Christian psychology

1. Introduction

Version followed: the Christian psychology movement as defined by the Society for Christian Psychology (SCP, now a division of the American Association of Christian Counselors, AACC) and as systematised in Eric L. Johnson's Foundations for Soul Care: A Christian Psychology Proposal (IVP Academic, 2007; paperback 2014). Clinical procedures come from Diane Langberg's three-phase trauma model (known through a review of her chapter "A Christian Psychology Approach", ch. 5 of Greggo & Sisemore, Counseling and Christianity: Five Approaches, IVP Academic 2012, and her training outline), from Siang-Yang Tan's account of practice (a conversation hosted by Johnson, and his lecture slides on implicit and explicit integration, which summarise his published seven-step inner-healing prayer outline), and from E. Christian Brugger's Catholic anthropology paper in the SCP journal Edification. Sources: publisher pages supply the chapter lists of both IVP five-views books (Robert C. Roberts and P. J. Watson, "A Christian Psychology View", ch. 4 of Johnson, ed., Psychology and Christianity: Five Views, 2nd ed., 2010; Langberg, ch. 5 of Five Approaches); Tan's slides supply his implicit/explicit integration definitions and inner-healing prayer steps (4.3, 4.11); professional statements on conversion practices are drawn from the UK Memorandum of Understanding (2024 text) and the APA (2021) (section 5). Not used as sources, so their content is not reported here [uncertain]: the Roberts & Watson and Langberg chapters themselves, Tan's Counseling and Psychotherapy: A Christian Perspective (2nd ed., Baker Academic, 2022; product page only), and any session-level manual (none is published in the sources used). Most steps in section 4 therefore remain [synthesis]. [source: AACC SCP page; IVP pages; CCT Biola conversation; Tan lecture slides (Fuller); Christian Scholar's Review; Brugger 2009]

What it is. Christian psychology is a movement and framework, not a single manualised therapy. The SCP states that it aims to develop a psychology "fundamentally shaped by the Christian Scriptures" and by Christian thinking, practice and research. Modern psychology is treated as a resource that must be "carefully reinterpreted in light of a Christian worldview", because, in the SCP's view, it has been shaped by naturalism and secularism. [source: AACC SCP page] Its proponents aim to "retrieve" an account of the person from Scripture and from Christian writers such as Augustine, Aquinas, Pascal and Kierkegaard. Johnson traces the modern movement to Kierkegaard and later to C. Stephen Evans. A critic, Keith Palmer, reports that the SCP was founded in 2004 and lists contributors including Robert C. Roberts, P. J. Watson, Diane Langberg, Larry Crabb and Dan Allender. [source: Palmer 2017, a secondary and critical source] Within Johnson's "five views" scheme, Christian psychology sits beside levels-of-explanation, integration, transformational psychology and biblical counseling. It differs from integration mainly because it builds a distinctly Christian account of persons first and only then draws on modern research. [source: IVP Five Views page; Palmer 2017]

How change happens (as its authors frame it). These are theological claims, attributed here and not stated as fact. Johnson holds that the ground and goal of soul care is the person's "union and communion with God". In his account, change comes through inwardness (self-examination, identifying and dismantling barriers, and internalising what he calls "signs of glory") and then outwardness (showing Christlikeness, which he calls "Christiformity"). The counsellor's task is the "therapeutic delivery" of those signs. [source: IVP Foundations for Soul Care table of contents] As John Piper summarises Johnson, soul-care methods count as Christian when they serve a "radically theocentric agenda", and God's part in healing should be acknowledged explicitly. [source: Desiring God, Piper 2007] At the clinical level, practitioners such as Langberg and Stavros treat the human relationship as the main vehicle of change, and they bring in explicit spiritual work gradually and only with the client's consent. [source: Christian Scholar's Review; Stavros 2012]

2. Framework

The movement has no single session protocol, session count or phase manual; none is published in the sources used or on the publisher pages [uncertain]. The nearest worked example is Langberg's chapter in Counseling and Christianity: Five Approaches (2012), where each of five contributors applies their approach to the same hypothetical client, "Jake", showing how they would assess, conceptualise, counsel and provide aftercare. Its session content is not reported here [uncertain]. [source: IVP Counseling and Christianity page] Three published structures can organise the work.

