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Nov 19 2012

Darrell Ray on the Therapist Project

One of the coolest things I’ve seen come out of the secular movement lately is the development of the Therapist Project, which provides a list of mental health professionals around the country who use evidence-based methods rather than religious ones. David Niose, president of the American Humanist Association and a contributor to Psychology Today, interviews Darrell Ray, the founder of the Therapist Project. On why this is necessary:

Q: What is the Secular Therapist Project and why do you say it is needed?

Darrel Ray: After I published my books Sex and God, and The God Virus, I was overwhelmed with requests from people asking for help finding a secular therapist. I began helping people and soon found that it is almost impossible to determine if a therapist is truly secular and uses evidence-based methods. A therapist may be well-trained, he or she may have received advanced degrees from the best schools, but that does not guarantee they are not influenced by belief in supernatural beings or New Age ideas. Many people wrote me saying they went to a therapist for months only to have the therapist recommend that they pray, go back to church, or use some New Age method.

Q: Aren’t therapists trained to keep their beliefs out of the therapy sessions?

Ray: Not necessarily. Certainly, the best schools train therapists to avoid imposing their beliefs on the client, but right now there are hundreds of religious schools graduating thousands of Christian counselors, licensable in most states. Graduates from Liberty University, Regent or Oral Roberts University are taught to incorporate religion into their counseling. Regent University and others have Ph.D. and Psy.D. programs in clinical psychology. How is it possible to get solid clinical training from a university that insists on teaching Pat Robertson’s theology to all students? This is the guy who thinks God sends hurricanes to punish cities for tolerating gays.

Graduates of religious schools look like any other Ph.D. or MSW to the lay person, yet they are an integral part of the evangelical right’s attempt to usurp the field of counseling in the service of their religious agenda. Graduates of these universities are highly unlikely to keep their religious views out of the therapeutic relationship. Do you think a gay or lesbian person will receive effective treatment from a Regent’s University Ph.D.? Could an atheist get evidence-based treatment from a graduate of Liberty University? It is possible, but why would you risk your time, money, and emotional health on someone who probably prays and reads the Bible more than they read professional journals?

Even someone who graduated from Michigan State or UCLA may not be secular. The school a person attends says little about their supernatural beliefs. Once a person is in practice, they may start using untested and non-evidence based methods. Methods that have not seen clinical testing and peer review.

He also points out that it can be dangerous for a therapist to put his name on the list, which is why they’re careful to protect their identities.

Q: Why so much emphasis on confidentiality and protecting the identity of the therapist?

Ray: Imagine that you are a secular psychologist or social worker in Oklahoma City. Most clients that come to you are religious and many of your referral sources are ministers or churches. If you openly advertised that you are secular, half your clients would leave and many of your referral sources would dry up. One therapist that I know in a major southern city gets 75% of her referrals from local ministers and churches. She used to be a strong Christian. She taught Sunday school for sixteen years, but is now an atheist. She wants to wean her practice away from religious sources, so she registered with us. She needs to keep under the radar or she would lose most of her current patients.

Another therapist gets many referrals from the courts. The majority of judges in his county are very religious. In his state, judges are elected, so they often cater to the wishes of the religious community. If the community learned that a judge was referring people to a secular therapist, the judge could lose the next election. As a result, the therapist has to keep a low profile and cannot reveal that he is an atheist to the judges or to the community.

This is an incredibly important project.

21 comments

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  1. 1
    Sastra

    I’m confused about how the word “secular” is being used here. I think this is our version of a deepity (a term with two different meanings — one common, one not — which is used as if these meanings were equivalent or interchangeable.) “Secular” can mean “worldly” in the sense that one separates religious views from how they use reason and science; “secular” can also mean “atheist.” That’s the less common meaning.

    I would want my therapist (and my doctor and my teacher and my grocer and so forth and so on) to be secular, but they wouldn’t have to be atheists. They would simply have to keep what they believe about the supernatural out of their professional opinions. That would be fine.

    I wish Darrell Ray would be clearer about this.

  2. 2
    Bronze Dog

    This is a good idea, though I understand therapists in religious areas being reluctant to sign on.

