Tag Archives: Spirituality and Religious Values

Spirituality and Religious Values

Counseling in the land of religious liberty

By Cebrail Karayigit and Jason Kushner August 7, 2019

The MerriamWebster online dictionary defines minority as “a part of a population differing from others in some characteristics and often subjected to differential treatment.” The United States is perhaps the most religiously pluralistic country in the world and one of the few to integrate religious freedom into its Constitution. Christianity is far and away the largest religion in the United States, however, and is in some ways the baseline faith that guides — simply as a matter of familiarity — how many counselors approach working with religious traditions that are different from their own.

According to the 2014 Pew Research Center Religious Landscape Study, Christians represent 70.6% of the U.S. population. Meanwhile, religious minorities in the U.S., such as Jews (1.9% of the population), Muslims (0.9%), Hindus (0.7%) and Buddhists (0.7%), are frequently viewed through the context of media and other popular portrayals. These portrayals often perpetuate stereotyped perceptions and promote the notion that religious minorities and Western traditions are in conflict with one another. Counselors, like all humans, have biases that inform our perceptions of self relative to some “other.” Given misunderstandings about religious minorities in the United States, this topic is particularly relevant for counselors because we are part of an inclusive profession that is oriented toward social justice.

Rethinking multiculturalism

In an era in which many people get to know about “others” via social media, an unfortunate side effect is that stereotypes can be easily formed or solidified because we usually see what we want to see. Therefore, counselors have an ethical obligation to cautiously evaluate their sources of information relative to news coverage and social media mentions about religious minority groups in the U.S. As is the case when working with people who are different from us in other characteristics such as gender, race, ethnicity, sexual orientation and degree of ability, there is no substitute for direct contact with religious minority groups to promote counselor competency. According to a report released by Pew in 2017, knowing someone from a particular religious group was associated with warmer feelings for that group. So, direct interaction with people of a faith tradition different from our own (or the absence of a faith tradition altogether) is key to reducing or eliminating our biases — conscious or otherwise — toward religious minorities.

Within and outside the counseling profession, the terms multiculturalism and cultural diversity tend to focus on racial and ethnic minority groups, a practice promoted at least in part because of the categories used by the U.S. Census Bureau and data collected on applicants by American employers. Religious minorities are not so highly visible and are not generally regarded as “important” by mainstream American society because of this relatively hidden status. As counselors, we are in a unique position to interact with people from diverse backgrounds, and in this way, we have a meaningful role to play in ensuring that minority groups’ values are incorporated into American society. Standard A.1.d. of the 2014 ACA Code of Ethics states, “Counselors recognize that support networks hold various meanings in the lives of clients and consider enlisting the support, understanding, and involvement of others (e.g., religious/spiritual/community leaders, family members, friends) as positive resources, when appropriate, with client consent.”

Misconceptions about religious minorities in Western societies are not new, but there remains an opportunity for counselors to lead the discussion and practice of widening the tent to welcome those of minority faiths. To do this, we must be uniquely competent as a collective profession at addressing the needs of this relatively small but growing population.

The relative absence of competence and knowledge about a plurality of traditions, beliefs and spiritual practices is perhaps one reason that counselors may not actively seek opportunities to engage with religious minorities. Within the counseling literature, few studies address the unique experiences of religious minorities. Therefore, engaging more research on this topic is an important step in increasing the visibility of religious minorities within the counseling profession. That larger research base would then inform practice as it does in the cases of other kinds of minority populations with whom counselors practice.

Do’s and don’ts

Perhaps the most important step is to examine our own attitudes and behaviors as counselors toward religious minorities. To that end, in their seminal cultural diversity book Counseling the Culturally Diverse: Theory and Practice, Derald Wing Sue and David Sue focused on the importance of examining our own attitudes by asking the following questions: Have you been influenced by the negative stereotypes regarding individuals of these groups? What would your reaction be if a client came in wearing traditional clothing?

One of the most common mistakes made by counselors is failing to recognize clients’ social and cultural identities and focusing only on visible manifestations of those identities, such as wearing a kippah or hijab. For example, when white American clients come to counseling, we do not typically refer to them as “Catholic clients” or “Protestant clients” and thereby put them in a categorical box. On the other hand, when a client wearing an orange robe comes to counseling, we are more likely inclined to refer to that person as a “Buddhist client.” Such labeling should not be considered the best practice of our profession.

It is necessary to challenge our stereotypical notions of the phenotypical appearance of minority groups to overcome the prejudiced messages that may be sent. Counselors must also be cautious in assuming that clients’ religious identity is the same as their social and cultural identity. Understanding clients’ behavior as a social-cultural concept, especially in today’s American society, is necessary to avoid a fixed and prejudicial view of their identity.

Religious minorities have typically been exposed to a history of oppression, so trust and empathy may be particularly important to them in a counseling relationship. Building rapport and developing a relationship with these clients is crucial to developing effective communication. Counselors should also understand that some religious minorities may be reluctant to seek counseling for a variety of reasons. Therefore, when working with these clients, counselors are encouraged to be active in and affirming of their help-seeking behavior and to assist them in processing resistance if any exists without forcing any particular religious or faith perspective.

In most cases and with most faiths, the individual expression of that faith is a uniquely personal experience. To that end, counselors should explore what it means to their clients without making assumptions based on the counselor’s own perceptions of various faith traditions. It is also important to note that people usually overestimate their openness to minority groups. As suggested in a 2014 study by David Amodio, individuals are typically unaware of their implicit biases. These biases can be particularly difficult to change in an era of news and social media that often reinforces prejudicial or stereotyped thinking rather than calling it into question.

Counselors are also encouraged to examine their use of theories in their practices because many widely used theoretical orientations (e.g., cognitive behavioral, person-centered) are rooted in Western value traditions that may ignore the unique needs of some minority groups. Some approaches focus on inward problems and view the individual as “problematic” outside of the context in which the individual lives. For example, some religious minorities experience a significant amount of tension and stress because of societal pressure and reminders of their differences. For this reason, a theoretical orientation that emphasizes knowledge of the effects of societal pressure and that has a social justice perspective ensures greater likelihood of a therapeutic alliance that will lead to more satisfying outcomes for the client and counselor alike.

As Derald Wing Sue suggested in Counseling the Culturally Diverse, to be multiculturally competent, counselors must also be knowledgeable about discrimination policies. If counselors learn about anti-discrimination policies, they will be able to raise clients’ awareness of their legal rights so that they can challenge discrimination and take appropriate actions when faced with discrimination. To be most effective, counselors need to educate themselves about laws, practices, policies, history and situations in a global context. No one expects counselors to be living encyclopedias, but to be competent healers, we have to be comfortable enough to ask religious minority clients about their faith traditions. In doing this, the counseling profession will expand its reach, make a difference and continue to uphold the value of diversity for which it is known.

Religious competencies

Religious competencies are important for all counselors to have, in particular when working with clients with religious and spiritual issues. Consistent with the 2014 ACA Code of Ethics, the Association for Spiritual, Ethical and Religious Values in Counseling (ASERVIC) provides a set of competencies for integrating knowledge of spiritual and religious issues into counseling practice. The purpose of the ASERVIC competencies is to “recognize diversity and embrace a cross-cultural approach in support of the worth, dignity, potential and uniqueness of people within their social and cultural contexts.”

