Discuss the main differences between a Christian and a secular/naturalistic perspective.

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CCN-601 Topic 1 Overview

What the Bible Has to Do With Life

Introduction

When you think of the Bible, what do you think? What images, associations, and

emotions come to mind?

If you were asked to describe the Bible in one or two sentences, what would you say?

Perhaps a starting point is to say that it is a book, or more accurately a collection of 66

books, each with its own characters and themes, that flow into one main story. In saying

this, you are acknowledging that the Bible is literature, in one way like any other book—

material written for a particular purpose. Literarily, it is comprised of a variety of

different types of literature or genres: history, law, wisdom, poetry, letters, and

apocalyptic literature.

In some ways, the Bible is just like any other book, but in other ways, it is very different.

According to Christian tradition, and the Bible itself, it is divinely inspired

communication originating with God but penned by human authors, approximately 40

of them writing in three different languages over the course of about 1,500 years. This is

what makes the Bible unlike any other book and the reason it is called the Holy Bible or

Sacred Scripture. People call it “Holy” because they believe there was one supernatural

author who assured that each of the authors and books were aimed at accomplishing

the same purpose, that it was and is true in all that it affirms and teaches, and that its

content is more important than that which is found in any other book in world history.

So, what is the Bible about? There are a lot of good answers to that question. According

to Bartholomew and Goheen (2004), “biblical Christianity claims that the Bible alone

tells the true story of our world” (p. 20). Like most stories, the Bible proceeds from a

beginning (the first two chapters of Genesis), to a middle wherein a conflict develops

that needs to be solved, and tension builds as the key characters take their places (the

rest of the Old Testament). And then after a very long wait (the intertestamental

period), the hero of the story arrives and saves the day, bringing a shocking and yet

wonderful solution that was not exactly what everybody expected (the Gospels). The

story proceeds by telling about the implementation of that solution (the New Testament

letters) and then, to the end of the story wherein the good guys win and the bad guys

lose (Revelation). God and love and goodness win, and he and his team live happily ever

after.

Worldview

A worldview is a person’s internalized framework for seeing, interpreting, judging, and

comprehending life and reality. It is a conceptual paradigm composed of basic beliefs or

presuppositions that are absorbed from family and culture and religion, and is much

 

 

more automatic and subconscious than conscious. Your worldview is the big picture or

map that directs and guides your explanations for and responses to life. It is an

interpretive system by which individuals explain and make sense of life. It functions like

a map, orienting and guiding individuals toward answers to the major questions of life,

including understanding of people and why they do and think and feel the way they do.

Every counselor has a basic perspective on what life is about. Counseling theories arise

out of the theorist’s particular worldview, entailed within which is their view about

people and problems and solutions. What is a human being? Are people merely physical

things, or are they more than that? Is spiritual stuff real, or just a figment of your

imagination that makes you feel or function better? Is the American dream the real

purpose of life?

According to Albert Wolters (2005), a worldview is “the comprehensive framework of

one’s basic beliefs about things…. Your worldview functions as a guide to your life. A

worldview, even when it is half unconscious and unarticulated, functions like a compass

or a roadmap” (pp. 2, 5).

Contemplate the following statement by J. D. Hunter (2010):

Perhaps the most important thing to realize is that this “worldview” is so deeply

embedded in our consciousness, in the habits of our lives, and in our social

practices that to question one’s worldview is to question “reality” itself.

Sometimes we are self-conscious of and articulate about our worldview, but for

most of us, the frameworks of meaning by which we navigate life exist

“prereflectively,” prior to conscious awareness. That is, our understanding of the

world is so taken-for-granted that it seems utterly obvious. It bears repeating

that it is not just our view of what is right or wrong or true or false but our

understanding of time, space, identity – the very essence of reality as we

experience it. (p. 33)

As a counselor, you will counsel out of some theory that is related to some worldview

that provides the basis for how you understand what is wrong with people and how you

should go about helping them. A particular worldview grounds a counseling theory,

which then directs counseling practice.

The counseling theories that you are learning provide explanations for human behavior,

thought, and emotion. They organize your knowledge about the person and guide what

you observe and ignore, and how you interpret, explain, and predict how people work.

