Academic journal article Journal of Psychology and Christianity

Use of Prayer and Scripture in Cognitive-Behavioral Therapy

Academic journal article Journal of Psychology and Christianity

Use of Prayer and Scripture in Cognitive-Behavioral Therapy

Article excerpt

This article covers the appropriate and ethical use of prayer including inner healing prayer, and Scripture in a Christian approach to cognitive-behavioral therapy (CBT). Expanded CBT now includes Mindfulness-Based Cognitive Therapy, Acceptance and Commitment Therapy, and Dialectical Behavior Therapy. Implicit and explicit integration in therapy are briefly described. A composite clinical case example is included to illustrate how prayer and Scripture can be explicitly used in Christian CBT Results of outcome studies on the efficacy of religiously-oriented CBT are also briefly mentioned.

Cogntive-behavioral therapy (CBT) is one of the most empirically supported treatments (ESTs) available for a wide variety of psychological disorders (Chambless & Ollendick, 2001; see also Butler, Chapman, Forman, & Beck, 2000; Nathan & German, in press; Roth & Fonagy, 2005; Tan, 2001a). It should be noted however, that a more recent randomized placebo-controlled trial of behavioral activation, cognitive therapy and antidepressant medication (paroxetine) with 241 adult patients with major depressive disorder (MDD) found that for severely depressed adults, behavioral activation is as efficacious as antidepressant medication and more efficacious than cognitive therapy (Dimidjian, et al., 2000).

Empirically supported therapy relationships (ESRs) and empirically supported principles of therapeutic change (ESPs) have also been more recently emphasized in addition to ESTs. In fact, evidence-based practice in psychology (EBPP) presently focuses not only on the best available research, but also on therapist clinical expertise, and client characteristics, culture, and preferences (see Tan, 2007).

Hayes, Luoma, Bond, Masuda and Lillis (2000) recently pointed out that a historical overview of behavior therapy can be divided into three major generations or waves: the first generation or wave consisted of traditional behavior therapy; the second generation or wave consisted of CBT (which is now more than 30 years old); the third generation or wave presently consists of relatively contextualistic approaches such as Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999), Mindfulness-Based Cognitive Therapy (MBCT; Segal, Williams, & Teasdale, 2002), and Dialectical Behavior Therapy (DBT; Linehan, 1993). CBT today has therefore been expanded to include such mindfulness and acceptance-based therapies as ACT, MBCT, and DBT (Hayes, Follete, & Linehan, 2004). Bishop et al. (2004) have recently proposed the following operational definition of mindfulness:

We propose a two-component model of mindfulness. The first component involves the self-regulation of attention so that it is maintained on immediate experience, thereby allowing for increased recognition of mental events in the present moment. The second component involves adopting a particular orientation that is characterized by curiosity, openness, and acceptance, (p. 232)

Mindfulness and acceptance-based CBT has some spiritual roots in Zen Buddhism and similar meditative and contemplative religious or spiritual traditions, including those that emphasize the sacrament of the present moment from a Christian perspective (see De Caussade, 1989). More explicit religiously-oriented or spiritually oriented CBT has also been developed in recent years, especially within Christian and Muslim traditions (Tan & Johnson, 2005). In such explicitly religious or spiritual approaches to CBT, the use of prayer and sacred Scripture (e.g., the Holy Quran for Muslims, the Bible for Christians) is a core component, especially with religious clients desiring a religiously-oriented CBT that is compatible with their religious faith. There are now at least 10 outcome studies (six Christian and four Muslim) with varying levels of methodological rigor, that provide some empirical support for the efficacy of religiously-oriented or spiritually-oriented CBT with religious clients, particularly for those with clinical depression, and to a lesser extent, those with generalized anxiety disorder (see Tan & Johnson, 2005, pp. …

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