Christian Counseling - The Use of Medication in Treatment of Depression

Some recovering from depression or who are in remission swear by antidepressant medication, while others are fearful of trying the treatment, and still others can't take them due to serious side effects.
Several short-term studies showed that 45% to 55% of chronically depressed participants had at least a 50% reduction in symptoms by taking tricyclic (older class) or selective serotonin reuptake inhibitors (SSRIs - newer class). Only 25% to 35% of those with chronic depression achieved remission with the first drug. (Harvard Mental Health Letter, December 2009, pg. 2.)
The belief is that those with chronic depression need an extended period of medication use. It is also believed that long-term medication management reduces relapses. Typically, clinicians think of long-term to be about six to 12 months. Clearly, there are others who need an indefinite period of maintenance therapy, and still others who may need it for the remainder of their lives. One study showed that outcome for chronic depression was improved when participants' wishes for a particular treatment was given to them. Twice as many achieved remission when participants desired and received drug therapy, and six times as many for those desiring and receiving talk therapy. Clients need to tell their therapists what they desire and don't. However, there are exceptions to "The client knows best," which I will get to in a moment.
Some, with some good reason, distrust putting any unnatural substance in their bodies. Side-effects can be substantial, and the long-term consequences may not be understood for years or perhaps even decades after the FDA grants approval. It can also be an issue of faith, just as it is for some who consider whether or not to enter counseling. They may believe God is sufficient to heal them and, if He meant it to be some other way, they would not be depressed. They reason they should endure the malady because it's God's will. But for how long?
One of the significant issues confronting those who are depressed is that their sense of judgment is often skewed by the disorder. Further, I don't believe depression is ever the result of God's will or desire. It is the result of evil in the world and in us, the beliefs we hold, the traumatic experiences of the past or present, and genetic vulnerabilities.
One important point in decision making regarding medication usage is comparing risk with benefit. If the risk for suicide, inability to work, or other health concerns exist (coronary disease), then it is highly important clients consider the use of medication. If necessary, a therapist can help a client understand and overcome his or her concerns, resistances and fears.
"The client knows best" is often true, but not always. There are times a client must rely on his or her doctor's judgment, such as when a client suffers from severe depression, or when he or she is unable to sufficiently participate in treatment.
The client always has the final decision about whether or not to take medication. But before doing so, the client should always be active in researching, thinking and discussing treatment alternatives with knowledgeable family, friends and doctors. The out-dated notions that either the client or the doctor always knows best is being supplanted by a greater and more relevant understanding--together, the doctor and client know best, and that, under the leading of the Spirit. A collaborative, working and trusting alliance is necessary to a good outcome, regardless of whether or not medication management is part of the treatment.

Christian Counseling - Two American's Way of Expressing Appreciation

I am deeply patriotic. I was raised to love my country and serve her, as I did in Vietnam. I appreciate the great abundance we Americans have through the gifts of God and the hard work of people. I am always moved by the wisdom of our founding fathers in creating our unique Constitution, written in opposition to governments run by one person or one party. The document and its promised freedoms are a shining model admired and emulated by many in the world, and which has drawn hundreds of millions to live in America. All of these things have a hold on me that is nearly as profound as my attachment to scripture. I am driven to express my thanksgiving through prayers to God and actions protecting our way of life.

I recently wrote an article for our Center's newsletter, the Navigator (for those who signed up online), entitled, "I'd Appreciate It." It culturally and biblically defines what appreciation means and suggests that it inevitably leads to an expression through various individually determined actions, much like works as an outgrowth of faith.

However, I had fallen victim to believing one person can't make a difference and, therefore, taking action was futile. That defeatist attitude was something I had to change. I realized change always begins with one person's conviction and action.

In that spirit, my wife and I recently expressed our appreciation for God's blessings, our country, freedom and the democratic way of life by taking protective action in challenging the position of the American Association of Retired People. Here is our letter:


A Barry Rand, CEO

AARP

601 E. St. N.W.

Washington, D 20049

Dear Mr. Rand:

My wife and I are members of AARP; that is, for the moment. We are both flabbergasted at your support of the health care reform bill (H.R. 3962), now in the hands of the Senate, and strongly urge you to revoke your support.

