Chapter 2 of Christians who Counsel by Ray Anderson discusses the human being as an integrated being that must be counseled through integrative means. Anderson states that humans are a gestalt of subsystems that include the social, personal, sexual, psychical, and spiritual. People progress through these subsystems in a developmental fashion, although not in a cut and dry stage manner. We continue to have difficulties in each subsystem throughout our lifetimes and problems in one subsystem will often create problems in other subsystems.

A second way in which we must be integrative beings is that we need to grow in relationship to God, others, and ourself. If we have problems in one realm that will create problems in the other realms. These realms are placed on equal standing, with no one relationship being more important than the others, which means that our relationship with God is not considered to the primary issue through which all other relationships are subject. Instead, relationships with others and self are considered to be so categorically different that they must not be treated as inferior in the quest for wholeness.

In order to facilitate growth towards an integrated being, therapy must utilize hermeneutics, narrative, and eschatology. Hermeneutics means the process of interpreting. Thus, counseling needs to help the client re-interpret life events so that they will have different meaning, perhaps even a spiritual significance. Next, counseling utilizes narrative by allowing the client to see his or her story as placed within the story of his community and thereby creates a value-oriented world for the client to enter. Finally, counseling must involve a look at eschatology or the end times. Having an eternal perspective can allow the client to gather a more global view of the world and their own personal and social problems.

What I enjoyed about this chapter was that it was anthropological. It began with a look into what a whole human being ought to be and therefore provided a goal for where therapy could lead. This is helpful because many theories for counseling do not have a clear vision for health and therefore can potentially remove one pathology only to have it replaced with another. But the chapter also described how wholeness could be promoted through specific growth promoting processes. I enjoyed that the hermeneutical task was more than just changing specific beliefs but was focused on changing entire worldviews. Overall, I really thought that this chapter laid a solid foundation for which therapy could be built upon.

Drugs and Spirituality

Many Christians believe that taking prescription drugs for mental illness is tantamount to a lack of faith. I believe the reason is that people wrongly believe that their spiritual nature is greater than their physical nature. Although this problem occasionally becomes evident when people refuse medical treatment in order to be healed of general medical conditions, this way of thinking is more rampant in regards to mental illness.

I'm taking a Psychopharmacology course and my professor, Dr. Archibald Hart, suggests that the reason for this belief is that people lack a comprehensive theology of creation. That is to say, people don't know how God works in creation. Specifically, people remain ignorant as to the physicality of our minds. God created us with miraculously complex brains that can sometimes go awry, just like other body parts. If we come to grips with this truth, we will find that drugs are merely a way to restore our body to it's "natural" condition.

Prescription Privileges for Psychologists

In the last month, a bill has been introduced to the California state assembly regarding prescription privileges for psychologists. Similar bills have already passed in New Mexico and Louisiana. Now, in case you didn't know, psychiatrists are medical doctors and have the ability to prescribe medications while psychologists do not. However, this bill would change that by allowing psychologists to gain prescription privileges (RxP) by undergoing a two-year post-doctoral education that involves both didactic instruction and practicum. The American Psychological Association is lobbying for this bill to pass under the auspices that psychologists can help meet the needs of underserved populations, particularly in rural areas. However, it seems that the true purpose is to gain a clear distinction for psychologists from other mental health workers - in other words RxP is for economic purposes. The bill is opposed by psychiatrists and some other members of the medical field.

I want to bring up a few key issues why I think it is a bad idea for California to allow psychologists to gain RxP.

1. There is little evidence to show that psychologists can provide quality medical care. 50% of all mental illnesses are associated with an underlying general medical condition. Psychologists may not be able to understand all of the nuances of these conditions to treat properly. The real problem is we do not know if psychologists will provide quality care, we should wait to see how it goes in New Mexico and Louisiana.
2. The reasons for pursuing RxP, particularly meeting the needs for clients in rural areas, may be a fallacy because it seems that most psychologists who pursue the further education will want to work in urban and suburban areas.
3. The training program may be too short to properly train. The APA is lobbying for a training plan but the plan is much different from the one that the Department of Defense used to train psychologists to prescribe. Again, it's a question of knowing whether or not it will work.
4. The occupation of the psychologist will work best if there is unity within the members. RxP will cause a disunity as psychologists choose to either pursue RxP or get left behind. As a field, psychologists need to stick together.

In the end I recognize that there are problems with the system we currently have. There are not enough psychiatrists and most prescribing is done by general practitioners who have little training in psychopharmacology (i.e. meds for mental health issues). This is a problem. But I don't think RxP is the solution at this time. Psychologists already have the ability to gain RxP through gaining an advanced nursing degree, which takes about three years, so proposing a separate avenue is premature at this point in time.