Thus, your counseling theory and practice arise out of some very basic beliefs about

reality and life and people.

Consider the following questions:

1. What is a human person? Are humans just physical things, or are they spiritual beings also? If they are both, how do body and soul relate to one another?

2. What are we here for: self-actualization or something greater?

3. What on earth is wrong with people? Why do they kill one another and themselves?

 

 

Why is there so much abuse, disorder, and unhappiness?

4. How do you fix this mess, or your mess?

Many counselors are naïve about both their personal worldview and the worldview of

the counseling theories they employ. The job of this course is to make sure that is not

true of you.

So, if the Bible tells the true story of the world, the Bible functions as the primary source

for developing a Christian worldview, a Christian psychology, and a Christian perspective

on counseling. Therefore, if your counseling is going to be Christian, you will have to

become more conscious of your worldview and let the Bible provide the primary cues

for your worldview and your psychology. “Psychology” in this paragraph, mean the basic

beliefs about what a person is, what the purpose of life is, why people do what they do,

and what is most essentially wrong with them.

The Bible and Counseling

What would be a proper relationship between the Bible and actual counseling

practices? A variety of answers can be found among contemporary Christian counseling

authors.

For some, the Bible’s primary function is that it provides an infallible or trustworthy set

of essential truths or control beliefs that serve as a grid to filter error out of their

counseling theory and practice. These control beliefs enable the counselor to screen out

that which is contradictory to God’s Word, to filter the ungodly toxins out of a secular

counseling concept or technique.

For example, the Christian counselor’s control beliefs would include the biblical doctrine

of original sin that would screen out Carl Rogers’s (1961) contention that people are

basically good, but would allow into their system Rogers’s contention that counselors

should be accepting and warm and exhibit positive regard toward their counselees (of

course, versions of this insight can be found in Scripture and a thousand other places,

many preceding Rogers).

Many Christian counselors would agree that Scripture should play this arbitrating,

judging, filtering role in counseling, much like an official in sports does, blowing the

whistle when the players violate the standards and rules of the game. So, many

Christian counselors believe the Bible should function as a protective screen, filtering

secular error out of concepts and methods.

Some Christian counselors go further and assert that the Bible can be more than a

referee or filter. They assert that the Bible provides essential truths that counselors

must incorporate in order to properly understand and care for their counselees. The

Bible functions as a foundation providing general concepts such as the nature of

persons, the purpose of life, moral standards, and guidelines and attitudes for

relationships. Their counseling model rests broadly upon this conceptual foundation

even though the details for the counseling model are provided by the social sciences,

 

 

common sense, and personal experience.

But some would say this is not enough, not sufficiently Christian. John Piper’s (2001)

comment reflects this concern:

Bible-saturated counseling does not treat the Word of God as an assumed

foundation which never gets mentioned or discussed or quoted. “Foundations”

are in the basement holding up the house, but they seldom get talked about, and

they are usually not attractive. That is not an adequate metaphor for the role of

Scripture in counseling. The Bible has power and is the very truth and word of

God…. It has a power to rearrange the mental world and waken the conscience

and create hope. (para. 8)

Another perspective is that Scripture functions like a counseling manual or textbook in

which individuals find a divine encyclopedia of human problems and God’s solutions.

Solutions are then sought in Scripture as if it were a recipe book, explicating steps or

principles for the cure. From this perspective, the only legitimate problems are those

explicitly referred to in Scripture. As a result, problems like anorexia or bipolar disorder

are viewed as invalid secular fabrications because they cannot be found explicitly in the

Bible.

Biblical counselor and pastor, Paul Tripp, warns against viewing the role of Scripture in

this way. “There are many issues the Bible doesn’t address in a topical fashion. The Bible

has nothing explicit to say, for example, about schizophrenia, ADD, teenagers, family

television viewing, or sexual techniques for married couples” (Tripp, 2002, p. 26). He

further avers that,

The Bible is not a topical index, a dictionary, or an encyclopedia. The Bible is a

storybook. It is God’s story, the story of his character, his creation, his

redemption of this fallen world, and his sovereign plan for the ages. (Tripp, 1997,

p. 58)

Finally, Tripp (2004) concludes, “the Bible was given so that the God of the plot would

be the God of your heart, and you would live with a deep and personal commitment to

the success of his story” (pp. 172-173). David Powlison (2007) concurs, noting,

“Scripture is not a textbook on ethics or theology of preaching or counseling. It is the

sourcebook” (p. 2).

