vol. 3, Pastoral Counsel (Grand Rapids, MI: Baker Books, 1987).
10
Ibid., 7.
11
J. B. Peterson, “Apostolic Constitutions,” The Catholic Encyclopedia (New York: Robert Appleton
Company, 1907), accessed January 6, 2014, http://www.newadvent.org/cathen/01636a.htm.
12
Schaff, Philip, Ed., “Constitutions of the Holy Apostles, Book II, Section V, XLI.” Ante-Nicene Fathers, vol.
7, accessed January 7, 2014, http://www.ccel.org/ccel/schaff/anf07.ix.iii.v.html Portions of this quote are included
in Oden, p. 52.
4
Another notable passage cited by Oden is from Pope Gregory I, also known as Gregory the Great (504-
604), who wrote Pastoral Rule:
Differently to be admonished are the joyful and the sad. That is, before the joyful are to be set
the sad things that follow upon punishment; but before the sad the promised glad things of
the kingdom. Let the joyful learn by the asperity of threatenings what to be afraid of: let the sad
bear what joys of reward they may look forward to. For to the former it is said, Woe unto you that
laugh now! For you shall weep [Luke 6:25]; but the latter hear from the teaching of the
same Master, I will see you again, and your heart shall rejoice, and your joy no man shall take
from you [John 16:22]. But some are not made joyful or sad by circumstances, but are so by
temperament. And to such it should be intimated that certain defects are connected with certain
temperaments; that the joyful have lechery close at hand, and the sad wrath. Hence it
is necessary for everyone to consider not only what he suffers from his peculiar temperament, but also
what worse thing presses on him in connection with it; lest, while he fights not at all against
that which he has, he succumb also to that from which he supposes himself free.
13
These instructions for the clergy informed them how to deal with individuals with different personality
types and to seek the underlying issues for the cause of their problems. Discipleship and spiritual
direction have always been a province of the church. Augustine (354-430) is considered the first
Christian psychologist as he pondered Christianity and considered the philosophical works of Plato.
Augustine wrote voluminously on many topics relevant to the field of psychology. Many issues classified
as mental health symptomology are at heart, spiritual problems. However, there have been people
throughout the centuries who suffered with mental health problems that were not healed through
spiritual direction or pastoral guidance.
The Renaissance and the Reformation
Thomas Aquinas (1225-1274) was a brilliant thinker who explored the works of Aristotle and
was one of the greatest Christian theologians. He wrote on topics like appetites, the will, habits, virtues,
vices, emotions, memory, and intellect; all topics that are considered today to be within the field of
psychology, although without the religious ideation that influenced the work of Aquinas and the
Scholastics. A few hundred years later, the paradigm shifting ideas of Copernicus (1473-1543) occurred
in the same era as the launch of the Protestant Reformation. Martin Luther’s proclamations (1483-
13
Pope Gregory I, Pastoral Rule, Book III, Chapter 3,” Translated by James Barmby, Nicene and Post-
Nicene Fathers, Second Series, vol. 12, ed. Philip Schaff and Henry Wace (Buffalo, NY: Christian Literature
Publishing Co., 1895), revised and edited for New Advent by Kevin Knight, accessed January 6,
2014, http://www.newadvent.org/fathers/36013.htm
5
1546), John Calvin’s influential works (1509-1564), and the Catholic Reformation (1560-1648) were all in
the same time period. The Copernican model conflicted with then-current interpretations of Scripture
and doctrinal teachings, along with scientific models of the day, and were difficult for anyone, not just
religious organizations, to accept. According to memoirs from informal ‘tabletalks’ held by Luther,
Luther was reported to have stated:
There was mention of a certain astrologer who wanted to prove that the earth moves and
not the sky, the sun, and the moon. This would be as if somebody were riding on a cart or
in a ship and imagined that he was standing still while the earth and the trees were moving.
[Luther remarked] "So it goes now. Whoever wants to be clever must agree with nothing that
others esteem. He must do something of his own. This is what that fellow does who wishes to
turn the whole of astronomy upside down. Even in these things that are thrown into disorder I
believe the Holy Scriptures, for Joshua commanded the sun to stand still and not the earth [Jos.
