Academic journal article Journal of Psychology and Christianity

Do Lay Christian Counseling Approaches Work? What We Currently Know

Academic journal article Journal of Psychology and Christianity

Do Lay Christian Counseling Approaches Work? What We Currently Know

Article excerpt

Paraprofessional counseling has received empirical evidence of its effectiveness, yet the status of lay Christian counseling models remains unknown. The authors review the current research on such approaches. A few models evidence practitioner surveys, client satisfaction research, quasi-experimental studies, or outcomes-based case studies. One eclectic approach had a randomized waiting list control group study. Preliminary evidence for the effectiveness of Freedom in Christ (the Neil Anderson approach) and Theophostic Prayer Ministry was noted. In all studies reviewed, the authors identified methodological limitations; therefore, the broad need for well-designed efficacy and effectiveness research on every model is clear. With current data, we cannot say definitively that lay Christian counseling works. Consequently, the authors make recommendations on potential improved research designs and encourage further investigations.

The role of paraprofessional counseling is increasing both nationally and internationally. Internationally, the breadth of need (e.g., mainland China, Hou & Zhang, 2007), as well as efforts to reduce the cost of some socialistic healthcare programs (e.g., Great Britain, Clarkson, McCrone, Sutherby, et al., 1999) has driven the proliferation of these services. Nationally, limitations in mental health insurance benefits have increased the need and utilization of paraprofessional services. With increased usage comes increased need for empirical evaluation; therefore, this article explores the current research on paraprofessionals who use lay Christian models.

Paraprofessional counselors (lay counselors) are persons who lack formal credentialing, training, and experience as licensed mental health professionals, yet they are involved in the care of emotionally hurting people (Tan, 1997). Example venues for lay counseling include hotlines, peer counseling, home visitation programs, and church-based ministries (Tan, 1991).

Tan (1991, 1992, 1997) described three common models used in delivering paraprofessional counseling. The informal, spontaneous model provides support in natural settings (restaurants, homes, churches, etc.) through informal friendships. These paraprofessionals may or may not have some basic training in helping skills. No ongoing supervision occurs. In the second model, the informal organized model, paraprofessionals still help in informal settings, but they receive systematic training and ongoing supervision. Finally, in the formal organized model, paraprofessionals counsel in more official settings such as a community agency or a church counseling center, receive regular supervision, and are usually trained by mental health professionals. Sometimes, hybrid models that combine the informal organized and formal organized models occur (Tan, 1997).

Research demonstrates the effectiveness of some kinds of paraprofessional counseling. Durlak (1979) reviewed 42 studies comparing professional and paraprofessional counselors. The studies focused primarily on mildly to moderately disturbed clients. Surprisingly, Durlak found no difference in client outcomes and some studies suggested paraprofessionals provided better care. Others reanalyzed the data using meta-analysis (e.g., Nietzel & Fisher, 1981; Hattie, Sharpley, & Rogers, 1984; Berman & Norton, 1985), yet similar results remained. Christensen and Jacobson (1994) conclude:

The later reviews often begin with a criticism of the previous reviews and then try to improve on the methodology. Yet, whatever refinements are made, whatever studies are included or excluded, the results show either no differences between professionals and paraprofessionals or, surprisingly, differences that favor paraprofessionals. (p. 9)

While more refined future studies matching specific diagnoses with particular clinical techniques (cf., Beutler, 2002) might lead to different comparative outcomes between lay counselors and professionals, current evidence supports no difference with generalized client populations. …

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