The following competencies shed light on how to improve our ability to serve members of religious minority groups:

  • The professional counselor recognizes that the client’s beliefs (or absence of beliefs) about spirituality and/or religion are central to his or her worldview and can influence psychosocial functioning. Counselors cannot effectively assess their clients’ problems and formulate strategies without first understanding their clients’ worldviews.
  • The professional counselor actively explores his or her own attitudes, beliefs and values about spirituality and/or religion. It is important for counselors to seek self-knowledge through an active practice of self-awareness and self-reflection. For example, counselors can examine their attitudes about religion by asking themselves the following questions: When did I last push the boundaries of my comfort zone to learn about religious topics that are different from my own perspectives?
  • The professional counselor continuously evaluates the influence of his or her own spiritual and/or religious beliefs and values on the client and the counseling process. It is necessary and essential to assess any possibilities of countertransference to prevent the development of a negative relationship with clients. For example, counselors who are very involved with religious organizations should not impose such practices on their clients. Many members of religious minorities have a paradoxical relationship to religion. Although they may have firm religious convictions, attending religious services can be a less frequent activity for them.
  • The professional counselor can identify the limits of his or her understanding of the client’s spiritual and/or religious perspective and is acquainted with religious and spiritual resources and leaders who can be avenues for consultation and to whom the counselor can refer. The fear of not knowing should not keep us from learning from our clients. Our clients are our best teachers. Although we strive to understand clients’ religious perspectives, it is important to allow our clients to educate us about their religious beliefs.
  • The professional counselor responds to client communications about spirituality and/or religion with acceptance and sensitivity. Counseling is a profession based on understanding, which goes well beyond simply showing tolerance for those who are different from us. Seeking understanding and respecting our clients’ religion is key to accepting clients for who they are.
  • The professional counselor can therapeutically apply theory and current research supporting the inclusion of a client’s spiritual and/or religious perspectives and practices. It is important that counselors are flexible enough to modify their treatment perspectives to best match the unique needs of clients. Perceiving psychological functioning as an internalizing problem or an inward-directed form of distress can be problematic when serving some religious minority populations. The most well-known therapeutic techniques do not emphasize a religious perspective; it is important that counselors strive to use techniques that will reduce clients’ symptoms, even if that includes learning about faith-affirming interventions that would be most helpful. One example could include using the egalitarian and empowerment principles of feminist therapy. From that perspective, clients could be encouraged to recognize the many aspects of their religious identity, increase their awareness of the origins of their presenting problems, and enhance their well-being.

Hypothetical case study

To further illustrate the highlighted competencies, we offer a hypothetical case study as an example of how specific strategies could be integrated into counseling practice.

Mary, a 19-year-old college student, was initially referred to counseling because she was experiencing social isolation and increased levels of stress. During the initial interview, Mary, a native-born U.S. citizen, described herself as an American Muslim feminist woman. She reported having never felt treated differently in the past by her friends, teachers or peer groups, perhaps because she was fair skinned, spoke English without an accent, and came from a family of high socioeconomic status. She also changed her original name, Mariam, to the English translation, Mary, while in high school. When Mary was asked about her motivation for doing this, she stated that she wanted to be well-integrated and active in larger American society.

After Mary began college, she decided that she wanted to learn more about her faith tradition, which eventually led her to choose to wear a hijab (headscarf). She realized that the hijab had a large impact on her relationship with her friends and with people in general. She even stated that she started getting fewer likes on her Instagram photos. Although Mary has never questioned her choice, she no longer feels like she fits in with her peer group.

Because building rapport and developing a relationship with a client is crucial in any counseling relationship, the counselor shows genuine interest in Mary’s story and demonstrates an openness to discussing her attitudes toward Mary’s religious beliefs. It is important to closely examine Mary’s own feelings and values regarding the hijab. By having an open dialogue with Mary, the counselor attempts to explore the meaning that Mary ascribes to the hijab. Mary states, “A lot of my friends are asking if I was forced to wear the hijab because a headscarf can be seen as a symbol of oppression. I think that my hijab gives me the freedom to set my own standards in a land of religious liberty, but I cannot convince people about that.”

The counselor acknowledges Mary’s emotional experience by stating, “You value your hijab and see it as a symbol of freedom. While you are also frustrated by your friends’ comments, you are aware that you do not have control over what your friends or society think of your decision.” The counselor further explores Mary’s experience by asking another question: “A friend you haven’t seen for a while sees you after you choose to wear the hijab. What would be different?” Such questions help Mary to reflect changes within herself and her environment.

The counselor knows that understanding Mary’s worldview and experiences is a crucial step toward effectively assessing her presenting problems and then formulating strategies to address them. From here, the counselor will connect on a deeper level the literal and metaphorical symbolism of the hijab. The counselor also examines her own attitudes by asking herself some questions: “What was my initial reaction when this client came in wearing a hijab? Have I been influenced by the negative stereotypes regarding individuals of groups who wear symbols?”

While exploring Mary’s religious values, the counselor avoids responding in a stereotypical manner by asking to be educated by Mary about her background and beliefs. The counselor encourages Mary to do this by saying, “Tell me more about your experiences of being treated differently.”

Mary states, “I do not understand why people focus only on my hijab. My hijab is an important part of my life, but I was born and raised in American culture, and that has always been the most important thing in my life.”

The counselor reflects, “You feel it is unfair that people ignore your core identity, which is your social and cultural identity. You want them to see you as an American Muslim feminist woman, not as an oppressed person who wears a hijab.” The counselor acknowledges Mary’s cultural background as a salient aspect of her identity. This could be an important step toward achieving a positive outcome. If the counselor focused mainly or exclusively on Mary’s religious identity, the counselor might fail to recognize Mary’s social and cultural identity.

The counselor will also help Mary recognize how her religious identity, even if it is not her core identity, may have caused her some disadvantages. The counselor will help Mary examine whether she has suffered from oppression as a member of a subordinate group, both as a woman and as a Muslim. It is important to note that Mary’s overall experiences make her an excellent candidate to benefit from a feminist counseling orientation, especially because of Mary’s stated identity as a feminist. Therefore, the counselor acknowledges the societal impact on Mary’s life.

Because Mary describes herself as a Muslim feminist woman, encouraging her to engage in an action can be an important step toward a commitment to social change. The counselor asks, “Do you like to do tasks between sessions? What is one powerful thing you could do for yourself between now and the next session?” By asking such questions, the counselor empowers Mary to take action and promotes an egalitarian relationship.

Mary answers, “One thing I would like to do is to share my personal story about why I decided to wear a hijab. I hope that this will lead to an open dialogue with my friends, and they will be more comfortable asking questions.”

The counselor asks, “What have you done toward this goal? How will you go about doing this? What difficulty might you have?” The counselor helps Mary to specify her direction and organize small steps toward desired behaviors.

The counselor also encourages Mary to be active in the therapeutic relationship by inviting her to direct the conversation. The counselor might ask, “Are there topics you talked about or discovered that you would like to pick up on next time?”

Finally, for the purpose of achieving better and longer lasting outcomes, it is important to help Mary build her own support system. The counselor says, “I wonder if there are any particular groups that could make you feel more connected and involved in the community?” This is important so that Mary can recognize she is not alone and that there are other women who are experiencing similar experiences. By engaging with other women, Mary can find support and become more assertive in promoting social justice.

Conclusion

In thinking about ways to work with clients from minority religions in the United States, counselors can pick from any number of similar cases in which they counsel people who are different from them in some aspect. It is important to remember that more often than not, a client’s religion, the client’s perspective on that religion, the client’s perspective of others, and what the client wants from a counselor will vary quite a bit. A client’s expression of faith is completely subjective and unique to that person. These hypothetical case studies should not be used to describe the basis of a faith’s visual aspects. Counselors should not make judgments or use phrases that may alienate clients over issues of religion, faith or spirituality. That is why it is important to have a discussion, or at least include a question, about the subject.

There are universal elements to most faith traditions (or the absence thereof) that transcend counselors’ observations about a client’s observable characteristics. The task for counselors is to understand our own perspectives and what they mean to us, and to obtain a general knowledge of many religious/spiritual traditions and how those traditions intersect with the experiences of our clients and the help they are seeking from us.

 

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Cebrail Karayigit is an assistant professor in the Department of Psychology and Counseling at Pittsburg State University in Kansas. Since coming to the United States in 2010, he has gained a reputation as an expert in multicultural counseling and school counseling, which are his areas of research and practice focus. Contact him at ckarayigit@pittstate.edu.

Jason Kushner is a professor of counselor education at the University of Arkansas at Little Rock. He is a licensed professional counselor with experience in school counseling, college counseling and mental health counseling. Contact him at jdkushner@ualr.edu.

 

Letters to the editor: ct@counseling.org

Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Respecting the faith of clients and counselors

By Laurel Shaler May 20, 2019

The Association for Spiritual, Ethical and Religious Values in Counseling (ASERVIC) describes itself as “an organization of counselors and human development professionals who believe spiritual, ethical, and religious values are essential to the overall development of the person and are committed to integrating these values into the counseling process.” Although ASERVIC is a division of the American Counseling Association, and all counselors likely would agree to the importance of ethics, not all counselors share the mission of ASERVIC in its entirety.