10:12].
14
Copernicus resisted publishing his findings, but they were finally printed while he was on his
deathbed in 1543.
15
Even though Copernicus’ model was mathematically errant, using circular rather
than elliptical orbits, it removed man from the center of the universe, ultimately causing a radical shift
not only in astronomy, but also in philosophy, and religion itself. But it was not until about one hundred
years later that Galileo, who championed a Copernican model with alterations, met with firm religious
resistance and was arrested and charged with heresy.
16
The relevance of this change for this paper is
that it denotes the beginning of a major shift in the relationship between science and religion.
One of the difficulties of finding literature from this period, besides natural deterioration due to
its antiquity, is the scarcity of written artifacts produced, due to the painstaking way manuscripts were
created by hand. Most writings were religious in nature in the period between the fall of Rome and the
12th century, commonly called the Monastic period. The Secular period began after the 12th century,
with the European emergence from feudalism. Manuscript and books began to be created by
universities and demand began to emerge from the general population as the Middle Ages came to a
close. The development of paper, instead of the use of vellum or parchment also made the creation of
books less costly. And the first printed item from Gutenberg’s press arrived on the scene in 1457. The
newly established printing industry made written material more easily accessible to the populace, more
14
Owen Gingerich, The Book Nobody Read: Chasing the Revolutions of Nicholas Copernicus (New York:
Walker Publishing Company, Inc., 2004), 136.
15
Ibid.
16
Copernicus, Nicholas, On the Revolutions of the Heavenly Spheres, ed. Stephen Hawking, On the
Shoulders of Giants Series (Philadelphia, PA: Running Press Book Publishers, 2002).
6
people had access to the Bible, and the general population created more demand for reading material in
general.
17
As a result of these technological advances and religious changes, more written material was
also created focused on pastoral care or pastoral psychology as some have termed it in retrospect.
18
According to Johnson,
In the Reformation traditions this pastoral psychology reached its zenith in the Puritan, Pietist,
and evangelical movements. Writers like Richard Baxter, John Owen, George Herbert, William Law,
John Gerhardt, John Wesley, Jonathan Edwards and John Newton developed sophisticated and
nuanced understandings of psycho-spiritual problemslike sin, melancholy, assurance and spiritual
desertions-and how to promote spiritual healing and development in Christ.
19
The Puritans, a dissenting religious group in the 16th-17th centuries, left voluminous writings on a
variety of common human problems. The Puritans have been the subject of recent interest, and while
not labelling themselves as pastoral counselors, provided biblically based solutions for these kinds of
concerns. Some of the better known authors of this period are John Flavel (1627-1691), Jeremiah
Burroughs (1600-1646), John Owen (1616-1683), John Bunyan (1628-1688), Jonathan Edwards (1703-
1758), William Bridge (1600-1670), and Thomas Brooks (1608-1680). Mark Deckard’s recent book
contains commentary from these authors on a range of topics including addictions, adultery, anxiety,
conflict, grief, rebellion, relationships, and spiritual warfare.
20
Along with changes in the religious structure and the Church’s political influence, new
paradigms in philosophical thinking emerged. The early period of modern philosophy included work by
philosophers such as Descartes, Locke, and Kant. Descartes (1596-1650), is considered the father of
modern philosophy. He rejected the Scholastic approach to philosophy prevalent in his day, which based
science on causation, and knowledge on sensation. He began his musings with systematic doubt, until
he found support for the existence of self with his famous statement, “I think, therefore I am.
Descartes explained the existence of God by basing his epistemology on a dualist worldview where
existence could be substantiated in both material and immaterial modes. His model established science
upon mechanistic and geometric models rather than the Thomistic reliance on causation.
21
17
Lucient Febvre. The Coming of the Book: The Impact of Printing 1450-1800 (London: Verso, 1976), 22-
23.
18
Eric L. Johnson, “A Brief History of Christians in Psychology, In Psychology & Christianity: Five Views
(Downers Grove, IL: IVP Academics, 2010), 9-48.
19
Ibid., 13.