We who work in the health care industry, are well aware that reforms are desperately needed. However, this bill is wrong. Here are some key reasons:

1. Rising taxes. You don't need to be a CPA to figure out that adding 30 million people to the health care system will substantially increase the tax burden of Americans (health care representing about 16% of GDP). There is no way it can reduce the deficit as promised. That deficit will substantially increase, which will require additional taxes to pay down the debt. The only exception to that is if the government continues its practice of using a second or third set of books to hide the true cost--a criminal offense to us citizens, should we do likewise.

2. Rising health care costs. The history of government -run anything tells us it costs between 300 and 900% more than Congressional projections. Germany is a good example of what can happen to us, if we pass this bill. This country now wants private sector, health care competition to take over the near bankrupt government health care system. AARP members are likely not willing to gamble with their health care benefits and cannot afford its true, monstrous cost.

3. Decreased accessibility. You don't have to be a Canadian to figure out that adding 30 million people to the health care system without adding doctors will put a serious strain on availability of services. You don't need to be a 45-year old woman (can't get a covered mammogram until 50 years of age) to feel the fear of a government-run health insurance that will change many insured's eligibility for preventative medicine and treatment. AARP's members, seniors, will either do without or pay out-of-pocket for health care when 570 billion dollars is cut from Medicare, which the current bill proposes. Who do you represent, your members or the government?

4. Anti-Constitutional legislation. Our founding fathers established the Constitution to keep the power in the hands of the States, run by you and me, and prevent the imbalance of power, which happens when the government takes over free market enterprise and establishes its own rules, especially in the oppositional face of the majority of Americans. (And to think the House of Representatives, which passed this bill, is supposed to represent, "We, the people.") The Congress has no legal justification for even offering a government-run health insurance option. Do you care about the Constitution, or is it outdated, irrelevant and to be ignored as many progressives believe? Do you care that these actions can lead to a slippery slope of transforming our democracy into socialism or communism?

A recent report from the Obama Administration's Centers for Medicare & Medicaid Services affirms the reality of the bill's consequences--rising health care costs and taxes and decreased accessibility, especially for seniors who are covered by Medicare.

I wonder Mr. Rand, did you read all 2200 plus pages of the bill before you published your website article "Health Care Reform: Get the Facts," which contains more fiction than facts? "No, you did not." AARP's article was written in September of this, while the second increase from the bill's 1500 pages to its current unreadable size of more than 220 pages happened mid-November. The article's spin and points of fiction leave thinking members like me quite skeptical about AARP's agenda.

Many of your members are an educated population capable of discerning truth from error and reasonably assessing an organization's political agenda. I have to ask, what is AARP's agenda, leading to supporting this bill? Could it be a quid pro quo for the 18 million dollars you received from the government for job creation (failure: AARP created zero jobs)? How about the financial gain from AARP's explosion of supplemental health insurance sales to its members, as the result of the projected widening gap between decreased Medicare coverage and what is necessary for its members, due to the passage of this bill?

My wife and I have to come to distrust AARP's promise to be our advocates in Washington. It seems more likely you are advocating for yourselves, and perhaps a minority of your members.

If AARP doesn't publicly recant its position on H.R. 3962 before the end of 2009, you can decrease your membership role from 35 million to 34,999,998. My wife and I will permanently terminate our membership and serve as spokespeople against AARP to those with whom we have influence. We hope other members of AARP will consider what is personally at stake for them, posterity, and the future of our country, as well as their support of AARP.

Good night, and good luck...



There are many ways to express appreciation, how will you?

Christian Counseling - Empathy

The essence of who we are is covered by a gloriously created human body. But, this same body acts as a boundary, which leaves us all profoundly disconnected and isolated. As social creatures, we repeatedly attempt to connect with others through verbal and nonverbal communication and physical touch, as well as indirectly through fantasy.

