Do All Types of Counseling Improve People’s Lives?

In most counseling situations, there is a desire for life to be different. With the help of a counselor, individuals seek a life where issues are resolved or they respond better to difficulties.

Whether your counselor is a friend, a professional, a pastor, or someone employed by an online telehealth platform, they should help bring hope for change and a better future.

Some people are dealing with a relationship gone sour, a consuming bad habit, an emotion that dominates, or nagging questions that have gone unresolved.

People choose to enter into a counseling process for a variety of reasons, but good counselors help them find a desired outcome.

Different Approaches

However, one of the difficulties with counseling is that one counselor’s idea of improvement is often different from another.

If you were seeing a doctor for a ruptured ligament in your knee, you would have a pretty clear desired outcome: a return to normal, pain-free activity after surgery. While not all surgeons have the same skill, they all perform knee repair with similar techniques, best practices, and goals. There is a standard protocol and way to measure the results.

When it comes to counseling, the right desired outcomes vary far more widely and there is far greater variance in the techniques to use.^[1] For instance, should I repair a relationship or end it? Are my guilty feelings really warranted or is my thinking misguided? What learned behaviors can be changed, and which need to be accepted as somewhat permanent fixtures of personality?

Further, some counseling techniques focus on short-term behavior solutions while others probe the past to search for the starting points of troublesome patterns. Some counselors are quick to suggest medication as the best answer for emotional distress while others seemingly just try to talk it out over time as a trusted guide challenging one’s perspective.

Every counseling model seeks to propose a cause and cure to some degree. Essentially they paint pictures of the “improved life” that a counseling client could pursue and perhaps even strongly advocate for some preferred outcome.

While evidence-based practices are often advocated, counseling is not like knee surgery because what constitutes success in counseling is far more variable and vague. Counseling often seems far more like an art form than a science.

Questions About Improvement

This leads us to one of the most important questions in counseling: Who determines what the improved life is?

The larger clinical counseling world is wrestling with this very question.

One therapist described the difficulty like this: “The problem is that there are an insane amount of variables when it comes to client symptoms — the most important and telling variable being whether the client is committed to getting ‘better.’ The greatest therapist in the world cannot help a person who is not committed to improvement.”^[2]

Unfortunately, these variables have led to a system where many “Private practitioners rarely track patient outcomes with any metrics of their own. The informal ‘I-know-improvement-when-I-see-it’ approach of private practice may work for many individual patients but fails to provide a cumulative body of knowledge for patients who are trying to shop between psychotherapy approaches. Without data, all they have are hearsay, anecdotes, and unsupported speculations.”^[3]

This lack of measurement and uncertainty in outcomes has resulted in a recent push by insurance and government regulators to develop methods to track progress and even incentivize counselors based on their success rates in improving client outcomes.^[4]

This brings us back to the question: how do we really define success or progress?

If counseling doesn’t have the right goal, it will miss the mark every time.

Measurements of Improvement

There are three basic ways that improvement is measured in the larger counseling world: the client, the culture, and the clinician.

1. What the Client Says

In this method, each client determines for themselves their goals/preferred outcome and how successful treatment was.

“Client-centered therapists make no assumptions about what people need or how they should be free. They do not attempt to promote self-acceptance, self-direction, positive growth, self-actualization, congruence between real or perceived selves, a particular vision of reality, or anything….Client-centered therapy is the practice of simply respecting the right to self-determination of others.”^[5]

2. What the Culture Says

With this approach, counselors act in ways that help clients pursue what is recognized as normal or healthy by their own culture.

“If you’re happy, healthy, and being a productive member of society, and your weirdness isn’t hurting you or anyone else, then who cares if you’re not someone else’s standard of being normal? What’s wrong with being abnormal if it benefits your life, and it doesn’t make you dangerous to be around?”^[6]

3. What the Clinical Counselor Says

While it would be generally frowned upon to impose the counselor’s preferred outcome within a clinical counseling relationship, the inevitable reality is that all counseling helps guide a counselee to choose some desired outcome.

Some counselors set goals for counseling “based on the assumption that the professional training and experience of the counselor or therapist equip him or her to manage the therapeutic process and to guide the client’s behavior.”^[7]

With this method, success is defined as achieving the goals that the therapist feels will help the client most.

How is Biblical Counseling Different?

Biblical counseling is guided by a faithful interpretation of God’s perspective of an improved way of life.

The best counseling helps people trust God enough to reorient their lives towards an application of His principles and purposes. Biblical counseling embraces that choices have consequences on a relational, spiritual, and personal level. Biblical counseling doesn’t view all possible outcomes as equally beneficial or even acceptable just because the client, culture, or clinician prefers it.

A biblical counselor has done their job well when the counselee sees that God is good, His word can be trusted, and your goal together is to discover how to best honor God in responding to life’s trials. A good biblical counselor commits to wrestling with various biblical principles and how they should impact the way we think, feel, and desire.

In a word, we believe that good counseling requires good theology.

The theologian AW Tozer captures it well with this quote: “What comes into our minds when we think about God is the most important thing about us.”

Good theology has a place in good counseling, and it is impossible to truly improve life without it. While biblical counseling is certainly more than a theology lesson, it must wrestle with how a counselee views God and how that impacts the trials they are facing.

Make sure the counsel your receive is biblically accurate and compelling so it won’t bring further harm or distress!

In our next post, we are planning to examine several of the theological themes that shape biblical counseling.

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[1] https://online.marquette.edu/education/blog/what-are-the-five-theories-of-counseling

[2] https://ct.counseling.org/2014/04/on-being-a-successful-therapist/

[3] https://www.psychologytoday.com/us/blog/stress-relief/201905/how-measure-improvement-in-psychotherapy-5-approaches

[4] https://www.apa.org/monitor/2019/11/interventions

[5] Grant, B. (2004). The imperative of ethical justification in psychotherapy: The special case of client-centered psychotherapy. Person-Centered and Experiential Psychotherapies, 3, 152-165.

[6] https://elementaltreatment.com/defining-normal-or-trying-to/

[7] https://dictionary.apa.org/directive-counseling