General Editors Managing Editors George Ohlschlager And .

Mediation . . . . . . . . . . . . . . . . . . . . 294Divorce Recovery . . . . . . . . . . . . . . 29615. Sexuality and Sexual Therapy . . . . . 299Sex After 50 . . . . . . . . . . . . . . . . . . 299Sexual Intimacy and Delight . . . . . . 301Sexual Abuse . . . . . . . . . . . . . . . . . . 303Sexual Desire Disorders . . . . . . . . . 305Orgasmic Disorder . . . . . . . . . . . . . 307Sexual Pain Disorder . . . . . . . . . . . . 309Paraphilias and Sexual Deviance . . . 313Pedophilia . . . . . . . . . . . . . . . . . . . . 316Sexually Transmitted Diseases . . . . . 317Sexual Therapy . . . . . . . . . . . . . . . . 319Sensate Focus . . . . . . . . . . . . . . . . . 321DEC-R Sexual Coaching . . . . . . . . 323Sexual and Gender Identity . . . . . . 325Homosexuality . . . . . . . . . . . . . . . . 327Homosexuals Seeking Change . . . . 329Sexual-Identity Therapy . . . . . . . . . 332HIV/AIDS Counseling . . . . . . . . . 33416. Families and Family Therapy . . . . . 337Family-of-Origin Issues in BlendedFamilies . . . . . . . . . . . . . . . . . . . 337Blended Families . . . . . . . . . . . . . . . 338Generational Transmission . . . . . . . 340Blessings . . . . . . . . . . . . . . . . . . . . . 342Individuation . . . . . . . . . . . . . . . . . 343Identified Patient . . . . . . . . . . . . . . 345Triangulation . . . . . . . . . . . . . . . . . 346Double Bind . . . . . . . . . . . . . . . . . . 347Gambling . . . . . . . . . . . . . . . . . . . . 384Pornography and Sex Addiction . . . 386Substance Abuse . . . . . . . . . . . . . . . 38819. Grief, Crisis, and TraumaIntervention . . . . . . . . . . . . . . . . . . 393Grief . . . . . . . . . . . . . . . . . . . . . . . . 393Disability . . . . . . . . . . . . . . . . . . . . 394End-of-Life Issues and Death . . . . . 396Death of a Child . . . . . . . . . . . . . . . 398Crisis Intervention . . . . . . . . . . . . . 399Combat Trauma . . . . . . . . . . . . . . . 402Posttraumatic Stress Disorder . . . . . 404Traumatic Memory . . . . . . . . . . . . . 406Part 5: Counselor Skills,Theories, and Therapies20. Core Skills and Concepts forChristian Helpers . . . . . . . . . . . . . . 413Helping Relationships . . . . . . . . . . . 413Therapeutic Alliance . . . . . . . . . . . . 414Counseling Skills . . . . . . . . . . . . . . 416Core SkillsCompassion and Empathy . . . . . . . 418Genuineness . . . . . . . . . . . . . . . . . . 419Respect . . . . . . . . . . . . . . . . . . . . . . 421Intermediate SkillsNonverbal Communication . . . . . . 423Attending Skills . . . . . . . . . . . . . . . . 423Reflecting Skills . . . . . . . . . . . . . . . . 424Modeling . . . . . . . . . . . . . . . . . . . . 426Open-Ended Questions . . . . . . . . . 428Visualization . . . . . . . . . . . . . . . . . . 429Role Playing . . . . . . . . . . . . . . . . . . 43017. Child and Adolescent Issues . . . . . . 349Childhood Development . . . . . . . . 349Childhood Maturation . . . . . . . . . . 351Moral Development . . . . . . . . . . . . 353Identity Formation . . . . . . . . . . . . . 354Developmental Disorders . . . . . . . . 357Intellectual Disabilities . . . . . . . . . . 360Conduct Disorder . . . . . . . . . . . . . . 362Impulse Control Disorders . . . . . . . 363Attention-Deficit/HyperactivityDisorder (ADHD) . . . . . . . . . . . 366Child Abuse . . . . . . . . . . . . . . . . . . 369Play Therapy . . . . . . . . . . . . . . . . . . 371Advanced SkillsImmediacy . . . . . . . . . . . . . . . . . . . 431Self-Disclosure . . . . . . . . . . . . . . . . 432Transference andCountertransference . . . . . . . . . 434Silence . . . . . . . . . . . . . . . . . . . . . . . 436Motivational Interviewing . . . . . . . 437Expertness . . . . . . . . . . . . . . . . . . . . 438Psychodrama . . . . . . . . . . . . . . . . . . 44018. Substance Abuse and BehavioralAddictions . . . . . . . . . . . . . . . . . . . 375Addiction . . . . . . . . . . . . . . . . . . . . 375Addictions Counseling . . . . . . . . . . 37712-Step Programs . . . . . . . . . . . . . . 380Dual Diagnosis . . . . . . . . . . . . . . . . 38121. Counseling Theories and Therapies . 443Psychodynamic Theory . . . . . . . . . . 443Adlerian Therapy . . . . . . . . . . . . . . . 445Existential Counseling . . . . . . . . . . 447Logotherapy . . . . . . . . . . . . . . . . . . 449Rogerian Therapy . . . . . . . . . . . . . . 451Copyrighted materialPopular Encyclopedia of Christian Counseling.indd 56/9/11 3:53 PM