Many people know the calming, sometimes teary-eyed effect of having someone deeply understand and share our thoughts and feelings. This empathy may be rare, but it is not easily forgotten, and it leaves most of us wanting more, except for those who have a powerful desire to be in control and find empathy threatening.

Even though God knows exactly what we feel and think, we don't get the sensory input directly from Him, as we do with others. We need the experience of hearing understanding words and feeling someone's touch. God knows this, and gave us each other. Adam was lonely and needed Eve. God desires to emotionally, spiritually, intellectually and physically touch others through His body, the church, you and me. We are His arms and His voice.

One of the best ways He is served, honored and glorified and shows forth His love is when we are empathetic to one another. But, if you lack this ability or it is underdeveloped, take heart, you can change. Here are two things about empathy you need to know and practice:

1. Empathy always begins with listening closely to all that a person says and looking to underlying thoughts and feelings that were not expressed. Understanding and attending to the central reason for the communication is crucial to empathizing. For example, Barbara says to her late-for-dinner husband, "Why didn't you call me? Your dinner is on the stove. I already ate." What he shouldn't say is, "Oh, I am sorry, I had a last minute project that I had to take care of, and traffic was worse than usual." He is not attending to her words or her underlying feelings, but providing a rationale for his behavior. It would be better to say, "Please give me a moment to respond to you." Then ask himself what is it that's deeply bothering her? Depending on the tone of her words, she may be disappointed, frustrated and/or worried. Once he believes he understands her he could say, "You took the trouble of making dinner for me. The least I could have done was call, instead of treating you as less important than my work." Agreeing with her assessment that he should have called and the "less important than my work" is the empathetic balm that will help heal the minor issue at hand and the greater underlying conflict.

2. To understand another's underlying or unspoken thoughts, feelings and wishes, he needs to evaluate her word's and tone. Next, he attaches meaning and significance to those words and asks himself what was not said, such as feelings. Empathy's next step requires him to be in touch with himself and ask how he would feel in that situation. This forms a base for empathetic understanding, but he isn't finished yet. He must modify that base of understanding according to what he understands about her general needs, wants, personality, etc. How he feels and she feels is not going to be exactly the same. Lastly, he checks out with her what he believes to be the central issue. Her response will guide him. This deeper work of empathy must continue, at least until there is a lessening or calming of her feelings, questions and thoughts. Feeling comforted, she may be ready to hear what unavoidably delayed him or his apology.

Proverbs 4:7 '"The beginning of wisdom is: Acquire wisdom; and with all your acquiring, get understanding."'

Christian Counseling - "Us and Them"

Do you remember the words from this song?
You and me against the world
Sometimes it feels like you and me against the world.
When all others turn their back and walk away
You can count on me to stay.


During the 70's the Australian born pop singer, Helen Reddy, sang the hit "You and Me Against the World" to her daughter Traci, who was featured in speaking the opening and closing words. The song is about commitment and dependability and speaks to the eternal bond between a mother and her daughter and of family life that continues beyond "when one of us is gone."


The peaceful security of knowing someone will always be there is something to which most everyone can relate. Those who know this have also likely experienced others who have walked away or abandoned them.


It is seriously unfortunate that many Christians take an "us and them" position. It is not infrequent to hear someone express, in so many words, that their denomination or even their specific church is the "us" and all others are "them," meaning the "us" alone has the truth. This kind of exclusivity is not birthed from scripture, but from protectionism and fear.


A person who feels he or she have been identified as one of "them," knows the pain of rejection, especially after having been a significant part of the life of a group or church. They are deeply affected by the suspicious and unaccepting attitude of others who have emotionally and/or physically walked away. They know the chastisement of being treated as a stranger. They also know it can easily happen by committing, what seems like, an unpardonable sin or by not believing exactly like the "us" does. They often continue on in their church the best they can, for a while.


