Christian counseling and psychotherapy: Components of clinician spirituality that predict type of Christian intervention.

It is not surprising that experts disagree on defining Christian counseling. McMinn, Staley, Webb, and Seegobin (2010) offered a useful categorization of Christian counseling, which may include biblical counseling, pastoral counseling, and counseling provided by clinicians identifying as Christian. Christian clinicians have published academic works specifically focused on integrating Christian spirituality and counseling (e.g., McMinn & Campbell, 2007; Tan, 2011). More recently, Worthington, Johnson, Hook, and Aten (2013) organized and evaluated a diverse collection of evidence-based practices for use in Christian counseling. In this study, we specifically invited participants who identified as clinicians providing Christian counseling or psychotherapy without regard to the way in which they conceptualized the construct Christian counseling and psychotherapy (CCP). Because of the possibility of diverse interventions, we asked a wide range of questions about spiritual practices that could be considered part of the construct. In this article, we do not distinguish between the concepts of counseling or psychotherapy. Instead, we focus on the treatment activities reported by clinicians.Any understanding of CCP requires some context. The roots of counseling in Western cultures may be traced to biblical guidance (Ellis, 1993), a long tradition of using specific scriptures in helping others (Tan, 1991), and the early work of James (1917) on the importance of religion. Given the long history of clergy care and more than a century of psychotherapeutic models and theories, it is not surprising to find a diversity of approaches to the practice of CCP. Fortunately, two trends provide a supportive and influential context for the current investigation.First, the substantive work of Hubble, Duncan, and Miller (1999) focused attention on what works in counseling. The focus was not just on various models but also upon such common factors as placebo and expectancy effects. The recent follow-up (Hubble, Duncan, Miller, & Wampold, 2010) to this line of inquiry led the authors to conclude, "Models achieve their effects in large part, if not completely, through the activation and operation of placebo, hope, and expectancy" (p. 36). Elsewhere, the authors assert that they are not supporting an "anything goes" approach to treatment. The evidence does support the importance of a coherent and meaningful approach. We see the findings of Hubble et al. (2010) as particularly useful in our current inquiry because several Christian counseling interventions offer coherent models of treatment (e.g., see Worthington et al., 2013) and these approaches are meaningful in the sense of accommodating the meaning inherent in the Christian religion.The second trend is the recent general recognition that spirituality is important to clients and their mental health treatment (Plante, 2009). This has led to an increase in general works on integrating spirituality with mental health treatment (e.g., Enright & Fitzgibbons, 2015; Walker, Courtois, & Aten, 2015) as well as more specific works focused on integrating Christian theology and mental health interventions (e.g., Ripley & Worthington, 2014; Tan, 2011). The burgeoning literature on Christian counseling not only leaves clients with an array of choices when seeking treatment but it also poses a challenge for researchers interested in identifying what about Christian clinicians and their practices has relevance for the field. After reviewing the extant literature, we elected to focus on characteristics of the clinician and four categories of clinical practice: (a) basic spiritual practices, (b) evidence supported treatments, (c) extra-session assignments, and (d) assessment of spirituality.Clinician CharacteristicsThere are several aspects of a clinician's values and practices that might be considered relevant to their selection and use of Christian practices in counseling, such as personal faith, social values, and spiritual practices as well as their education and experience. …