The Waverley Integrative Framework: the Use of Christian Faith Interventions in Clinical Practice

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https://doi.org/10.52456/WACJO312

This is part 2 of an article on the Waverley integrative framework in Counselling Practice. Part 1 was published in the previous edition of this journal, and it set out some of my personal background and motivation for creating and developing a higher education counselling programme which is validated by a university, underpinned by a Christian worldview, and supported by the use of the Waverley integrative framework. In this second part, the focus is more on the practical application of the Waverley integrative framework and the competent and ethical use of Christian faith interventions in clinical practice.

The Waverley integrative framework

In part 1 of this paper, I provide an account of the creation and development of a BA (Hons) programme underpinned by a Christian worldview and a critical evaluation of the Waverley integrative framework. I also explain that the curricula of the counselling programme ensures students are facilitated to critically evaluate the use of Christian faith interventions and to be able to assess when it is appropriate to make use of these. In this second part of the article, I therefore continue my explanation of the training provided by the programme, with the focus on the practical application of the Waverley integrative framework and the competent and ethical use of Christian faith interventions in clinical practice.

(It is important to highlight that the approach promoted in this article fully respects clients’ rights to hold their own faith beliefs [or none] and values. Graduates of the College are therefore equipped and qualified to work with clients of all faiths or none.)

The use of Christian faith interventions

As students consider the use of Christian faith interventions in counselling practice, it is important they are facilitated to make a decision as to whether Christian faith interventions should be implicitly or explicitly utilised in counselling. Their decision will be significantly influenced by the context in which they work; for example, whether the setting in which they work has specific regulations regarding the incorporation of a faith-based approach. It will also be dependent on the specific needs and individual wishes of their clients, with students keeping in mind the client’s right to autonomy and to be self-governing at all times (Chappelle, 2000; Leach et al, 2009; Schlosser & Safran, 2009; Worthington et al, 2009; Tan, 2011; Sbanotto et al, 2016). The following two sections explain implicit/explicit integration in slightly more depth.

Implicit/covert integration

In certain contexts, for example when working in a context that either prohibits the use of Christian faith interventions and/or in a context where a client does not hold a Christian faith and/or when a Christian client makes the choice not to explore faith concerns, it is important that students engage in what Tan describes as ‘implicit’ integration (2011:340) or what Gubi describes as a ‘covert’ approach (2011:65. See also Tjeltveit, 2013). With implicit/covert integration, the integration and use of Christian faith interventions would not be obvious to an observer, for example a Christian practitioner may or may not choose to silently pray for their client. Admittedly, implicit integration is not without a level of ethical complexity and it is therefore vital that when students undertake implicit integration, they reflect all the attributes of respect, care, compassion and inclusiveness that are linked with a number of key themes derived from the doctrine of imago Dei, that were set out and explained in part 1 of this paper.

Explicit/overt integration and what is meant by Christian faith Interventions

Tan describes an explicit’ approach to integration (2011:66), or what Gubi describes as an ‘overt’ stance (2011:65), as one which includes the explicit and obvious use of a range of faith interventions in clinical practice. These are broad and can include:

  • Use of faith language, metaphors and analogies;

  • Taking a faith history of the client;

  • Use of spiritual relaxation and/or meditation;

  • Assisting a client to explore their faith and beliefs and concerns;

  • Use of prayer (client or therapist led);

  • Exploring issues of guilt and/or forgiveness;

  • Exploring issues related to meaning and purpose;

(Gingrich & Worthington, 2007; Gubi, 2007; Pargament & Saunders, 2007; Wade et al, 2007; Frazier & Hansen, 2009; Schlosser & Safran, 2009; Barnett & Johnson, 2011; Sbanotto et al, 2016; Captari et al, 2018).

The work I conducted with a client, ‘Jane’ (a pseudonym) illustrates both an implicit and explicit approach to integration. (All three case studies in this paper make use of pseudonyms and in addition, identifying details have been significantly changed in order to protect client confidentiality.)

Case study: Jane

Jane’s presenting problem was that having experienced a significant car accident the previous year, she felt unable to get into the driving seat of her car without re-experiencing traumatic and what she described as ‘terrible’ memories of the accident. I thought Jane might be a Christian because I had seen her at a distance at a local ecumenical event. Nevertheless, during the assessment session, when I asked whether there was anything that gave Jane meaning or comfort during times of stress, she gave no indication of a Christian faith, nor did she disclose any specific faith issues.

This indicated an implicit approach to integration would be of benefit and I duly spent time with Jane helping her process some of her trauma and in particular to assist her with some of her trauma related symptomology (e.g. flashbacks and avoidance strategies). After several months, Jane felt sufficiently recovered so as to not only be able to sit in the car, but actually drive herself to the session. As she stood on the doorstep pointing to the car she had driven, I was really pleased for her and spent time affirming and congratulating her.

Having apparently achieved her goal in therapy, I wanted to explore with Jane whether she considered it might be the right time for therapy to come to an end, or whether she felt there were any other issues of goals she wanted to consider. During this review, Jane stated that she wanted to explore where ‘God was in her accident’. At this point in the therapeutic process with Jane, I re-contracted with her, in that I explicitly sought her wishes as to whether she felt it would be helpful to explore her faith difficulties and I duly gained her permission to work in this area.

During the therapeutic process with Jane, I asked her views as to where she felt God was in the accident and this led to us exploring the belief that Jane held, which was that when a Christian suffers, they must have somehow ‘done something wrong in the past’.

In order to explore this belief further, I asked Jane whether she would be interested in drawing a Spiritual Genogram (Hodge, 2001). Jane agreed and this was helpful as it enabled Jane to describe how she had experienced God at varying times of her life and in addition assisted her to identify some of her unresolved issues of guilt and forgiveness. I also explored with Jane the value of spiritual meditation/relaxation (Collicutt et al, 2016). Both of these interventions helped me to facilitate Jane to resolve some of her difficulties and she reported the interventions helped her to ‘relax’ and to ‘feel closer to God’.

Reflection

In reflecting on the therapeutic process with Jane, on the one hand, I consider if I had rejected Jane’s request to continue with the therapy outright, I would have denied her right to autonomy and self-determination and in addition it would have risked disrespecting her decision to explore issues that she believed were pertinent to her difficulties. Nevertheless, on the other hand, I did wonder whether Jane was finding a way to prolong the therapy and, in order to ensure I was working in Jane’s best interests, I discussed this issue in supervision. I also explored with Jane in more depth what the key issues were that she was concerned about.

After these discussions, I made a clinical judgement that it would be of benefit to Jane to continue the therapeutic relationship and to explore with Jane her faith concerns. Having reached this decision, I verbally re-contracted with Jane to ensure that there was a shared and clear agreement between us, with explicit permission from Jane, to explore faith issues and, if appropriate, make use of faith interventions in our work together.

Competent skills and ethical practice

Whether counselling students adopt an explicit approach from the very beginning of therapy with their client, or, as in the case study of ‘Jane’, take an explicit approach to integration later on in the therapeutic process, it is vital they develop competent and ethical skills when working with a client’s faith issues (Pate & High, 1995; Young et al, 2007; Aten & Worthington, 2009; Watson & Everleigh, 2014; Swinton, 2016).

Whilst the following eleven points are not an exhaustive list of the ethical guidance the programme provides to students, they highlight some of the key areas that I believe are crucial for trainers to address in order to ensure counselling students gain ethical competence when addressing a client’s faith issues and difficulties.

Students are facilitated to understand the importance of the following:

1.     To openly explore and contract with their client their wishes regarding as to whether they want to or do not want to explore any faith issues and concerns and/or receive the use of faith interventions in therapy (see also point 2 below). This ensures the practitioner gains explicit informed consent from their client to work in this area and ensures the client’s right to autonomy (see British Association for Counselling and Psychotherapy (BACP), 2018 9). It also ensures that a shared understanding is reached between both the practitioner and the client regarding the client’s wishes (Chappelle, 2000; Hathaway & Ripley, 2009; Leach et al, 2009; Jenkins, 2011; Tan, 2011; Gubi, 2015).

2.     Counselling students are often hesitant or concerned as to how to raise the issue of faith in the assessment session, mainly due to the fear of being accused of proselytising (Saunders et al, 2010). I discuss with students the need to exercise caution, but at the same time suggest that they ensure they allow sufficient space for clients to feel able to raise faith concerns if they desire to do so (Knox et al, 2005; Hage et al, 2006; Barnet & Johnson, 2011). Furthermore, I recommend students ask their clients questions such as ‘is there anything that is important to you or helps you find meaning?’, or ‘how do you find comfort in times of stress?’ I believe these open, non-leading, questions give a client permission and an opening to disclose any faith issues that they might want to discuss in therapy (Jenkins, 2011:34).

3.     To always fully respect a client’s autonomy and to take care to ensure the client does not feel coerced or pressurised to engage with faith issues/material (Knox et al, 2005; Barnett & Johnson, 2011; West, 2011:222. See also BACP, 2018:16, item 25).

4.     To appreciate there must be a clear rationale regarding their use of faith interventions; having given careful consideration as to the potential benefit or harm that the intervention might create (Tan, 2011; West, 2011; Sbanotto et al, 2016; Captari et al., 2018). This includes ensuring students understand the inappropriateness of attempting to proselytise and impose beliefs, Christian or otherwise, onto a client (Rose et al, 2008; Leach et al, 2009; Worthington et al, 2009; Tan, 2011; West, 2012).