20
Mark Deckard, Helpful Truth in Past Places: The Puritan Practice of Biblical Counseling (Ross-shire, GB:
Christian Focus Publications, Ltd, 2010).
21
Kurt Smith, "Descartes' Life and Works," The Stanford Encyclopedia of Philosophy (Fall 2012), ed.
Edward N. Zalta, accessed January 7, 2014, http://plato.stanford.edu/archives/fall2012/entries/descartes-works/.
7
The Modern Era
Modern philosophy is said to have begun at the Renaissance and continued to be influential
during the 20th century in western thought, although postmodernism is the current philosophical
viewpoint in vogue today. Later modern philosophical thought helped introduce competing worldviews,
with a separation from religion. In particular, evolutionary theory was and is influential; Darwin’s
publication of On the Origins of Species first appeared in 1859. Positivism also was a pivotal position,
based on the work of Auguste Comte (17981857).
22
His writings established social sciences, which
differed from modern day study of sociology, and created the law of the three stages, which was a sort
of progressive history of mankind. This law says:
[…] in its development, humanity passes through three successive stages: the theological, the
metaphysical, and the positive. The first is the necessary starting point for the human mind; the last,
its normal state; the second is but a transitory stage that makes possible the passage from the
first to the last. In the theological stage, the human mind, in its search for the primary and final
causes of phenomena, explains the apparent anomalies in the universe as interventions of
supernatural agents. The second stage is only a simple modification of the first: the questions
remain the same, but in the answers supernatural agents are replaced by abstract entities. In the
positive state, the mind stops looking for causes of phenomena, and limits itself strictly to laws
governing them; likewise, absolute notions are replaced by relative ones.
23
Compte’s model attempted to eliminate God and the supernatural completely. His philosophical work
waned in popularity after the 1950s or so in the United States, but his attempt to place man as the focus
of scientific inquiry and eliminate God had an impact.
24
Soren Kierkegaard (1813-1855) was a very influential Christian philosopher known as the father
of existentialism. Kierkegaard addressed the choices available to the individual and the responsibility of
making those choices. The choices one makes are what lead to the self that will ultimately encounter
God. He believed faith was the most important thing one needs to learn. According to one summary,
Kierkegaard’s writings cross the boundaries of philosophy, theology, psychology, literary criticism,
devotional literature and fiction.”
25
22
Johnson, 20-22.
23
Michael Bourdeau, "Auguste Comte," The Stanford Encyclopedia of Philosophy (Winter 2013), ed.
Edward N. Zalta, accessed January 7, 2014, http://plato.stanford.edu/archives/win2013/entries/comte/.
24
Ibid.
25
William McDonald, "Søren Kierkegaard," The Stanford Encyclopedia of Philosophy (Fall 2012), ed.
Edward N. Zalta, accessed January 7, 2014, http://plato.stanford.edu/archives/fall2012/entries/kierkegaard/.
8
Psychology is Birthed as a Science
In the midst of philosophical, scientific, and religious flux, in 1879, Wilhelm Wundt opened the
first psychological laboratory in Leipzig, Germany, where he began to study and record accounts of
people’s reflections; he was the first to use the term “introspection. This is considered the official
launch of psychology as a science because Wundt employed the scientific method to measure and
record sensations. Wundt’s work became known as the field of structuralism in psychology, where
elements of consciousness were explored. Around the same time, Williams James started a
psychological laboratory at Harvard University; James established the functional school of psychology,
which was heavily influenced by Darwin, and developed into the evolutionary approach to psychology in
vogue today. And then a Viennese psychiatrist named Sigmund Freud developed the psychodynamic
approach, which taught that many of the problems adults experience are based on unconscious
memories, feelings, or inner drives. He became very well-known throughout the world, founded the
International Psychoanalytic Association, and left voluminous writings.
Other movements in the history of psychology include behaviorism, cognitive theory, and socio-
cultural approaches. These models of treating people for mental health care were new and exciting, and
ultimately with the scientific approach to psychology came new medications used to treat patients. The
grand theories of psychology are secular in nature.