With some counselors and counselor educators, this is related to a lack of knowledge, in particular because few counseling programs — other than those whose own missions include the integration of faith — address spirituality and religion thoroughly. Still other counselors and counselor educators perceive a value conflict between counseling and religion or spirituality. Although other spiritual, ethical and religious values should be explored, this article pertains specifically to the Christian faith because I believe this is something that is often misunderstood and overlooked by many counselors and counselor educators.

Unfortunately, many individuals in the counseling field are not comfortable addressing issues of faith. Although the majority of Americans highly value faith, the same cannot be said of mental health professionals, according to researcher Pamela Paul. If counseling students are not being trained to assess and treat from a faith-based perspective, how can they best meet the needs of clients who are seeking this?

The lack of comfort and competency in this area is reflected across presentations, publications and even Listservs such as CESNET (the Counselor Education and Supervision Network). At best, this is because of a lack of knowledge, training or understanding. At worst, it is a brushoff of the Christian faith of clients — in particular, if those clients are conservative or evangelical. Sadly, it is not just clients’ faith that is sometimes disrespected. Often, the Christian faith of the counselor is not respected by fellow counselors either.

From a personal perspective, I have seen many professional counselors put in writing disparaging remarks about conservative and evangelical Christians — including their own clients. If these counselors are making those comments publicly, how can we ensure that they are treating their clients who hold these views with authenticity and respect? I have even read where counselors attempt to persuade clients to “explore” their biblical worldviews — with a clear agenda of trying to encourage clients to change their deeply held beliefs. Much like the serpent in the Garden of Eden asks Eve in Genesis 3:1, “Did God really say you must not eat from any tree in the garden?” there are counselors who ask their clients, “Does the Bible really say … <fill in the blank>?”

There may be a place for this — such as when a Christian counselor and a Christian client are working together, based on a common belief system, to explore the truth of God’s Word about who the client is at his or her core, for example — but there is no place to try and convince clients that they are wrong about their biblical convictions.

Simply put, the faith of the client and the faith of the counselor must be respected. It is entirely possible for clients and counselors who do not share a similar faith to work together effectively. The ACA Code of Ethics applies equally to the evangelical Christian who should not force his or her beliefs on to a client as it does to the nonevangelical (Christian or otherwise) who should not attempt to force his or her beliefs on to a client.

Instead of just lamenting over the way that this population of clients and counselors is often discounted, I would like to offer three practical tips for integrating and respecting faith. Truly, this is what is expected of all counselors as they work with clients and interact with colleagues.

1) Listen: As the saying goes, listen to hear rather than to respond. If your first instinct is to prepare a rebuttal, that is a clear indication that you need to take a step back. Understand first, respond second. This is true not only in the counseling room with our clients, but also in communication with our fellow counselors. We should be willing to hear from those who are not like us without making assumptions or jumping to conclusions.

It is not our job to change anyone else’s belief system or way of thinking. While we absolutely should ensure that students and fellow counselors are upholding ethical standards, we should also recognize that we are all different; that is not only “OK,” it is good. For example, on more than one occasion I have worked in non-faith-based settings. When a potential client would come in requesting to see a counselor who was Christian, the client was often referred to me. It wasn’t that the other counselors could not work with the client effectively. Rather, we were trying to listen to the client and meet his or her needs. Instead of going to a place of defensiveness, our team was able to see the benefit of placing clients with counselors who shared similar values with them when possible.

2) Think: Put yourself in the other person’s shoes. We often call this empathy. Ask yourself how you might feel if your deeply held beliefs were brushed off or challenged in a demeaning or disrespectful way. Think through how you would want to be treated, and then treat the other person that same way. Take some time to reflect on what you are hearing before you immediately respond.

Interact critically with what you are hearing. It is unlikely that someone will change their mind because someone has belittled or criticized them, but they may be willing to flex a bit in their thinking if given some time to process. For example, CESNET often becomes abuzz with emails flying back and forth rapidly. What if we took some more time (as some do) to really think through what is being stated before we respond? We talk about the value of silence in counseling. Perhaps it would be helpful if we put that into practice and spent more time thinking and less time speaking.

3) Ask: After taking the time to listen and to think, there is also a time and a place to ask questions. As every counselor learns in a basic counseling skills course, this can be done in a respectful manner. As we all know, open-ended questions typically produce richer responses that contain more depth and meaning. We should make sure that we are not attempting to lead the other person to what we perceive to be the “correct” answer.

Ask to learn rather than to teach. What do you want to know about the faith of the client? Don’t be afraid to ask about the client’s belief system, how they came to that belief system, how they are living out their belief system, and how they want to (or do not want to) integrate their belief system into their counseling sessions.

This does not mean that the counselor has to share the client’s belief system (although they very well may, and there is strength in that too). It does mean that as counselors, we should be able to respect our clients and meet their needs to the best of our abilities.

Evangelical Christian clients — as well as those who simply identify as traditional or conservative — deserve to be heard and treated with dignity and respect, even when the counselor does not agree with their points of views. I also identify as a Christian who is evangelical and conservative, but there are certainly times when I do not agree with all of these clients.

Years ago, I was working with an individual whose relative was dating someone of a different race. Because of my client’s deeply held beliefs, the client became distressed about this. When seeing the young couple together, my client became distraught, went home and attempted suicide.

Was there more going on with this client? Yes. Yet the reality was that this was the straw that broke the proverbial camel’s back. I consulted with a colleague about this case. In the process, I expressed my shock and disdain over someone reacting this way to a relative dating someone of a different race. I did not understand the client’s gross overreaction.

My fellow counselor reminded me of what I have shared in this article — that although I may not always understand my clients’ views, I should strive to empathize with them and that this situation had meaning for my client beyond what I could comprehend. My colleague was neither conservative nor Christian, but she was respectful of all clients — and of me.

Although I viewed my client’s beliefs as a distortion of the Bible, the client and I both identified as conservative evangelical Christians. Yet we have to be able to accept our clients where they are and take them where they desire to go — not based on our own agendas but on theirs. (There are limitations to this, of course, such as in the case of suicidal ideations.) I had to work hard to empathize with my client’s pain while also helping him work on his desired outcome of changing his thoughts and feelings about the situation as he grappled and struggled to accept what he could not change. With proper supervision, I was able to do this and supported this client during his time in counseling.

Likewise, we should be respectful of our fellow counselors. When we make disparaging remarks about people who are not like us — when I make disparaging remarks about people who are not like me — we are inevitably disparaging some of our colleagues. It is one thing for us to challenge one another, hold each other accountable, and even heartily debate. It is another thing entirely to expect that any group of people should change their entire belief system or else not be included in the field.

Conservative or evangelical Christians are not a rogue group or a small group. We constitute a substantial number in the field who share varying views and beliefs. We cannot all be lumped together. Neither can our clients. With so many clients seeking Christian counseling, perhaps the field should recognize the value of having counselor education programs that teach the ethical integration of Christian faith into counseling (while also recognizing that not all graduates from these programs will hang their shingles as Christian counselors). In fact, it may be time for more training programs to address spiritual assessments, religiously accommodated psychotherapy, and the impact of spirituality and religion on both the client and the counselor.

If you do not understand this perspective, I encourage you to get to know us for yourself. Listen. Think. Ask. Most importantly, get to know your clients. And respect them — and us — for who we are rather than for who you want us to be.

 

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There are many excellent resources for the integration of the Christian faith into counseling settings. These books, journal articles and videos provide the research behind and the details about the practice of being an ethical and effective Christian counselor. They make it clear that this type of treatment is not one-size-fits-all, and it can (and should) be provided at the highest competency level. If one wishes to be a Christian counselor, or if one desires to further understand the Christian faith of a client, the education is available and accessible through the works of individuals such as Tim Clinton, David Entwistle, Fernando Garzon, Ron Hawkins, Harold Koenig, Anita Knight Kuhnley, Mark McMinn, Jim Sells, Lisa Sosin, Siang-Yan Tan, John Thomas and many others.

 

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Laurel Shaler is a national certified counselor and licensed social worker. She is an associate professor and the director of the Master of Arts in professional counseling program at Liberty University. Contact her at doctorlaurelshaler@gmail.com.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

In search of an affirming faith

By Laurie Meyers July 25, 2018

One of Cyndi Matthews’ most vivid memories of growing up in a fundamentalist Christian church was watching the minister point at her brother’s best friend during a service and say, “You don’t belong here. Get out.” The reason? The boy was gay.

