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Suicide is Not Advocacy

Along with many of you, I was shocked and dismayed to hear of Jarrid Wilson’s death by suicide last week. Jarrid was an associate pastor and mental health advocate who was vocal about his own challenges with depression and suicidal thoughts. With his death, we have one less voice in the fight against stigma in the church.

I’ve been keeping an eye on the headlines to see how his death is portrayed. Most are helpful, some sadly equate suicide with an unpardonable sin, but one in particular causes me to pause. A USA Today headline: “Suicide of Prominent Pastor Jarrid Wilson Forces Church Leaders to Confront Mental Health.” No. Period. Full Stop. No. His death did not force us to confront an issue. Many have already been working to confront this issue (which the article details quite nicely). Jarrid was part of that work. We have a lot of work to do, but Jarrid’s death is not forcing us into doing it.

I react strongly to that in part because I have seen the ways that depression twists thoughts and causes people to believe that the world would be better with their death. I don’t know what Jarrid might have been thinking the night he died, but it is possible that he thought something like, “Nothing seems to be working. No one is paying attention. Maybe I can get them to listen more if they see what suicide is.” Again, I do not want to put any words into his mind that were not there. I simply raise it to say that leaders are at risk for thinking in that way when they are depressed. I’ve heard those kinds of words from others, and it’s a type of martyrdom that we need to reject outright.

Suicide is not advocacy work. We do not need tragedy to shine light on this issue. We need more voices, more workers in this fight, not fewer. Every death means we have one less person out there working to share their story or decrease stigma. We have one less person in our world to make a difference. For leaders, that is critically important. If we are going to do more to address pastors’ mental health in particular, we cannot endorse any lie that suggests suicide is an effective way to advance the cause. That lie just might kill someone else.

Check out my Twitter thread on this topic and join the conversation: https://twitter.com/ChurchTherapist/status/1173193467410964486

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Why Church Therapy?

The mission of Church Therapy Associates is to help the church provide quality mental health care and to train Christian counselors to work in church settings. Why does this matter? There are several reasons why the church needs the Church Therapy model of Christian counseling:

Our History Requires a Better Approach

Since the 1960s and 1970s, the church has had a tenuous relationship with psychology and mental illness. During that time, many in the church were making critically important statements about the church’s mission and the inerrancy of Scripture in the face of a rising field of humanistic psychology. The push-back of biblical counselors on the early Christian psychologists was necessary to bring the conversation forward. The integration of psychology and theology was the positive by-product of this debate, and I wish I could say that we all continued to move forward and advance in our research and approach. However, decades-old debates continue to rage in our churches, with parishioners caught in the crosshairs. Some are still discouraged by their pastors from seeking mental health treatment, while others find pastors and churches who are very friendly to mental health care. Church Therapy is a bridge and hopefully an answer to bring us away from debate and help us focus on those who need help from multiple sources of support. We must not remain in old conversations when new approaches are developing around us. Church Therapy is a model that seeks to bring all of the best counseling research and careful theological discourse together and align it with the work and mission of the local church. This approach also serves as a means of healing within the church for those who have been stigmatized and harmed by poor theology and ineffective counseling tools.

The Numbers Aren’t Good Enough

According to the National Alliance on Mental Illness, only about 40% of American adults with symptoms of a mental illness actually get treatment. As Christians, we cannot rely entirely on worldly systems to solve problems. Broken health care models and inaccessible services as well as stigma about getting treatment must not hold the church back from creating real solutions. We know from many studies that people turn to their pastors when they experience mental health challenges. The Church Therapy model is a call to professionally trained and licensed counselors to serve and work within the mission of the local church. Pastors and counselors can work together to provide short- and long-term mental health care treatment within the walls of the church. Mental health services located where people already go create accessibility and help decrease the stigma associated with getting help. Creative payment structures are also possible when churches help decrease the overhead costs for professional counselors.

