Why would a therapist try to change a client's worldview? That would be
unethical. I don't think that's what you mean -- I would imagine you mean
why wouldn't we suggest a different worldview?
The most painful case I had in this regard was a man who had strong Catholic religious beliefs-who believed deeply that homosexual urges and behavior were sinful and yet who experienced uncontrollable homosexual desires. His choices were to drink himself into sever alcoholism or kill himself if he didn't alter his worldview. Do you try to alter the world view or watch him die slowly or more quickly-perhaps taking someone else with him?
Again, also problematic, although I'm not saying it shouldn't be offered.
Maybe a specific example would help.
Let's say the person comes into therapy (and this happens...), and says due
to his/her religious beliefs, divorce is NOT an option. But the client is clearly
in a miserable marriage.
So, one might argue the worldview is "causing" the mental distress, and
could be changed. But should a therapist offer a different view?
And what happens when the client rejects any change in his/her view?
What then?
> > adjustment to life stressors. One of the problems is that many
> > psychologists are neither trained nor comfortable in dealing with
> > religious issues in therapy. This is supported by survey research
> > investigating training issues (cf Schulte et al, 2002).
>
> But lack of training about specific attitudes and values must be
> true for many areas, not just religious values (e.g., training in
> attitudes of poor to financial problems, attitudes of rural
> people toward the land, attitudes of gay and lesbians toward
> gender, ...).
Absolutely.
One of the difficulties multicultural counseling has presented, especially to
graduate students, is the occasional implicit message that a therapist must
be all things to all clients.
And that is not possible.
I think it's unrealistic to expect a therapist to be well-versed in religions
anymore than a variety of cultures.
The key is to help the therapists, particularly in training, to recognize their
lack of knowledge, and to keep any biases about religion, culture, etc. from
interfering with the therapeutic process.
That's much more realistically attained.
> Sorry, but it seems to me that if you advocate some of the
> religious coping strategies (e.g., collaborating with god), then
> you are indeed lending your professional support to those
> religious beliefs.
So we should tell the clients NOT to do this?
> I can also imagine a scenario where people
> with certain beliefs find like-minded "psychologists" to help
> them "cope" without really challenging those beliefs (e.g., that
> everyone but people in their clique will go to hell for eternity,
> that women should be subservient to men, that parents are allowed
> to punish children and withhold medical treatment, ...).
Too many examples. As far as the issue of withholding treatment,
any therapist must inform a client/clients of the necessity of adhering to the
law, and the therapist would have a duty to report clients where their
failure to abide by the law endangers the client's or someone else's (e.g.,
child) health.
I'll step over "clique," and "subservient" -- I believe at least one of these has
been covered before, and is a distortion of what churches teach about gender
roles IN (not outside of) the church.
> I've had many atheistic, agnostic, or non-religious clients
> > and the issue of religion or spirituality was never addressed. But I've
> > also had a number of religious client (primarily evangelical Christians)
> > for whom their faith was a central organizing framework through which
> > they conducted their life.
>
> And what have you done when you thought that their religious
> perspective contributed to their problems?
Good question. Examples would be good.
Could you provide one that would be helpful to examine? Seriously -- that is
a great question.
> And are you honest with your clients that although you are using
> "religious" strategies, those strategies do not in fact operate
> by supernatural (i.e., religious) means? And do you provide them
> with the non-religious explanations for their effectiveness?
I would assume he does, but let him speak for hisself.
You'll find Christian therapists to vary widely on the inclusion of religious and
non-religious explanations for mental health issues/problems.
It is certainly not a case of either-or, but emphasis.
Some emphasis religious explanations and strategies more, some
emphasize them less.
Of course, this also depends on the client's religiosity -- how "religious" the
client professes to be may also mediate the extent of religious and non-
religious explanations/approaches.
> And, of course, if the non-religious explanations are correct,
> then there is really no need to adopt the religious orientation,
> except perhaps for purely pragmatic reasons (i.e., that is where
> they can find social support).
What if the non-religious and religious explanation concur?
Then the non-religious explanation becomes buttressed. That's pretty good,
ain't it?
> Not being a therapist (although my wife is), I have long wondered
> whatever became of Rogers' idea of congruence? As I remember it,
> Rogers thought that mental health involved an accurate conception
> of external reality, and that incongruence resulted in
> psychological difficulties and even disorders. Some moderate
> degree of incongruity was associated with neuroses (this was some
> years ago), whereas marked incongruity was associated with
> psychoses.
As I remember it, Rogers' view of congruence pertained to how one sees
himself, and how one would like to be seen/like to be. The greater the
disparity, the more likelihood of mental distress/personal problems.
Rogers wasn't so much focused on external reality as internal. Quite the
phemomenological dude.
> For me as a scientist, I find it somewhat strange
> that psychotherapists might actually reinforce or at least accept
> (tolerate) beliefs about the external world (including our social
> worlds) that could conflict with a well-founded worldview.
Can you elaborate on this?
> Just as one example of this, an article in the newspaper here
> today noted that exorcisms continue to be conducted in the
> Catholic church, including several over recent decades by the
> Pope himself. They cited one example of a woman who's demon told
> her she would vomit radio parts. She proceeded to throw up parts
> of a transistor radio. The "treatment" was exorcisms by a priest
> (I forget whether this was one the "cases" "treated" by the
> Pope). Can my more religiously oriented colleagues explain how
> they can in good conscience NOT challenge a religious explanation
> and treatment for such conditions?
This is quite complicated. And something I have no experience in.
For one, it gets into the notion that Catholics believe their constituents can
become demon-possessed. You'll generally not find bible-thumpers arguing
this.
Regardless of theological differences, I think we should always look for the
medical explanation FIRST before doing something like an exorcism. I would
hope the Catholic church is doing just that. Otherwise, beeg trouble.
Q: BTW, do you know what happens when you refuse to pay your exorcist?
A: You get repossessed!
Sorry, that was dumb, but I couldn't help myself.
> Why this discussion on TIPS? There appears to be a
> well-orchestrated effort to intensify the role of religion and
> spirituality in psychological training and treatment, hence in
> education of therapists. For example, there have been a number
> of books published by APA in recent years, the clustering of
> which does not seem random. Much of the writing on culture and
> psychology also emphasises the importance of spirituality for the
> non-Eurocentric minded.
Agreed. Could be good, could be bad.
Maybe both.
Thanks,
Jim
************************************************************************
Jim Guinee, Ph.D.
Director of Training & Adjunct Professor
President, Arkansas College Counselor Association
University of Central Arkansas Counseling Center
313 Bernard Hall Conway, AR 72035 USA
(501) 450-3138 (office) (501) 450-3248 (fax)
"He who passively accepts evil is as much involved
in it as he who helps to perpetrate it"
-Martin Luther King, Jr.
**************************************************************************
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