This course contends that Holy Scripture is the sourcebook for Christian counseling and

that it does in fact provide the true story of the world and the people that inhabit it.

Therefore, we will assert that Scripture should play a comprehensive role, a normative

role, and a transformative role in a counseling model that merits the name of Christ the

Lord.

Comprehensive

The scope of the Bible is universal. It provides a worldview, a comprehensive

perspective of the cosmos and its inhabitants. Individuals use God’s Word to interpret

 

 

God’s world and the persons within it that he created in his image and likeness. This is

not to claim that the Bible is exhaustive or explicit in addressing all things in detail or

that it answers all questions that might be asked. It is to say that it interprets cosmic and

human history and each individual life in such a way that their true meaning and

purpose is revealed.

Thus, Scripture provides a perspective on people, problems, change, and counsel that

answers the most important questions about the source of problems: how individuals

can change and flourish, and what authentic, careful and compassionate help looks like.

It gives a meta-narrative through which individual narratives find their meaning and

purpose. You must know God’s story before you can begin to make sense of the stories

of others that you aim to counsel. That is what this course is about.

Normative

The Bible is the norming norm, a basic guideline for understanding people, problems,

and how to help them change. It provides answers to the big questions in life. Who is

God and what is he like? How are God and people related to one another? What is the

nature of humanity? What is and how does one achieve the good life? What is wrong

with the world, that person, or me? How can we change? What is the nature of wise,

effective love? Scripture provides general and sometimes specific answers to these

questions.

Therefore, primacy and finality are granted to the Bible. It is given the first word and the

last word. Theologians characterize Scripture with words like divinely inspired, infallible,

inerrant, authoritative, and sufficient. This means that Christian counseling distinguishes

the Word of God from any other words. Therefore, it begins with the question, “What

does the Bible have to say about…?” Of course, this assumes that counselors are

biblically literate and also that they accurately interpret and properly apply Scripture to

the matters of counseling. Biblical literacy is therefore essential to full-orbed Christian

counseling.

Transformative

Scripture is divine communication that aims to transform people, inside and out.

Because it is supernatural and divine, it has a creative and effective power that cannot

be ascribed to any other word or text. To say that it is transformative is to say that it not

only explains life, it changes lives. It is creative and restorative. It is holy script—a blend

of the Spirit and text—that has a unique capacity to open eyes and turn on the lights in

lives darkened by whatever. It can be more than a referee or filter that controls error

and protects from secular, atheistic impurities that may infect one’s counseling model. It

is capable of functioning as a well of relevant truth, brimming with living water from

which counselors themselves drink and then under the Spirit’s direction pass on to those

they counsel.

 

 

Conclusion

One way to understand Christian counseling in the professional world is that it is like

being a missionary in a foreign land. One must be honest, wise, and respectful of others

to do this in a way that is honorable and professional and yet still Christian.

References

Bartholomew, C.G., & Goheen, M.W. (2004). The drama of Scripture. Grand Rapids, MI:

Baker Academic.

Hunter, J. D. (2010). To change the world: The irony, tragedy, and possibility of

Christianity in the late modern world. New York, NY: Oxford University Press.

Piper, J. (2001). Toward a definition of the essence of biblical counseling. Retrieved from

www.desiringgod.org/resource-library/articles/toward-a-definition-of-the-essence-

of-biblical-counseling

Powlison, D. (2007). The practical theology of counseling. Journal of Biblical Counseling.

25(2), 2-4.

Nature Or Nurture: Genetic Similarities And Differences

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Watch either of the following films (select one; each 52 min):  Secret Life of Twins: Natural Similarities or Secret Life of Twins: Nurtured Differences

First, share which film you elected to view.