Matthews, a licensed professional counselor supervisor (LPC-S), says that incident was her first glimpse of a pattern of spiritual abuse directed at congregation members who identified as lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ). The animosity that leaders of the church held for LGBTQ members did not fit Matthews’ conception of Christianity. This religious cognitive dissonance would lead her to leave the church and subsequently focus her research and counseling practice on spiritual abuse.

Matthews, a member of the American Counseling Association, sees many LGBTQ clients in her Garland, Texas, private practice who struggle to reconcile their religious beliefs and experiences with their affectional orientation or gender identity. Many of these clients grew up internalizing a message that it wasn’t just their identity or orientation and behaviors that were wrong, but that there was something “wrong” with them as people, she says.

The LGBTQ community has frequently encountered intolerance from religious institutions. Although there are religious traditions that are affirming and open to LGBTQ people, many are not, says Misty Ginicola, lead editor of the book Affirmative Counseling With LGBTQI+ People, published by ACA. Nonaffirming religious groups usually have markedly rigid beliefs — there is wrong and there is right, and nowhere in between, she says. These are the voices that call for anti-LGBTQ legislation under the guise of exercising their religious freedom. As a result, even LGBTQ individuals who do not identify as religious are affected by nonaffirming religious beliefs, points out Ginicola, a member of ACA.

This conflict has produced not just a broader culture clash, but in some religious traditions, a pernicious history of rejection and outright abuse of LGBTQ individuals. Many of Matthews’ LGBTQ clients have been subjected to a wide range of religiously sponsored or endorsed abusive techniques intended to “cure” them. One client — a gay male — was not allowed to cross his legs or wear pink. He was directed to pray anytime he had “gay” thoughts and to replace “gay behavior” with Scripture reading or increased proselytizing. Other of Matthews’ clients were sent to church-sponsored “reparative” retreats where they were prayed over or even subjected to “exorcisms.” Matthews, an assistant professor of counseling at the University of Louisiana Monroe, has also been told about particularly horrific techniques such as forced ice baths and electroconvulsive therapy.

The emotional and even physical abuse that some LGBTQ individuals from strict religious traditions experience is so traumatic that Matthews says all of the survivors she has encountered in her practice were actively suicidal or had been suicidal in the past. At the same time, because clients from strict religious traditions have internalized the idea that what they are told in their churches is God’s word, it is often difficult for them to label their experience as abuse, she says.

Even LGBTQ individuals who break away from their religious traditions so they can fully embrace their affectional or gender orientation have a hard time discounting what they were taught. If someone who identifies as LGBTQ has been told from a young age that they are inherently wrong and immoral, it creates an inner message that lingers, says Ginicola, an LPC in West Haven, Connecticut, whose practice specialties include LGBTQ issues.

Brady Sullivan, a provisionally licensed professional counselor specializing in LGBTQ issues, has worked with clients who believed God hated them. “Every time they engage in sexual or romantic behavior or participate in pride activities, they feel an overwhelming sense of guilt,” he says.

Examining beliefs

Matthews says that, despite their experiences with spiritual abuse, some of her LGBTQ clients still want to find a way to reconnect with religion or at least retain a sense of personal spirituality. Others no longer want anything to do with religion; they come to counseling to untwine the message of being sinful or wrong from their sense of self and sexuality or gender identity.

The therapeutic relationship that is the core of counseling is especially crucial with clients attempting to navigate a conflict between their religious upbringing or current beliefs and their identity as LGBTQ, Matthews says. When people have been taught to seek comfort and strength from a religious tradition that then ends up rejecting them, it feels like a violation of trust, she says. Unfortunately, that sense of rejection can be further compounded when people in the LGBTQ community seek therapy from a practitioner who turns out to be nonaffirming. Matthews always asks clients if they have previously been in counseling and, if so, what that experience was like. This information helps her to address the therapeutic trauma that some LGBTQ clients have experienced.

Matthews screens for spiritual abuse as part of her intake process. She asks clients about their religious background and beliefs and if their experiences are something they would like to address as part of the counseling process. She says that LGBTQ clients from strict or fundamentalist religious backgrounds are highly likely to have experienced spiritual abuse, so the question usually isn’t “if” they will need to work through their experiences, but “when.”

These clients don’t always disclose or even perceive a history of spiritual abuse. However, counselors can look for a number of red flags, Matthews says. These include clients who:

  • Talk about how they are the cause of their own suffering and need to attend church more and to be more faithful and forgiving to alleviate their suffering.
  • Display magical thinking attached to “good” and “bad” behavior; they commonly believe that accidents, illnesses and other tragedies are the result of their “sinful” behavior.
  • Have a difficult time setting boundaries and saying no because of underlying guilt and shame.
  • Feel powerless to take action or make decisions because they fear repercussions from family members, church members, church leaders or their personal deity.

It is critical that counselors understand their role as helping professionals dedicated to providing a safe and affirming space for all clients, including those who are LGBTQ, says Ginicola, a professor of counseling and school psychology and coordinator of the clinical mental health counseling program at Southern Connecticut State University. Simply sitting with clients, supporting them in their pain and validating their experiences helps the healing process begin, she says.

Once clients are ready to talk about their conflicted views and feelings related to their sexual or gender identity and their experiences with religion, Matthews helps them explore the harmful beliefs they have been holding on to and works to dispel them. She is careful not to disparage clients’ faith traditions but does encourage them to question whether the condemnation they have been confronted with is actually the voice of God.

Lorrie Byrd Slater, a licensed professional counselor-mental health services provider in Chattanooga, Tennessee, who counsels many survivors of spiritual abuse, uses her knowledge of Christianity to help clients examine their beliefs. She urges clients whose religious communities have condemned or disparaged them to consider what the Scriptures say about the nature of Jesus Christ. She then asks them if their experiences are in line with Christ’s teachings. Slater, an ACA member, also reminds clients that their particular church is just one church out of many; other places of worship hold very different — and affirming — views of LGBTQ individuals.

Ginicola says cognitive behavior therapy is particularly helpful when confronting clients’ internalized beliefs that being LGBTQ is wrong or sinful. She asks clients to consider how those beliefs began and who taught them that they are inherently wrong. Ginicola exposes clients to religious viewpoints that are affirming to LGBTQ individuals through documentaries and bibliotherapy or putting them in touch with affirming pastoral help. She also encourages clients to explore a question for themselves: If God is love, as they have been taught by their faith communities, how could he hate them?

Practicing GRACE

Both Ginicola and Sullivan have found the GRACE model originally developed by counselor R. Lewis Bozard and pastor Cody J. Sanders — particularly helpful for guiding LGBTQ clients through the resolution of their conflicted religious views. Sullivan, who is practicing part time in addition to earning his doctorate in counselor education at the University of Missouri–Saint Louis, emphasizes that the model is just a guide, not a step-by-step process. For most clients, he uses only a few of the “stages.” The process involves:

  • Goals: Sullivan, an ACA member, talks to clients about their religious background, asking questions such as what faith tradition they grew up in (Christian, Muslim, Jewish, other) and whether they identify with a particular denomination or sect. He also asks how they feel about what they have experienced, both good and bad.

Ultimately, he wants to find out what clients are hoping to achieve by addressing the conflicts they feel between religious belief and who they are as a person. Sullivan asks: “If you woke up tomorrow and all these issues went away, what would that look like?”

As Sullivan guides clients through their background and goals, he stays alert for reactions, particularly any signs of trauma. If a client seems too upset in a particular session, he will back off and switch to another topic.

  • Renewal of hope: This stage involves uncovering shame and abuse and working through it, Sullivan says. For instance, some nonaffirming religious leaders individually confront LGBTQ congregants with questions about their affectional orientation or gender identity. These confrontations often take on the tone of an interrogation, culminating with  a reminder that “God hates those people.”

Sullivan tells clients that although a particular pastor might think that God hates LGBTQ people, many other religious leaders and faith communities do not hold that belief. If clients are amenable, Sullivan offers to help them make contact with an affirmative pastor to talk about religious views that do not condemn those who are LGBTQ.