    Thankfully, the therapist I visited stayed professional. She was Christian but generally kept that out of the sessions, and when it did come up, it was mostly so we’d both jab at fundies a little.

  3. 3
    Johnny Vector

    Sastra: From the sitewide footer at the project’s website:

    Therapists in our database agree to use secular therapeutic methods only. They promise not to recommend prayer or other supernatural methods. While a therapist may be religious, they promise to keep their spiritual / religious ideas out of the therapeutic relationship.

    I think that’s pretty clear.

    Also, people who use “secular” to mean “atheist” need to be strapped to a chair and lectured to in rhyme by Cuttlefish about the importance of language.

  4. 4
    Deanna Joy Lyons - Mentioner of Patriarchy

    In other interviews, Darrel gives a bit more detail on what is meant by secular in this case. The idea is that the therapist pledges to use evidenced based methods in their practice not spirituality, and not woo woo, and not to push their own religion on a client.

  5. 5
    Deanna Joy Lyons - Mentioner of Patriarchy

    Johnny @3 beat me to it. Thanks, Johnny! :)

  6. 6
    spamamander, internet amphibian

    I really hope this takes off. One of the large reasons I gave up on therapy was the fact that things always seemed to creep in after a while. One woman was rather nice, even if giving me a lot of very bland, generic advice (Do things for yourself! Get out and make friends! Well duh, if I could do those things, I would be.) Then I noticed a copy of “The Courage to Heal” among all the books and worksheets she liked to hand out. Another told me I should go to church to meet people, that my pentacle and dragon tattoo meant that I had some kind of spirituality in my life. Not overtly religious/new age things foisted on me, but enough to make me wonder.

  7. 7
    Sastra

    Therapists in our database agree to use secular therapeutic methods only. They promise not to recommend prayer or other supernatural methods. While a therapist may be religious, they promise to keep their spiritual / religious ideas out of the therapeutic relationship.

    Yes, that’s pretty clear. But this is not:

    If the community learned that a judge was referring people to a secular therapist, the judge could lose the next election. As a result, the therapist has to keep a low profile and cannot reveal that he is an atheist to the judges or to the community.

    As I said, he seems to be switching back and forth.

    As for keeping religion/spirituality out of therapy, I’d think the spirituality deepity would be a massive problem. What is “spirituality?” It means love, life, and appreciation. It means connecting to the Higher Power which flows through all things. It’s one, it’s the other, it’s both! And it’s totally secular, because quantum physics proves cosmic consciousness!

  8. 8
    eric

    Sastra, the two comments are consistent. Remember, a lot of strongly religious people think that to be truly religious, one’s religion must be an active part of everything you do, including your work.

    I think its perfectly true to say that, for some communities, if that religious community learned that a judge was referring people to a therapist who did not pray with people, talk to them about God, recommend church, etc., then that judge could lose the next election (and the therapist a lot of referrals).

  9. 9
    ph041985

    Sounds like we need a similar project for judges, as well

  10. 10
    heddle

    What is an example of an “evidence based” therapy? I have a suspicion it only means that religion is never mentioned. I seriously doubt that it is any more scientific. There is religious woo and secular woo (a good example of the latter being the old fraud Dennet’s “consideration-generator”.)

    My son received treatment from a Christian therapist and a secular therapist. They both did more or less the same thing. Neither was effective although the secular therapist was more likable. (She, at least, remembered my son’s name from one appointment to the next.)

    Are there studies that compare the efficacy of “evidence based” v. Christian therapy?

  11. 11
    Gretchen

    heddle, we can agree that religion is not science, right?

    If so, then removing religion would necessarily make the therapy more scientific. Just as therapy which previously included instruction on how to vote would be made more scientific by removing the politics.

  12. 12
    becca

    There actually are evidence-based therapies. I believe that cognitive/behavioral therapy is well regarded in this respect. I haven’t read any, but I have heard that EMDR has a good track record in dealing with trauma. But mostly CBT has the best research track record.

  13. 13
    heddle

    Gretchen,

    If so, then removing religion would necessarily make the therapy more scientific.

    I disagree. I’ll again use Dennett’s model of the free will as an example. Just because it doesn’t refer to religion doesn’t make it more scientific–and in fact it has zero scientific content. The same could be true of therapy.