The Church is a Place for Spiritual and Emotional Healing

Larry Crabb wrote a book titled “The Safest Place on Earth,” describing a vision of what the church can and should be. Imagine if church was more than a place to go on a Sunday morning. Imagine if you could be loved and accepted and helped in all the areas that the Holy Spirit is seeking to heal and transform you. The Church Therapy model provides a higher level of care than pastors are trained to provide. Licensed mental health counselors provide mental health treatment for more complicated issues like trauma, addiction, clinical depression, or social anxiety. Some churches do not know what to do with someone who has a chronic mental illness, and this lack of skill inadvertently marginalizes those who need help. Church can’t just be a place for upper-middle class people who have generally stable lives. The kinds of people that followed Jesus around are ones that don’t think ahead about packing a lunch and need a miracle meal. They are the ones that have been cast aside and forgotten in the graveyards of society. Instead of sending all the “complicated” people somewhere else, Church Therapy provides care in and for the church.

More times than I can count, my clients have said to me, “I would never have gone to counseling if it weren’t part of the church.” Others have expressed comfort in the fact that they can share every part of their story and still be accepted and valued by the church. I hope to do more extensive research on this model and on mental illness within the church so that we can more clearly understand the scope of the problem and find new strategies that work uniquely in church settings. Comment below if you are a pastor or counselor who would like to be a part of this model!

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Exciting Changes!

Last month I was excited to announce the creation of a new non-profit, Church Therapy Associates, which will provide low-cost mental health counseling services in church and Christian college settings and will provide training opportunities for Master’s-level counseling students and graduates. As a result of these changes, you will soon notice changes to this website. The blog will operate in the background, but the site will become a platform for the non-profit and its services. If you have subscribed to this blog, I sincerely appreciate your support. I hope that you continue to follow me on Twitter (@ChurchTherapist) to see the latest news. Join me in advocating for those with mental illness in our church communities!

Blessings and thank you for all the support,

Kristen

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Boundaries in Church Therapy

Many people ask me, “How does it work for the professional therapist to see clients at his or her own church? Doesn’t that violate counseling boundaries?” This is a great question that is worthy of attention. Clearly professional counselors are bound by ethical codes, such as the one created by the American Counseling Association. Boundaries must be in place to protect the therapeutic relationship, the client, and the counselor.

Licensed therapists practice in a variety of settings, such as hospitals with a group milieu and agencies that offer wraparound services (multiple providers offering different aspects of treatment all around a common goal). Those in private practice typically only see the client in the office and do not interact with clients outside the office. For the private practice setting this is absolutely essential for both the client and the counselor as this is the agreed-upon context in which the work can take place.

Church therapists are professionals working on a church staff. You are a part of the church’s leadership team, offering insights and education to pastors as well as providing care in the context of the church. Your office is in the church building. When thinking about appropriate boundaries, it is critical to first look at the context of treatment. Where and how have both you as the counselor and your client agreed upon for treatment to take place? In church therapy, both the counselor and the client have entered into treatment with the understanding that work will take place in the church building, that the pastors are a part of the treatment team (be sure to have the client sign releases for any pastor or other provider to whom you may speak), and that the counselor will be present in other areas of the church building at other times when therapy is not in session.

Now we enter the more complicated realm: when the church therapist and client see each other in the church setting but OUTSIDE the therapy office, how do they interact? I personally begin treatment with the client by talking about this before we begin any work. I assure them that I will never ask them follow-up questions or get therapy updates outside of the therapy office. I ask the client to use my voicemail to reschedule appointments rather than approaching me in church. Once I was even asked if I would ever share a prayer request about one of my clients… (That would be a big NO!). My clients and I may wave or say hi in the church building, just as I would with anyone else. The goal here is to make your interaction with clients at church mirror your interaction with anyone else. Remember, even the fact that a client is coming to see you must remain confidential along with the content of the therapy itself. Only those for whom the client has signed a release form can know that he or she is in treatment with you. To be a successful church therapist, you MUST be on guard to keep very tight lips.

Because the church therapist is on church staff in the role of professional therapist, anytime he or she is in the church building he or she is in that role. Those in private practice or agency work have the right to expect that their church experience will be their own and will not become complicated with client interactions. Their place of work is outside of the church setting, and as a result their client interactions are all separate from their church lives. However, the church therapist is one who has felt a calling to church leadership AND to counseling. Therefore, your expectation is to be “on” when you are at church. This is more similar to the role of pastor in the sense that your social/spiritual life is supplementally fed outside of your church.