In the not too distant past, people with severe mental health problems were considered
frightening or possessed. People with severe problems were institutionalized, and little help was
available for them in the form of treatment. With the advances in psychological care, medication and
treatment brought improvement to the lives of many. Through the process of social science research,
deinstitutionalization policies were developed in the United States, beginning in 1956. It was believed
that mental health patients could be better served by being in the community than being housed in
state psychiatric hospitals. A population of 559,000 in 1956 decreased to 154,000 in 1980, and
subsequent years saw the closing of many institutions and hospitals. Today there is still a need for
community services, and the government actually funds community services more than the institutions.
Psychotherapy has been shown to be effective through ongoing research and randomized controlled
clinical trials; yet many people today opt for medication alone, which will not solve relationship
problems, negative self-talk, or other issues that therapy addresses.
26
In 2003, the President launched
the New Freedom Commission on Mental Health, which hopes to encourage people to reach out for
help, and to support those people living with mental illness, along with their caregivers.
27
26
A. Brownawell and K. Kelly, “Psychotherapy is Effective and Here’s Why,” Monitor on Psychology 42, no.
9 (October 2011): 14.
27
Kaiser Commission on Medicaid and the Uninsured. “Learning from History: Deinstitutionalization of
People with Mental Illness as a Precursor to Long Term Reform.” Prepared by Chris Koyanagi, (Washington, D.C.:
9
Christianity and Psychology
The popularity of secular psychologists of various specialties who treated mental health issues
came into its own during the early 1900s. Its influence grew, and those antagonistic to the new science
believed the church was losing ground. Some issues addressed by mental health practitioners are
spiritual in nature, such as the consequences of unforgiveness, guilt, and many relationship problems.
Some Christians resisted psychology, claiming that those who accommodated psychology weakened
their stance on faith. In the early part of the 1900s, conservative (then called fundamentalist) Christians
tended to stay away from psychology and remained focused on doctrine, moral issues, and evangelism
rather than “inner matters of the soul and its well-being.”
28
But not everyone who was interested in
psychology was atheistic or agnostic, even though the grand theories of psychology avoided religion.
Some Christian contributors to early psychology include Franz Brentano, James McCosh, G. T. Ladd, and
G. Stanley Hall.
One of the early founders of pastoral care was Anton Boisen (1876-1965). His autobiography,
entitled Out of the Depths, describes his lifelong battle with mental illness which ultimately led to the
birth of his pastoral care model for the mentally ill.
29
He was committed to mental health institutions
several times. While still a patient, Boisen became interested in developing activities for the men in the
hospital and also recorded their activities. Upon his release from Westboro State Hospital, after a 15
month stay, he entered Harvard to study theology and psychiatry. He became very interested in the fact
that religious ideation was often apparent in mental illness, as had been the case with his own. Boisen
became a chaplain at Worcester State Hospital for the mentally ill. Before this time, most mental
hospitals only held religious services led by local pastors one day a week. Boison wrote that he believed
there was only one other full time chaplain in the country at a mental health institution at that time.
30
His experiences at Worcester eventually led to a connection with Chicago Theological Seminary and
Elgin State Hospital where he began what would become the first program of Clinical Pastoral Training.
Boisen’s contributions to the field of pastoral care also include many books and articles.
Kaiser Family Foundation, 2007), accessed January 8, 2014,
http://www.nami.org/Template.cfm?Section=About_the_Issue&Template=/ContentManagement/ContentDisplay.
cfm&ContentID=137545
28
Johnson, 29.
29
Anton Boisen, Out of the Depths (New York: Harper & Brothers Publishers, 1960).
30
Ibid., 150.
10
In 1954 the Christian Association for Psychology Studies (CAPS) was founded. Clyde Narramore
began a radio show about psychology and faith. Paul Tournier, both a physician and psychotherapist,
became popular with the publication of On the Meaning of Persons (1957). Other well-known early
contributors to psychology from a faith perspective include Smiley Blanton, Norman Vincent Peale, M.
Scott Peck, and Karl Menninger. Fuller Theological Seminary began a doctoral program in clinical
psychology, and others followed. Seminary training included both ministry and psychological education.