Reality Therapy . . . . . . . . . . . . . . . . 452Integrationist Perspective . . . . . . . . 454Cognitive-Behavioral Therapy . . . . 455Dialectical Behavior Therapy . . . . . 458Narrative Therapy . . . . . . . . . . . . . . 460General-Systems Theory . . . . . . . . . 461Emotion-Focused Therapy . . . . . . . 462Interpersonal Psychotherapy . . . . . . 465EMDR Practice . . . . . . . . . . . . . . . 466Eclecticism . . . . . . . . . . . . . . . . . . . 468Thinking/Feeling/Acting Paradigm . 471Multimodal Therapy . . . . . . . . . . . . 472Theoretical Integration . . . . . . . . . . 474Career Counseling . . . . . . . . . . . . . 475School Counseling . . . . . . . . . . . . . 477Gerontological Counseling . . . . . . . 47922. Christian Cognitive andStrength-Based Therapy . . . . . . . . . 481Christian Cognitive Therapy . . . . . 481Core Beliefs and Schemas . . . . . . . . 483Self-Talk . . . . . . . . . . . . . . . . . . . . . 485Emotional Reasoning . . . . . . . . . . . 486Renewing Your Mind . . . . . . . . . . . 488Brief Therapy . . . . . . . . . . . . . . . . . 489Solution-Focused Counseling . . . . . 491Strength-Based Counseling . . . . . . . 493TRUTH Model of Counseling . . . . 495Cognitive Change Techniques . . . . 497Part 6: Systemic and EthicalIssues, Education, and Research23. Multiculturalism, Diversity, andOther Challenging Issues . . . . . . . . 501Assimilation and Acculturation . . . . 501Cultural Competence andMinority Groups . . . . . . . . . . . . 503Ethnicity . . . . . . . . . . . . . . . . . . . . . 505Multicultural Counseling . . . . . . . . 507Racial Identity . . . . . . . . . . . . . . . . . 50924. Ethical and Legal CounselingIssues . . . . . . . . . . . . . . . . . . . . . . . 513Accountability . . . . . . . . . . . . . . . . . 513Confidentiality and Exceptions . . . . 514Documentation and Records . . . . . 516Dual Relationships (Ethics) . . . . . . 519Informed Consent . . . . . . . . . . . . . 520Legal Issues in Counseling . . . . . . . 522Consultation and Referral . . . . . . . . 525Termination . . . . . . . . . . . . . . . . . . 527Compassion Fatigue, Burnout,and Self-Care . . . . . . . . . . . . . . . 52925. Education, Supervision, andResearch . . . . . . . . . . . . . . . . . . . . . 533Counselor Education . . . . . . . . . . . 533Continuing Education . . . . . . . . . . 534Supervision . . . . . . . . . . . . . . . . . . . 536Effectiveness of Psychotherapy . . . . 538Evaluation in Counseling . . . . . . . . 539Empirically Supported Treatments . 541Meta-Analysis and Theory . . . . . . . 543Outcome Research . . . . . . . . . . . . . 545Qualitative Research . . . . . . . . . . . . 546Quantitative Research . . . . . . . . . . . 54826. New Developments in ChristianCounseling . . . . . . . . . . . . . . . . . . . 551Coaching . . . . . . . . . . . . . . . . . . . . 551Cyber-Counseling . . . . . . . . . . . . . . 552Forensic Psychology . . . . . . . . . . . . 554Leadership and OrganizationalPsychology . . . . . . . . . . . . . . . . . 557Positive Psychology and HumanFlourishing . . . . . . . . . . . . . . . . 559Managed Care . . . . . . . . . . . . . . . . 562Contributors . . . . . . . . . . . . . . . . . . 565Alphabetized Index of Articles . . . . . 571Copyrighted materialPopular Encyclopedia of Christian Counseling.indd 66/9/11 3:53 PM