It is critical for the church therapist to realize that he or she cannot develop many intimate friendships at church. I personally have a small handful of confidants, 2-3 of whom attend my church and 2-3 of whom do not. Those I trust who do attend my church never ask about my work and I never discuss it with them. We also have a clear understanding that (much like the pastor) when we are at church I am in the role of on-staff therapist. Within that church leadership role, I lead ministries related to prayer and caring for the soul. My focus is not on catching up with my friends at church. Rather, we set aside intentional times to connect outside of church. I will talk in more detail about this in a later post about self-care for the church therapist.

The American Counseling Association has some helpful information on this topic. Here is a useful link  related to dual relationships: http://ct.counseling.org/2006/12/new-guidelines-on-dual-relationships/

The following article which can be read in its entirety on web.ebscohost.com also offers help on this topic:

Haug, I. E. (1999), Boundaries and the Use and Misuse of Power and Authority: Ethical Complexities for Clergy Psychotherapists. Journal of Counseling & Development, 77: 411–417. doi: 10.1002/j.1556-6676.1999.tb02467.x

*One final note: the article focuses on “clergy psychotherapists” in which the therapist IS the pastor. In my definition of church therapy, the church therapist is on staff for the primary purpose of providing counselor and does not take on pastoral roles with clients. This role definition is useful in the development of clear role expectations.

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NEW DEVOTIONAL!

I am excited to announce the release of my brand new devotional — Freedom For Today: The Book of Mark. Designed for those new to the Bible, this daily reading guide walks you through the entire book of Mark in 45 days. The devotionals are written in plain, everyday language that anyone can understand. In addition, each day has a highlighted sentence that focuses on the emotional freedom that the Gospel brings us. This is a great resource for your church to give to new guests or to help introduce someone to the habit of daily Bible reading. You can find more of my daily devotionals at FreedomForToday.com.

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Christian Mindfulness

The word “mindfulness” is defined as “a quality or state of being conscious or aware of something.” While this idea has Buddhist origins, the direction of one’s awareness is what can make this practice different between Christians and Buddhists. That being said, there are many aspects of mindfulness that would be the same regardless of religious belief. For example, relaxing your body and paying attention to your own thoughts as they come in to your mind is neither Christian nor Buddhist.

So why should Christians practice mindfulness and how is it best done from a Christian worldview?

Mindfulness Brings Awareness of God’s Presence

God is always with us, as he said he will never leave us or forsake us. Yet as Christians we are only partially aware of God’s continual presence. Mindfulness can help bring back a more full awareness of God’s presence as we connect to him in intentional and mindful prayer.

You can practice this by finding a quiet place with no distractions. Close your eyes and focus your thoughts on God. You can have 2-3 Bible verses memorized or on index cards that you reflect on. If your thoughts wander, simply bring them back gently to the verses you have selected. (Colossians 3:15 is a great example). After you have meditated on these verses, bring your awareness onto the presence of God. You can imagine sitting at his feet or you can picture him hugging you. You can also picture him dwelling in you. As you do this, you can relax your body and breathe more slowly, just resting in his awesome presence. When we are actively aware of God, we connect with the Kingdom of Heaven and we can experience greater levels of peace.

Mindfulness Helps Us Renew Our Minds

Romans 12:2 tells us that as a Christian you should “be transformed by the renewing of your mind.” Mindfulness is a skill that takes practice, as we mentally train ourselves to focus on God and his word. Our brains are constantly adapting to new experiences and changing through learning. Relaxation and mindfulness creates actual changes in the brain (a concept known as neuroplasticity). Focusing our attention on God through mindfulness helps renew our minds as we reduce stress in our bodies and bring healing to our brains.

Increased awareness of the presence of God, of our own bodies and of the thoughts in our minds helps us to be intentional. A lack of awareness brings more chaos as we fall into a trap of rushing through our day with little awareness of God or our own needs. Mindfulness, whether practiced alone in a quiet place or simply as a momentary check-in in the midst of a crowd, helps us intentionally refocus on God and his Kingdom. Mindfulness can also help slow our bodies down, which is quite counter-cultural for us Americans. Jesus was never in a hurry, and he was continually mindful of his Father and his mission.

