The Ethics of Prayer in Counseling
Weld, Chet, Eriksen, Karen, Counseling and Values
Spirituality has become increasingly important in counseling, with prayer being the spiritual intervention of choice for Christian counselors. The controversial nature of including prayer in counseling requires careful consideration of ethical issues. This article addresses the intersection of spiritual interventions, particularly prayer, with client welfare, multicultural sensitivity, values, and countertransference. The authors consider the ethical mandates, articulate concerns, and make recommendations.
Spirituality has been increasingly recognized as important in counseling (Miranti & Burke, 1995; Wade & Worthington, 2003). The majority of mental health professionals claim some type of religious affiliation, believe that spirituality is personally relevant, and value personal prayer (Bergin & Jensen, 1990; Carlson, Kirkpatrick, Hecker, & Killmer, 2002; Shafranske & Malony, 1990). Many mental health professionals also speak of the importance of spirituality to people's well-being (Genia, 2000; Miranti & Burke, 1995; Wade & Worthington, 2003). Prayer is the spiritual intervention most frequently used by Christian counselors (Sorenson & Hales, 2002; Wade & Worthington, 2003). Even secular practitioners regularly incorporate religion into their practices (Ball & Goodyear, 1991), with many believing that praying for a client is appropriate. Some secular practitioners do pray with clients, although most believe that it is inappropriate to do so (Carlson et al., 2002; Shafranske & Malony, 1990).
Perhaps as a result of the majority of the U.S. population's belief in God (Gallup Organization, 2006) and the power of prayer (Princeton Survey Research Associates, 2003), many clients want to discuss religious or spiritual issues within the context of counseling (Rose, Westefeld, & Ansley, 2001). Christian clients in particular expect prayer to be included in Christian counseling (e.g., Belaire & Young, 2002). Because sensitivity to clients' expectations helps build the therapeutic alliance, which in turn contributes to positive outcomes (Horvath & Symonds, 1991; Kim, Ng, & Ahn, 2005; Strauser, Lustig, & Donnell, 2004), methods for including prayer in counseling with some clients need to be examined.
However, ethical concerns are often raised when considering the use of prayer as an intervention in counseling, particularly when considering audible in-session prayer (Richards & Potts, 1995). Conversely, ethical concerns exist about secular counselors' inability to respond helpfully to clients' spiritual needs and expectations because of lack of awareness or countertransference related to religious issues (Richards & Potts, 1995). Therefore, in this article, the authors consider the ethical mandates that intersect with the use of prayer in counseling, articulate concerns, and make recommendations. Ethical areas to be discussed include client welfare, multicultural sensitivity, values, and countertransference. Types of prayer assumed in this discussion include clients praying without being in the presence of the therapist, sometimes at their own instigation and sometimes as "homework" given to them by the counselor; counselors praying silently in session or outside of the session for the client; and either the practitioner or the client praying audibly during the session (Decker, 2001; Magaletta & Brawer, 1998; McCullough & Larson, 1999).
Prevalence and Beliefs About Prayers in Counseling
Surveys of both secular and Christian mental health professionals have begun to establish the degree of acceptance and frequency of use of prayer as an intervention (Ball & Goodyear, 1991; Carlson et al., 2002; Shafranske & Malony, 1990; Sorenson & Hales, 2002; Wade & Worthington, 2003; Worthington, Dupont, Berry, & Duncan, 1988). Research indicates that 78% of counselors in Christian agencies and 100% in Christian private practices believe it is appropriate to pray with or for a client (Wade & Worthington, 2003). …