5.     To appreciate that faith can be viewed as an aspect of cultural diversity and that they need to develop sensitivity when working with clients who hold a variety of faith beliefs and/or come from a different (or even the same) cultural background (Pitner & Sakamoto, 2005; Hage, 2006; Wade et al, 2007; Schlosser & Safran, 2009). This is in order to ensure students develop inter-cultural (and intra-cultural) competence and practise in a non-discriminatory manner, avoiding oppressive practice (Hodge & Bushfield, 2007; Aten & Leach, 2009; Vieten, et al, 2016. See also BACP, 2018; 15, item 22). As Russell & Yarhouse highlight, faith is ‘an expression of diversity that warrants sensitivity and awareness in assessment and treatment planning’ (2006:435). (See also Plante, 2007 and Hathaway & Ripley, 2009.)

6.     That a client’s faith beliefs should not be ignored or undermined, but fully respected, irrespective of whether the counselling student has a negative response to the client’s views and opinions (Young et al, 2007; Frazier & Hansen, 2009; Saunders et al, 2010; Barnett & Johnson, 2011; Cook, 2013).

7.     Not to make assumptions about a client’s faith issues, but rather spend time listening to their client in order to gain a comprehensive understanding of the client’s faith difficulties (Captari et al, 2018).

8.     Documenting their use of faith interventions (alongside their use of other interventions) and in addition discussing with their supervisor all of their work with clients, including any work undertaken in the faith and/or spiritual area (Chappelle, 2000; Russell & Yarhouse, 2006; Gubi, 2007; Barnett & Johnson, 2011).

9.     Reflecting on the potential danger of role confusion if the therapist has another role with the client (for example, they are a member of the same church and/or act in another role, for example, a pastoral carer, a member of the clergy or hold a position of authority in a faith community) (Hage, 2006; Plante, 2007). Students are facilitated to appreciate that the responsibility to protect their clients and keep appropriate boundaries rests with themselves as the counsellor (Haug, 1999). This includes understanding the importance of avoiding dual/multiple relationships wherever possible and when this is not possible, to reflect with their supervisor on the ethical complexities and implications of the dual/multiple relationship. (The training provided by the programme pays particular attention to this issue, since there is evidence that the risk of a therapist holding dual/multiple relationships can be more prevalent within the Christian community [Hill & Mamalakis, 2001]). For example, in a survey amongst Christian therapists (albeit in the USA), 58% believed it was appropriate to deliver therapy to a client who belonged to their church (Sanders, Swenson & Schneller, 2011:336). When church ministers/vicars/leaders are also trained therapists and see their own church members as clients, there is the potential for role confusion to take place, which ultimately risks harm occurring to the client and/or a misuse of power and authority taking place (Haug, 1999; Sanders, 2013, b; Hill & Mamalakis, 2001).

10.  Awareness that in certain circumstances there are sound reasons for excluding the use of faith interventions. For example, when a client has a severe mental illness or psychotic episode, where faith and/or religious hallucinations and delusions can occur. Students are provided with training to ensure they are aware that in these circumstances, supervisory advice should be urgently sought, together with, if appropriate and with informed consent from the client, advice from their client’s GP or psychiatrist (Siddle et al, 2002; Koenig, 2009; Jenkins, 2011; Sbanotto et al, 2016).

11.  To appreciate that for some clients, experiences connected with faith, religion and spirituality have been far from a source of comfort or growth, but have been distressing and/or even traumatic (Aten & Leach, 2009).

Self-awareness of the student: counter-transference and developing a reflexive approach

As I designed the programme curricula, I also considered it essential that sufficient space was provided in the timetables to ensure students were able to critically reflect on their own Christian faith, their beliefs and their faith journey in order to enhance their self-awareness and their ability to identify any assumptions and prejudices that they might hold (Barnett & Johnson, 2011; Schmidt & Adkins, 2011). Underpinning this approach is evidence that a therapist’s self-awareness of their own personal responses and difficulties with faith, is a determining factor as to how effectively they are able to respond to their client’s faith material in clinical practice (Crossley & Salter, 2005; Hodge & Bushfield, 2007; Young et al, 2009). As Worthington et al, note,‘knowing about a client’s spiritual and religious values and background is not sufficient unless therapists recognise their own values and the consequent biases’ (2009:273).

Furthermore, I considered it essential that students were facilitated to reflect on how their own faith issues might trigger a potential transference/counter-transference response, which in turn, might negatively impact their work with their clients (Swinton, 2007; Young et al, 2007; Frazier & Hansen, 2009; Jackson & Coyle, 2009; Wiggins, 2009; Jenkins, 2011:33). The following case study illustrates the importance of this in practice.

Case study, Pam (a pseudonym)

Very early on in my counselling career, a client, Pam, was referred to me by a church leader (not from my own church). Having formed what I felt was an effective therapeutic relationship, Pam disclosed a number of painful life events, including childhood sexual abuse and what we both deemed was a form of spiritual abuse in adult life. We spent time together exploring the abuse Pam had experienced, both in childhood and in adult life. After several months of therapy, Pam announced during one session that she felt the therapy had really helped her ‘feel a lot better’ and as a result had decided to ‘stop attending church’ and in addition, was questioning whether she was ‘really a Christian’.

I remember feeling very uneasy during the session and a subsequent session with my supervisor valuably pulled out of me two concerns (which were largely unconscious prior to the discussion I held with my supervisor). Firstly, as we looked back over the work with Pam, I identified that I had felt quite ‘flattered’ when the pastor had referred the client to me. As I continued to reflect on this, I identified that I was now somewhat anxious as to how he would view my counselling abilities now Pam had decided to leave the church.

Secondly, I felt ‘very responsible’ that Pam was questioning her faith and wondered whether I had done something wrong in the therapy to cause this. As I continued to reflect on this issue, both on my own and with my supervisor, I became conscious of an even deeper issue, namely that I was concerned that I had somehow let God down in my work with this client. Nevertheless, I continued my work with Pam and helped her explore her future goals and plans. (See below for a further reflection.)

Reflection

It was important that I was able to identify and acknowledge the unconscious dynamic that was occurring in my work with Pam, not least because without this insight and recognition, I might have unconsciously influenced the client, and/or imposed my own views, rather than recognising her autonomy and helping her explore her own life choices, including those that surrounded her faith beliefs and practices. This case study illustrates to students the importance of developing a high level of self-awareness and to become, as far as is possible, consciously aware of the unconscious dynamics that might occur between themselves and their clients. It is also important that students understand the value of undertaking reflexive practice.

The appropriate use of Scripture in clinical practice

A further area included in the curricula is that students are facilitated to appreciate both the benefits and limitations/dangers over the use of Scripture in counselling. As explained in part 1 of this paper (published in the previous edition), a high regard for Scripture is taken on the programmes as a source of knowledge, on the basis that many Christians believe it to be the inspired Word of God (2 Timothy 3: 16) (Hurding, 1992; Johnson, 1992; McMinn, 1996; Hughes, 2002; Kallmier, 2011). Nevertheless, as Johnson notes, the ‘task of relating the Bible to the human science is fraught with difficulty’ (1992:346) and this is certainly true when it comes to the use of Scripture in clinical practice. For this reason, the programme specifically facilitates students to critically evaluate the use of Scripture, not least because there is considerable evidence that some Christian counsellors can use Scripture texts as a corrective tool; a means of ‘speaking truth in love’ (Powlison, 2010:258). Counselling students are facilitated to understand that this directive approach is unhelpful and risks unethical practice; as Tan points out: ‘the thoughtless and superficial use of scripture in therapy can lead to harmful consequences’ (2011:353).

I also believe it is essential that students are aware that counselling is not an appropriate space to have doctrinal discussions and debates. Therefore, if a client raises the use of Scripture during their counselling session (and it would normally be expected that the client and not the therapist would refer to Scripture) students are encouraged to take a neutral and curious exploration approach; providing clients with sufficient space to explore their own (and not the therapist’s) interpretation of Scripture (Young et al, 2009). I believe this nondirective and curious exploration approach is ethical and allows a client’s perceptions to be explored. I also explain to students that it is of far more therapeutic value to listen to what a client’s beliefs and views are than to take a directive approach, which risks a practitioner’s own agenda being imposed.

In addition, if a client requests the use of Scripture in counselling, students are urged to discover what biblical texts the client personally finds brings them comfort and/or they find helpful (Johnson, 1992). This approach is demonstrated by the following case study.

Case study, Ann (a pseudonym)

Ann sought counselling over what she described as a ‘problem with anger’. She disclosed during the assessment session that she was a Christian and that she wanted to explore her difficulties from ‘a Christian perspective’.

As we discussed together some of Ann’s life experiences, we explored some of the losses that she had recently experienced, including the loss of her mother six months previously. As we continued to discuss and explore the last year of Ann’s mother’s life, Ann became very angry at what she perceived was the neglect of her mother by some of the hospital staff.