A. Johnson's soul-care sequence [source: Foundations for Soul Care table of contents; Johnson's own chapter procedures are not reproduced in the sources used, so the descriptions below are [synthesis] built from the chapter titles]

• Self-examination. Goal: the client honestly explores their inner life, motives and story before God.
• Identifying and deconstructing barriers. Goal: name what blocks the client from receiving love and truth (for example trauma, shame, false beliefs, sin patterns, defences) and loosen it.
• Internalising "signs of glory". Goal: the client takes in, emotionally and cognitively, the Christian meanings Johnson holds to be healing, such as being loved by God and an identity in Christ.
• Outwardness and Christiformity. Goal: changed love, virtue and relationships that show up in everyday life and community.
• Moving on: Johnson's titles call these "parts" of one process. Expect them to overlap and to repeat across a course of therapy rather than to run strictly one after another [synthesis].

B. Langberg's three-phase model for trauma [source: Langberg, Global Trauma Recovery Institute outline; Christian Scholar's Review]

1. Safety and stabilisation. Goals: a trusting relationship, symptom stabilisation and physical safety.
2. Processing of content. Goal: working through the traumatic material.
3. Connection and growth. Goals: reconnection with others, meaning-making and spiritual growth.

• The reviewer reports that in Langberg's chapter "Spirituality and Scripture are not emphasized until the final stage", and that explicit Christian interventions are brought in step by step. [source: Christian Scholar's Review]
• A related Christian trauma writer, Ron Hawkins, follows Heather Gingrich's version of the same phases: "safety and stability, trauma processing, and consolidation and resolution". In that version each phase builds on the one before, and processing waits until relational security exists. [source: ChurchLeaders, Hawkins]
• Phase-move criteria are [synthesis], adapted from general phase-oriented trauma practice:
  • Move to processing when the client can name and use grounding and self-soothing skills, current abuse has stopped, daily functioning is stable, and the client consents.
  • Move to connection and growth when intrusive symptoms have eased and the client can recall the material without being flooded.

C. Format. Individual outpatient psychotherapy by a licensed clinician is the usual format implied. Tan adds referral to church groups, support groups or group therapy so the work does not stay individualistic. [source: CCT Biola] Session counts are not specified [uncertain].

Assessment framework (Catholic strand). Brugger offers eight anthropological "domains" to organise case conceptualisation:

• five philosophical: the person as bodily, rational, volitional, interpersonally relational and a unity of body and soul;
• three theological: created in God's image, fallen, and redeemed in Christ.

[source: Brugger 2009, Edification 3(1)]

3. Guiding principles

• Scripture and Christian tradition shape the model; modern psychology is used critically. In practice: before adopting a technique, check its assumptions about persons and reinterpret it within a Christian frame. Adopt it if it fits and drop it if it does not. [source: AACC SCP; Tan in CCT Biola: "integration is not integrating all the time"]
• Retrieval of the Christian soul-care tradition. In practice: draw on classic Christian writers and practices, such as patristic soul care, Augustine and Kierkegaard, as resources. [source: Palmer 2017; Stavros 2012]
• Theocentric goal. In practice: proponents hold that the deepest aim is the client's relationship with God, not only symptom relief. Hold this as your framework, while keeping the client's own stated goals in the treatment plan [synthesis on the second clause]. [source: Johnson TOC; Piper 2007]
• Client consent governs explicit religious work. In practice: use Scripture, prayer or faith discussion only when the client agrees, and never pressure them. Tan notes that not all Christians want it. [source: CCT Biola, Tan]
• Implicit before explicit. In practice: the counsellor's values shape the work quietly, and overt spiritual interventions are added only when they are welcome and fit the phase. [source: CCT Biola, Tan; Christian Scholar's Review, Langberg]
• The relationship is the vehicle of change. In practice: put trust, reduced shame and knowing the person well ahead of technique. [source: Stavros 2012]
• Clients bear God's image. In practice: Brugger grounds unconditional regard in the belief that "Their clients are images of God." [source: Brugger 2009]
• Realism about the Fall. In practice: Brugger expects "partial remediations, not complete cures", so set modest, honest goals. [source: Brugger 2009]
• Hope grounded in redemption. In practice: Brugger urges clinicians "never to lose hope in their clients". [source: Brugger 2009]
• Clients take part in their own healing. In practice: because the will is central, invite active effort and choice. Brugger calls clients "self-healers". [source: Brugger 2009]
• Relational health is central. In practice: assess early and current relationships as possible roots of the problem. [source: Brugger 2009]
• Holism: one integrated person. In practice: attend together to body, mind, relationships and spirituality, rather than splitting them across professionals. [source: CCT Biola, Tan; Brugger 2009]
• Community over individualism. In practice: link the client with church or other supportive communities. [source: CCT Biola, Tan; Hawkins]
• Suffering can be a place of growth. In practice: help the client make meaning and build resilience, without hurrying them past grief. Tan speaks of "holy brokenness". [source: CCT Biola; the caution against hurrying is [synthesis]]
• Take evil and abuse of power seriously. In practice: Langberg warns that naivety about abuse in homes and churches harms the people seeking help. [source: Servants of Grace review of Langberg]
• Protect the helper. In practice: Langberg treats counsellor self-care as essential and warns that a counsellor lost in the client's sorrow stops being effective. [source: Servants of Grace review]
• Ethical boundaries around dual roles. In practice: pastors should usually refer for intensive therapy. Tan regards the dual-role rule as not absolute in small communities, provided judgement is not impaired. [source: CCT Biola, Tan]