1CHRISTIAN COUNSELINGDESCRIBED AND DEFINEDchristian counselingChristian counseling is a worldwideenterprise—a ministry-profession that ismaturing in complexity and in membership.It consists of professional clinicians, pastoral counselors, and many others who delivercounseling and care-giving services to a widerange of clients from a distinctively Christian worldview. It is a triadic form of counseling that implicitly or explicitly honorsJesus Christ and believes the Holy Spirit isalways present in the counseling relationshipwith the counselor and the client. Christian counseling has many goals, includinghelping people deal with severe losses, conflicts, and disorders, but it has one ultimateconcern: helping clients become more likeChrist and grow into a deeper intimacy withGod and with one another.Definitions and Purposes. Christiancounseling has grown into a “big tent” thatencompasses a wide range of definitions andpractices. A pioneer Christian counselor,Gary Collins (1993), found that attempts to define or describe Christian counseling tend to emphasize theperson who does the helping, the techniques or skills that are used, and thegoals that counseling seeks to reach.From that perspective the Christiancounselor is: a deeply committed, spirit-guided(and Spirit-filled) servant of JesusChrist who applies his or her God-givenabilities, skills, training, knowledge,and insights to the task of helping others moveto personal wholeness, interpersonalcompetence, mental stability, andspiritual maturity (Collins, 1993,p. 21).Another pioneer, Larry Crabb (1977),argued that the goal of Christian counseling should not be to make clients happy, butto promote Christian maturity (both spiritual and psychological) and to “free peopleto better worship and serve God by helpingthem become more like the Lord” (p. 20).He suggested that effective counseling needsboth “a caring relationship and an understanding of human functioning” (p. 14) andthat counseling insights and skills should befilled with Christ’s love.Everett Worthington (1999) offeredthis careful, cryptic, and comprehensivedefinition:Christian counseling is an explicit orimplicit agreement for the provision ofhelp for a client, in which the counselorhas at heart the client’s psychologicalwelfare, but also the client’s Christianspiritual welfare and tries to promotethose goals through counseling methods, and the client can trust the counselor not to harm and to try to help theclient psychologically and spiritually(Worthington, 1999, p. 189).In Competant Christian Counseling (Clinton & Ohlschlager, 2002), we wrote that:Copyrighted materialPopular Encyclopedia of Christian Counseling.indd 116/9/11 3:53 PM

12The Popular ENcyclopedia of Christian Counselingwe propose a Paracentric focus that melds two crucial aspects of Christiancounseling . Our yieldedness to theParaklete of God—the Holy Spirit—who is the invisible God present incounseling [and our commitment]to Paraklesis to “come alongsidesomeone to help.” These terms describeSpirit-directed and Christ-centeredpeople committed to assisting othersacross a wide range of needs, from consolation to encouragement to confrontation . A Paracentric focus representsa centered convergence in Christ as ourexalted model, and on the client as theclinical and ethical object of our ministry. This focus conveys the full arc ofthe helping process The competent Christian counselor,yielded to an active, holy, and merciful God (1 Corinthians 1:18), meetsthe client at his or her point of need(diverging and becoming all thingsto all people [1 Corinthians 9:19,2]), and connects with the client tocreate a working alliance. This activity includes comforting the brokenhearted, supportingthe weak, encouraging the discouraged, exhorting those who aremotivated, entreating and guiding the misdirected, and warningthe rebel and sinner (the full scopeof Spirit-led counselor behavior isdescribed in 1 Thessalonians 5:14and 2 Corinthians 1:3-7). The counselor serves to refocus, facilitate, instruct, and reinforce clientaction toward growing up into maturity (Ephesians 4:12-16) and livingin more intimate relationship (John17:9-13) with the divine object ofour faith, Jesus Christ. This involvesde-centering ourselves (Lamentations 3:20-24) and converging orcentering on the Author and Finisherof our faith (Hebrews 12:2).Christian counseling must be abiblical-clinical process that facilitatescase-wise client sanctification. It is builton the sure foundation of Scripture,dependent on the inspired leading ofthe Holy Spirit, and selectively using thebest of helping ministry resources andthe bio-psycho-social sciences (Clinton& Ohlschlager, 2002, pp. 50-51).The revised edition of Psychology andChristianity (Johnson, 2010) has five coreparadigms through which to view the content and process of Christian counseling, upfrom the four views of the original edition. The biblical counseling model holds thatthe Bible alone is the source of all wisdom and revelation in counseling, andany reliance on psychology or extrabiblical resources has a high likelihoodof tainting the counseling endeavor. The levels-of-explanation model holdsthat Christian religion and psychology are two different fields that arebest left and approached as they are,without any mixing. The integration model attempts to synthesize psychology and theology withthe Bible as the controlling source.Any psychology in contravention ofthe Bible is rejected as unacceptablefor integration. The Christian psychology model assertsthat psychology from every era andhistory is worthy of study, especiallythat done by church leaders andsaints from throughout history. The newest model, the transformativeworldview, conceives of doing psychology and theology in an embodiedredemption, in the power of the HolySpirit. Sanctified scientists make a hugedifference in the doing of psychology.Possibly the best one-sentence descriptionof Christian counseling was given recentlyCopyrighted materialPopular Encyclopedia of Christian Counseling.indd 126/9/11 3:53 PM