One of the interventions that I used was to ask Ann to write a letter (that would at this point not be sent) setting out her concerns and feelings at her mother’s perceived mistreatment. As Ann read the letter back to me in a subsequent session, she made a comment along the lines of that ‘God would be very unhappy with my anger’ and that it ‘demonstrated a lack of forgiveness’ on her part. I asked Ann if we could explore a little more this concept that God would be unhappy with her anger and this caused Ann to disclose that anger was something she had never been allowed to express as a child. As we continued the exploration, I spent time listening and encouraging Ann to express her grief and anger.

At one point, Ann again stated that she thought God was disapproving of her anger and I asked her whether she believed God always disapproved of anger. This caused Ann to mention that she thought the Bible indicated that Jesus might have been angry in the temple and that this was possibly ‘OK anger’. I asked Ann to help me understand why her anger was ‘not OK anger’ as a Christian.

This was of therapeutic value, because during subsequent sessions Ann felt able to express anger and grief, reaching a point where she said during one session that she thought ‘God was OK over her anger’.

As we continued to work in this area over several weeks, I observed from her comments that she seemed to be slowly changing her perception of God from a harsh, disapproving God to a God who loved and cared for her.

 

Benefits and limitations of faith interventions and/or a Christian therapist/client dyad

The programme training also endeavours to facilitate students to attend to all aspects of culture and to develop cultural competence when working with both similarity as well as difference in counselling practice (Collins & Arthur, 2010). This is particularly relevant when working with Christian faith, since this has frequently been referred to as an aspect of cultural diversity (Brawer et al, 2002; Bufford, 2007; Barnett & Johnson, 2011; Delaney et al, 2007).

I consider the programme training has two key tasks in this area. Firstly, to facilitate students to reflect on the potential damage and limitations, as well as the benefits, of the use of Christian faith interventions in therapy. Secondly to assist students to consider the potential limitations of a Christian therapist counselling a Christian client. The following two sections discuss this in more depth.

Benefits/damage of the use of Christian faith interventions

Students are facilitated to critically evaluate literature which demonstrates the benefits of the use of Christian faith interventions and/or the exploration of a client’s faith issues (see Knox et al, 2005; Post & Wade, 2009; Cragun & Friedlander, 2012; Greenidge & Baker, 2012; Zenkert et al, 2014). However, students are also required to evaluate research which indicates the problems and difficulties that can occur when working with a client’s faith beliefs and material. For example, research by Martinez et al, (2007) highlighted at times:

i.                Counsellors were ‘condescending’ and/or ‘offensive’ in their delivery of faith interventions (2007:952);

ii.              The use of faith interventions increased the client’s feelings of anxiety and/or guilt and/or the client felt judged by the counsellor;

iii.             There was a lack of clarity over role boundaries, for example, when the counsellor was also the client’s spiritual leader;

iv.             There was a lack of understanding as to when it was inappropriate to use faith interventions in therapy, for example, when the client felt they should not be addressed in therapy.

One issue that is particularly emphasised to students regarding the potential misuse of faith interventions is over the issue of power. They consider in depth the work of Peter Gubi who highlights how faith interventions have the potential to create a ‘power imbalance’ (2009:119).

Benefits/limitations of a Christian therapist/client dyad

Students also evaluate research which gives evidence that when Christians seek counselling, many actively seek faith-based (Christian) counselling (Aten & Hernandez, 2004; Aten & Leach, 2009; Post & Wade, 2009; Worthington et al, 2009) and in addition they review research which indicates that clients can benefit by being matched with a counsellor who holds similar (Christian) faith beliefs and values as themselves (Aten & Hernandez, 2004; McMinn et al, 2010). The findings from this research are perhaps unsurprising, since there is evidence that better client outcomes can be achieved when a client and therapist are culturally matched (Farsimadan et al, 2007). As Clarkson highlights, ‘people who share similar problems or come from similar backgrounds may have greater ease in establishing rapport, empathy or an effective early working alliance’ (2003:42).

Whilst acknowledging the benefits of a Christian therapist/client dyad, nevertheless, it is also important that students appreciate, as Clarkson points out, that this very similarity can sometimes cause difficulties and that as therapy progresses, a ‘greater perceived dissimilarity’ can be more beneficial ‘(2003:42. See also Jackson et al, 2013:10).

Plumb also highlights the danger of an ‘over identification,’ especially since a practitioner might make the assumption that the client holds the same belief system and then ‘proceed without caution’ when making use of faith interventions (2011:14). As Penny points out, within a faith matched dyad, there is a risk that therapists may be less alert to the danger of potential areas of collusion, misunderstanding or have ‘mismatched expectations about the goals and process of counselling’ (2018:9). Students also consider Bretherton’s paper which highlights a further danger of a faith-matched dyad, namely the risk that those who belong to ‘your particular’ group are consciously/unconsciously perceived to be ‘right’ and those who do not can be perceived to be ‘lacking’ (2006:269). This difficulty is supported by research (again which students evaluate) conducted by Scott (2013), which found that some Christian counsellors; those who ‘had mostly had Christian influences in training, supervision and work place,’ struggled to accept the client’s belief systems (2013:274, 278).

The development of a core competence framework for working with a client’s religious/spiritual issues

Having developed counselling training for students over many years which has taken into account all of the principles that have been set out in this paper, it is worth mentioning that in 2021, I turned my attention to developing a framework which specifically assists Christian counsellors to work ethically, empathically and competently with Christian clients whose faith/religious/spiritual concerns emerge in clinical practice. This framework was published by the Association of Christian Counsellors in 2021 and is available as a resource at www.acc-uk.org › the Churchill Framework.

Conclusion

To bring this paper to a conclusion, in summary, this second part has endeavoured to set out a brief explanation of the principles underpinning the counselling training provided by Waverley Abbey College and in addition briefly pointed the reader to the development of a core competence framework when working with a client’s faith, religious or spiritual issues.

It is important to acknowledge that an obvious limitation of the training (and indeed the competence framework), is that its benefit to the counselling profession might be considered as being restricted to only those who hold a Christian faith. As a Christian, I consider it is important to respect and embrace diversity and to build positive relationships with those who belong to different faith communities to myself (Greggs, 2010; Holland & Walker, 2018; Robinson, 2019). I therefore hope that practitioners who hold different faith beliefs or none will find the principles set out in this paper to be of interest, utilised and potentially adapted to meet the specific needs of other faith communities. Furthermore, my hope is that the success of the counselling programme will encourage those from other faiths (for example, Muslim, Jewish, Hindu) to create similar counselling programmes from within their own faith tradition.

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About the author

Dr Heather Churchill, DCPsych (PW) (Middlesex), MTh (Middlesex) BA (Hons) (Brunel), Registered member BACP (Senior Accred, Counsellor/Psychotherapist) and Supervisor, Fellow of Association of Christian Counsellors and Registered Accredited Counsellor

Heather is Head of Counselling Faculty for Waverley Abbey College and has many years of experience as a trainer, counsellor/psychotherapist and a supervisor. She has co-authored two books: Insight into Helping Survivors of Childhood Sexual Abuse and Insight into Shame and has published a number of articles in the Accord journal of the Association of Christian Counsellors. In her private clinical practice, Heather specialises in counselling adults who have experienced abuse in childhood.

Copyright 2022 Heather Churchill

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The creation and development of a BA (Hons in counselling): the use of the Waverley integrative framework in counselling practice

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https://doi.org/10.52456/WACJO213

This is part 1 of an article on the Waverley integrative framework in counselling practice, with part 2 due to be published in the next edition of the journal. In this paper, I set out some of my personal background and motivation for creating and developing a higher education counselling programme, validated by a university, underpinned by a Christian worldview, and making use of the Waverley integrative framework. In the next edition, the focus will be more on the practical application of the Waverley integrative framework and, in particular, the use of Christian faith interventions in clinical practice.

 

Introduction and personal background

For the last 25 years, my passion has been to proclaim the benefits and the complexities of integrating Christian faith in counselling practice, when appropriate, and as I look back over the years, two key difficulties have strengthened this passion. The first difficulty has been the significant resistance I have personally experienced by some within the counselling profession, to any notion of integrating Christian faith into counselling practice. An early example of this resistance was when, as a novice therapist, I was told by my first clinical supervisor that any faith issues that were raised by my clients (several of whom professed to have a Christian faith) were not to be discussed or explored in therapy; the rationale being that faith issues were for the clergy; psychological issues were for therapists. At the time, I accepted my supervisor’s advice, although I found it disturbing and challenging, not least because I viewed (and continue to view) my faith in ontological terms, that is, I consider it to be a vital part of who I am. I also considered this to be potentially true for some of my clients. Therefore, even at this early stage of my career, I felt that to ignore a client’s struggle over their faith issues in counselling, was a denial of the whole person (see Jenkins, 2011). In addition, as my counselling practice developed, I was beginning to find that many of my Christian clients’ faith issues were entangled with their psychological difficulties, making the separation of Christian faith and therapy very challenging.