    Perhaps a more pertinent question is this: if there is a therapy that is evidenced-based, whatever that is, is there any evidence that Christian therapists would not use it, if it is effective? For example, becca mentioned CBT. Let’s grant that it is evidence based an effective. Is there a reason why Christian therapists would not use it as well?

  14. 14
    Gretchen

    I’m confused. Nobody said Christian therapists wouldn’t use evidence-based techniques. The working definition of “secular therapist” here is one who refrains from inserting any sort of religious thinking into his/her practice, regardless of whether that therapist is a Christian or atheist or anything else.

  15. 15
    Sastra

    It’s not a problem if religion is mentioned; whether it’s a problem or not depends on how it’s brought up or involved. A therapist should not be trying to convert people into or out of their religion (or lack of it) unless there’s a significant issue with the religion itself (it’s a dangerous cult, say.) But of course if someone is very religious the therapist might need to work along with that.

    I suppose the same rules apply to politics. A liberal Democrat or a tea-party Republican should not automatically be informed that their depression is surely the result of their poor grasp of the Constitution or some such nonsense.

  16. 16
    shockna

    Perhaps a more pertinent question is this: if there is a therapy that is evidenced-based, whatever that is, is there any evidence that Christian therapists would not use it, if it is effective? For example, becca mentioned CBT. Let’s grant that it is evidence based an effective. Is there a reason why Christian therapists would not use it as well?

    Important phrase in bold.

    The point, as far as I can tell, isn’t necessarily that they wouldn’t use it, but that, in addition to the evidence-based treatment, they’d also resort to bullshit. Depending upon the individuals devotion to religion, his/her preference for using the latter would likely increase as religious devotion increases (Part of the whole “make your religion a part of everything in life” bit of fanaticism).

    The idea here is to create a means of directing people to therapists who use exclusively evidence-based practices.

  17. 17
    Nick Gotts

    The point, as far as I can tell, isn’t necessarily that they wouldn’t use it, but that, in addition to the evidence-based treatment, they’d also resort to bullshit. – shockna

    I would think that for many therapy methods including CBT, a practitioner allowing their own views on politics, religion, metaphysics or UFOs to become obvious would not be practicing the method properly; so any findings of efficacy for the method would not apply to those practitioners. Therapies that involve expressing such views and even pushing them on the client could in principle have supporting evidence of their efficacy; but many of us would nevertheless deprecate their use.

  18. 18
    heddle

    Gretchen,

    I am confused too. Ray’s words (which as an essay would receive a D-, given he serves pure speculation with no support, e.g, Once a person is in practice, they may start using untested and non-evidence based methods.–but OK it was a radio interview) do in fact seem to suggest that the likely scenario is that Christian therapists would not use so-called evidence-based therapy.

    Sastra,

    A therapist should not be trying to convert people into or out of their religion (or lack of it) unless there’s a significant issue with the religion itself (it’s a dangerous cult, say.)

    Agreed.

    shockna,

    The idea here is to create a means of directing people to therapists who use exclusively evidence-based practices.

    I defy you to demonstrate that such in approach is possible. Since therapy is not science, every single therapist on the planet will to some extent be using techniques that are not based in science. They will do what their gut tells them to do, or what they think is effective or might be effective or was effective once, regardless of whether it is a scientifically demonstrable viable approach. So again, you have religious woo v. secular woo. I think most of you just like the sound of secular woo better and are willing to give it a free pass.

    The bottom line, it seems to me, are results. If secular therapists and Christian therapists who use best practices have comparable results then nothing else matters.

  19. 19
    Gretchen

    Since therapy is not science

    No, but it’s science based, or at least it should be.

    They will do what their gut tells them to do, or what they think is effective or might be effective or was effective once, regardless of whether it is a scientifically demonstrable viable approach. So again, you have religious woo v. secular woo.

    Effectiveness is a scientifically demonstrable thing. If therapy is effective it’s not “woo,” religious or secular.

  20. 20
    heddle

    Getchen,

    Science based?–well it is either science or it isn’t. Evolutionary psychology might be science based, drawing on ideas from evolution, and yet (in my opinion) be completely unscientific (and a good example of secular woo.)