4. Intervention inventory

No published step-by-step protocol was found for most of these interventions. The exceptions are Tan's seven-step inner-healing prayer outline (4.11) and the safety-stage tasks in 4.4, which follow SAMHSA's trauma-informed care protocol (TIP 57). Steps marked [synthesis] are the writer's synthesis, consistent with the named intent. All example language is illustrative. Christian theological concepts (sin, glory, union with God, Christlikeness) are each author's own theology and are attributed, not stated as fact.

4.1 Informed consent for faith-based work and spiritual assessment

• Purpose / when: At intake, and again before any explicit spiritual intervention. Tan holds that Scripture, prayer or faith discussion are used only if the client agrees, without pressure. [source: CCT Biola, Tan]
• Steps [synthesis]:
  • Explain your orientation and what explicit faith-based work could involve.
  • Ask whether the client wants it, how much, and in what form.
  • Ask about their tradition, church involvement, the place of faith in their coping, any religious harm, and their images of God.
  • Record the client's preferences, and revisit them at each phase change.
  • Make clear that declining has no effect on their care.
• Example language (illustrative): "Some clients want their faith to be an open part of our work, through prayer or Scripture. Others prefer we keep it in the background. Both are fine. What would you like?"
• Watch for: Deference or pressure to please a Christian counsellor. Religious trauma that makes explicit work harmful. Consent is working when the client can say no comfortably and changes their preference over time.

4.2 Case conceptualisation through a Christian anthropology

• Purpose / when: Assessment and formulation. Brugger proposes eight domains, five philosophical (bodily, rational, volitional, relational, a unity of body and soul) and three theological (image of God, fallen, redeemed), to organise symptoms and form hypotheses. [source: Brugger 2009]
• Steps:
  • Gather a standard clinical assessment, including risk.
  • Map the findings onto each domain. Brugger's own example asks whether a presenting problem reflects a deeper relational issue. [source: Brugger 2009]
  • Identify which needed fulfilments are absent. Brugger describes disorder as a "privation".
  • Set goals for growth in truth-seeking, stable character and healthy relationships. [source: Brugger 2009]
  • Johnson's chapters on a "multilevel" model of human life suggest also mapping biological, psychosocial, ethical and spiritual levels. [uncertain: inferred from chapter titles only]
• Example language (illustrative): "Let's look at how this is affecting your body, your thinking, your choices, your relationships and your faith, and where things feel most stuck."
• Watch for: Reducing distress to sin, or spiritualising medical or psychiatric problems. Keep standard diagnosis and medical referral in place [synthesis].

4.3 Implicit integration

• Purpose / when: Throughout, and the default for clients who decline explicit work. Tan describes it as quiet: the counsellor's Christian values shape the work without overt religious content. [source: CCT Biola, Tan] In Tan's 1996 definition, implicit integration is a covert approach that does not initiate discussion of religious or spiritual issues or openly use spiritual resources; explicit integration "directly and systematically deals with spiritual or religious issues in therapy". [source: Tan lecture slides (Fuller), citing Tan 1996, p. 368, and Tan 2022]
• Steps [synthesis]:
  • Hold regard for the client grounded in your own convictions; Brugger links regard to the image of God.
  • Choose goals and techniques consistent with your values.
  • Pray privately for clients outside session if that is your practice.
  • Keep your theology out of the client's decisions unless they invite it.
• Example language (illustrative): Ordinary therapeutic language; no religious content is required.
• Watch for: Covert persuasion or value imposition. It is working when the client experiences respect and steady hope.