Highlight 3 significant ideas or points made in the film about our understanding of human development and how it is influenced by either genes (nature) or experience (nurture).  Compare and contrast the key points you presented with information in Chapter 2 of the text.  Are the ideas in the film supported by factual information in the text, or are they contrasted, or contradicted in some way?

What additional thoughts and questions do these ideas raise about your understanding of the influence of either nature (biology) or nurture (experience/environment) on development overall?  Did the information from the film and/or text confirm thoughts and you already held about the influence of nature v. nurture, or did it challenge your assumptions?  Explain.

Discussion

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Diagnostic Skill Application II

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For this assignment, you are provided with four video case studies (linked in the Resources). Review the cases of Julio and Kimi, and choose either Reese or Daneer for the third case.  Review these two videos: •The Case of Julio:  Julio is a 36-year-old single gay male. He is of Cuban descent. He was born and raised in Florida by his parents with his two sisters. He attended community college but did not follow through with his plan to obtain a four-year degree, because his poor test taking skills created barriers. He currently works for a sales promotion company, where he is tasked with creating ads for local businesses. He enjoys the more social aspects of his job, but tracking the details is challenging and has caused him to lose jobs in the past. He has been dating his partner, Justin, for five years. Justin feels it is time for them to commit and build a future. Justin is frustrated that Julio refuses to plan the wedding and tends to blame Julio’s family. While Julio’s parents hold some traditional religious values, they would welcome Justin into the family but are respectfully waiting for Julio to make his plans known. Justin is as overwhelmed by the details at home as he is at work. •The Case of Kimi:  Kimi is a 48-year-old female currently separated from her husband, Robert, of 16 years. They have no children, which was consistent with Kimi’s desire to focus on her career as a sales manager. She told Robert a pregnancy would wreck her efforts to maintain her body. His desire to have a family was a goal he decided he needed to pursue with someone else. He left Kimi six months ago for a much younger woman and filed for divorce. Kimi began having issues with food during high school when she was on the dance team and felt self-conscious wearing the form-fitting uniform. During college, she sought treatment because her roommate became alarmed by her issues around eating. She never told her parents about this and felt it was behind her. Her parents are Danish and value privacy. They always expected Kimi to be independent. Her lack of communication about her private life did not concern them. They are troubled by Robert’s behavior and consider his conspicuous infidelity as a poor reflection upon their family. Kimi has moved in with her parents while she and Robert are selling the house, which has upended the balance in their relationship.  For a third case, choose one of these videos: •The Case of Reese:  -Reese is a 44-year-old married African American female. Her parents live in another state, and she is their only child. Her father is a retired Marine Lieutenant Colonel who was stationed both in the United States and overseas while Reese was growing up. She entered the Air Force as soon as she graduated high school at age 17 and has achieved the rank of Chief Master Sergeant. She has been married 15 years to John, and they recently discovered she is pregnant. The unexpected pregnancy has been quite disorienting for someone who has planned and structured major decision her entire life. Reese is fiercely loyal to her extended family and frequently travels to help her parents care for her aunts, uncles, and cousins whenever they experience hardships. Her efforts are not always appreciated, because she offers very specific guidance and is easily frustrated by their lack of followthrough. •The Case of Daneer:  Daneer is a 50-year-old male. He emigrated to the United States from Serbia with his parents and older brother when he was four years old. Daneer and his brother were harshly disciplined by their parents when they failed to follow family rules or did not live up to their standards. It was not unusual for his parents to refuse to speak to the boys for days when their grades were low. Daneer’s parents are practicing Muslims, but Daneer rejected their faith when he reached adulthood. His relationships with his parents and brother are strained by his tendency to alternate between being a doting son and lashing out when they rebuke his lifestyle. They disapprove of his life choices that are inconsistent with their religious beliefs. Daneer was briefly married in his 20s, but his wife left him after six months and filed an order of protection. He was briefly hospitalized after a serious suicide attempt shortly after his marriage ended. He has worked several jobs as a waiter and often quits before he is fired due to conflicts with other staff.  Download the Unit 9 Assignment Template. Use it to complete your assignment.  Instructions  For each case, you will complete a diagnostic analysis you select from the list of assessment tools provided late in this assignment. Each case requires the following information to be addressed: •Describe presenting concerns and relevant history. •Explain what information has been provided in each case that helps to determine which disorders are appropriate for consideration (differential diagnoses) for a final diagnosis. Evaluate how at least one assessment tool, which is listed in the List of Assessment Tools resource, will aid in obtaining further information to back up your final diagnosis. The Differential Diagnosis Decision Tree may be helpful to guide this process. •Present DSM-5 and ICD-10 codes including relevant Z codes. Assume that the client has presented for treatment with their partner or parents. •Provide a descriptive rationale for the DSM diagnosis that best fits the information provided, including relevant ICD codes. This should be written in a narrative form using complete sentences. Support your rationale with scholarly sources. Optional readings found in the course syllabus may be particularly relevant. •Describe indications or contraindications that help determine whether a medication consultation is appropriate, and provide rationale with support from scholarly sources.

