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Category: Psychotherapy

The Most Troubling Issues to be Addressed When Considering Death and Dying

Posted by Nick Roy in Psychotherapy Tuesday, 9 March 2010 12:48 2 Comments

Euthanasia, or “physician assisted suicide,” is a particularly troubling issue to this writer. Recently, advocates and lobbyists have changed their argument for legalizing euthanasia from suicide as a relief from pain, to suicide as an issue of personal choice. At first this seems benign, especially in a culture where personal choice is already connected to the beginning of life. However, countries that legalize euthanasia tend to adapt their policies quickly, including the Netherlands, where in the short span of seven years, the Euthanasia Act has come to include protocol for euthanizing infants (Finlay, 2009). This may not be as unusual as it sounds, since even in the text used for this class, the author cited research questioning the validity of spending large amounts of money to keep premature infants alive (Feldman, 2008).

Help For Those Addressing These Issues Personally or in Caring for a Family Member

Just like in other areas of life, the Bible can be a central focus for dealing with the issues of death and dying. A person’s relationship with God makes all the difference both in their eternal destination and in the approach a counselor should use when addressing these situations. While the Bible says that followers of Christ have nothing to fear in death (1 Corinthians 4:16-18; 5:8, New American Standard Version), it does indicate that open expressions of grief both before and after the event are appropriate (Psalm 119:28; Romans 12:15, Genesis 50, etc.). Preparation for death can also be helpful. In Scripture, parents often blessed their children as their death neared (Genesis 49), and parents today can alleviate some strain on their children by making their wishes known ahead of time (Khodyakov & Carr, 2009).

References

Feldman, R. (2008). Development across the lifespan, (5th ed.). Upper Saddle River, NJ: Pearson Prentice Hall.

Finlay, I. (2009, May 30-June 5). The art of medicine: Dying and choosing. The Lancet, 373,        1840-1841.

Khodyakov, D., & Carr, D. (2009). The impact of late-life parental death on adult sibling relationships: Do parents’ advance directives help or hurt? Research on Aging, 31(5), 495-519.

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How To Help Someone in Middle Age Identify and Deal With the Issue of Eustress and Distress?

Posted by Nick Roy in Psychotherapy Tuesday, 9 March 2010 12:47 No Comments

Because of its affect on health, stress is a major concern for those going through middle age (Feldman, 2008). Not all stress is bad, and whether or not an external situation results in eustress (good stress) or distress (bad stress) depends entirely on how the situation is appraised by an individual. Therefore, it may not be as important to identify eustress versus distress as it is to change distress into eustress (Le Fevre, Kolt, & Matheny, 2006).

So how can an individual of middle age gain control over their distress levels by appraising a potential stressor in a positive manner? A proper perspective on who God is can help. In Christ, one can always know that “his or her coping strategies are adequate to overcome the challenge posed by the potential stressor” (Feldman, 2008, p. 450). How can one know this? Romans 8:35-39 (New American Standard Bible) is an intense list of terrible, stressful things that could happen in life, but also contains a reassurance that nothing, no matter how great, can separate a believer from the love of Christ. The expectation of this passage is not that the follower of Christ would just survive until the crisis passes, but rather that they would “overwhelmingly conquer” the situation. The Bible is replete with comfort and instruction for stressful times (1 Corinthians 10:13; 1 Peter 5:7; Psalm 23, 37:1-11; 2 Corinthians 4, etc.). Research supports the theory that strong religious commitment helps alleviate the stress associated with middle adulthood (King, Cummings, & Whetstone, 2005).

References

Feldman, R. S. (2008). Development across the lifespan, (5th ed.). Upper Saddle River, NJ:           Pearson Prentice Hall.

King, D. E.  Cummings, D., & Whetstone, L. (2005). Attendance at religious services and            subsequent mental health in middle age women. International Journal of Psychiatry in             Medicine, 35(3), 287-297.

Le Fevre, M., Kolt, G. S., & Matheny, J. (2006). Eustress, distress, and their interpretation in        primary and secondary occupational stress management interventions: Which way first?            Journal of Managerial Psychology, 21(6), 547.

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Confronting Sin in Counseling

Posted by Nick Roy in Psychotherapy, Theories of Counseling Friday, 5 March 2010 21:22 1 Comment

Confronting sin is usually not advised if there is not a good level of trust between the counselor and the client. McMinn (1996) identified four situations in which counselors can use to confront sin: silence, pondering, questioning, and direct censure. Direct censure is the most risky as it has the potential of damaging the therapeutic relationship. As McMinn (1996) has stated, sometimes silence is golden.  Not saying anything causes the client to think through what they just said.  The use of silence is best to show an impartial stand towards a client without having to play judge and jury. As counselors, we are not in the position to play judge and jury. Our goal in counseling is to help a client become more psychologically healthy by bringing them closer to God.