In 1976, the APA launched Division 36 for psychologists interested in religious research. Jay Adams
published Competent to Counsel in 1970 and Larry Crabb published Effective Biblical Counseling in 1975.
In 1988, the first international convention on Christian counseling was held.
31
But in the early 1970s, there was a backlash of concern about the dangers of integrating
psychology with Christianity, beginning with the work of Jay Adams. Generally, more conservative
Christians tended to avoid integrating, while more liberal views embraced psychology in practice. To
bring this brief historical perspective on psychology, Christianity, and pastoral care to a close, the
emphasis will be on the ways that Christianity intersects with the needs of people with distressing
mental health symptomology. There are licensed Christian psychiatrists, psychologists, and counselors
along with chaplains, social workers, and others who work in a variety of settings. Universities with
theological schools train their students according to their stance on integrating secular psychology with
biblically-based pastoral care.
Today, a generic form of spiritual integration in secular psychology is mainstream; in fact, the
American Psychological Association published a book entitled, Spiritually Oriented Interventions for
Counseling and Psychotherapy in 2011.
32
There are, of course, licensed Christian mental health
practitioners who counsel from a secular viewpoint, and those who integrate Christianity into practice in
a variety of ways.
There are five general views on the topic of integrating psychology and Christianity, according to
Johnson; these five current competing views are briefly summarized below.
33
A Biblical Counseling View
Jay Adams wrote Competent to Counsel in 1970, criticizing psychology and psychiatry for their
humanistic and deterministic views of man, and called on Christians to avoid a Freudian approach and
31
Daryl. H. Stevenson, Brian E. Eck, and Peter C. Hill, eds., Psychology & Christianity Integration: Seminal
Works that Shaped the Movement (Batavia, IL: Christian Association for Psychological Studies, 2007), 255-259.
32
Jamie D. Aten, Mark McMinn, and Everett L. Worthington, Jr., Spiritually Oriented Interventions for
Counseling and Psychotherapy (Washington, D.C.: American Psychological Association, 2011).
33
Eric L. Johnson, ed. Psychology & Christianity: Five Views (Downers Grove, IL: IVP Academics, 2010).
11
embrace the Bible alone, using a nouthetic approach. Noutheteo appears eight times in the New
Testament. It is a verb that is translated as admonish or admonishing (Acts 20:31, Rom 15:14, 1 Cor 4:14,
Col 1:28, Col 3:16, 1 Thes 5:14, and 2 Thes 3:15) and instruction (1 Thes 5:12).
34
In this counseling model
based on the Bible alone, the focus is on repenting from sin, looking for God’s solution, and viewing
pastors as the church’s primary counselors. The model of care offered is one of discipleship, where
spiritual growth eliminates troubling symptoms by addressing underlying behaviors, negative thinking,
and keeping the focus on God. Practitioners of nouthetic counseling do recognize that some problems
are biological in nature and will refer people to appropriate mental health care providers when
necessary.
35
Levels-of-Explanation View
Christians embracing this model understand psychology and theology to be on different playing
fields. For example, we might study chemistry, anatomy, psychology, sociology, or French from different
viewpoints with different assumptions. Long ago, theology was considered the queen of the sciences,
because religious thought permeated all aspects of life; but now it is simply another discipline. People
who embrace this levels-of-explanation view believe each discipline should be studied in different ways
appropriate for it. Trying to combine things like sin and psychopathology is wrong in this view, because
they are concepts from different perspectives. A person who holds a levels-of-explanation view may be
delighted to see that Christian practices can be shown “scientifically” through research to have a
positive impact on life. But they would also be interested in learning that sometimes psychological
research may call for a reexamination of the interpretations of particular biblical passages.
36
Integration View
In this view, Christians embrace the value of psychological inquiry and feel that this information
should be integrated with the practice of a distinctly Christian counseling or psychological approach.
People who hold this view are generally trained in both fields. It is a view that seeks to integrate special
revelation (God’s Word) with natural revelation (scientific findings). Gary Collins was influential in this
34
Joseph Thayer, Thayer's Greek-English Lexicon of the New Testament: Coded With the Numbering
System from Strong's Exhaustive Concordance, (Peabody, MA: Hendrickson Publishers, 1996), 3560.