Mindfulness Gives Us Grace For Ourselves and Others

A common struggle people have when beginning to practice mindfulness is that of cluttered or racing thoughts. The moment you close your eyes, your mind can be flooded with all the worries and stress of your day. Too often our reaction is to push those things away or become frustrated that they are in the way of focusing on God. In this process we can actually grow in the area of giving ourselves and others grace. We can pay attention to these thoughts without judgment as we observe the areas in which we need the most help from God. We can then invite him into those worries and cluttered thoughts and allow him to align our thoughts to his.

One important aspect of mindfulness is acceptance of yourself in a non-judgmental way. Christians can sometimes get nervous with this language because they fear that in reducing judgment on themselves they will give into their sinfulness or stop growing in Christ. “I’m okay, you’re okay” feels like lying to ourselves and simply covering over sin. But at the heart of the Gospel is the idea that we are loved and accepted as we are. If we are in Christ, then he alone is our judge and he chooses to love us. We can align our perspectives with his in this way, and while practicing mindfulness become more aware of God’s unconditional love and acceptance for us. Allow his love for your to bring peace and healing into your mind and soul today.

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Exciting News!!

I am thrilled to announce that I have launched a new non-profit, Church Therapy Associates, in order to provide low-cost mental health counseling services in churches and Christian college settings. The idea builds on the Church Therapy model, embedding professional counseling directly into churches where services are accessible. The presence of a counselor helps decrease stigma as well, changing the church culture towards one that embraces mental health treatment as a positive option.

Church Therapy Associates will use a subscription model, in which both churches and clients pay a subscription fee. The services are provided by Master’s-level counseling students, graduates working towards licensure, and licensed clinicians. This non-profit creates opportunities for training and supervision for mental health counselors, increasing the number of qualified mental health professionals committed to serving within the church.

Here’s how it works:

  1. A partner church subscribes, outsourcing the clinical mental health care needs of their congregation to Church Therapy Associates. Their subscription fee is based on the number of client slots they want to have (based on church size). The subscription level can increase as the need increases over time. The church also provides office space and emergency on-site support.
  2. A Master’s-level counseling intern is placed at a new site. Clients pay a co-pay level subscription fee weekly or monthly, and this is automatically billed to them.
  3. Licensed counselors provide weekly supervision. Emergency on-site support is present at every site whenever the counseling interns are seeing clients.
  4. When the counseling intern graduates, they can continue at their site to accrue hours towards licensure. They are working for Church Therapy Associates throughout the process, creating a seamless transition and continuous services for the partner churches. As they grow professionally, they will become licensed and will begin to supervise others.
  5. All fees, liability, regulatory oversight, record keeping, and phone systems are centralized under Church Therapy Associates through a HIPAA-compliant electronic health record, so that churches do not have to worry about any of these details.

To start we will be focusing on the Boston area, but I believe this model can expand around the country. Our expansion will focus on areas near Christian seminaries and graduate schools that offer licensure-based mental health counseling programs. If you are a pastor interested in this model or you are part of a Christian counseling Master’s program, let me know!

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Increasing Accessibility: When Proximity Works

Since the time of Freud and his trained psychoanalysts, there has been a belief in the counseling world that counselors must be distant from their clients. While boundaries are critical to any successful therapy experience, human connection does not need to be rejected. Carl Rogers certainly did his part to change this idea, emphasizing the importance of genuineness and unconditional positive regard given by the counselor. Now there is much data to support the idea that the relationship between the therapist and the client is the largest factor in the success of the therapy.

Despite this move towards relationship and connection, the mental health field still has systemic flaws when it comes to decreasing stigma and increasing accessibility to services. Many still believe that all dual relationships must be avoided, despite changes made in 2005 to the American Counseling Association’s code of ethics allowing for “helpful” dual relationships. Many therapists believe that they cannot be known at all by their clients, even though it is often helpful for clients to hear that their counselor shares in human experiences.