Discussion: Applying Differential Diagnosis To Depressive And Bipolar Disorders: The Case Of Sam

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What is it truly like to have a mental illness? By considering clients’ lived experiences, a social worker becomes more empathetic and therefore better equipped to treat them. In this Discussion, you analyze a case study focused on a depressive disorder or bipolar disorder using the steps of differential diagnosis. You also describe lived experiences of depression.

To prepare: View the TED Talk “Depression, the Secret We Share” (TED Conferences, LLC, 2013) and compare the description of Andrew Solomon’s symptoms to the criteria for depressive disorders in the DSM-5. Next review the steps in diagnosis detailed in the Morrison (2014) reading, and then read “The Case of Sam,” considering Sam against the various DSM-5 criteria for depressive disorders and bipolar disorders.

By Day 3

Post a 300- to 500-word response in which you address the following:

  • Provide the full DSM-5 diagnosis for Sam. For any diagnosis that you choose, be sure to concisely explain how Sam fits that diagnostic criteria. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, medical needs, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.
  • Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
  • Recommend a specific evidence-based measurement instrument to validate the diagnosis and assess outcomes of treatment.
  • Describe your treatment recommendations, including the type of treatment modality and whether or not you would refer the client to a medical provider for psychotropic medications.

    The Case of Sam

    Sam is a 62-year-old, widowed, African American male. He is unemployed, receives Social Security benefits, and lives on his own in an apartment. Sam has minimal peer relationships, choosing not to socialize with anyone except his daughter, with whom he is very close. Sam raised his daughter as a single father after his wife passed away. Melissa is 28 years old and works as an emergency medical technician (EMT). When Sam was 7 years old, he was placed in foster care and has had very limited contact with his extended family.

    Prior to September 11, 2001, Sam had a steady employment history in food services and retail. He had no psychiatric history before that time. Sam reported his religious background is Catholic, but he is not affiliated with a congregation or church.

    Sam became depressed and psychotic sometime after 9/11 and had to be taken to an emergency room. He was hospitalized at that time for several weeks. His mental status exam (MSE) and diagnostic interview showed no history of alcohol or substance abuse issues, and he had no criminal background or current legal issues. Sam was released to outpatient care but was deemed unable to return to work. At that time, he had a diagnosis of major depression with psychotic features; he also has a history of high blood pressure and migraines. After several additional multiple psychiatric hospitalizations, he was gradually stabilized.

    Sam has been seeing a psychiatrist once a month for over a decade for medication management and is currently prescribed Depakote®, Abilify, and Wellbutrin®. Sam has a positive history of medication and treatment compliance. He was treated by a social worker at an outpatient program for about 2 years after his hospitalizations for his psychosis and depression. He gradually stopped attending sessions with the social worker after his symptoms stabilized, and his termination from the outpatient program was deemed appropriate; he continued to see the psychiatrist monthly for medication management.

    After about 10 years of seeing only the psychiatrist, Sam scheduled a meeting with this social worker for increased feelings of depression. These feelings were brought on after his daughter moved out of the apartment they had shared for many years to live with her boyfriend. He reported difficulty adjusting to living alone and said he often feels lonely and anxious. He reported during sessions with his social worker that he speaks to his daughter frequently, and although she only lives 10 blocks away, he misses her terribly.

