Finding the Right Counselling Approach

The urgent question which arises for people with anxiety and depression leading to suicide ideation, is what types of counselling are available and will be helpful. These are two common mood disorders which are characterised by an extreme high or low which inhibits everyday functioning. In most cases, depression and anxiety result from peoples’ way of dealing with stressors on their lives. Good therapy involves trust, opening up, attention, rapport, naming the problem, instilling hope.

According to  Handbook of Positive Psychology [C.R. Snyder and Shane J. Lopez, Eds.], Positive Psychology  focuses on developing strength and virtue and the prevention rather than cure of psychopathology. It differs from mainstream Psychology in that it is not based on the disease model which focuses on negative environmental stressors on the individual such as divorce and abuse. It is not just about curing depression but giving the client positive reasons to live. Martin Seligman enthuses that Positive Psychology appears to have have returned to its Latin root – the true study of the soul.  It places much emphasis on returning the locus of control to the clients who are seen to be primarily responsible for their own recovery and whose way of constructing their thoughts about their experiences, plays a cricual part in that recovery.  The premise is that maladaptive behaviour that is learned can be unlearned. Nevertheless, there is a lack of spiritual depth to this relatively new branch of Psychology which fails to address existential issues such as who is God, what is His plan for mankind and how then should we live.

One of the cornerstones of Positive Psychology is that positive interaction within one’s social context, whether family, friends or work colleagues, is key to personal life satisfaction.

In Cognitive Behaviour therapy CBT, Beck’s Cognitive triad is used as a framework for understanding and addressing depression and anxiety. this consists of a negative view of the world, self and the future.

Practitioners of Clinical Psychology bring certain belief symptoms to the initial consultation with the client e.g.

  • Behaviour is either  normal or abnormal
  • Distinct syndromes called mental disorders actually exist and represent reality
  • People who come to clinics must have clinical problems
  • She is an unbiased, objective assessor of behaviour.

For example, the DSMIV pathologises common human behaviour such that humor, altruism and affiliation are dubbed “defence mechanisms”[p.752].  It is a diagnostic manual for mood disorders used by clinicians but useful for all counsellors, no matter the model used, since it enables them to stay current with medical language and relate to clients who have been given diagnostic labels.  However, care must be taken in recognising when clients may be becoming stuck in labels. Not only has the DSMIV seen an exponential increase in its disease categories, but it is also prone to removing categories when it is no longer culturally acceptable to deem them pathological. [DSMV is the latest version]

Practitioners of the clinical model take the view that the brain or genes  can be blamed for behaviour such as alcoholism. On the other hand, Edward T. Welch, author of Blame it on the Brain (1998) contends that the body is the mediator not the initiator of the heart. Therefore. the prescription of psycho-active medication for such conditions as depression or anxiety is to alleviate the symptoms without getting at the root cause, thereby prolonging the patient’s agony. But there is no question that in some cases where the distress of the patients are at critical levels, it is probably best to initially employ the twin treatment of  medication and talking therapy with a view to weaning them off the medication gradually as they become more equipped with psycho-spiritual tools to overcome their mental strongholds. 

Welch further argues that whereas sciience is strong on diagnosing and treating disease, the Bible explains the origin and manifestation of sin. Welch further cites cases where sin can lead to disease , such as in the case of alcoholism.

The TROG strategy for suicide prevention arises from Solution Focused Pastoral Counseling and was concretised by Charles Allen Kollar as follows:

True Identity

Resisting the Accuser

Other-person centred

Go beyond your comfort zone

Kollar stresses the importance of attentive listening which helps to createa collaborative relationship with the counsellee. All goals of recovery need to be made meaningful to the counsellee, and imagineering or imagining a future solution is encouraged. This may be a future where the potential triggers for the presenting problem persist such as where there is family or marital discord. [See The Art of Psychotherapy, p.85-86]

The role of the biblical counsellor is to:

  • seek to understand the individual heart (although Jeremiah 17: 9 and 1 Samuel 16 state that it can only be fully known by God) through data gathering, God’s Word (Hebrews 4:12-13) and prayer.
  • promote hope – the confidant expectation of what God promises because of His proven faithfulness, the longing to experience what God has promised and the willingness to wait on His timing.
  • If necessary, work together with physicians where unusual symptoms occur such as disorientation, lapses of consciousness with no readily available triggers and changes in body movement such as twitches, tremors and altered gait.
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