Looking back, and with the benefit of hindsight, I have concluded that my supervisor’s advice was potentially influenced by Freud, who considered religious/spiritual beliefs to be a form of neurosis and something to be overcome (Freud, 1927/1973). The arguments made by Ellis (1973) are also likely to have contributed to this view, with Ellis arguing for the separation of the paradigms of faith and therapy. Nevertheless, despite the resistance shown by my supervisor (and the theories proposed by Freud and Ellis), I have noted that in recent years the counselling profession appears to have become more open to spirituality (Bartoli, 2007; Delaney et al., 2007; Gingrich & Worthington, 2007; Pargament & Saunders, 2007). That said, along with others, I consider there remains a level of reluctance to the concept of integrating Christian faith and counselling and/or an avoidance of any concept of working with a client’s Christian faith issues in therapy (Macmin & Fosket, 2004; Gubi, 2009; West, 2011; Harborne, 2012; Ross, 2016).

The second difficulty I have experienced, perhaps surprisingly, has come from within the Christian community itself. A significant event that demonstrated this issue occurred in 2001, when I met with a number of Christian leaders, in order to promote the benefits of counselling and encourage them to refer any of their parishioners with mental health difficulties to the counselling service I was developing. While some Christian leaders were broadly supportive, I was quite shocked by the significant resistance to counselling I encountered from several other leaders. A few argued that counselling was unsympathetic to the Christian faith, while others reported negative experiences that members of their congregation had experienced from their counsellors when they had mentioned their Christian faith during their therapy (and admittedly, this resonated with my own experience in supervision). Over the years I have discovered that these views have been strongly supported by a number of Christian writers and therapists, in both the UK and the USA, where they demonstrate a strong resistance to the notion of integrating Christian faith with counselling and psychotherapy (see Almy, 2000; Bobgan & Bobgan, 2008; Powlison, 2010; Adams, 2014).

The difficulties reached a peak for me personally in 2002, when I gained sufficient clinical hours to begin an application for accreditation with the British Association for Counselling and Psychotherapy (BACP). By this time, and despite my first supervisor’s advice, as I developed into a more experienced therapist, a number of Christian clients had raised faith issues and concerns and I had facilitated them to explore these (I had a different supervisor by this time who supported my work in this area). However, as I began to write my BACP application, I was faced with a dilemma. In the light of the resistance and avoidance that I had experienced from some within the counselling profession to the concept of discussing Christian faith issues in therapy, did I stay true to myself and my work and submit a philosophy and case studies to BACP that truly reflected my clinical practice? In other words, did I set out that I was explicitly helping the two clients that I had selected for my case studies to explore Christian faith issues, which had become intertwined with their presenting problems? Or, did I submit a philosophy and case studies that I thought BACP would pass? I am embarrassed to admit that I was strongly tempted to do the latter, especially since I had been told by a number of fellow counselling professionals that if I mentioned Christian faith in clinical practice, I would never get it passed by BACP. Fortunately, my new supervisor challenged me to submit a true reflection of my clinical work, which I did, and I was somewhat surprised to learn, a few months later, that BACP had accepted my application and awarded me accredited status. I didn’t realise it at the time, but this was to have a significant impact on me in later years as it gave me the first indication that I could be explicitly Christian in my worldview, theory and practice and still be viewed as professional and competent by my secular colleagues.

The creation of the BA (Hons) underpinned by, and in dialogue with, a Christian worldview

Moving forward a few years to early 2009, a highlight of my passion to integrate Christian faith with therapy took place when I was approached by the chief executive officer (CEO) of Waverley (CWR). The CEO shared with me that he was looking to appoint a person with the specific task of transforming the organisation’s existing unvalidated certificate and diploma in Counselling, into a professional higher education counselling programme that would be validated by a university. In addition, the aim was for it to become the first single honours programme in the UK that would be explicitly underpinned by a Christian worldview and in addition would acknowledge the importance of the use of Christian faith interventions with clients when appropriate. I confess I had a mixture of emotions at the offer. On the one hand, it was my dream to create the BA that he was suggesting, because I was aware that, if successful, it would demonstrate to the counselling profession that it was possible to deliver a higher education counselling training programme that was explicitly underpinned by, and engaged in a dialogue with, a Christian worldview. On the other hand, in view of the hostility I had experienced, from both Christians and secular counselling professionals to this notion, I felt somewhat overwhelmed and was far from sure that I was up to the task of convincing a university to validate a professional counselling programme that integrated Christian faith. What made the task even more of a challenge was the fact that, as acknowledged by writers in the UK (Martinez & Baker, 2000; Swinton, 2007) and in the USA (Richards & Bergin, 1997; Brawer et al., 2002; Schulte et al., 2002; Aten & Hernandez, 2004; Cassidy, 2007; Delaney et al., 2007; Young et al., 2007; Post & Wade, 2009), there was minimal, even non-existent, training provided by other counselling programmes in the UK and USA, which assisted counsellors to develop competences in addressing a client’s faith issues in clinical practice. Nevertheless, after a period of reflection, I accepted the challenge, with one of my first tasks being to critically evaluate the Waverley integrative framework, then called the ‘Waverley model’; an approach unique to Waverley that underpinned the existing counselling training that was delivered at the time.

A critical evaluation of the Waverley model

The Waverley model was formulated by Selwyn Hughes (the founder of CWR/Waverley) in the 1980s. The model’s anthropological, ontological and epistemological underpinnings have been set out in a number of Hughes books, including: A Friend in Need: How to Help People Through Their Problems (1981), What to Say When People Need Help (1982), Marriage as God Intended (1983), My Story: From Welsh Mining Village to Worldwide Ministry (extended edition, 2007) and his main publication Christ Empowered Living (2002). Hughes based his model on an approach developed by Crabb in the USA (Crabb, 1987; Kallmier, 2011:7) and, as already explained, it was used as the foundation for Waverley’s existing (unvalidated) certificate/diploma in counselling. While over the years I had become familiar with the approach, I was aware that the definition and practice of the model would need to be significantly adapted if it was to be deemed appropriate for use in a professional counselling programme validated by a university.

In critically evaluating the model, I identified a number of strengths and limitations. The strengths included, firstly, its holistic perspective, which took into account a number of areas of human functioning, including the spiritual area (Hughes, 2002). Secondly, the model’s ontological underpinning recognised human individuals as being created in the image of God: imago Dei (Hughes, 2002:139). Thirdly, Hughes proposed that all human beings are driven by deep needs/longings for security, self-worth and significance (Hughes, 2002:139). The search for love, security, meaning and purpose is congruent with the writings of many other theorists (Bowlby, 1969, 1973, 1980, Cassidy, 1999: 3-20; Gerhardt, 2004). Fourthly, the model was integrative and open to both Christian faith/religion/spirituality and psychological/psychotherapeutic insights (Hurding, 1986:300; Hughes, 2002; Kallmier, 2011:131-181).

However, my main concern was that in Hughes’ writings, a specific goal of the Waverley model was to assist clients to move from ‘self-centredness to Christ centeredness’ (Hughes, 1981:100). While I have some sympathy with this from a Christian pastoral/discipleship perspective, from a professional counselling perspective it was inappropriate, too directive and thus incompatible with both the goals of counselling and the ethical demands of the profession. My concern was intensified by research conducted by Fouque & Glachan (2000), who concluded that Christian counsellors ‘are perceived as significantly more directive and more powerful than professional counsellors and the overall outcome was perceived more negatively’ (2000:201). While there was no accusation that the counsellors included in the research had utilised the Waverley model, the researchers specifically mentioned Waverley (CWR) as a Christian counselling training provider in their introduction (2000:203).

In critically examining the research by Fouque & Glachan, a significant limitation appeared to be the failure to define what they meant by ‘Christian counselling’; nevertheless, the research provided valuable evidence that counselling underpinned by a Christian worldview had the potential to be both directive and damaging. It was therefore crucial to make some major adjustments to both the definition and the practice of the model in order to ensure that students were fully aware of the ethical constraints and requirements of the counselling profession. In addition, I believed it essential that a number of explicit learning outcomes should be included in the counselling programme, which would sit alongside the model and ensure graduates attained the ethical standards of proficiency required by the profession.

Learning outcomes of the programme

Drawing on research and literature, including: McMinn, 1996; Chappelle, 2000; Exline & Yali, 2000; Fouque & Glachan, 2000; Aten & Hernandez, 2004; Knox et al., 2005; Richards & Bergin, 2005; Hage et al., 2006; Russell & Yarhouse, 2006; Aten & Leach, 2009; Gubi, 2009; Post & Wade, 2009; Worthington et al., 2009, and in addition my own experience in clinical practice over a number of years, I drafted a set of what I believed to be essential learning outcomes for a programme. These were designed to not only enable students to assist clients with their psychological difficulties, but also be ethically proficient to explore any Christian faith difficulties that emerged in the therapeutic process, when appropriate. The learning outcomes were designed to ensure that:

  • students were made fully aware of the ethical constraints of the counselling profession, including the inappropriateness of attempting to proselytise and impose beliefs, Christian or otherwise, onto a client.

  • students were trained to be alert to issues of difference and diversity in order to practise in a non-discriminatory manner and to avoid oppressive practice. This included training students to recognise how social, cultural and issues of difference may impact the counselling process.

  • students were trained to be alert to any faith issues that might be entangled with clients’ psychological difficulties and to have ethical and professional competence to make use of appropriate interventions in clinical practice in order to address these and facilitate therapeutic change.

  • students were assisted to develop a self-critical and reflective approach to their counselling practice. This included assisting students to reflect on their responses and reactions to their own, as well as their clients’, faith issues.