    Effectiveness is a scientifically demonstrable thing.

    Not always. My autistic son was an uncontrollable nightmare until he was about six. Then he began playing the piano. Within six months he was the most pleasant and sociable child you could ever hope for. In spite of my strong believe that music lessons were an effective therapy there is no way to prove it and indeed there are many counter-examples were it does not work. But if I were a therapist I might be inclined to tell a parent–maybe we should try music–it seemed to work in at least one case.

    That is not science. It is in fact woo. But I don’t think it is far-fetched, or even unreasonable. Perhaps another way of putting it is that humans are way too complex to rely solely on “evidence-based” techniques. Faced with a lack of results therapists will try something, anything even if it has no basis in reproducible experimentation but because it “just might work.”

    I remember reading the book the Exorcist. At some point a (Catholic-priest) psychologist (or psychiatrist, I don’t recall) suggested exorcism–not because the girl was actually possessed (or so he thought in the story), but because if she believed she was then the ritual might make her believe she was cured. Is that reasonable? I don’t know–if it is there would be a case where religious woo might offer an advantage.

    I fully admit I could be wrong about all of this–I know nothing about therapy except what I’ve seen of it in practice with my son.

  21. 21
    Dr X

    @Becca:

    But mostly CBT has the best research track record.

    I know this is widely thought to be the case, but it isn’t so. Most of the research shows that the major models of therapy produce roughly equal outcomes and that they are generally effective for a variety of problems. There are lots of caveats and qualifications beyond what we can get into here. There’s also some evidence that psychodynamic therapy results may hold up better over time than the results of the other major modalities.

    I’m not talking here about developmental disorders, but run-of-the-mill personality disorders, anxiety conditions and variations on what amounts to non-psychotic depression, the latter three covering over 90 percent of the patients in outpatient psychotherapy. There is also a great deal of change that people often consider desirable, though the the areas of change don’t revolve around what would be defined as a DSM disorders. What psychodynamic therapies tend to do is change not just initial complaints, but other areas of functioning that often amount to collateral benefits that weren’t specifically targeted and weren’t areas that a patient expressed concern about.

    Psychodynamic therapy generally emphasizes relative therapist anonymity and neutrality, so identifying one’s religious beliefs or inserting religion wouldn’t be helpful and is also rife with possibilities for hindering progress by colluding with defenses. The same would be said for identifying oneself as a non-believer or inserting non-belief into the therapy.

    The issue isn’t whether particular beliefs are true or false, but whether they figure prominently in defenses that are concealing issues that are compromising sense of well-being, adaptability, relationships and general adjustment. A dynamic therapist isn’t the decider of how a person feels about these areas of life. They bring, we explore together and generally things improve, to varying degrees, in all of these areas.

    My biggest concerns are the proliferation of two year degrees, lack of depth and rigor in training, and expansion of programs that accept students who would not have been remotely qualified for admission to training just two or three decades ago. It’s this lack of rigor, even a hostility to depth and rigor in training, that seems to be giving rise to a lot of woo with some therapists after they go out to practice. I also see people marketing themselves as using a particular mainstream modality, but it appears that they know little about what they’re claiming do.

    If someone never learned much in the first place, if their training lacked depth and their thinking is unsophisticated, undisciplined, the shiny objects marketed in weekend seminars and popular books can also be appealing. If you’ve had a better education, you take one look at most of that stuff and can see that it’s riddle with problems.

    The few graduates of religiously-based training programs that I’ve encountered are atrocious, but there is nothing to stop a well-trained, religious therapist from doing sound, effective psychotherapy. But I wouldn’t expect they’d be talking about sin, or trying to change sexual orientation or advising prayer or church. Actually, psychodynamic therapists should refrain from advice of any kind, again because of the important role of neutrality to avoid collusion with defenses of any kind. Taking sides makes the conflict something between two people, rather than dealing with it as something that occurs internally.

    BTW, I had solid training in CB theory and therapy, client-centered/experiential approaches, systems approaches and analytic/dynamic therapy. All enter my thinking, but in individual therapy I mostly rely on psychodynamic therapy. I do use methods of CBT sometimes and, occasionally, use it exclusively, with certain patients depending upon a variety of considerations.

    Example

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