The fear of loss and rejection pressures people to be like the "us." We all need to belong and to be accepted and cared for, and we know that some sacrifice of individuality is required, but how much? Morally, not very much, for our acceptance of people should not be based on a requirement that others believe exactly what we believe, but based on the truth that they are a unique creation of God. The righteous attitude is to "accept one another, just as Christ also accepted us..." (Romans 15:7). We are fully accepted right in the middle of living our sinful life and with all the varied differences of beliefs, thoughts and feelings. As Christians, we are called by God to be like Him, to love all people and regard anyone who follows Christ as family. Yet, for the many who do not have this love or accepting and gracious attitude, their insecurity demands of others a devastating amount of negative self-denial to fit in.


The wounded are left anxious and restless, and grow dissatisfied with superficial acceptance. They feel adrift from the anchoring of deep relationships, inhibited from volunteering to do the work of the church and can be overwhelmed by loneliness. If that isn't enough, they often experience a cooling in their relationship with God. Over time, most realize that the price to pay for inclusion is too great and something has to give.

In their pain and as a result of their maturity, they come to realize they should be true to God and their own beliefs. The collected knowledge and insights gained over the years inevitably leads them to see a different light than others, and they know it is right to say so by reasonable comments and good questions. That assertive behavior is supported by the Word, but often not taken well by others who feel threatened, especially if the group or church has maintained an "us and them" mentality. In the end, many feel driven from their brothers and sisters in the Lord. Some will give other churches a try, but it will be difficult to rebuild a sense of safety and become an integral part of another church body.

Another response of the wounded is to join the ranks of 10's of millions of Americans who no longer attend church. They either go it alone with God or they create or find a small group to attend. Ironically, they can end up with a similar "us and them" attitude, if distrust prevails. God cares deeply about those who fall victim to this sin, and desires their recovery.

Perhaps you can be of help. Have you or others you know experienced the "us and them" mindset? What have you or others found to be helpful? Do you have any suggestions?

Christian Counseling - Slow Me Down, Lord

Slow me down, Lord
Ease the pounding of my heart
by the quieting of my mind.
Steady my hurried pace with a vision
of the eternal reach of time.
Give me, amid the confusion of the day,
the calmness of the everlasting hills.
Break the tensions of my nerves and
muscles with the soothing music of the
singing streams that live in my memory.
Help me to know the magical, restoring
power of sleep.
Teach me the art of taking minute vacations
of slowing down to look at a flower, to chat
with a friend, to pat a dog, to read a few lines
from a good book.
Slow me down, Lord, and inspire me to
send my roots deep into the soil of life's
enduring values that I may grow toward
the stars of my greater destiny.

from Pocket Cross, Inc., Houston, PA

It is easy to lose sight of what is important in life. It is easy to become so entangled in the information age or the abundance of opportunities that exist in America. It is easy to subtly exchange life for "have to's," "high-end performance," and "keeping up." Before we know it, we have lost our lives and become taskmasters and slaves. Peace, relaxation, time-out and doing some things you want to do are overshadowed by "must do's." So, we walk a little faster, talk a little faster and complete tasks a little faster, but we also languish, lament and loose our cool.

I joyfully remember visiting Aunts, Uncles and cousins on their farms in upper state New York. There was always a lot of work to be done, but there was always time for talking, listening, kindness, play and a corny farm joke. And there was time to patiently teach me about farm life and to experience its lighter side.

Bailed hay stacked near to the barn ceiling through which a maze would allow us to crawl. Straw poked at you under your shirt. Smiles came easy when you found someone else coming in the opposite direction, knowing the maze was only big enough for one. The mice, who scurried from the morning light when the barn door was opened, seemed a welcomed part of the family, as long as they didn't pay a visit to the house. Horses and cows taught me they didn't tail-twitch because they were happy to see me, but to chase away persistent flies. That was disappointing. Family at dinner, all together, gave you a sense of peace and belonging. We'd hear stories of local and some world news, and each person's daily experience. Amid the hard work and life was the comfort of feeling needed and important. Responsibility and healthy pride were gleaned from completing a share of the work, even if it was shoveling cowpies. It is amazing the kind of games one can create with cowpies. As the sun took rest from its daytime travels, we knew bedtime was near. Soon, two crowing cocks would signal the start of another day, and happily so, on most days.