 

Revised ontological/epistemological positioning of the model

Having critically evaluated aspects of the practice of the Waverley model, it was important to also evaluate the ontological and epistemological underpinning of the approach. Since a person’s worldview sets out how they construct reality, perceive truth and in addition make meaning in the world (Horton, 2000; Nason, 2015), I wanted to ensure that the counselling programme would be underpinned by a Christian worldview and that it specifically set out a Christian understanding of what it means to be a human person. I therefore decided to retain Hughes’ ontological and epistemological underpinning of the model, including the concept that human beings are created in the image of God, imago Dei. Nevertheless, in critically evaluating the model, I rejected Hughes’ modernist/individual ontology that underpinned the model on the basis that I deemed it vital that a relational ontological understanding underpin the approach (Dr Ashley, having undertaken a PhD thesis evaluating the model, had made a similar observation of the approach, Ashley, 2013:14).

To explain my criticism in a little more depth, it is worth noting that there is a considerable divergence of opinion amongst theologians as to the precise meaning of imago Dei, with Millard Erickson valuably dividing the various opinions into three main groups: those who take a substantialist/individual interpretation; those who adopt a functional view and those who argue for a relational interpretation of imago Dei (Erickson, 1985: 495-517. See also Grenz, 2001:4). It is beyond the scope of this paper to set out and critically evaluate all three interpretations in depth, however, suffice it to say that after a period of reflection, I concluded that all three interpretations had legitimacy and in addition I considered it unhelpful to pit one interpretation against another. Furthermore, I reached the view that the core understanding of imago Dei should be viewed in relational ontological terms, mainly because, from the imago Dei scriptural texts, there is an understanding that human beings are relationally and ontologically connected to God and to each other (Green, 1999; Vanderploeg, 1981; Miner & Dowson, 2012; Hobson, 2019).

I acknowledge the limitations of adopting imago Dei as the philosophical underpinning of the counselling programme, not least because Scripture and Christian doctrine do not teach a theory of personality or explain psychopathology in the way that psychotherapeutic theories do (McMinn & Campbell, 2007). Indeed, attempting to use Scripture in this way risks treating the biblical texts as though they were written as a psychological or scientific manual (Benner, 1985; Jones, 2010). Nevertheless, the understanding of the Christian doctrine imago Dei; that human beings are created in God’s image and likeness (see Hoekema, 1986; Clines, 1996; Grenz, 2001; Harrison, 2010) is considered foundational to a Christian understanding of human nature (Bufford, 2007; Johnson, 2010, a; Jones, 2010, a:111. See also McMinn 1996 and Vitz et al., 2020).

Key themes emerging from the doctrine imago Dei

 

My critical evaluation of imago Dei enabled me to identify a number of key themes and I used these to underpin the philosophical assumptions of the counselling programme and its learning outcomes. In addition, I used the themes to assist me to explain the programmes and defend their position to the university’s panels during the validation events.

The key themes are as follows:

  1. Firstly, clients (irrespective of whether they are aware of, or acknowledge, that they are created in the image of God) should be viewed as persons of infinite worth and value and deserving of care, love, compassion and dignity (Guthrie, 1979; Hall, 2004; Bufford, 2007; McMinn & Campbell, 2007; Cherry, 2017; Vitz et al., 2020).

2.     Secondly, for a Christian, imago Dei has profound implications for their vocation as a therapist, in that in response to God’s activity in the world, human beings are also called to live, not just for themselves, but to care for others and affirm their worth (Vanderploeg, 1981; Barr, 1982; Canning et al., 2000; Olthuis, 2006; Jones & Butman, 2011:461; Tan, 2011). I particularly appreciate the writings of Henri Nouwen on this area, who points out that responding to those who suffer ‘is the concrete expression of the compassionate life and the final criterion of being a Christian’ (2006).

  1. Thirdly, the doctrine of imago Dei enables a therapist to fully respect issues of difference and diversity, in that it is inclusive in recognising that all human beings are created in the image of God, irrespective of their intellectual ability, age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation (Hall, 2004).

  2. Fourthly, all three interpretations of imago Dei assimilate well with the psychological theories and approaches to counselling that the programmes would integrate; for example:

a)     The substantialist view, which emphasises the individual and rational ability of a person, provides a point of contact with contemporary cognitive therapy, which also values the embodied aspect of a human being, and the importance of the role of cognition in emotional distress (Beck, 1995; Padesky & Greenberger, 1995; Jones & Butman, 2011).

b)     The functional view has a point of contact with the psychological view that human beings have the capacity for volition (the faculty of using one’s will), the freedom to choose, the right to autonomy and have the ability to reach their full potential (Guthrie, 1979; Gabriel, 1991; Simpson, 1999; McMinn & Campbell, 2007; Bosman, 2010; King & Whitney, 2015).

c)     The relational ontological interpretation of imago Dei, which perceives a person as being relational at the core of their being, fits well with the value placed on the quality of the therapeutic relationship in counselling. For example, the importance of the therapeutic relationship between the client and the therapist has long been recognised as being the foundation for effective therapeutic work (Mearns & Cooper, 2005) and is emphasised by most of the main modalities (for example, see DeYoung, 2003; Gilbert & Leahy, 2007; Knox, 2008; Shedler, 2010; Atzil et al., 2015; Sandage & Brown, 2018; Vitz et al., 2020).

  1. Finally, by adopting all three interpretations of imago Dei, a holistic approach is taken in that all aspects and functioning of a human being can be acknowledged: physical, emotional, volitional, rational, spiritual and relational (Guthrie, 1979; Chandler, 2015). In addition, it allows for the recognition that each aspect of human functioning has the potential to impact a person’s mental health and well-being. This perspective sits comfortably with the Waverley model (and what would become the Waverley integrative framework-see later sections) and it’s areas of human functioning.

Additional philosophical assumptions underpinning the approach

In addition to the Christian doctrine imago Dei, two other key philosophical assumptions would underpin the approach taken by the programme. Firstly, the assumption that there is a ‘legitimate’ role for psychotherapy to supply the knowledge and skills to help someone with mental health and emotional difficulties (Jones, 2010, a:101). Central to this position is the understanding, from a Christian perspective, that truth can be discovered from both special and general revelation. To explain what is meant by these terms, the discoveries of truths from psychology and science are sometimes referred to as ‘general revelation’, that is truth discovered through the natural world (Hurding, 1986:258). The revelation of God through the Person of Jesus Christ and the Old and New Testaments is referred to as ‘special revelation’ (Mizell, 2005). Thus, the truth discovered from psychology/psychotherapy is valid on the basis that God is the source of all truth (Guy, 1980) thus ‘all truth is God’s truth’ (Mitzell, 2005:53).

A second assumption underpinning the approach is that since the programme would be underpinned by a Christian worldview, it was important to facilitate students to engage in a dialogue between Christian faith and psychotherapeutic theories, with the aim of students taking a dialogical and relational approach to the integration of Christian faith in counselling practice (see Richardson, 2005). This would enable insights from both paradigms to be considered and mutually respected.

Change of name to the Waverley integrative framework

Having set out a critical evaluation of the Waverley model and in addition briefly described the philosophical underpinning of the BA (Hons) counselling programme, it is worth noting that I had concerns regarding the approach being described as the Waverley model. I considered calling the approach a model to be a misnomer, in that, in the counselling world, the approach cannot be perceived as a model of counselling as such, in the way that the main approaches to counselling, e.g. psychodynamic, cognitive behaviour therapy and humanistic therapy are understood as models of counselling. I also wanted to make it far more flexible than that suggested by Hughes, in order that students could formulate, develop and critically evaluate their own personal integrative philosophy of counselling, rather than having a prescriptive method or a model imposed on them to use with their clients. From this perspective, the approach is rather viewed as a framework that facilitates students to undertake a dialogical approach between the insights and knowledge provided by psychological and psychotherapeutic theories and Christian faith. I therefore considered it was important to not only significantly amend how the approach was practised, but to also change the name to ‘Waverley integrative framework’. Describing the Waverley approach as an integrative framework also enabled it to have points of contact with a number of other integrative approaches in the counselling world (for example, see the integrative approach suggested by Lapworth et al., 2001).

 

Reflection

As I implemented all of the changes to the Waverley integrative framework, I was faced with a considerable challenge. On the one hand, I wanted to honour and respect Selwyn Hughes, whose writings had inspired many (including myself). On the other hand, I believed it essential for me to critically review and amend the theory and practice of the approach for all of the aforementioned reasons. Furthermore, it was crucial that I convinced the staff team, tutors, Waverley (CWR) management and ultimately the Waverley (CWR) board that the changes were appropriate and necessary. As I look back on this challenge, I recognise that as a staff member and ‘insider’ of the organisation I was in a privileged role (Costley et al., 2010:3), which helped me to make the necessary changes to the integrative framework. However, on reflection, I believe that, at the time, I failed to fully appreciate some of the underlying tensions that were connected with the task, not least the fact that I was employed by the very organisation whose founder I was criticising (Costley & Gibbs, 2006). I do remember that it felt as though I was walking on eggshells and I was nervous when I presented the proposed changes to the Waverley (CWR) board.