  • Action: This stage represents decision time. Sullivan and the client have talked about the religious conflict for a while, and together they’ve processed the client’s trauma and grief. What does the client want to do now?

Sullivan says his role is to explain clients’ options to them and help them identify what they need to do to move forward. Some clients choose to remain planted in their current religious tradition, unready to move on from a community in which their spiritual roots were cultivated, even if that means continuing to wrestle with painful beliefs and practices. Other clients want to stay under the larger umbrella of their current religious faith but choose to find another church home or denomination that is more affirming of LGBTQ people. Still others decide to make a more drastic change, such as converting to a different faith system entirely. And, finally, Sullivan says, many clients decide that they no longer want anything to do with religion at all.

  • Connection: For some clients, processing their past experiences and finding a new place to worship isn’t enough, Sullivan says. Instead, they need to examine their personal relationship with God or whatever higher power they relate to. Ultimately, this involves clients identifying what God or that higher power believes about them and how that affects their view of their religion as a whole.

For instance, Sullivan might probe by asking clients what they believe God’s reaction is when they engage in sexual activity with someone of the same sex. He says that most clients are only able to develop the view that although they are sinning, God loves them anyway.

Sullivan does not like to end the GRACE process with this belief still intact. However, he says the pervasive sense of shame that many LGBTQ clients feel often makes it difficult for them to let go of the notion that living a life that embraces their true affectional or gender identity is sinful behavior. “It’s a struggle to get people to realize that God has made them this way and to accept that they are not sinners,” he says.

  • Empowerment: Sullivan acknowledges that he doesn’t see this stage achieved very often. It takes place only after clients have taken some kind of step such as attending a different church, joining a church-affiliated small group gathering or Bible study, or connecting with a church-sponsored social event, he says. Counselors have an obligation to help clients process these experiences, particularly if they are negative.

“The goal of the empowerment phase is to keep the client traveling down the path toward connection of spiritual and sexual identities, even if they have a negative experience,” Sullivan explains. “This is important because self-confidence and comfort with sexual identity are increased as a result of exploring the intersection between spiritual and sexual identities.”

In reality, Sullivan says, most clients who go through the GRACE model still struggle to reconcile their religion beliefs with being LGBTQ, but they are more at peace with the conflict.

Looking for aff irmative alternatives

One way that counselors can support LGBTQ clients who want to maintain their religious affiliation but feel conflicted is to help them find an affirming congregation, Sullivan says. However, he stresses that counselors must do their due diligence. It isn’t enough to read that the church is part of an affirming denomination or to see that it includes a rainbow flag on its website.

To ensure that he isn’t sending clients into a religious environment that appears affirming but actually isn’t, Sullivan makes a point of calling churches directly. He tells whoever answers the phone that he is a gay man and wants to know the church’s stance on the LGBTQ community. If the person tells him that he is welcome to attend the church and that the church will pray for him and support him in efforts to leave the gay lifestyle, Sullivan thanks them for their honesty but says the church is not for him. Although “welcoming” to LGBTQ people on the surface, churches that hold those types of beliefs do not make it on to Sullivan’s “recommended” list for clients.

Matthews notes that some faith traditions pose a specific and significant challenge to LGBTQ individuals who want to maintain a religious connection. Churches such as the Jehovah’s Witnesses and the Church of Jesus Christ of Latter-day Saints (the Mormon church) embrace particularism — the belief that their particular religious tradition is the only authentic path to God. These paths rest on tenets that are significantly different from what mainstream Christians believe.

For those raised in a church that embraces particularism (and is not affirming of LGBTQ individuals), pursuing their faith by switching denominations is akin to losing their religion entirely, Matthews says. When someone has been told all their life that there is only one path to becoming a Christian and gaining salvation, envisioning another form of faith and worship is almost inconceivable, she explains.

LGBTQ individuals struggling to align their personal and religious identities may look to their families for support. Unfortunately, families are sometimes part of the problem, Matthews says. Many families find it difficult to reconcile their religious beliefs with the reality of their child identifying as LGBTQ.

Matthews has worked with couples from strict religious backgrounds grappling with how to support a child who, according to what the parents hear in church, is living a sinful lifestyle. She provides these parents with psychoeducation by recommending books, giving them information about PFLAG (an advocacy and support organization for the friends, families and allies of those who identify as LGBTQ) and answering their questions, such as whether being LGBTQ is a choice. Matthews might also ask the couple to look for what the Bible actually says about being gay rather than relying solely on what their religious leaders say.

Counselors must also consider that particularly for LGBTQ people of color (POC) or those of low socioeconomic status (SES), leaving their religion behind may also mean losing their community, Ginicola says. “If you are a POC or have low SES, religion is not just a place you go sometimes; it could be a lifeline,” she says.

Losing a whole community can be devastating for anyone, but particularly for someone who has multiple marginalized identities, Ginicola continues. She gives the hypothetical example of a gay black man who, by coming out, loses his church. But when he turns to the LGBTQ community, he may encounter sporadic instances of racism. As a result, he ends up feeling like he is not fully accepted — and, thus, can never feel totally comfortable — anywhere.

Counselors need to let those with marginalized multiple identities know that counseling is one place where they can be fully themselves, Ginicola says. Counseling can encompass all of who these clients are — black, Christian, gay — without judging. Many people seem to think that they can identify either as LGBTQ or religious, but not both, Ginicola notes. She believes the idea that these two identities can’t coexist is harmful because faith — believing in something greater than ourselves, even if it isn’t a deity — is an integral part of life.

Given their negative experiences, some LGBTQ people lose all desire to return to organized religion. Regardless, spirituality can remain a significant part of who they are as people, says Slater, an assistant professor of counseling and associate dean of students at Richmont Graduate University. Spirituality is not the same as religion. In fact, an individual’s spirituality may not even encompass God. Spirituality is simply something that is bigger than us and that provides people with a sense of purpose, Slater says. For some people, that sense of spirituality and meaning can derive from nature, philosophy, personal ideology, science or even the belief in human rights for all, she explains.

Even when LGBTQ clients ultimately decide that they no longer identify with their past religious faith, Matthews tells them that it is possible to hold on to certain positive aspects and values of their religious upbringing that still resonate with them, such as practicing generosity and gratitude and loving others. Or, if these individuals previously enjoyed reading the Bible as literature, she might suggest that they explore other religious or spiritual texts outside of their faith tradition. If the ritual of prayer once provided clients with a sense of peace, she might encourage them to replace that experience with something nonreligious, such as a meditation practice.

Wearing blinders

Counselors who identify as religious know that imposing their values on clients is unethical, and most counseling professionals work hard to bracket their beliefs. Laura Boyd Farmer, an assistant professor of counselor education at Virginia Tech, has published numerous research studies on LGBTQ issues. She recently completed a research study that has not yet been published but that was presented at the 2017 ACA Conference & Expo in San Francisco. The study consisted of a survey that asked 455 mental health and school counselors how they thought their religious beliefs affected their work with LGBTQ clients.

Some respondents said that because their religious traditions were based on acceptance and the idea that Jesus loves everyone, their beliefs had a positive effect, helping them to provide LGBTQ-affirmative counseling. Other participants said their work was in line with their religious tradition, which calls on believers not to judge. Some counselors said that they disagreed with the LGBTQ “lifestyle” but chose not to judge. Others disclosed that their religious beliefs pose a conflict with which they struggle — striving to practice ethically despite their nonacceptance of LGBTQ individuals. Some respondents said that they agreed with the statement “love the sinner, hate the sin” and that this belief did not negatively affect their counseling of LGBTQ clients.

When counselors refuse to counsel LGBTQ clients because their religious beliefs tell them that doing so is wrong, that represents an obvious violation of the ACA Code of Ethics. But where things get tricky is with counselors who take a low-profile nonaffirming stance, says Farmer, an LPC who provides pro bono counseling for LGBTQ individuals in the Roanoke, Virginia, area. These are the counselors who say that they don’t agree with the “lifestyle” but wouldn’t refuse to counsel LGBTQ clients. These practitioners may think that no matter what their beliefs are, they can still maintain unconditional positive regard for their clients, but they might be operating with a big blind spot, Farmer contends.