35
David Powlison, “A Biblical Counseling View,” In Psychology & Christianity: Five Views, ed. Eric L.
Johnson (Downers Grove, IL: IVP Academics, 2010), 245-273.
36
David G. Myers, A Levels-of-Explanation View,” In Psychology & Christianity: Five Views, ed. Eric L.
Johnson (Downers Grove, IL: IVP Academics, 2010), 49-78.
12
movement to develop a biblically based psychology. Larry Crabb’s early works were from an
integrationist perspective. There are varying viewpoints and models within this view.
37
Christian Psychology View
Christian philosophers have explored topics and developed a line of specifically Christian
approaches to understanding particular topics; some psychologists have also taken this approach.
Philosophers such as Nancy Murphy, Andrew Purvest, Ellen Charry, and Ray Anderson have examined
traditional, historical models of soul care and advanced a specifically Christian approach to care. People
holding this view believe there is no solution without considering spiritual, metaphysical, and specifically
Christian approaches. An example of this approach is reading the Sermon on the Mount and viewing it
through a psychological lens. In a way, it is an attempt by some learned psychologists, theologians, and
Christian philosophers to reclaim the study of people, which they claim has always been in the province
of the church. Larry Crabb moved away from his early integrationist approach to more of a Christian
psychology view in his current work.
38
Transformational Psychology View
Some former integrationists have moved from an intellectual viewpoint of attempting to
understand human beings from both a psychological and theological approach and focused instead on
“personal, ethical, experiential, and spiritual matters.”
39
The focus in this model is to embrace the
changes that occur as a result of healing through Spirit-guided therapists and practitioners. This model is
integrationist but is based more on how people live out their faith rather than developing a hybrid
model. Practitioners seek to avoid the divide between science and faith as if the two were antithetical.
Coe and Hall describe this model with a touch of the mystical: “Thus a transformational model affirms
that doing science is a single, unifying act that mingles both the act of faith and the act of observation-
reflection on creation into one, by loving God in the object of science the object of science in God.”
40
37
Stanton L. Jones, “An Integration View,In Psychology & Christianity: Five Views, ed. Eric L. Johnson
(Downers Grove, IL: IVP Academics, 2010), 101-128.
38
John H. Coe and Todd W. Hall, “A Transformational Psychology View.” In Psychology & Christianity: Five
Views, ed. Eric L. Johnson (Downers Grove, IL: IVP Academics, 2010), 199-226.
39
Johnson, “A Brief History of Christians in Psychology,” 37.
40
Coe and Hall, 207.
13
Current Christian Lay Counseling Models
This article was meant to give the reader a broad, historical picture of the current counseling
movement from a Christian perspective. Lay counseling has not been addressed thus far, but peer
counseling and counsel from friends and family have always been sought when facing the issues of life.
Alcoholics Anonymous (A.A.) developed as a way to help people who were addicted find healing in
support groups led by peers rather than through professional counseling resources, and The Big Book,
which is the basic handbook for A.A., was first published in 1936. Often, churches host such groups,
and many people have had a spiritual awakening due to participation in them. In fact, a spiritual
awakening was believed to be the reason many found healing although each person was free to have
their own unique experiences.
41
Similar groups launched, including Narcotics Anonymous, which claims
to have 61,000 groups meeting weekly in 129 countries.
42
Al-Anon is for family members of addicts, and
includes a specialized group called Al-Ateen for adolescents, and these groups meet in over 130
countries worldwide.
43
Another version of the 12-step model includes Overeaters Anonymous, boasting
6500 meetings worldwide. This group serves those with anorexia, bulimia, binge-eating, and other food-
related issues.
44
Celebrate Recovery combines large and small group approaches to care with lay leadership in
the groups, and although it follows the A.A. 12-step model, it incorporates Scripture and is firmly
Christian in its approach. It was developed by John Baker at Saddleback Church in 1991 and is currently
in use by 20,000 churches internationally according to their website.
45
Church Initiative, founded by
Steven and Cheryl Grissom in 1993, is responsible for other church-based support groups such as
DivorceCare, GriefShare, and DivorceCare for Kids, and their website claims to have programs in 19,000
churches worldwide.