    Our sessions for the last 3 months have focused on his mixed feelings around his daughter’s new life with her boyfriend. He said he is happy that she is happy but misses her very much. I emphasized his strengths and helped him reframe his situation by focusing on the positive changes in her life as well as his own life. Our goals were to help him reduce his symptoms of anxiety and begin searching for new opportunities for socialization outside of his daughter.

     

     

    During our last two sessions, I became concerned because Sam, who was normally articulate, had been appearing confused and slightly disorganized. I asked him if he had a recent medication change and if he had been compliant with his current medications, but he denied noncompliance or any recent medication adjustment.

    I asked Sam if he was experiencing any physical health problems. He denied any ongoing problems but mentioned that he had collapsed on the street recently. He reported that he had been hospitalized and had undergone a number of tests, which he thinks were all negative. He said he still feels “foggy” at times, and sometimes time seems to be “missing.”

    I reviewed his medications with him. As he went down the list, he reported taking Cogentin® and Ativan®, which according to his chart history had been discontinued months ago. When I asked Sam where he obtained these medications, he stated, “I got them out of the bag.” Sam reported he has a bag at home in which he puts all leftover and discontinued medications. He could not explain why he was taking discontinued medication or for how long. Sam stated, “I thought I was supposed to take it.”

    I called his daughter, and she verified he had recently been hospitalized and that the MRI, CT scan, and EEG tests were negative. I requested that Melissa go to her father’s apartment to look for the bag of medications he mentioned, because it seemed likely that her father was taking discontinued medications. I then scheduled a meeting with Sam and his daughter for later that week. During that session, Melissa reported that she found multiple vials of old medication on the kitchen counter mixed in with her father’s current medications. Melissa reported that she collected and disposed of all the old medications. I recommended obtaining a daily medication planner. Although the hospital tests were negative, I recommended scheduling an appointment with a neurologist, and both agreed.

    Sam saw a neurologist who reported that his test results were negative but did not rule out the possibility of a seizure disorder. The neurologist recommended a follow-up appointment in 3 months. He also contacted Sam’s psychiatrist and recommended that the Wellbutrin be discontinued because it is known to have the potential to cause seizures and that Sam should start on another antidepressant. Sam began to focus and become more cognitively alert after the discontinued medications were disposed of and the Wellbutrin was discontinued.

    I scheduled another family session for Sam to discuss his feelings regarding Melissa moving out. Sam was tearful when he told Melissa he missed her and her dog Sonny. He also told her he was concerned he would not be financially able to remain in the apartment. Melissa reported working long and odd hours but did call her father often and invited him over to her apartment. She further reported that he often declined her invitations. Sam reported he declined because he did not want to intrude on her life or her boyfriend. Melissa assured her father that both she and her boyfriend wanted him to visit and be part of their lives. I asked Sam if Melissa’s dog had been company for him, and he replied, “Yes, and I miss him.” I asked Melissa if it would be possible for Sonny

     

     

    to spend some time with her father. Melissa reported her long work hours were making it difficult to take care of Sonny and asked her father if he would like Sonny to live with him. Sam replied, “I would like that.”

    I discussed with Sam how he spends his time, which normally consists of reading a newspaper, watching television, or listening to talk radio. I suggested Sam increase his socialization and recommended a social club for older adults that is near his home. Sam said he would consider this idea. I asked Sam to discuss his financial concern that he may not be able to remain in his apartment. Sam stated that Melissa had been contributing to the household expenses but stopped when she moved out. He stated he had been too embarrassed and ashamed to discuss this with Melissa and had been keeping this to himself. Although Sam is on a fixed income, he is currently able to meet his expenses. However, he is concerned about his rent, which is his largest expense.

    I explored state and federal rent assistance programs for seniors and the disabled. I found a program through which tenants who qualify can have their rent frozen at their current level and be exempt from future rent increases. Sam met the program requirement of being at least 62 years of age, currently living in a rent-controlled apartment, and having a household income that was within the specified guidelines. I obtained the required forms and personal documentation from Sam and completed the application, sending it to the appropriate agency.

    Adapted from: Plummer, S.-B., Makris, S., & Brocksen, S. (2013). Social work case studies: Concentration year. Baltimore, MD: Laureate Publishing.