4.4 Safety and stabilisation (trauma phase 1)

• Purpose / when: First phase with trauma survivors. Langberg's model begins with "Safety and Stabilization", and Hawkins, following Gingrich, stresses that processing cannot begin until relational security exists. [source: Langberg GTRI outline; Hawkins]
• Steps [source: SAMHSA TIP 57, ch. 5, for safety planning, grounding and self-soothing, replacing unsafe coping, and predictable structure; the other steps are synthesis]:
  • Assess current danger, including ongoing abuse. Langberg distinguishes past from ongoing trauma. [source: Servants of Grace review]
  • Build a safety plan.
  • Teach grounding and self-soothing skills, and when to use them [source: SAMHSA TIP 57]; add containment skills [synthesis].
  • Help the client move from unsafe coping, such as substance use, to safer strategies, and build predictable routines [source: SAMHSA TIP 57].
  • Coordinate medical or psychiatric care.
  • Build a predictable, trustworthy relationship.
• Example language (illustrative): "Before we go into what happened, we'll make sure you have ways to steady yourself, so you're not facing it alone or unprepared."
• Watch for: Ongoing abuse, including in church or family settings, which needs a protective response first. It is working when the client can self-regulate and keeps coming.

4.5 Listening to and processing trauma (phase 2)

• Purpose / when: Once the client is stable. Langberg's training session centres on "how the counsellor listens to trauma" and on entering more deeply into the experience of abuse. [source: Langberg GTRI outline]
• Steps [synthesis]:
  • Agree on pacing and a stop signal.
  • Let the client tell the story in tolerable portions while you stay grounded and attuned.
  • Name and challenge shame. Langberg highlights shame's power, and Hawkins describes shame keeping him isolated. [source: Servants of Grace; Hawkins]
  • Help the client grieve.
  • Close each session with containment.
  • An evidence-based trauma method may be used within this frame. Langberg's chapter is reported to draw on trauma-focused therapy. [source: Christian Scholar's Review]
• Example language (illustrative): "You can tell me as much or as little as you can today. If it gets too much, we'll pause and come back to the room."
• Watch for: Dissociation, flooding and rising self-harm risk. Return to phase 1 if these appear: SAMHSA advises stopping exploration of the triggering material, offering emotional support and showing the client ways to self-soothe [source: SAMHSA TIP 57]. It is working when memories become tellable with less shame and fewer intrusions.

4.6 Guided self-examination (Johnson: inwardness, part 1)

• Purpose / when: Johnson's first step in opening up to God; for clients who have consented to explicitly Christian work. [source: Johnson TOC]
• Steps [synthesis]:
  • Invite honest exploration of feelings, motives, desires and patterns.
  • Frame it as safe, grace-based honesty, not condemnation.
  • Use reflective listening and journaling.
  • With consent, invite the client to bring what they find to God in their own prayer.
• Example language (illustrative): "What do you notice in yourself when this happens? There's no need to tidy it up here."
• Watch for: Scrupulosity or harsh self-condemnation, especially with OCD, depression or religious shame. Slow down or switch to compassion-focused work.

4.7 Identifying and deconstructing barriers (Johnson: inwardness, part 2)

• Purpose / when: To loosen what blocks change. Johnson's chapter title names "Identification and Deconstruction of Barriers". [source: Johnson TOC] Stavros notes that patristic soul care focused on "repentance, healing, and growth" relies on change mechanisms similar to cognitive therapy: self-observation, reframing meaning, and altering destructive schemata. [source: Stavros 2012]
• Steps [synthesis]:
  • Identify the barrier, such as a belief, defence, shame, unhealed wound or habitual sin pattern as the client sees it.
  • Trace its origins.
  • Test it against the client's experience and, if they want, their faith.
  • Build and practise an alternative.
  • Use standard cognitive or schema methods, reinterpreted within the client's frame.
• Example language (illustrative): "Part of you seems convinced you have to earn being loved. Where did you learn that, and does it match what you believe about grace?"
• Watch for: Labelling trauma responses as sin. How the movement's authors separate sin from suffering in practice is not described in the sources used [uncertain]. It is working when the client tries the new response outside session.

4.8 Internalising "signs of glory" (Johnson: inwardness, part 3)

• Purpose / when: In Johnson's terms, the client takes in Christian meanings he regards as healing (his chapter: "The Constitutive Internalization of Signs of Glory"); explicit-consent clients only. [source: Johnson TOC; content inferred from the title [uncertain]]
• Steps [synthesis]:
  • With the client, choose a truth from their own faith that speaks to the identified barrier, such as being loved, forgiven, or not abandoned.
  • Explore what it would mean emotionally, not only intellectually.
  • Agree a between-session practice, such as slow reflective reading, journaling or prayer in the client's own tradition.
  • Notice and process the emotional resistance that comes up.
• Example language (illustrative): "You know in your head that you're forgiven. What happens in your body when you let yourself consider it might be true for you?"
• Watch for: Intellectual assent without felt change, and "spiritual bypassing" of grief or anger [synthesis]. It is working when self-talk and emotion shift, not just belief statements.