Stories are so important. It gives us a chance for vicarious living. It gives us new ways to think about and live life. Most of us are attracted to people who live a slower paced life with peace and contentment. Perhaps the Lord uses those people to help slow down others who live life at the speed of a driver on a European autobahn.

We live in the Age of Stress, and it seems tiredness covers the earth. The complaints about these are as frequent as the dropping of fall leaves. The busyness can overwhelm to the point that people feel they can't do anything about it, and don't know where to begin. So, here is a point of entry. "Cease striving and know that I am God" (Psalm 46:10). The presence of God is meant to have a calming effect.

Recovery begins with a time-out from the ways in which we live. In that sacred place we find peace and refreshment. We come to understand how we are living our lives, how we and others lived in times past, and how we and God want it to be. The difference between our real life and the ideal one can stir us to action. Consider giving yourself 30 days in which you slow down and cease striving by taking regular time-outs from life as usual. Get to know the peace of God, assess the quality of your life, then dream, pray and do something different.

Christian Counseling - Self-Attention verses Self-Centeredness

As the world turns, it seems Americans are increasingly becoming more focused on themselves and their horizontal relationships than on God. Such is the belief of Mark Galli (Senior Managing Editor of Christianity Today) as presented in the October 2009 article, "In The Beginning, Grace." He solution is for people to refocus on God first, then "do the horizontal thing we are called and gifted to do" (pg.29). While I believe God is to be first in almost everything (presenting God is second to food for starving people, etc.), Galli's presentation misses the mark of understanding and/or showing his readers the critical role self-understanding, need-meeting and human relating play in our mental, physical and spiritual health, and some of the credible, but sometimes unfortunate, reasons for people's growing self-focus.


It is true that self-attention can become a self-centered obsession with the result of losing interest in or focus on God. But, self-attention should be the baby we keep and nurture, while the dirty bath water of exclusive self-focus is thrown out. Self-attention is required for understanding whether or not we have a log in our eye, sin in our life, a saving faith, are becoming like Christ, etc. The self that is to die is not the personality or the "I" or "me," but the separate sin nature (Romans 7:14-21). Thus, the core of individuality is rightfully and necessarily maintained, so that we can pray like Moses, Jeremiah, Obadiah, Jesus and others who wrestled with God concerning His will. Yet, individuality has its limits. For example, it isn't a replacement for needed community.


Today there are many reasons for the increase in self-focus, not all of which are inappropriate or wrong. The attention given to oneself will likely increase in America as a result of the continued breakdown of family life, increasing socialized government, and the church's misunderstanding regarding the great necessity for open, horizontal relationships.

The traumatizing effect of divorce on children, even adults, often leaves its victims in survival mode, where the exaggerated self-focus is on how to keep safe and remain alive. Their needs, wants and avoidance of further pain and deprivation become their overarching concern influencing decisions and other behaviors. We are seeing, and will likely continue to see, an effect of trauma in the increase in personality disorders, such as: borderline (rage, impulsivity, unstable relationships), narcissism (admiration seeking, grandiosity, lack of empathy), and histrionic (attention seeking, over emotional).

We will also probably observe an increase in anxiety, depression, fear of commitment, loneliness, isolation and self-protective behavior, the latter of which can include the growing use of the Internet and cell phones that replace face-to-face contact). Childhood learned survival mode persists into adulthood where home life, work and even holding onto one's salvation are managed by a self-focused survivor mentality.

As a government takes more control over the lives of its citizens, they inevitably suffer the loss of freedoms and rights. Many purists, like Texas Congressman Ron Paul, believe our American liberties are seriously threatened by our Congress and Supreme Court who frequently pass bills or make laws in discord to Constitutional guidelines, partially because some of them view it as outdated. Most American's don't want to be told how to raise their children or they cannot home school their children or be forced to redistribute their wealth through increased taxes and government-run health care insurance. These issues rightly cause people to self-focus on their fear, grief, anger and insecurity, perhaps similar in sentiment to those in Jesus' time over the controlling government and burdening Pharisaical law.