To illustrate her point, she describes a recent casual conversation she had with a practicing counselor. This person talked about working with gay clients despite believing that being LGBTQ is a sin. The counselor said that they just tried not to judge. Farmer, an ACA member, asked how the practitioner was able to do that. Their response: “To be honest, it doesn’t come up.”

In providing counseling yet not fully accepting LGBTQ clients, this counselor was attempting to manage conflicts with their personal religious beliefs by avoiding pertinent topics. For example, Farmer says the practitioner was working with a gay youth struggling with depression, yet the challenges of identifying as LGBTQ “never came up.” Farmer says this makes her wonder how many other professional counselors are walking around wearing blinders.

Counselors like the one in Farmer’s story are not fully owning — or understanding — their bias, Ginicola says. A bias isn’t just, “I hate these people,” she explains. It’s also that working with someone who is LGBTQ doesn’t feel “right” and the counselor isn’t comfortable with it. By not confronting the discomfort, counselors are much more likely to miss signs (even if unintentionally), miscommunicate and project their worldview on the client rather than identifying the real issues, Ginicola asserts.

Disaffirming counselors resent that ACA’s ethics code requires them not just to set aside their personal beliefs to work with LGBTQ clients but to actually be advocates for them, Ginicola says. These counselors don’t view the experiences of LGBTQ clients as valid, she adds, and it is impossible to work effectively with clients unless you intrinsically embrace their value.

 

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Additional resources

To learn more about the importance of exploring aspects of religion and spirituality in clients’ lives, take advantage of the following select resources offered by the American Counseling Association:

Counseling Today (ct.counseling.org)

Books (counseling.org/publications/bookstore)

  • Critical Incidents in Integrating Spirituality Into Counseling, edited by Tracey E. Robert and Virginia A. Kelly
  • Integrating Spirituality and Religion Into Counseling: A Guide to Competent Practice, second edition, edited by Craig S. Cashwell and J. Scott Young
  • Understanding People in Context: The Ecological Perspective in Counseling, edited by Ellen P. Cook

Journal of Counseling & Development (counseling.org/publications/counseling-journals)

  • “Psychological Safety and Appreciation of Differences in Counselor Training Programs: Examining Religion, Spirituality and Political Beliefs” by Amanda L. Giordano, Cynthia M. Bevly, Sarah Tucker and Elizabeth A. Prosek
  • “The Ways Paradigm: A Transtheoretical Model for Integrating Spirituality Into Counseling” by Joseph A. Stewart-Sicking, Paul J. Deal and Jesse Fox

Competencies (counseling.org/knowledge-center/competencies)

  • Competencies for Addressing Spiritual and Religious Issues in Counseling

ACA divisions

  • Association for Spiritual, Ethical and Religious Values in Counseling (aservic.org) and Association for Lesbian, Gay, Bisexual and Transgender Issues in Counseling (algbtic.org)

 

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Laurie Meyers is the senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

Letters to the editorct@counseling.org

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

 

Ethics, religion and diversity

By Gregory K. Moffatt February 5, 2018

Tears streamed down her face. Kaylah (not her real name) was a 21-year-old woman struggling with a romance in trouble. I’d seen it many times, even though I’d only been in the field for a few years at this point. My heart broke for Kaylah as I saw the same old story played out in the same old way — only the names and a few of the details were new.

Kaylah had been psychologically mistreated and her relationship was in serious trouble. Her partner demonstrated what social psychologists call the principle of least interest. This principle teaches that the person in any relationship — work, friendship, marriage — who has the least interest in maintaining it possesses the most power. My client’s partner treated her well on occasion but at other times humiliated her in front of others, exploded at her or ignored her for days on end. Kaylah tolerated these behaviors because she was desperate to maintain the relationship.

Kaylah’s partner’s emotions ran hot and cold. One day, they were talking about starting a family; the next, Kaylah’s partner threatened to leave, causing Kaylah to feel confused, hurt, angry and torn. Like most abused women, at times Kaylah felt surges of confidence that she should leave the relationship and never look back. Then, as if someone had flipped a switch, she was overwhelmed with love, hope and compassion for her relationship. In this phase, Kaylah made excuses for the pitiful way she was treated and assumed all the responsibility for their relationship troubles. It was classic battered woman syndrome.

What readers also need to know about Kaylah is that she was a lesbian. She was also a staff member at a church. Her lover, a member of the pastoral staff, was also Kaylah’s boss, which created a serious power issue (and a significant ethical issue too). For obvious reasons, the relationship was a carefully guarded secret. Kaylah had no one to talk to because her family wasn’t receptive to her lesbian lifestyle and she didn’t feel she could confide in her friends in the religious community. She also worried that if anyone found out, her partner would terminate the relationship — the thing Kaylah feared most in the world. Exposure might also mean that Kaylah could lose her job, her family and the few friends she had. She was totally isolated. What a mess.

One last thing that I need to tell readers: I am a person of religious faith, and until I met Kaylah, I hadn’t been forced to clarify the place for my religious beliefs in the counseling profession. That day, the decision I faced became crystal clear to me.

No room for debate

It was around the time that Kaylah entered my world that I taught my first college course overseas. As I was preparing to teach a marriage and family course in India, it dawned on me that our two cultures were very different. I worried that my knowledge would be so based in American culture that it wouldn’t translate well into Indian culture. But without denying our vast differences, my host reassured me. “Dr. Moffatt,” he said, “problems are problems.”

How right he was. Hurting relationships are the same regardless of culture, age, religion or sexual orientation.

In some ways, I can’t believe that equity for LGBTQ clients even remains a topic for debate. I remember when the AIDS epidemic first became public in the 1980s. Some people of religious faith actually stated that AIDS victims deserved the outcome as punishment for their lifestyle. I hope that even the most cold-hearted person today wouldn’t utter such nonsense. Even in those uncertain times when we didn’t know much about the disease, doctors served these men and women because it was their professional duty to do so, regardless of their personal opinions on homosexuality, drug use, multiple partners or other factors. Today, many nonprofit counseling agencies are run by faith-based agencies specifically for those who have HIV/AIDS. Thank goodness.

How, then, could there still be any possibility of debate in the 21st century over whether we should discriminate against our clients? Our concept of human rights as counselors is that all people deserve the same treatment, regardless of worldview, religion, gender, age or creed. Our modern view of equality has been evolving for decades, yet even counselors have not yet perfected it in practice. Just in the past decade or less, there have been several highly publicized court cases in which graduate students have refused to work with gay clients and suffered academic consequences because of their beliefs. These include Julea Ward in 2009 at Eastern Michigan University, Jennifer Keeton in 2010 at Augusta State University and Andrew Cash in 2014 at Missouri State University.

Supporters of these students lauded their bravery and commitment to their religion. Even though I am a person of faith, I cannot see why this type of irresponsibility to clients should be lauded. Interestingly, Christian tradition teaches that Jesus spent most of his time with the outcasts of his culture, not with the religious upper echelon, and he didn’t abandon people simply because they behaved in ways that were contrary to Jewish teachings. Gandhi and Mother Teresa also demonstrated a seeming lack of interest in religious pedigree. Instead, they helped the people who came to them.

Sadly, the three lawsuits from academia that I noted are just the ones that made the news. I suspect that many more therapists are practicing discrimination without the public becoming aware. “I’m not culturally competent to work with those issues” is a common argument that I hear among some in the profession to justify their referral of LGBTQ clients. In fact, the real reason is often a personal belief system rather than a question of competence. There is no way to tell how much of this type of referral or redirecting of client goals happens in our profession, but if my anecdotal experiences as a clinician, supervisor, professor and public figure in the field are any measure, the answer is a lot.

This clearly violates our ACA Code of Ethics. Under Standard A.4.b., we are clearly called to “seek training in areas in which [we] are at risk of imposing [our] values onto clients, especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature.” Notice that it says seek training, not refer. In fact, Standard A.11.b. specifically prohibits referring solely on the basis of a conflict between the counselor’s values and the client’s values.

This culture war hit home for the American Counseling Association in 2016 when the Tennessee Legislature passed a bill that the state’s governor subsequently signed into law making it legal for counselors and therapists to discriminate against their clients if the client’s “goals, outcomes or behaviors … conflict with the sincerely held principles of the counselor or therapist.” This legislation clearly contradicted the ACA Code of Ethics. Consequently, ACA moved its planned 2017 annual conference from Nashville to San Francisco.