4.9 Explicit use of Scripture

• Purpose / when: Tan's "explicit integration". In Langberg's trauma model it comes mainly in the final, connection-and-growth phase. [source: CCT Biola; Christian Scholar's Review]
• Steps [synthesis]:
  • Check consent.
  • Ask which passages already matter to the client, or have been used against them.
  • Read or reflect on a short passage the client chooses or agrees to.
  • Explore what it evokes; let the client interpret.
  • Link it to treatment goals.
• Example language (illustrative): "Is there a passage that has meant something to you through this, or one that has hurt?"
• Watch for: Scripture used as a weapon, or texts previously used by abusers. Proof-texting that shuts down feeling. Proceed only if it consolidates hope rather than shame.

4.10 Prayer in session

• Purpose / when: Explicit integration with consenting clients. [source: CCT Biola, Tan]
• Steps [synthesis]:
  • Ask whether the client wants prayer, who prays, and whether aloud or silently.
  • Keep it brief and client-led.
  • Debrief afterwards.
  • Never use prayer to end a difficult emotional moment prematurely.
• Example language (illustrative): "Would you like to close with a moment of prayer, or would you rather not today?"
• Watch for: Prayer in which the counsellor prescribes outcomes, or that implies the client lacks faith if not healed.

4.11 Inner-healing prayer for painful memories

• Purpose / when: Tan names "inner-healing prayer for painful memories" as an explicit intervention [source: CCT Biola, Tan]. It belongs to explicit integration, so only with consenting Christian clients who want it. Tan published a seven-step outline (Tan 2003a, "Inner healing prayer", Christian Counseling Today 11(4), 20–22), known here only through his lecture slides; the article itself is not drawn on here [uncertain on detail]. No published session manual, contraindication list or consent protocol for it is documented here, and the Roberts & Watson and Langberg chapters are not drawn on, so whether they describe it is unknown [uncertain]. [source: Tan lecture slides (Fuller)]
• Steps (Tan 2003a, paraphrased from the slide summary):
  1. Open with prayer for protection from evil (Tan's theological framing, attributed).
  2. Help the client into a relaxed state.
  3. Guide the client to focus attention on a painful past event or traumatic experience.
  4. Offer no specific guided imagery or visualisation; the slide says none is "directively given".
  5. Wait quietly for what Tan describes as the Lord ministering "healing grace and truth". The counsellor guides and speaks "only if necessary", and periodically asks gently what is happening and what the client is feeling, to track them.
  6. Close in prayer.
  7. Debrief and discuss the experience with the client.
• Safety frame (not in the outline as summarised; [synthesis]): obtain explicit consent first and confirm the client can stop at any point; use only after stabilisation (4.4); work only with memories the client already recalls; agree a stop signal; ground before the session ends. Tan's paper on ethical guidelines for spiritual interventions in psychotherapy (2003b) is not drawn on here [uncertain].
• Related published variant (not an SCP procedure): Garzon (2004) demonstrates "contemplative inner healing prayer" alongside cognitive therapy and medication. The prayer form is introduced and discussed the session before. In session the client focuses on a core belief and the feelings it brings, asks God to take them to where those feelings began, stays with what arises, and then asks for truth about the belief; the therapist closes in prayer and both process the experience. The client knew he could stop at any time, and Garzon calls for a "thorough religio-spiritual assessment" beforehand. [source: Garzon 2004, ACA VISTAS]
• Example language: Tan's tracking question, "What's happening?" [source: Tan 2003a via slides]. Illustrative: "As you hold that memory, is there anything you want to say to God, or ask?"
• Watch for — risk flag: Neither Tan's outline as summarised nor Garzon's article addresses memory reliability or suggestibility [source: as above]. Because the procedure pairs relaxation with focus on past events, treat it with the cautions that apply to any memory-focused imagery work: never use it to search for or "recover" unremembered abuse; do not suggest images, perpetrators or events; stop and stabilise if the client floods or dissociates; and process spiritual distress if the client feels "nothing happened" or that God was absent [synthesis].