Within the church context, extending genuine love to others is a key principle demonstrated by Jesus himself. Human connection, infused with the love of God, is a powerful force of change that can produce healing. Church therapy, then, must be centered around the idea that we foster genuine love within our therapy. Within this framework, the church therapist is one who is known and who is available. There is no stigma in needing love, since this is the state in which we all find ourselves. There are no barriers to accessibility of counseling, because it is available to all in the church who are in need.

When a person experiences a problem in life (whether it be trauma, depression, anxiety, or adjustment problems), one of the most difficult things he or she could do would be to go to an unfamiliar office in a building they have not seen before and talk to a stranger about the deepest hurts of the soul. Without church therapy, this is the only option for obtaining professionally trained help. But church therapists have had the opportunity to demonstrate to those in the church that they are trustworthy. Proximity, usually avoided in counseling relationships, actually offers safety and comfort. The church therapist’s office is located right within the church walls, directly in the place of deep security and familiarity.

Many in the mental health field would argue that anonymity and distance make therapy a safe experience for the client and therapist.  For some, this may be true. However, it is my belief that proximity and familiarity actually offer a kind of safety that allows those who would otherwise avoid counseling to feel able to enter in. Church therapy promotes accessibility and decreases stigma because it creates a church culture that says, “We expect you to need help. We are here for you.” This culture inherently encourages those who might not have sought help otherwise to come and receive services that can free them from emotional burdens.

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Why Women Don’t Report Sexual Abuse

As a counselor I have sat with countless women who have experienced sexual abuse. Only one had reported her assault, because she and a friend were able to report together on the same man. Most women do not report, and if they do it is rarely right away. In many cases, I was the first person they ever told, years later. I thought about ways to write about this topic, increasingly in the news as more women do speak out and raise awareness on the frequency of sexual abuse and assault. I felt the best approach was to make a list of the reasons women have directly told me that they did not tell anyone about their abuse.

Here are the reasons why women I know did not report (#WhyIDidntReport):

  1. “I knew it would tear apart my family.”
  2. “I thought it was my fault.”
  3. “I didn’t know it was rape because it wasn’t violent.”
  4. “No one would have believed me.”
  5. “He told me not to tell anyone or he’d hurt me again.”
  6. “I didn’t remember the attack at all until years later.”
  7. “I didn’t remember all the details.”
  8. “I was a child and he was my parent.”
  9. “I didn’t realize it was wrong.”
  10. “I felt ashamed.”
  11. “I didn’t want to ruin his life.”
  12. “My family didn’t talk about serious things.”
  13. “The first person I told blamed me.”
  14. “Good Christian girls don’t talk about that.”
  15. “He was my brother who was favored by my parents.”
  16. “He was my boyfriend and I wanted him to love me.”
  17. “It was a while ago, there is no evidence so it’s my word against his.”
  18. “I was afraid I would get taken from my parents.”
  19. “I was too scared to talk to the police.”
  20. “I didn’t want to go to court and tell strangers what happened.”
  21. “I was frozen with fear and could never get the words out.”
  22. “I wanted to just try to forget about it.”
  23. “I didn’t think my parents would handle the news well.”
  24. “He was my pimp and he knew where I was at all times.”
  25. “I didn’t want to have to see him again in a courtroom.”

These are the reasons that immediately come to my mind that I can directly link to someone’s story. I’m sure there are more, and certainly other women have other reasons besides these. The fact that I can create a list of 25 different reasons in about 5 minutes troubles me. Our world should not be this way.

Pastors, let me speak to you directly. With hashtags like #MeToo and #ChurchToo, I have heard some troubling responses to the discussion about sexual abuse against women. Many pastors and Christian men have responded with a focus on how the world is no longer safe for men with accusations becoming more prevalent. Please, when you think on this topic, and even more so when you speak on this topic, focus on women. Focus on believing them. Focus on their safety. Focus on the ways this can teach us about how we contribute to fear and suppression of information. If you are concerned for all the men when you hear these women’s stories, you are fundamentally beholden to a dangerous system that looks nothing like the Kingdom of God. Jesus drove away the men with the stones, he listened to women, and he valued them. Now more than ever, we need you to do the same. Thank you to all those who have listened, believed, and responded with compassion.