46
41
Alcoholics Anonymous, “Spiritual Awakening,.” The Big Book Online, 4th ed. (New York: Alcoholics
Anonymous World Services, 2001).
42
Narcotics Anonymous, “Public Information,” Narcotics Anonymous World Services, accessed January 8,
2014, http://www.na.org/?ID=PR-index.
43
Al-Anon Family Groups, “Alanon Family Groups Media Center,” Al-anon Family Groups: Strength and
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anon.alateen.org/media-files.
44
Tina Carroll, “Memorial Planned to commemorate Passing of Overeaters Anonymous Founder,”
Overeaters Anonymous, February 19, 2014, accessed February 26, 2014,
http://www.oa.org/mediaprofessionals/press-releases/.
45
John Baker, “Pastor John’s Testimony,” Celebrate Recovery: A Christ-Centered Recovery Program,
accessed January 8, 2014, http://www.celebraterecovery.com/index.php/site-map/pastor-john-s-testimony.
14
In addition, following a model published by Dr. Siang-Yang Tan and other writers after him,
many churches have provided training for a network of lay counselors who provide one-on-one support
for church members in addition to what the pastoral staff is able to offer.
47
Besides church and
community resources dedicated to pastoral care and recovery, there are also faith-based residential
treatment centers established throughout the United States. Stephen Ministries is another church based
approach to providing care, which was founded in 1975 by Rev. Kenneth Haugk, who is a clinical
psychologist. This model provides training to lay counselors who then provide one on one care for
church and community members. This model is in use by 11,750 congregations and organizations
around the world today.
48
Training in pastoral care for ministers is an option. Those whose vocation involves pastoring
have duties such as preaching, teaching, and administration in addition to offering pastoral counseling.
For those who choose to emphasize this aspect of their education, many seminaries offer clinical
pastoral training. Chaplaincy training and qualifications also emphasize the care-giving aspect of
ministry.
Summary
Although psychology has taken an important role in the healing of wounded people, there is still
a great need for mental health care in the United States, and a reduction of the stigmatism associated
with reaching out for help.
49
The church and the greater community of faith can play a role in meeting
the needs of people with mental illness and those who struggle with the common issues of life, as well
as supporting the caregivers and family members of those people by expanding pastoral care and lay
counseling efforts. Is the church caring for people the way the early church in the New Testament
modeled it? Our understanding of people, and biologically-based mental health disorders, has changed
throughout the centuries, but people themselves are basically the same. According to the American
Association of Pastoral Counselors’ website, today about 3 million hours of pastoral care are provided
annually in church and community settings.
50
According to the U.S. Census Bureau, there are 318 million
46
GriefShare, “History,GriefShare: Your Journey from Mourning to Joy, accessed January 8, 2014,
http://www.griefshare.org/startagroup/staff/about/history.
47
Siang-Yang Tan, Lay Counseling: Equipping Christians for a Helping Ministry (Grand Rapids, MI:
Zondervan, Publishing House, 1991).
48
Stephen Ministries, “Stephen Ministry Statistics,Stephen Ministries, October 1, 2013, accessed
January 9, 2014, http://www.stephenministries.org/PDFs/SSstats.pdf.
49
Obama, “National Conference on Mental Health.”
50
American Association of Pastoral Counselors, Brief History on Pastoral Counseling.” American
Association of Pastoral Counselors, 2009-2012, accessed January 7, 2014, http://www.aapc.org/about-us/brief-
history-on-pastoral-counseling/.
15
people in this country in 2014.
51
If one out of five people struggle with mental illness at some point in
their lives, the church has a great opportunity and calling to serve the needs of its congregants and the
greater community by offering lay counseling or professional pastoral care.
51
United States Census Bureau. U.S. and World Population Clock,” U. S. Department of Commerce:
United States Census Bureau, January 9, 2014, accessed January 9, 2014. http://www.census.gov/popclock/
16
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Alanon Family Groups Media Center Al-anon Family Groups: Strength and Hope for Friends and Families of Problem Drinkers
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