On the other hand, there are those who find security and comfort in the caretaking role of big government. They will not likely lament much about the loss of freedoms or rights because, to some of them, they are an acceptable price to pay for receiving help. These people may find they are less self-focused, having met some financial need, for example. It is possible, however, if they have a sense of entitlement, they could become more self-focused by looking for more of the same.

The church speaks about our need for human relationships and fellowship and makes some attempts to connect people through activities and programs. But it falls short and often teaches incomplete truths. Though the focus on one's individual relationship with God is necessary and healthy, it has often been presented from a separatist viewpoint, accompanied by the false belief, "God is all I need."

Encouraging an individual relationship with God without simultaneously encouraging relationships with others is incomplete and can lead to disappointment and an inflated dependence on God to the near exclusion of others. This has contributed to the neglect, impoverishment and decline of fellowship that is now often shallow. Instead of communicating openly, revealing imperfections, and confessing sins to one another, many Christians put on their spiritual cloaks and hide the truth about how life is really going for them. The result is a focus on meeting one's own needs and wants because the depth of human relationships is restricted. Further, without vital, honest, horizontal relationships, people will not only miss out on God's involvement in changing lives, but God Himself.

God is not all we need, we need people. Adam, who walked and talked with God, was lonely (Genesis 2:18). God recognized Adam's powerful need for other human beings. Further, we discover and better understand God as a result of our relationships with other believers. People can be saved in hearing the gospel through others. And Jesus said, '"For where two or three have gathered together in My name, I am there in their midst"' (Matthew 18:20). If we have a correct focus on our need for God and others, we will likely have healthier, need-meeting relationships that lessen self-centered thinking and behavior.

To further the point on our need for horizontal, human relationships that can diminish self-focus, and increase our God-focus, consider the following question. Where is God? The answer is He lives in His people. Primarily, God works and intervenes in the world through people. It is there in the lives of others we can also find Him, truths about ourselves and challenges and support in developing our character, far more so than in the solitary relationship with God alone.

The church would do well to learn about and teach how to develop and maintain deep and meaningful relationships and present a cohesive emphasis on a believer's almost inseparable relationships with both God and others. Church leadership needs the courage to model openness about the realities of who they are; that is, their sin nature, which will free others to open up about their troubles. The effect being people who become appropriately and moderately self-attending, less self-centered and more centered in others and God.

Christian Counseling - Do not Judge! Never?

"'Do not judge so that you will not be judged. For in the way you judge, you will be judged; and by your standard of measure, it will be measured to you. Why do you look at the speck that is in your brother's eye, but do not notice the log that is in your own eye?"' (Matthew 7:1-3) And James 4:11,12 says, "...(h)e who speaks against a brother or judges his brother, speaks against the law and judges the law; but if you judge the law, you are not a doer of the law but a judge of it...who are you who judge your neighbor?"

The simple and safe solution to judging is don't do it, ever.

Yet, that creates a problem. Without judging a person could never discern or form any conclusion about any person's character or behavior--good or evil, right or wrong, appropriate or inappropriate. How then could anyone decide to associate, or not, with a particular person, group, church, business or government? How then could any church vote on accepting someone's membership, or discipline a member? How then could a person decide to whom they will make contributions, or for whom they will vote, hire, or fire? No, the simple solution to never judge doesn't work. So, what is it that God means when He says don't do it? The answer is found in the definition.

In Greek, the same word for judge can mean two very different things. The first meaning is to take actions that try, condemn, punish, damn and avenge someone. Second, it refers to thinking, determining, concluding, and calling something or person into question. The first use of judging is condemned in the Bible, but the second is expected and required.

Biblical support for judging is found in the following verses:

Luke 12:57 tells us, "'And why do you not even on your own initiative judge what is right?"'
In John 7:24 Jesus tells us to, "judge with righteous [in Greek, justice or equitably]
judgment."
Romans 2:27 says we are to make judgments about what the law means.
I Corinthians 5:12 gives us permission to judge those in the church, but not those outside of it.
I Corinthians 6:1-5 informs us we are to judge small or significant issues regarding people or
things.