It should be noted that before we even get to the standards in the ACA Code of Ethics, our association’s mission statement directs that we exist to “promote respect for human dignity and diversity” through the profession. The key word here is not diversity but rather promote. We are actively to promote diversity, not actively run away from it.

A common base for truth

For any reader who thinks that I am not sensitive to the importance of religion, please bear with me. Religion does indeed matter, and many religions have clear teachings on a variety of subjects — sex, marriage, work, the roles of men and women — that are central to people’s faith and shouldn’t be ignored. But we must also recognize that many discriminatory traditions have their roots in religious teachings. Even in my short lifetime, I can remember a relative of mine excusing the discriminatory practices of his all-white church, saying, “God didn’t intend for the races to mix.” He then proceeded to use Bible verses to justify that belief. He made similar comments about mixed-race marriage, again justifying them weakly through religious teachings. Refusing to see clients based simply on sexual orientation is no different.

Some religious therapists have defended discriminatory practice by arguing that equating racism with clinical treatment of gay couples is comparing apples and oranges. The argument goes that if a counselor’s religious views teach that, for example, the heart of a couple’s problems is directly related to homosexuality — something the counselor’s religion teaches is inappropriate — then helping these clients maintain the very relationship that is causing their grief would be problematic if not unethical/immoral. I’ll address this argument momentarily. But, first, a brief tangent.

It would be disingenuous to say that counselors never force a worldview on a client. Of course we do. For example, one of the goals we almost always have for clients who are addicted is that they stop doing their drug of choice, even if they don’t want to stop. The difference between this worldview and that of the anti-gay worldview, however, is that this worldview is based on objective research, not moral code or religious teaching. Using methamphetamine destroys tooth enamel, leads to degenerative behaviors and can eventually kill the user. Alcohol abuse changes brain structure, destroys the liver and leads to degenerative lifestyle and potentially death, not to mention a host of other social ills.

As for a religious argument against homosexuality, there is no scientific evidence that being gay, transsexual, bisexual, etc., is clearly linked to any social or physical issue that is not also present among the heterosexual population. We must have a common base for “truth,” and that base is research, not religion.

Many years ago, a religious group, knowing I am a person of faith, asked me to do a seminar addressing why homosexuals would not be good parents. I refused because there is absolutely no evidence that one’s sexual orientation has anything to do with quality of parenting. It would be unethical to promote such a baseless argument. Academic integrity demands that as professional counselors, we pursue what we know. We must be driven by facts, not opinions and preferences.

Make a choice

Empathizing and working with a diverse population does not mean that a counselor must sacrifice her or his own position. We are free to think what we want, engage in our own religious practices and beliefs, and live our lives as we choose.

For many years, I’ve spent part of my year in the United States and part of the year in Chile, my second home. During this time, I have also traveled the world. Whether I’m in a clinic in India, the Philippines, Peru or Mexico, I still think like an American/Chilean. But when I’m in those varied cultures, I try to see the world through the eyes and culture of the people I encounter. I can easily do that without making any value statement about the culture itself, and even though I have personally adopted many customs and preferences from around the world, I have done so voluntarily. I would still be a competent counselor in those cultures if I hadn’t. My preferences are irrelevant when working in another country.

Our professional ethic simply means that we will not thrust our belief systems upon our clients any more than we would try to sell our clients a car, recruit them into a political party or manage their retirement accounts. What we cannot do is make choices that are at odds with wanting to work as a counselor, such as simultaneously wanting to function as a missionary who proselytizes clients into our personal belief system.

I occasionally work with individuals who have been mandated to treatment. Some of them have drug issues. I’ve heard all the arguments:

“Why is weed illegal? It’s a dumb law.”

“Who cares what I do in my own home?”

“Smoking weed doesn’t affect my job or my personal life, so why should I have to go to addiction counseling?”

My response is always the same. You can do anything you want — but all behaviors have consequences. If you want to smoke weed, go ahead. But if you don’t want to risk arrest, being fired from your job or kicked off your athletic team, don’t smoke weed. You can’t have it both ways.

To our profession, I make the same suggestion. If you are a pastor or priest, be a pastor or priest. Nobody is trying to stop you. But do not attempt to be a pastor while you are a counselor. If your religion teaches that you must proselytize in the workplace, then the counseling profession is not the best fit for you. There is nothing wrong with being a pastoral counselor in which your focus is pastoring, not counseling. But don’t pretend to be a counselor who is religious when, in fact, you want to function as a pastor who is also a counselor.

As counselors, our job is to help the hurting. We cannot — we must not — attempt to evaluate who we think is worthy of our help. Whether our clients are gay or lesbian, battered women or batterers, abused children or abusers, we don’t pick and choose who we help. Our ethical standards determine when we refer or step away, but our personal feelings — whether driven by religion, morals or anything else — have no role in our decision to help. Pain is pain. The pain of Kaylah’s relationship was no different than the pain from any other relationship. The fact that she was a lesbian was, in some ways, irrelevant.

Diversity includes people of faith

History hasn’t always been friendly toward people of faith. We hardly need to be reminded of the many wars and episodes of genocide that have been perpetrated against various religious groups throughout history. Even today in different places around the world, including the U.S., Christians, Jews, Muslims and others are persecuted for their faith. Television mogul Ted Turner brashly claimed in 1990 that Christianity was a “religion for losers.” These were thoughtless words from one who knew nothing of the religion. Jewish men, women and children are still isolated in many parts of the world. And I can’t imagine how difficult it must be to live as a Muslim in the U.S. Sadly, the words “Muslim” and “terrorist” are sometimes used interchangeably these days.

The field of psychology has not always been friendly to people of faith either. Sigmund Freud proposed that neurosis and religion were closely related and that religious people were weak and in need of a dominant father figure. In the 1950s, Alfred Kinsey despised religion, claiming it repressed “healthy sexual desires.” And as a graduate student, I was taught that we should never talk about religion in session, even if our clients brought it up, because it would only distract from more important issues. Really? Faith can be a central part of a person’s existence, influencing almost everything, from food, dress and marriage to job choice and child rearing. Yet I was taught that this was somehow unimportant and distracting.

About 20 years ago, I was presenting an ethics seminar for professional counselors. One of the case studies the seminar participants were supposed to discuss involved religion. The concise version of the question I posed was, “If your client was a person of religious faith, would it be acceptable to include that person’s religion in your therapeutic process?” Every single one of the 75 or so participants said no. Apparently, they had the same training I had.

I have personally witnessed bias within the counseling profession against people of faith. At professional conferences, I have heard comments in hallways and elevators openly disrespecting people of various religions. One clinician, wearing her conference name badge, rolled her eyes as the elevator door closed and said to another attendee, “Oh, God, this hotel is crawling with Christians. Heaven help us!” To which her friend snickered and nodded consent, as if Christians, Jews or Muslims were some sort of infestation.

At a past ACA annual conference, I attended a workshop on gay and lesbian issues. In the workshop, the leader subtly condescended to people of faith — something Derald Wing Sue calls microaggressions — and the audience openly jeered, laughed and mocked Christians in their public comments. No one said a word about the overtly biased, thoughtless and hurtful commentary. Although I certainly didn’t fear for my safety, I didn’t feel comfortable confronting this bigotry. And even though I agreed with the position presented by the session leader, I have never felt more discriminated against in my life.

The heckling I witnessed was the same thing that those in the LGBTQ community have rightly fought against in times past. It was the same behavior — only the target had changed. People of faith should be as welcome as members of any other group in a professional meeting.

I might also argue that people of religious faith can make outstanding counselors. Many religions teach the inherent value of all humans, creating a natural empathy among the religious for a hurting world. Although there are individuals who have used religion to pursue their own selfish agendas, there is no scientific evidence that people of faith are less intelligent, weaker or any less capable of working in the helping professions than are nonreligious individuals.

Conclusion

In a public presentation many years ago, Albert Ellis, a man known widely for his aggressive approach to his clients, littered his address with profanity. Visibly upset, several participants in the room eventually made an overtly public statement by storming out. The only remark Ellis made about it was this: “Counselors should never be upset with what people say.”

