In the last year, new information has come out that has helped me better understand cultural competency, which is not the same as cultural sensitivity and humility. And I want to answer the question, is it even appropriate for us to incorporate Christianity into counseling practices at all? Or are things like our church mental health awareness cards actually problematic because they are not culturally sensitive? More on those in a minute.
First, what is cultural competency? The layman's version is that we need to not only understand that there is someone in front of us who is experiencing some kind of mental illness or disability problem, but a whole person with values, beliefs, spirituality or religion, an ethnic heritage, and cultural upbringing that we do not fully know.
Within this topic, I'm speaking as a licensed professional counselor, and how Christianity is not only something to be aware of in the counseling session, but can be a huge asset. I recognize there are pastors, individuals with mental illness, and family/friends of those with mental illness who are also reading this. I want to encourage you to read through this so you have an awareness of how and why counselors do what they do, as well as be able to better educate others on what counselors are actually allowed to do.
Before we get to this, it should be understood by everyone why this is a touchy subject. As counselors, psychologists, and psychiatrists, we are given a position of power when we work with our clients. Clients are struggling, hurting, impaired, desperate, or in some way not whole. You do not sign up for counseling for a good pep talk. Counseling is for recovery and restoration. When we sit with our clients, we need to be aware we have influence, and be ethical, moral, and law-abiding in how we approach it. Thus, proselytizing to clients is not only considered unethical, you could lose your license; you open yourself up to malpractice lawsuits and other issues. In fact, one part of the American Counseling Association’s code of ethics states we are clearly called to “seek training in areas in which [we] are at risk of imposing [our] values onto clients, especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature.” This goes beyond Christian values, but we will keep the lens focused there.
So, we can be fired from our job, lose our license to be unable to practice again, and be sued for large amounts of money with possible other ramifications. Why would I say that having a strong Christian faith is actually an asset?
This code of ethics is about not imposing your beliefs on others. But if a client comes in with Christian values or is wanting to incorporate it at any capacity into the counseling treatment, now we are at a different position. I love that in Dr. Steve Grcevich's book Mental Health and the Church, he asks questions about faith to better understand the client, including if mental illness or disabilities impact their ability to worship and participate in their faith. As an ethics professor at Denver Seminary stated, "This is a cultural competency that actually allows you to better serve Christian clients and those seeking to incorporate Christian values than non-Christian counselors." So when looking for a counselor, it is more than appropriate for pastors, Christians, and other counselors to refer someone to an experienced Christian counselor. If you want to know some things to look for in a Christian counselor, check out this article.
Cultural Sensitivity and Humility
Cultural competency was defined above, but recently this is limiting. Competency is knowledge and understanding of someone or something, but I do not expect a coworker who has not been raised in the Church to be competent in Christianity. Further, "competent in Christianity" is a rigged response because we have so many different denominations within Christianity. Even I do not know all about the many different traditions and practices within each of these denominations. The same is true for other aspects of my clients.
So instead of being competent in someone's culture, we instead must have cultural sensitivity and humility. These can be defined as understanding the needs and emotions of your own culture, as it impacts the clinical session, as well as allowing the client to explore and understand theirs. Further, with humility, we need to understand this is a life-long process of self-reflection and self-critique that doesn't require us to master the understanding, but to allow for continued exploration and respect for clients who want to do so as well. I do not have to earn my Masters in African American culture, military traditions and culture, or what it means to be a woman growing up in a small-town, Republican community, but I need to allow and educate the client on how this impacts counseling and be aware of it.
The same is true for our faith. When a Christian counselor sits with a Christian client who wants to pray as a coping skill, help them explore this and connect with their pastor on discipleship techniques. When clients want to include Scripture into closing remarks of the session, be prepared with appropriate verses or allow them time to find passages at home. And always point to the whole person, the God-breathed, Christ-redeemed, Holy Spirit-filled Christian in front of you, as they seek healing and recovery. And understand you speak the language for Christians who can help complement their recovery and be part of the journey.
Jeremy Smith is a clinical mental health counselor in Ohio and founder of www.churchandmentalhealth.com.