In confrontation it is important to remember the purpose and goal.  The purpose of counseling and specifically of confrontation is to bring healing, redemption, and reconciliation (Brewer, n.d.).  With this in mind the counselor’s aim should be to fully examine their own motives and reasons behind confronting a client.  The best interest of the client at that particular period in time should be the guiding determinant as to what form to use and whether confrontation is appropriate.  Guiding a client toward healing and restoring their relationships between God, self, and others should drive this technique (Brewer, n.d.).

Brewer (n.d.) indicated that many times the word confrontation is immediately linked to what he calls direct censure.   Direct censure involves the common idea of verbally bringing out sin into the open and entails significant risk in the counseling office if the client is not prepared or ready for this specific approach.  Brewer (n.d.) states that the meaning of confrontation in counseling involves many different approaches such as silence, pondering, questioning, visualization of end outcome, and prayer.  These techniques can all be used as a way to encourage the client to work through sinful behavior or questionable situations.

Reference

Brewer, G. (n.d.). [Confrontation and confession in Christian counseling]. Liberty University.

McMinn, M. R. (1996). Psychology, Theology, and Spirituality in Christian Counseling. Carol Stream, IL: Tyndale House Publishers, Inc.

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Types of Prayer for Counseling

Posted by Nick Roy in Psychotherapy, Theories of Counseling Sunday, 28 February 2010 21:37 No Comments

Mark McMinn (1996) seven types of prayer that are appropriate for use in counseling sessions. They are arranged in order of increasing risk of misuse in counseling.

  1. Praying for clients outside of sessions. As counselors, we are committed to the health of our clients. Therefore, we have a spiritual obligation to pray faithfully for our clients. This type of prayer is the least risky for a counselor to use.
  2. Silently praying for clients during sessions. The counselor needs to use this type of prayer with care. McMinn (1996) recommends using it during pauses in the session in order for the counselor to ask for guidance from the Holy Spirit. The counselor should keep it brief and set other limits so as to not interfere with the counselors listening ability. Having a counselor engaged in silent in-session prayer at the same time the client asking the counselor a question could damage the client-therapist relationship.
  3. Devotional meditation outside of sessions. This type of prayer can be as effective in reducing anxiety or anger issues in a client. However, whereas in Eastern religions, the use of imagery and meditation is used to empty one’s mind, this type of meditation is used to fill one’s mind with positive thoughts from the Holy Spirit as the guide.
  4. Devotional meditation during sessions. This type of prayer is considered effective as part of cognitive behavior therapy when a counselor is trying to help a client modify faulty core beliefs.
  5. In-session prayer training. Clients learn the various types of prayer during the counseling session and complete homework assignments at home to strengthen their spiritual life.
  6. Occasional in-session prayer. This type of prayer may be beneficial for those clients facing acute stress or grief, such as for people coping with the loss of a loved one. However, praying with a client who is known to have a mental disorder, such as schizophrenia could be destructive to the patient and to the therapeutic relationship.
  7. Routine in-session prayer. This type of prayer is what Jesus condemned as it is praying for social effect. Most prayer should a private relationship with God. Routine in-session prayer runs the risk of becoming a ritual as with praying before meals is a ritual and social effect.

References

McMinn, M. R. (1996). Psychology, theology, and spirituality: In christian counseling. Carol Stream, Illinois: Tyndale House Publishers, Inc.

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Prayer in Counseling Continued

Posted by Nick Roy in Psychotherapy, Theories of Counseling Sunday, 28 February 2010 12:05 No Comments

Mark McMinn (1996) describes four types of prayer that may be used in the field of Christian counseling. Counselors may silently pray for clients during pauses in conversations, counselors may also pray for clients outside of sessions. I believe these two forms of prayer are always beneficial and should be implemented by the Christian counselor. The final two types of prayer that McMinn (1996) describes are when counselors orally pray with clients during a session and when counselors encourage clients to pray outside of sessions. I believe these forms of prayer may be, but are not always appropriate. When prayer is unwanted or causes the client to become uncomfortable it actually becomes counter effective and may be detrimental to the process of helping and healing. We as counselors should be open to yet cautious when using prayer in counseling settings.

References

McMinn, M. R. (1996). Psychology, theology, and spirituality: In christian counseling. Carol Stream, Illinois: Tyndale House Publishers, Inc.

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