4.12 Bibliotherapy with Christian classics

• Purpose / when: Tan gives clients spiritual classics and early church writings alongside self-help books. [source: CCT Biola] Practice draws on the Christian soul-care tradition. [source: Palmer 2017; Stavros 2012]
• Steps [synthesis]:
  • Match a short, accessible reading to the client's issue and tradition.
  • Assign a small portion.
  • Discuss reactions next session.
• Example language (illustrative): "Writers centuries ago wrote about this kind of darkness. Would reading a few pages be useful to you?"
• Watch for: Readings that reinforce shame or scrupulosity, and reading load during depression.

4.13 Critical reinterpretation of mainstream techniques

• Purpose / when: The SCP says modern psychology must be "carefully reinterpreted". Johnson has a chapter on "Translating the Text of Other Communities" for soul care. Langberg's chapter is reported to use trauma-focused therapy. [source: AACC SCP; Johnson TOC; Christian Scholar's Review]
• Steps [synthesis]:
  • Choose an evidence-based technique (e.g. cognitive restructuring, exposure, schema work).
  • Identify its implicit assumptions.
  • Keep the active ingredients.
  • Frame its rationale in language consistent with the client's faith if the client wishes.
  • Follow the technique's own safety and contraindication rules; for exposure, informed consent and stabilisation first.
• Example language (illustrative): "This exercise trains your mind to notice thoughts and test them, something Christian writers also described as watching over your heart."
• Watch for: Diluting effective techniques until they lose effect.

4.14 Promoting outwardness and Christlike character (Johnson: "Christiformity")

• Purpose / when: Johnson's "call to outwardness: the manifestation of Christlikeness"; later phases. [source: Johnson TOC] Stavros lists prayer, worship and service as forms of patristic soul care. [source: Stavros 2012] Roberts' virtue-focused work is not drawn on here [uncertain].
• Steps [synthesis]:
  • Identify the virtues or relational changes the client values, such as patience, forgiveness, generosity or honesty.
  • Plan concrete behavioural steps.
  • Review them and connect them to the client's own sense of who they are becoming.
• Example language (illustrative): "What would love look like this week with your brother, given everything we've worked through?"
• Watch for: Premature pressure to forgive or reconcile with abusers. Forgiveness is not reconciliation, and safety comes first [synthesis].

4.15 Connecting to Christian community

• Purpose / when: To counter individualism. Tan refers clients to church groups, support groups or group therapy. Hawkins describes recovery through family, friends, professionals and church. Tan's slides list referral to religious groups among the explicit uses of religious resources, alongside prayer, Scripture, dealing with spiritual issues in therapy, and fostering the spirituality of therapist and client. [source: CCT Biola; Hawkins; Tan lecture slides (Fuller)]
• Steps [synthesis]:
  • Map the client's current supports.
  • Assess church safety, especially if abuse occurred there.
  • Identify one realistic link.
  • Rehearse how to make contact.
• Example language (illustrative): "Is there one person or group where you could be known a little more?"
• Watch for: Communities that shame, discourage treatment, or protect abusers. Langberg warns of abuse of power in churches. [source: Servants of Grace review]

4.16 Meaning-making in suffering

• Purpose / when: Later phases. Tan emphasises growth through suffering and resilience. Langberg holds the cross as central to hope for trauma survivors. [source: CCT Biola; Servants of Grace review]
• Steps [synthesis]:
  • Allow lament and anger first.
  • Explore the client's own theology of suffering.
  • Gently examine meanings that harm, such as "God is punishing me".
  • Support meanings the client finds true and life-giving.
• Example language (illustrative): "Many people of faith have cried out 'why?'. What have you been saying to God about this?"
• Watch for: Imposing meaning or rushing to redemption narratives. These are theological claims to be held by the client, not supplied by you.

4.17 Counsellor self-care and formation

• Purpose / when: Throughout. Langberg devotes extended attention to protecting helpers and warns against being "overcome by evil". Her training covers vicarious traumatisation. [source: Servants of Grace review; GTRI outline]
• Steps [synthesis]:
  • Arrange regular supervision.
  • Set caseload limits for trauma work.
  • Keep personal spiritual and restorative practices.
  • Monitor yourself for intrusion, numbing or cynicism.
• Watch for: Over-identification with clients, and rescuing.

5. Handling problems

The sources used say little about clinical difficulties. Unless a source is cited, the guidance below is [synthesis].