As I pondered further on my nervousness over the presentation, an issue that I have struggled with for many years came to mind. Over the years in Christian environments, I have frequently hidden the professional counsellor part of myself, mainly because, as I have already mentioned, the disapproval of the counselling profession from Christians, sadly including those from within my church. Likewise, in professional counselling environments, I have frequently hidden the Christian part of myself, due to my perception that in holding a faith, I might be judged in some way as not being fully professional. Part of my development over the years has been to acknowledge and be proud of these parts of myself and to allow both of them to come to the fore; to fully embrace them as part of who I am, my identity, theme, as shown in Figure 1.

 

I believe the presentation to the board was one of the first occasions where I had to make sure that both parts of myself came out of hiding to be seen by all. Looking back, I believe a number of factors helped me during this time. Firstly, I had had the honour and privilege of meeting and listening to the teaching of Selwyn Hughes in 1997 and 1998. I truly believe that he would have approved of the changes I had made, especially since, when he wrote his books, he did not have access to the substantial psychological and counselling resources that I had been able to draw upon when I critically evaluated his approach. Secondly, his vision was that at some time in the future, Waverley (CWR) would form a Christian university. I therefore considered that my work was the first stage of implementing his overall vision. Thirdly, the CEO of Waverley had a professional mental health background and he, together with the director of training, were fully supportive of my recommended changes. It was a relief (and a considerable achievement) to gain agreement from management and final approval from the board to my proposed amendments. The only change that I was not able to secure initially was the change of name of the approach from the Waverley model to the Waverley integrative framework. However, on the basis that change within an organisation at times needs to be incremental (Neal & Tromley, 1995), I was content at that point to proceed without changing the name. (In 2012, I subsequently achieved agreement from all parties to change the name of the approach to the Waverley integrative framework.)

Validation of the programme

During the summer of 2009, along with senior management of Waverley (CWR), I spent time explaining to university academics that when Christians seek counselling, many actively seek faith-based counselling (Aten & Hernandez, 2004; Aten & Leach, 2009; Post & Wade, 2009; Worthington et al., 2009; McMinn et al., 2010; Scott, 2013; Kim, 2019). I also described the significant absence of any training in the UK (and the USA for that matter) that assisted counsellors to work with a client’s faith difficulties and concerns, when they were entangled with their psychological issues. In addition, I argued that the lack of training resulted in many therapists having to find their own way of dealing with the professional and ethical issues that are involved when they undertake a dialogue between Christian faith and psychological/psychotherapeutic theories in the context of counselling practice and/or when they work with their client’s faith concerns and difficulties (Crossley & Salter, 2005; Jackson & Coyle, 2009; Koce & Baker, 2019). This situation had resulted in a significant gap in provision and there was thus a need and demand for a BA in Counselling underpinned by a Christian worldview and where the insights from both Christian faith and psychological/psychotherapeutic theories were considered and mutually respected. Furthermore, I set out the ultimate aim of the programme which was to be as follows:

The overarching aim of the programme is to provide a robust and effective undergraduate training programme that ensures students who exit with a Diploma of Higher Education (Dip HE) or BA (Hons) Counselling are professional, competent and ethical practitioners who have attained the standards of proficiency that are required by professional counselling bodies.

(BA (Hons) Counselling programme specification, 2010).

I anticipated a level of resistance and lack of acceptance from the counselling professionals in the university to the possibility of integrating Christian faith in counselling training and I was therefore pleased that I managed to convince them of the uniqueness and what I believed would be the ethical professionalism of the programme. We were subsequently given permission to progress to the next stage in the validation process and I am delighted to say the programme was validated and the programme was launched on the 1 September 2009.

Key features of the training

In order to bring this paper to a conclusion, it is valuable to summarise and further evaluate five key concepts that relate together and provide the foundation for the integrative approach that underpins the BA (Hons) Counselling programme. I provide a diagram that sets out a conceptual framework of the five key concepts at the end of this paper (see Figure 2).

1. A flexible dynamic approach to integration

It is interesting to note that back in the 1980s Hurding acknowledged that he (and others) hesitated to apply a ‘how to do it approach’ when it involved ‘activities which largely concern relationships’ (1986:304). In more recent times, Strawn et al., point out that literature indicates there have been three past ‘waves’ of integrating psychology and the practice of counselling with Christian faith, namely, ‘apologetic, model building and empirical validation’ (2014:85). Without going into depth and defining each of the waves, suffice it to say, a ‘fourth wave’ is now emerging, one which mirrors my own approach, where the focus is far more on how each individual therapeutic encounter influences and shapes the nature of how integration takes place (Strawn et al., 2014:85, 89, 91. See also Sandage & Brown, 2015; Neff & McMinn, 2020). The focus on integration taking place within a unique dynamic therapist/client relationship, where each individual therapist and client bring their own perspective, background, faith, beliefs and values and engage in a unique dynamic relationship, is also in harmony with the embodied and relational perspective proposed by others (Augustyn et al., 2017) and the relational understanding of imago Dei that was explained earlier.

2. A dialogical approach to integration

The term integration, related to the word integrity, is commonly understood as an amalgamation of two or more things being brought together and joined into a harmony, unity and wholeness (Evans, 2012; Santrac, 2016; Finlay, 2021). While Stanton Jones acknowledges that the term integration has been criticised for failing to appreciate the complexities of the integrative task and in addition recognises that some claim it suggests the combining together of ‘two things that do not naturally belong together’ (2010, a:102), he believes ‘what matters ultimately is not the word, but what the term summarizes’ (2010, a:102).

However, words do matter and it is important to try and capture, as near as is possible, exactly what one is attempting to achieve when making use of a particular word or term. After a process of reflection, I have come to the view that the best way to describe what the programme is seeking to achieve regarding integration is to say it takes a dialogical approach to the integrative task. I have found the argument made by Richardson persuasive when he states he has ‘strong concerns’ about the basic idea and project of ‘integration’ on the basis that there is ‘no neutral external criteria for resolving differences among diverse perspectives or fields’ (2005:186). Richardson goes on to argue that it is more helpful to consider the integrative task as one that engages in a dialogue between Christian faith and psychology and psychotherapy (2005:206).

The use of the term dialogue is also helpful as it is understood as a collaborative term that involves listening, understanding and evaluating the views of another (and, in this context, listening, understanding and evaluating both psychological theories/counselling practice and Christian faith) in order to find meaning, greater insight and fresh understanding (Angel, 2018). In addition, the term includes the implication that things are not fixed or resolved, but are open ended and, thus, it is accepted that contradictions and paradox will inevitably arise. This is in contrast to the use of the term debate which is more oppositional/dualistic, with one side trying to force thinking into right or wrong choices (Angel, 2018). As Neff and McMinn point out, dialogue can be ‘messy, complicated and nuanced’ and ‘fluid in nature’ (2020:3, 21). Nevertheless, from this perspective, insights from both Christian faith and psychology and psychotherapy can be mutually respected (Martin, 2015).

3. The Waverley integrative framework: A tool for integration

As already mentioned, rather than imposing on students a ‘method’ or a ‘model’ (as originally proposed by Hughes), the Waverley integrative framework is rather utilised as a flexible framework that enables students to formulate, develop and critically evaluate their own personal integrative approach to counselling. From this perspective, the Waverley integrative framework can thus be viewed as a tool; a scaffolding, which facilitates students to undertake a dialogical approach, at a theoretical and practical level, between the insights and knowledge provided by psychological and psychotherapeutic theories and Christian faith and doctrine.

4. A two-person relational and embodied approach to integration

By adopting a dialogical and relational approach, the concept of integration moves from a ‘one-person view of integration’ to a ‘two-person’ and relational embodied understanding of integration (Sandage & Brown, 2015:166). Furthermore, it gives prominence to working with a client, wherever possible, at ‘relational depth’ (Mearns & Cooper, 2005, xi). (This is irrespective of whether faith (Christian or otherwise) is addressed or not within the counselling room). Trying to define what is meant by relational depth is difficult and can, as Mearns & Cooper articulate, be almost ‘beyond language’ (2005, xi). Nevertheless, they sum it up well by saying it is:

a state of profound contact and engagement between two people, in which each person is real with the Other, and able to understand and value the Other’s experiences at a high level (2005, xii).

This notion of working at relational depth resonates with the approach of Martin Buber, in his description of an I-Thou encounter (Buber, 1923. See also Metcalfe & Game, 2012; Ross, 2018). This two-person relational and embodied approach to integration, together with an emphasis on the unique relational and dynamic encounter occurring between a therapist and their client, the significance of the therapeutic relationship and the importance of adhering to the core conditions is embedded within the counselling programme.

5. The vocational aspect of integration

Ultimately, from a Christian faith and worldview perspective, integration means having humility and being aware that clients (irrespective of their faith, beliefs and values) are persons of infinite worth and value and deserving of care, love, compassion and dignity (Guthrie, 1979; Hall, 2004; Bufford, 2007; Cherry, 2017). In addition, the vocational aspect to integration includes the understanding that as human beings we are called to live not just for ourselves, but to care for others.

Below (see Figure 2) is a conceptual diagram of the five key concepts of the integrative task that relate together and underpin the counselling programme.

Part 2 of this paper, due to be published in the next edition of the journal, will continue to discuss the integration of Christian faith and counselling, with the focus on the practical application of the Waverley integrative framework and in particular, the use of Christian faith interventions in clinical practice.