Christian Counseling Described and Defined13by Siang-Yang Tan (2011, p. 363), emphasizing the role and work of the Holy Spirit:“Christian counseling or psychotherapy canbe simply described as counseling conductedby a Christian who is Christ-centered, biblically based, and Spirit filled” (p. 363).nouthetic counseling, and Gary Collins’Helping People Grow (1980) and Case Studies in Christian Counseling (1991). Afterevaluating the various theories and theirconstruction, Worthington notes, “the challenge before our profession [is] to fashion atruly integrated set of Christian counselingTheory-Building and Research.theories, supported by Scripture, experience,Everett Worthington (1993) has analyzed and research” (1993, p. 33). Recent develChristian counseling theory building from opments, such as Mark McMinn and ClarkCampbell’s (2007) social cognitive thethree distinct conceptualizations.Academic and research-based theories. Beut- ory and Siang-Yang Tan’s (2011) Christianler and Bergan (1991) have shown not only counseling development reflect Worthingthe value-laden nature of psychotherapy but ton’s concern and integrate Scripture, thealso how values similarity influences client ory, experiences, and science.identification with a counselor, and howvalues differences (faith-based vs. secular Current Status. Currently, many levels ofapproaches) impact counseling outcomes. care can be given to clients based on the proWorthington (1988) suggested three dimen- fessional proficiency of the helper.sions of values (i.e., the role of authority ofhuman leaders, Scripture or doctrine, and Professional counselors and cliniciansare licensed professionals across thereligious group norms) essential in workingdisciplines of psychology, social work,with religiously committed clients. Allenmental-healthcounseling, marriageBergin (1980) identified and contrastedandfamilytherapy,and the two meditheistic values with nonreligious clinical andcaldisciplines,psychiatryand nursing.humanistic values.Religious versions of secular theories. The Pastoral and biblical counselors workmany adaptations of secular models revealedlargely in the church.the strong reliance of cognitive therapiestransformed into sources of “renewing the Recovery counselors work largely in theaddictions field.mind.” These included counseling models byLarry Crabb (1977), Robert McGee (1990), Lay and peer counselors also workNorm Wright (1981), Everett Worthingtonmostly in the church.(1989), and Bill Backus (1985). Also notedIn Caring for People God’s Way (Clinton,were eclectic attempts at integration, suchas models by Smith (1990) and the leaders Hart, & Ohlschlager, 2005), we outlinedof the Minirth-Meier Clinic in their heyday seven synthesizing traits that we believe(Minirth, Meier, & Wichern, 1982). Jones anchor most of what is done in Christianand Buttman’s (1991) analysis of secular the- counseling today.ories from a Christian worldview is also an1. Scripturally anchored. True Christianimportant contribution.counseling is as dependent on ScripSpecifically religious theories. Some theture as people are on food and waterories have been developed superficiallyto live. The Scriptures are, in fact, theas Christian approaches. These theoriesfood and water of spiritual life.are represented by Paul Tournier’s (1965)The Healing of Persons, Charles Solomon’s 2. Spiritual forming. Christian counselors are called to help form the Spirit(1977) spirituotherapy, Jay Adam’s (1973)Copyrighted materialPopular Encyclopedia of Christian Counseling.indd 136/9/11 3:53 PM

14The Popular ENcyclopedia of Christian Counselingof God into the lives of those whocome to us for help.3. Short-term (initially). Nearly all clients terminate counseling in six toten sessions. Brief therapy is mandatory for all clients, but long-termtherapy is discretionary, chosen bythose who want it and can afford it.4. Solution-focused. Solution-focusedtherapy arose as did brief therapy,with counselor and clients looking forsolutions that have worked before andwork partially on the client’s behalf.5. Strength-based. Intimate sibling tosolution-focused and brief forms oftherapy, strength-based assessmentinvolves searching for and magnifying client strengths, which, as theygrow stronger, crowd out any roomfor problems to fester and grow.6. Storied narratives. Human beingslive by stories, tell about their livesin stories, and relate to God and others primarily in storied forms. Godreveals himself to us primarily in theway of a grand story of creation-Fallredemption that cycles over and overthroughout history. Therapy at itsbest is a lived narrative.7. Scientific. In a scientific world, alltruth claims are submitted to the rigors of the empirical way. Christiancounseling must do the same and hasnothing to fear

General Editors Managing Editors George Ohlschlager and Pat Springle Contributing Editors Ryan Carboneau Joshua Straub Laura Faidley Hitomi Makino Popular Encyclopedia of