• Stuck client.
  • Recheck the phase. Spiritual or growth work started before stabilisation often stalls; Langberg defers Scripture and spirituality to the final stage. [source: Christian Scholar's Review]
  • Revisit the formulation across Brugger's domains for a missed relational, bodily or medical factor. [source: Brugger 2009; application is synthesis]
  • Remember Brugger's realism: "partial remediations" may be the honest goal.
• Resistance to faith content.
  • Treat it as information, not unbelief. Return to implicit integration (4.3); Tan insists clients are not pressured. [source: CCT Biola]
  • Explore whether the resistance comes from religious harm, doubt or embarrassment.
• Resistance to psychological methods ("I just need more faith").
  • Validate the client's faith.
  • Use the movement's own position: the SCP treats modern psychology as a resource to be reinterpreted, not rejected. [source: AACC SCP]
  • Offer one small, reframed technique (4.13).
• Overwhelm or flooding during processing or memory-focused prayer.
  • Stop and ground the client.
  • Return to stabilisation (4.4).
  • Suspend inner-healing prayer (4.11).
  • Review risk.
• Non-adherence to between-session practice.
  • Shrink the task.
  • Check whether it was experienced as religious duty and failure, which feeds shame.
  • Separate the practice from the client's worth.
• Ruptures.
  • Common triggers: the client feels judged as sinful, preached at, or that their faith or doubt is being evaluated.
  • Name the rupture, take responsibility for your part, and ask what felt judging.
  • Re-contract about explicit faith content (4.1).
  • Stavros stresses trust and diminished shame as the vehicle of change. [source: Stavros 2012]
• Scrupulosity or religious OCD.
  • Self-examination and confession-like work can feed compulsions.
  • Use an evidence-based OCD treatment, with consent and the safety steps for exposure.
  • Consider consulting the client's faith leader about reassurance-seeking.
• Religious trauma or spiritual abuse.
  • Explicit Christian interventions may retraumatise. Lead with safety and choice.
  • Langberg warns against naivety about abuse of power in homes and churches. [source: Servants of Grace review]
• Abuse disclosures in a church context.
  • Follow mandatory-reporting and safeguarding law exactly as in any other setting.
  • Do not route reports through church leadership instead of authorities.
  • Do not press forgiveness or reconciliation.
• Suicidal risk.
  • Use standard risk assessment and safety planning, including lethal-means counselling (storage and removal).
  • Watch for religious meanings that raise risk, such as guilt or feeling abandoned by God, and those that protect, such as moral objections or community ties.
  • Never treat prayer as a substitute for crisis care.
• Medication and psychiatric care.
  • Explicitly support medical and psychiatric treatment.
  • Correct any belief that taking medication shows lack of faith.
• Values conflicts, including sexuality and gender.
  • Christian-identified counsellors may hold views that conflict with a client's identity.
  • Conversion practices: the Christian psychology sources do not address them. Professional statements: the UK Memorandum of Understanding on Conversion Therapy (MoU, version 2 from 2017, extending the 2015 version to gender identity; July 2024 text) defines conversion therapy as any approach that treats one sexual orientation or gender identity as better than another and tries to change or suppress it, notes it may be practised "under the guise of mainstream practice", and calls it "unethical and potentially harmful". Signatories include BACP, BPS, BABCP, NHS England, NHS Scotland and the Association of Christians in Counselling and Linked Professions (ACC); the Royal College of Psychiatrists is a supporter. UKCP signed the 2015 and 2017 versions but withdrew in April 2024, citing concern about exploratory therapy with trans young people. [source: BACP-hosted MoU, July 2024; Wikipedia MoU page] In the US, the APA Council adopted resolutions on 26 February 2021 opposing sexual orientation change efforts (stating "there is no evidence of sexual orientation change") and gender identity change efforts, citing evidence of harm, including higher rates of reported suicide attempts among LGBTQ youth exposed to change efforts. [source: APA press release, 2 March 2021]
  • Guidance: the MoU states that practitioners may still explore uncertain feelings about sexuality or gender identity, help clients who are distressed about them, and support self-acceptance, provided they have no agenda favouring one orientation or identity. [source: MoU 2024] So [synthesis]: do not attempt to change or suppress sexual orientation or gender identity, including through prayer, inner-healing prayer or "identity" reframing; let a religious client explore conflicts between faith and sexuality or gender without a predetermined outcome; check your licensing body's code and local law (several jurisdictions restrict conversion practices; not verified here jurisdiction by jurisdiction [uncertain]); refer when your values would impair care.
• Dual roles.
  • Pastor-counsellors should generally refer for intensive therapy. Tan allows exceptions in small communities if judgement is not impaired. [source: CCT Biola]
  • Document your rationale and get supervision for any exception.
• Concerns raised about the model (reported neutrally).
  • From biblical counselling, Palmer (ACBC) argues that Christian psychology holds a "faulty view of the Scriptures". He says its counselling looks "surprisingly secular", that it imports modern psychological concepts such as "needs", and that Langberg's account of redemption is therapeutic. [source: Palmer 2017]
  • From a professional-ethics standpoint, the risks are value imposition, insufficient consent for religious interventions, and blurred pastoral and clinical roles [synthesis].
  • Tan's own emphasis on consent and avoiding pressure addresses some of these. [source: CCT Biola]
• Counsellor burnout and vicarious trauma.
  • Use supervision, caseload limits and restorative practices.
  • Langberg warns that a counsellor lost in the client's sorrow is ineffective. [source: Servants of Grace review]