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About the author

Dr Heather Churchill

DCPsych (PW) (Middlesex), MTh (Middlesex) BA (Hons) (Brunel)

Registered member BACP (Senior Accred, Counsellor/Psychotherapist)

and Supervisor

Fellow of Association of Christian Counsellors and Registered Accredited Counsellor

Heather is Head of Counselling Faculty for Waverley Abbey College and has many years of experience as a trainer, counsellor/psychotherapist and a supervisor. She has co-authored two books: Insight into Helping Survivors of Childhood Sexual Abuse and Insight into Shame and has published a number of articles in the Accord journal of the Association of Christian Counsellors. In her private clinical practice, Heather specialises in counselling adults who have experienced abuse in childhood.

Copyright 2022 Heather Churchill

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Critical reflexivity: A personal account of my counselling career and journey

Reading Time: 20 minutes

https://doi.org/10.52456/WACJO113

Introduction

As I look back over my counselling career, I recognise that I have experienced resistance and suspicion from a number of Christians and Christian leaders in the UK towards counselling and counselling training. As I have reflected on this resistance, I have reached the conclusion that this response has often been driven by the belief that counselling will either challenge or weaken a person’s Christian faith and/or that Christian faith and beliefs will not be respected during counselling training (Clarkson, 2003: 203; Delaney et al., 2007; Winfrey, 2007; West, 2011, a; West, Biddlington & Goss, 2014).

In addition, I have experienced hostility and avoidance by some within the counselling profession to the notion of integrating a Christian worldview with counselling and psychotherapy. Whilst in recent years I believe the profession has become more open to spirituality (Bartoli, 2007; Delaney et al., 2007; Gingrich & Worthington, 2007), nevertheless, I agree with others that there remains a level of avoidance of working with a client’s religious and/or spiritual issues (Macmin & Fosket, 2004; Gubi, 2009; Harborne, 2012).

I believe the conflict I experienced from these two groups created in me a passion to create and develop three professional higher education counselling programmes, all underpinned by a Christian worldview/anthropology. However, in order to dig deeper and reflect more on my passion to create these programmes, over the last couple of years I have engaged more extensively with the task of critical reflexivity. In this short paper, I will endeavour to define the difference between reflection and reflexivity and explain how, in undertaking the task, it has assisted me to become more aware of how my history, beliefs and values have shaped and impacted my counselling work and career as a trainer.

My overall aim for this article is that it will help explain the importance of critical reflexivity for personal growth, demystify the process and encourage readers to engage with critical reflexivity in order to discover some of their own hidden motivations in their life choices and counselling journey.

A contentious concept?

It is important to acknowledge that the task of critical reflexivity has, at times, been a contentious concept in the world of psychotherapy: some people strongly appreciating the task and others believing it should be avoided (McLeod, 2001; Mruck & Breuer, 2003). Those who argue against critical reflexivity frequently come from a positivist position, which regards knowledge and truth as that which can only be verified by objectivity and observation and discovered through scientific enterprises (McLeod, 2003; Gemignani, 2017). From a positivist perspective, personal experience is thus viewed negatively and rather seen as a potential source of bias (Hansen, 2004; Ponterotto, 2005; Alvesson &Sköldberg, 2009).

Therefore, prior to defining the difference between reflection and critical reflectivity, it is important to briefly mention my own personal ontological and epistemological position.

My ontological and epistemological position towards reflexivity: A critical realist position

An ontological perspective is a way of understanding the core nature and being of a person (McLeod, 2001). Epistemology, on the other hand, is concerned with how we determine what is true, providing the rationale for the assumptions that have been formed and which underpin beliefs (Bager-Charleson, 2012: 86). Various ontological and epistemological approaches can be taken, where at one end of the continuum lies the positivist approach (where reality is perceived as objective and independent of human ways of knowing) and at the other end lies a relativist approach (where reality and human knowledge are seen as being socially and culturally constructed) (McLeod, 2001: 184; Alvesson & Sköldberg, 2009).

I believe that both my view of reality and my theory of knowledge (ie my ontological and epistemological assumptions) are ‘intertwined’ (Etherington, 2004:71) and sit between a positivist and a relativist position in that I acknowledge that there is a reality that exists independently from an individual’s perception. However, I also believe that truth can be socially constructed. It is for this reason that I have personally found the philosophical approach of critical realism convincing.

Critical realism, originating from the work of Bhaskar, is complex to define, since there are a variety of approaches and methodologies that fall under this approach (Archer, et al., 2016). Nevertheless, in basic terms, it is an approach that accepts that there is an objective reality, but also recognises that an individual’s personal and subjective interpretation plays a part in explaining and defining reality (Almashy, 2015; Taylor, 2018). Critical realism is therefore a position that sits between positivism (an approach which emphasises empiricism and objective facts) and social constructionism (which accepts a socially constructed view of reality) (Hansen, 2004; Peters, et al., 2013; Zachariadis, et al., 2013; Taylor, 2018).

I have found the approach plausible, not least because I reject a positivist approach on the basis that I believe there is a subjective element to knowledge that cannot always be explained by observable evidence and scientific findings (Costley et al., 2010). I also reject a purely social constructionist approach in that I do not believe reality should be totally, as Alvesson & Sköldberg point out, ‘limited’ to considering how it is socially constructed (2009; 37).

There have been criticisms of the critical realist approach; for example, it has been challenged for not providing a methodology as to how the two positions can be combined (Alvesson & Sköldberg, 2009). Nevertheless, I find the approach credible and one that sits comfortably with my Christian faith in that I believe Christians should admit that they do not know or own the whole truth: ‘the truth is with God’ (Losch, 2018: 164). However, the position’s acceptance that there can be a subjective and socially constructed view of reality enables Christian faith to be seen as a ‘legitimate form of knowing’ (Martin, 2001: 248).

I have therefore adopted a critical realist position towards the task of critical reflexivity – a position that values the role of personal experience and perceives knowledge in part as co-created with others in the context of a story (Howard, 1991; Reason, 1994; Denscombe, 2003; Etherington, 2004; Li Mao et al., 2016).

Reflection and reflexivity; defining the difference

To define the difference between reflection and reflexivity, the work of Donald Schön (1983), considered by many to be the pioneer of reflective practice (Kinsella, 2007), is of value.

Schön differentiated between two activities: ‘reflection-in-action’ and ‘reflection-on-action’ (Costley et al., 2010: 122). He described the former as having the capacity and ability to draw on knowledge and conviction in order to deal with changing events, a ‘thinking on our feet’ approach (Costley et al., 2010: 122). ‘Reflection-on-action’, however, he defined as the task of critically reflecting on experience after the event has occurred in order to gain a fresh understanding that promotes learning and improves future action (West, 2000; Kinsella, 2007).

Admittedly there has been some confusion over the precise meaning of the terms and Schön has been criticised for failing to adequately clarify the difference between them (Smith 2001; Brockbank & McGill, 2007). Nevertheless, Schön’s concept of ‘tacit knowledge’ is helpful, in that it recognises that a practitioner knows more than they realise and by engaging in ‘reflection-on-action’ they have the potential to discover some of the tacit knowledge that has guided their practice so far (Kinsella, 2007: 396).

Wright and Bolton’s (2012) distinction between reflection and reflexivity is also helpful. They define reflection as an exercise that looks ‘outwards towards others’, taking into account any relevant customs, traditions and surroundings that might be important (2012: 37, 38). Reflexivity on the other hand is described as paying attention ‘inwards’ almost a ‘dialogue with the self’ as a person critically reflects on their thought processes, their values and their actions (Wright and Bolton, 2012: 38).

To be reflexive, therefore, it is important to find a way of ‘standing outside of self’ in order to reflect on and question how one’s beliefs, assumption, prejudices and behaviour might have impacted practice (Bolton, 2010: xix, 13). In other words, reflexivity is a step further than reflection. It is a deeper process that a person can engage with in order to uncover the possible unconscious motivations that might have impacted the development of their work (Cresswell, 2007; Kinsella, 2007; Bager-Charleson, 2012; Etherington, 2017). Reflective practice has also been described as ‘single loop’ and ‘double loop’ learning, with single loop being a reflection that can challenge and bring about change; double loop on the other hand being reflexivity that can enable challenge and question of one’s own assumptions, values and practice (Brockbank & McGill, 2007: 51; Bolton, 2010).

Putting it into practice: Interpersonal process recall

To uncover any hidden motivations for my passion to deliver counselling programmes underpinned by a Christian worldview and to train students to integrate faith/religion/spirituality with counselling, I decided to adopt a narrative approach to critical reflexivity, one which facilitated me to retell and investigate my story (McLeod, 1997; Etherington, 2017). Since I am a visual and imaginative person, I decided to use a variation of the technique of interpersonal process recall (IPR), a model developed by Kagan and others (Kagan & Schauble, 1969; Wosket, 1999)[1], to assist me in engaging with this task.

Using IPR, in my mind’s eye, I took myself back in time to a number of defining moments in my career and replayed these events as though they were occurring in the here and now. As I did this, I paid attention to my thoughts, feelings, values and actions. My belief was that as I engaged with IPR, more material would be revealed because I was fairly sure that underneath my story, there was, as Rennie (1994: 242) notes with storytelling, ‘more going on than is being told’. In other words, I wanted to dig down and discover some tacit knowledge that I was possibly unwilling or unable to allow myself to access.