Judging, as punishing others or even oneself, is not right. Judging, as trying to figure out what is true or right, is always good. Therefore, judging others can be right or wrong. Looking a little more closely to self-judgment, the same thinking applies. It can be either good or bad. Self-judgment is good because it is necessary to see the log in one's own eye, to confess sin and to evaluate if one has turned away from it. But what scripture condemns is anyone who takes God's place and acts like a judge who tries, condemns and punishes oneself. Right self-judgment is limited to discerning the rightness or wrongness of one's own thoughts, feelings and behavior. We then take this and confess it to God who, as the righteous judge, decides on any chastisement. Sinful self-judgment is visible when people carry around a load of guilt and when they condemn themselves to limited joy and pleasure. This is often the result of holding on to false beliefs like, "I don't deserve to be happy" or "I am a bad person."

One reason God tells us not to judge (condemn and punish) is that our judgments tend to be short-sighted. They are based on what we want or desire to satisfy or control some thought or feeling, such as hurt or angry. Jesus said in John 5:30 that His judgment was just because He didn't seek his own will, but that of the Father. Also, we tend to "judge after the flesh" (or carnally), says John 8:15.

We need to understand God's judgments (how He thinks and arrives at His decisions, and not as an authority who takes actions against someone or ourselves). We do this the best we can, apply those learnings in our everyday life and ask God to take any righteous actions He deems necessary.

Christian Counseling - How Long Does Therapy Take?

Every person entering treatment has a desire or some sense of how long therapy should last. This is somewhat dependent upon what they believe it is all about. Those who think of counseling as a professional passing along logical information will probably think it should only take a few sessions. Those who view human life as simple and easily changeable will also think a few sessions will do the trick. And those who see life as complex, problems as years in the making, and change coming only by much time and effort will likely hold a view that treatment will last a year, or two, or longer. People who have attempted to change a thought, feeling or behavior that has existed in their lives for many years know there is no quick fix.

Medical science is more of a hard science, therefore, a doctor can prescribe a specific round of meds for a specific time with success. However, the science and spirituality of counseling is soft. Therefore, we do not possess the same ability to prescribe services for a very specific period of time. The exception would be an educational format (providing instruction) or perhaps the treatment of a simple issue (phobia) where cognitive/behavioral therapy is applied.


There are many other reasons for the indeterminate length of counseling. Things like:


1. The number and type of treatment goals.
2. The length of time the disorder has existed.
3. The type, number and rigidity of defense mechanisms.
4. The client's ability to trust.
5. The client's motivation to explore the issues and complete assignments.
6. The client's sense of personal power and need to be in control.
7. The complexity of a client's personality.
8. The client's ability for insight.
9. The severity of trauma.

10. The age at which trauma began.

11. The client's courage to face one's pain and stay with it until it is resolved.


Change in counseling is like the change in becoming Christ-like, in terms of time. We will spend our lives working toward improvement and working on our sin nature, without ever finishing. Therefore, the overarching counseling goal is not 100% recovery, having the marriage you always dreamed about, or being free of all sin, but achieving a 60% to 70% improvement with regard to agreed upon personal goals. This is realistic. When a client passes this marker and there is mutual confidence he or she will be able to maintain and make continued improvement on his or her own, then the person is ready to discuss termination.

How long does it take to complete counseling? There is no concrete answer. However, to define this as best as one can, we at CCCRD take an in depth history of each client toward the beginning of counseling. The results are used to formulate a treatment plan that is based on a client's personality and how past experiences impacted his or her development and influence present problems. The therapist's experience in working with other similar issues and personalities gives him or her an idea of how long treatment is expected to take. It can be longer or shorter, depending on factors, such as future conflicts or new information gathered from further exploration in treatment.

When counseling is said to take a year or more, it may be helpful to think about it in light of the thoughts previously presented, and the following one. One year of weekly sessions is equivalent to less than one 40-hour work week. This one week of treatment is stretched out over the course of one year and, therefore, seems like a long time. All things considered, one full week of attending to oneself is not much time in which to make significant and long-lasting change.