Sources

Pages consulted:

• Foundations for Soul Care: A Christian Psychology Proposal (IVP): description and table of contents
• Foundations for Soul Care (Logos resource page)
• Society for Christian Psychology Division (AACC)
• Can Psychology Be Christian? CCT Conversations: Eric Johnson and Siang-Yang Tan (Biola)
• Psychology and Christianity: Five Views, 2nd ed. (IVP): table of contents (Roberts & Watson, ch. 4)
• Counseling and Christianity: Five Approaches (IVP): table of contents (Langberg, ch. 5) and common case
• Review of Counseling and Christianity: Five Approaches (Christian Scholar's Review)
• Langberg, Complex Trauma: Going Deeper and Case Study, session outline (Global Trauma Recovery Institute / FOCL)
• Hawkins, The Path Forward: Personal Reflections on Healing and Recovery from Trauma (ChurchLeaders)
• Review of Suffering and the Heart of God by Diane Langberg (Servants of Grace)
• Piper, Attention All Counselors and Psychologists (Desiring God, 2007)
• Palmer, Christian Psychology: An Introduction and Biblical Analysis (ACBC, 2017)
• Stavros, Ancient Christian spirituality as evidence base for practice in psychology, with responses (Edification 6(2), 2012; BU repository)
• Brugger, Psychology and Christian Anthropology (Edification 3(1), 2009; ResearchGate)
• Tan, Implicit and Explicit Integration in Christian Counseling and Psychotherapy, lecture slides (Fuller Theological Seminary upload, 2021)
• Counseling and Psychotherapy: A Christian Perspective, 2nd ed. (Christianbook product page)
• Garzon, Cognitive Restructuring Through Contemplative Inner Healing Prayer (ACA VISTAS, 2004)
• Memorandum of Understanding on Conversion Therapy in the UK, July 2024 (BACP)
• Memorandum of Understanding on Conversion Therapy (Wikipedia)
• APA press release, 2 March 2021: resolutions on gender identity and sexual orientation change efforts
• SAMHSA (2014). Trauma-Informed Care in Behavioral Health Services, TIP 57, ch. 5: Clinical Issues Across Services (NCBI Bookshelf) (cited as SAMHSA TIP 57)
• Siang-Yang Tan on Implicit and Explicit Integration (Fuller Studio, 19 March 2021)

Books cited (known through publisher pages or reviews) [uncertain on chapter-level detail]:

• Johnson, E. L. (2007; pb 2014). Foundations for Soul Care: A Christian Psychology Proposal. IVP Academic.
• Johnson, E. L. (Ed.) (2010; released September 2009). Psychology and Christianity: Five Views (2nd ed.). IVP Academic. Ch. 4: Roberts, R. C. & Watson, P. J., "A Christian Psychology View" (contents verified).
• Greggo, S. P. & Sisemore, T. A. (Eds.) (2012). Counseling and Christianity: Five Approaches. IVP Academic. Ch. 5: Langberg, D., "A Christian Psychology Approach" (contents verified).
• Langberg, D. (year not verified). Suffering and the Heart of God.
• Tan, S.-Y. (2022). Counseling and Psychotherapy: A Christian Perspective (2nd ed.). Baker Academic.
• Tan, S.-Y. (1996). Religion in clinical practice: Implicit and explicit integration. In E. P. Shafranske (Ed.), Religion and the Clinical Practice of Psychology (pp. 365–387). American Psychological Association. (Cited via Tan's slides.)
• Tan, S.-Y. (2003a). Inner healing prayer. Christian Counseling Today, 11(4), 20–22. (Cited via Tan's slides.)
• Tan, S.-Y. (2003b). Integrating spiritual direction into psychotherapy: Ethical issues and guidelines. Journal of Psychology and Theology, 31. (Cited via Tan's slides.)