Unconscious intersubjectivity

In addition to using IPR, I also read Bager-Charleson’s comments on ‘relational research reflexivity’ and ‘unconscious intersubjectivity’ (2016: 58-70; 64). As I allowed myself time to reflect back on my counselling journey, I recalled two key events relevant to my professional life.

The first event occurred right at the very beginning of my counselling training (which was in a secular context) in the mid-1990s, and, as I visualise it now, I can remember it as though it was yesterday. In the training session, the leader played a tape recording of a counselling session, during which the counsellor started to proselytise and tried to ‘convert’ the client to their Christian faith. I remember feeling embarrassed, partly ashamed of being a Christian and incredibly uncomfortable as my peers started to discuss how appalling the counsellor’s behaviour was. At this point in time, I had not developed a clear understanding of what was ethical behaviour, or not, and just remember feeling silenced, saying absolutely nothing.

The second incident occurred about a year into my counselling training. The course required me to have personal counselling and I duly formed a therapeutic relationship with a counsellor in my locality. Whilst I found the counselling immensely helpful (in that it assisted me to stand back and consider my childhood experiences from a more objective stance), the issue that troubled me most was one that was directly related to my Christian faith. However, I felt I could not discuss this with my counsellor (even though I was aware she was a Christian) because I believed it was not acceptable to discuss my faith issues in therapy. The issue was that I had become a Christian at the age of 15, having come from a non-Christian background and whilst I had discovered a faith that was very real and important to me, I constantly struggled with the feeling that God was disappointed with me. So I took the problem to my pastor, who merely told me that God loved me and I was to accept this in faith.

With hindsight, and with so much more understanding and clarity now, I realise that, as a Christian, whilst I profoundly disagree with Freud’s assumption that faith in God is a mere ‘wish fulfilment’ and something to overcome (1927/1973), I believe he was right in determining that faith, at times, can be a projective system; this supposition being supported in later years by much independent research (Rizzuto, 1979; Brockaw & Edwards, 1994; Kirkpatrick, 1999; Aten & Leach, 2009)[2]. In my case, in childhood I had experienced both my mother and father as being constantly disappointed with me and it would have been of immense therapeutic value if I had been able to explore in therapy the link between my early life experience and my relationship with God.

The impact of these two events on my motivation and passion for creating higher education counselling programmes, which train students to competently and ethically integrate Christian faith/religion/spirituality with the practice of counselling, seems blindingly obvious now, but until I had engaged in the critical reflexive task, they had both remained largely unknown. In undertaking the critical reflexive task, it also assisted me to consider in more depth how much of my counselling development and my career as a trainer has been undertaken at an unconscious level in order to resolve some of my own past difficulties.

Further motivational factors

Over the years, I have faced considerable opposition (within the counselling profession and within my Christian community) to any notion of integrating Christian faith/religion/spirituality with counselling. Again, as I allowed myself to go back in time and replay some of the early events in my counselling career, I remembered the level of frustration I experienced and how, at one point, the opposition seemed sufficiently difficult that I felt like giving up on the whole process.

As I questioned and asked myself what it was that had made me doggedly continue to pursue this path, I became convinced that, in the main, it was the work I had undertaken with a number of my clients. I have assisted many clients over the years when their religious/spiritual issues have impacted their psychological difficulties. I have personally witnessed the subsequent therapeutic change that has occurred as a result of exploring these issues in therapy. In addition, I have sought feedback from clients when we have concluded therapy and asked them what aspect of therapy they felt had been the most helpful. With all my Christian clients, the answer has invariably been the work that we have undertaken together in the spiritual area. (The work has ranged from helping clients to explore unhelpful spiritual beliefs, expressing anger towards God, discovering God’s unconditional love, and working with spiritual abuse.) As I critically evaluated my work, I realised how much this was a significant influence and motivational factor in my passion for training students to ethically integrate Christian faith/religion/spirituality with the practice of counselling.

Acknowledgement of faith

I recognise that permeating many of the reflections in this paper has been the importance of my Christian faith. I believe it is important to acknowledge this for three reasons.

Firstly, as West (2011, b,196) notes, Christian faith and spirituality are topics that evoke fervent reactions and responses. Secondly, I believe it is important to recognise that holding a faith and Christian beliefs points towards a lack of neutrality (Robson, 2002). I am in agreement with West’s epistemological position that, for Christians, it can be ‘exceedingly difficult’ (2011, b:196) to adopt ‘a neutral position’ on the issue of faith. Furthermore, I agree with Bergin (1980) that attempting to adopt a ‘value-free’ position is completely unattainable (1980, 97).

Thirdly, as Bager-Charlson (2016) points out, it can be valuable for researchers to ‘position their knowledge… in a sociocultural context’ (2016: 61). This is of particular relevance to me in that, in recent years, those holding a Christian faith have been identified as belonging to a specific socio-cultural group (Knox et al., 2005; Cragun & Friedlander, 2012; Greenidge & Baker, 2012). As I have reflected on my efforts and motivation to combine the two paradigms of faith/religion/spirituality and counselling, I have been struck by how, in many ways, this has mirrored my own personal internal journey. In order to be true to myself, over the years I have felt the need to acknowledge to myself and (when appropriate) to others, the ‘spiritual’ and ‘Christian’ part of myself, since that is core to who I am as a person. On the other hand, my ‘professional self’ has also demanded recognition. Integrating these two parts of self has been a parallel process in many ways to that of my passion to train students to integrate the paradigm of faith/religion/spirituality with the paradigm of psychology and psychotherapy.[3]

The Waverley integrative framework

Before concluding (in this, the first issue of the Waverley Abbey College Journal), it seems fitting and important to make some mention of the Waverley integrative framework and the task of critical reflexivity.

I believe the critical realist and relational approach to reflexivity, as set out in this paper, fits well with the Waverley integrative framework for a number of reasons. Firstly, the holistic approach taken by Hughes takes into account a number of areas of human functioning, including the relational and spiritual area (Hughes, 2002). Secondly, the framework’s ontological underpinning recognises human individuals as being created in the image of God: imago Dei (Hughes, 2002:139) and thus human beings can be perceived as relational at the core of their being (Green, 1999; Vanderploeg, 1981; Miner and Dowson, 2012; Hobson, 2019). Thirdly, Hughes proposed that all human beings are driven by deep needs/longings for security, self-worth and significance (Hughes, 2002:139). The search for love, security, meaning and purpose is congruent with the writings of many other theorists (Bowlby, 1969, 1973, 1980, Cassidy, 1999: 3-20; Gerhardt, 2004). Finally, the approach is integrative and open to both theological insights and psychological insights (Hurding, 1986: 300; Hughes, 2002; Kallmier, 2011: 131-181) and thus takes into account Christian faith (which might be considered subjective and socially constructed) and psychological understanding (based on observable facts).

Concluding reflection

In conclusion, I admit that undertaking the reflexive task is not for the faint hearted as, at times, I have found it to be a painful and poignant experience, often reducing me to tears. I certainly have realised the truth of Josselson’s argument, namely that reflecting on our work is sometimes a task we ‘must do in anguish’ (Josselson, 1996, as cited by McLeod, 2001: 198).

In addition, as I have engaged with the task of critical reflexivity over the last couple of years, I have realised that the task takes time (Dyer and Hurd, 2016). Memories have taken a while to surface and it has made me appreciate even more that this is not a cognitive exercise, but rather a pulling out of memories, some of which are quite deeply buried and some intensely painful, even traumatising. My experience has been that described by Bolton (2010: 8) when she observes that the more one tries to focus and reflect, the more ‘elusive’ the memories can be.

However, whilst painful, I have found the task of critical reflexivity has been of great value, enabling to reflect deeply on my personal and professional journey and to become more aware of how my values, beliefs, experiences and context have influenced and impacted my work (Alvesson, et al., 2008; Bager-Charleson, 2012; Etherington, 2004).

Footnotes

[1] Interpersonal Process Recall (IPR) is a model developed by Kagan and his colleagues, which assists counsellors to reflect upon their work with clients and to discover unconscious perceptions and motivations that the counsellor is often not immediately aware of (Cashwell, 1994). The main aim of IPR is to increase self-awareness in order to benefit the therapeutic relationship and the work the counsellor undertakes with their client (Kagan & Schauble, 1969; Wosket, 1999).

[2] The research gives evidence that a person’s relationship with God can sometimes correspond with, and mirror, the quality of the attachment relationship they experienced with their care-givers in childhood.

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About the Author

Heather Churchill MTh. (Middx); BA (Hons. Brunel) – Registered Member, MBACP (Senior Accredited) Counsellor/Psychotherapist; Registered Member, ACC (Accredited Counsellor and Supervisor)

Heather Churchill has many years of experience as a trainer, counsellor/psychotherapist and a supervisor. She has co-authored two books (Insight into Helping Survivors of Childhood Sexual Abuse and Insight into Shame) and has published a number of articles in the Accord Journal of the Association of Christian Counsellors. In her private clinical practice, Heather specialises in counselling adults who have experienced abuse in childhood. She is currently conducting a reflexive audit on the work she has undertaken in developing higher education counselling training within a Christian paradigm.

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