I have never forgotten those words. Whether or not Ellis was right, the message I took away was that, as counselors, we treat those who need help. In that regard, our clients’ words, sexual orientation, religion, age, gender, race, criminal history and socioeconomic status have no relevance. We help. That is what we do.

Many people in the counseling profession are also, in their personal lives, deeply committed to their faith. These counselors see clients daily without issue and function at the highest level of ethical conduct. But the few who feel they are called to change the profession, rather than to accept the profession as it is or to move on to another line of work, give us a black eye. Even worse, these counselors leave clients hurting — and perhaps discourage them from ever seeking help from another counselor again. It is always about the client.

Counselors using their religion as an excuse to refer clients or to force their ideas about sexuality upon their clients can deceive themselves into thinking they have ethical grounds for doing so. You don’t. Period. You must seek training to work through this issue (Standard A.4.b.) rather than perpetually referring LBGTQ clients.

As a footnote, I saw Kaylah in counseling off and on for a little over a year. During that time, her relationship went through various ups and downs. When we terminated, her daily functioning had improved significantly, but she was still nursing her seriously troubled relationship.

Months after termination, I happened across Kaylah in a shopping center. She was with her mother. Meeting clients on the street always makes me nervous, but when our eyes met from a distance, she beamed and ran toward me, towing her mother along by the hand.

Kaylah introduced me to her mother and, in turn, her mother’s face brightened. She stepped forward and hugged me tightly. When she stepped away, she had tears in her eyes. “I don’t know what all you did, but I know you saved my daughter,” she said. “Thank you for helping my baby.”

These were the most sincere and heartfelt words of gratitude I have ever received. I’m positive I did the right thing by my client, and I can’t imagine a world in which my religion would have allowed me to tell Kaylah to move along because I don’t work with clients who are gay.

 

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Gregory K. Moffatt is a professor of counseling and human services at Point University in Georgia. He is a licensed professional counselor and certified professional counselor supervisor. Contact him at Greg.Moffatt@point.edu.

Letters to the editor: ct@counseling.org

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Spirituality in a church-based counseling program

By Jane S. Joyce October 11, 2017

As a counselor in a group supported by a church, I regularly encounter clients who want to discuss spirituality, or who even want spiritual guidance, assuming that because the counseling department is located within the church building, all the counselors are equipped to be spiritual leaders.

The situation can cause ethical concerns, especially considering Standard A.4.b. of the 2014 ACA Code of Ethics: “Counselors are aware of — and avoid imposing — their own values, attitudes, beliefs and behaviors.” The struggle emerges when clients want to discuss spirituality. Although I wish to stay clear of this topic, it can be misinterpreted as my being uninterested or avoiding the topic, which can lead the client to feel disrespected or unimportant. At the very least, the scenario is challenging.

The role of a counselor becomes blurred if too much emphasis is placed on spirituality; in the client’s eyes, the representation of the counselor’s job changes. For instance, the use of prayer can be risky, perhaps setting the counselor up as an “expert” in addressing God and conveying personal beliefs in the wording or delivery. There may be drastically differing belief systems between the counselor and the client, which could potentially damage the relationship. How can I address this situation so that the client’s beliefs and values are respected, while at the same time I follow my ethical code?

In his book Spiritual Practices in Psychotherapy: Thirteen Tools for Enhancing Spiritual Health (2009), Thomas Plante gives some very thoughtful suggestions on using spirituality in one’s practice. I have listed them here, followed by my personal experience of working with them in my practice.

 

1) Become aware of your cultural competencies.

I have learned not to be afraid to admit when I am unfamiliar with a client’s belief system. As with all clients, I strive to be respectful and sensitive to them and make notes to guide myself in learning more. Research, research, research: The internet is a treasure trove of information. Take advantage of programs offered by different faiths and different cultures. For instance, in a larger neighboring city, several annual festivals are held that highlight Native American, Hispanic, Asian and Greek cultures. Food, ritual, and crafts abound, and the experience lessens anxieties when working with other races.

In my graduate multicultural course, I was required to experience a different cultural setting. I attended the Hispanic mass at a Roman Catholic church. The mass was in English and Spanish, but the hymns were all Spanish. A little boy helped me sing by pointing to the words as they came up. It was a warm and uplifting evening, showing the importance of faith and family and giving me a new picture of that culture.

 

2) Take advantage of available resources and programs to increase your knowledge base.

Although I may be a church-based counselor, my job is not to promote my own belief system but rather to be available to hurting people. Learning about these clients’ cultures and beliefs assists me in becoming a better counselor. I mentioned some ways to connect in the previous paragraph, and looking for more opportunities around your area can be a fun way to expand your family’s knowledge too.

 

3) Consider religion to be like any other type of diversity.

Removing the emotion that can be attached to religion frees me to see it as just another facet of the client, just like race or sex. In fact, it can help me form a more objective view of the client’s total perspective. The ACA Code of Ethics emphasizes the need for counselors to honor diversity and adopt a multicultural approach to treating clients. Spirituality is a part of that diversity.

 

4) Consult colleagues.

I am fortunate to have three other counselors who are available for “brainstorming” sessions, and I receive differing viewpoints and possible approaches from them. Additionally, the American Counseling Association offers a wealth of resources on its website (counseling.org) that can guide counselors in learning more about multicultural counseling.

At times, the questions raised by clients are above my expertise. For example, one client questioned why she had not been given the desires of her heart when the Bible plainly states they will be granted. With her consent, I emailed the senior pastor and asked for his guidance. His answer was considerate and timely and gave her comfort in the situation.

Additionally, my mentor has a degree in theology, in addition to his counseling degree, and is always available for my queries. Clients appreciate that I will go the extra mile in exploring a matter that has so much importance for them and that I consult with reliable sources. It enhances the counseling relationship.

At times, the problem is deciding whether spirituality works in the treatment plan designed for a client. In his article, “A Qualitative Exploration Into How the Use of Prayer in Counseling and Psychotherapy Might be Ethically Problematic” (2009), Peter Madsen Gubi presented four words that can assist in deciding whether to include spirituality. He refers to it as EBQT, an easy way to remember his guide.

Evidence: Does enough quality evidence exist to support a spiritual adjunct to therapy? For me, this would be the amount of importance the client attaches to his or her spirituality and beliefs. Another decision-making took is determining whether the presenting problem includes a struggle with spirituality, which happens quite frequently in the church setting.

Belief: Is there congruence between the client’s beliefs, the counselor’s beliefs and the relevance of therapy? I see this as meaning do we both agree on the necessity of inclusion, and does respect exist for differing viewpoints? This is where knowledge and respect come into play. I must examine my own beliefs and biases to provide the best care for my client.

Quality: Will this improve the quality of care for the client? Does it enhance or detract? Will it derail what has been accomplished? Will it derail where counseling is supposed to take the client to accomplish his or her goals? I must be brutally honest on this point and be sensitive to where the client leads, not where I want to go.

Time: Can the component of spirituality be addressed in the time constraints of the session, with respect to the client? My sessions are 50 minutes in length. At times, addressing a spiritual problem can take the whole session, or a session might even have to be ended before crucial questions are addressed. I don’t have the luxury of allowing the session to run over because of other scheduled clients. This can be a real concern.

One last consideration does not apply to me but may to other people. Addressing components of spirituality can be tricky when dealing with third-party payers (insurance) because, generally, it is not reimbursable. We do not accept insurance at my church, but many other church-based counseling groups do. The treatment plan must be grounded in applicable theory, with goal-oriented, measurable results, to be reimbursed by insurance. Spirituality may be mentioned, but other treatment options must be included in filing claims. This is another time when consultation with peers is most helpful. Experience is the best teacher.

These recommendations have served me well for the past three years of practice. They have kept me on target and allowed me to provide the highest-quality attention to my clients’ needs without the input of my own beliefs. By following these shared techniques, it is my hope that your own practice will be strengthened and improved.

 

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Jane Joyce is a licensed professional counselor and doctoral candidate at Carson-Newman University in Tennessee. She is a counselor with LifeSource Counseling, First Baptist Church, Morristown, and an assistant to Dr. William Blevins at the Blevins Institute for Spiritual and Mental Health of Carson-Newman. She retired in 2014 from the Tennessee State Board of Probation and Parole after 25 years and began her second career. Contact her at jsjoyce@charter.net.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.