Technology and Christian Counseling: Possibilies and Perils

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Technology and Christian Counseling: Possibilies and Perils

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Posted: Jul 16, 2010 |Comments: 0

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Balancing a grande mocha in one hand and a briefcase in the other, Dr.Washington swings shut the door of her sports utility vehicle and heads towardthe office, strategically pressing the remote control on her key chain to lockher car doors and activate the security system. At the office door, she swipesher magnetic key card, enters, goes directly to the wall panel to deactivatethe electronic security system, and switches on the computers and photocopymachine. After checking her voice mail and e-mail, Dr. Washington sits to enjoythe last few sips of her mocha while reviewing her appointment schedule on herhandheld electronic organizer. Another day at the Christian counseling officehas beguna day filled with the possibilities and perils of technology. Thetechnological revolution has brought unprecedented possibilities for Christiancounselors.

At the dawn of this new millennium we can research diagnoses and treatmentplans on the Internet, be supervised by a counselor on the other side of theglobe, communicate instantly with colleagues and consultants throughout theworld, bill insurance companies electronically, prepare PowerPoint talks forchurch groups and professional presentations, and study Scripture and theologywith hyperlinked CD-ROM study aids. The possibilities are so vast that it isdifficult to wrap words around what is happening in a short article such asthis. But armed with my word processor, spell checker, autosave andautoformatting features, and electronic grammar advisor, I charge ahead withthe taskhoping that my Windows operating system wont crash today and my surgeprotector will do its job. In a recent review of the scientific literature, Idescribed three waves of technology for counselors. 1 In a flurry of uncreativethought, reinforced (sadly) by my work in the ivory tower, I labeled these Wave1, Wave 2, and Wave 3 technologies. Wave 1: Well-Established Technologies LikeDr. Washington, many counselors use certain well-established technologiesroutinely.

These technologies typically involve routine office management tasks such asword processing, billing systems, facsimile machines, photocopying, telephoneanswering systems and voice mail, pagers, and database management. A recentsurvey of California psychologists suggests that about three fourths usecomputers, three fourths use a FAX machine, half use a pager, 65% have accessto a photocopy machine at home or at the office, and 40% use computerized voicemail.2 Wave 1 technologies have more possibilities than perilsthey are notparticularly dangerous. These office management technologies don’t typicallyaffect what happens inside the counseling office and may even free counselorsfrom mundane clerical tasks so they can concentrate more intently on counselingrelationships. The possibilities increase with Wave 2 and Wave 3 technologiesas do the perils. Wave 2: Partially-Established Technologies Wave 2technologies have greater direct impact on our clients than Wave 1technologies, and should be considered partially established in that somecounselors, but not most, use them. Examples of Wave 2 technologies includeusing computers to assist with: test administration or interpretation, playtherapy with children, interviewing and diagnosis, therapy or supervision bye-mail (or telephone), and so on. There are many possibilities with thesetechnologies. Computerized test scoring is more accurate than hand-scoring andcan provide counselors with interpretive printouts thus giving them access toleading experts in the field of test interpretation. Computerized interviewingguides the counselor or client through a series of questions and decisions tohelp formulate a diagnosis. Clients are sometimes more candid when respondingto a computer than when responding to another human being, thus increasing theaccuracy of diagnosis. Computerized interviews can also help identify mentalhealth needs before they become difficult to manage.

Imagine walking into your physicians office in the year 2002. As you sit inthe waiting room, you are given a handheld electronic device and asked toanswer a series of questions. Your answers are compiled, compared with datafrom normative samples, then sent electronically to your doctor before theappointment begins. At some point during the appointment, your physician says,Some of the symptoms youre experiencing suggest a mild form of depression.Would you be interested in talking with a counselor about your situation?Scary?Well, maybe a little. But the possibilities for early detection, prevention,and treatment are worth considering. Computers can also be used to facilitatecounseling methods. Many play therapists use computers to help engage childrenin the treatment process. Rehabilitation therapists find computers useful inhelping their clients regain certain cognitive functions. Are you feelingnervous as you read about the possibilities technology may bring to thecounseling office? If so, I commend you. Peril walks hand in hand withpossibility.

We will consider two significant perils later. Wave 3: Emerging TechnologiesSome technological innovations have only begun to influence the work ofcounselors, but we will be hearing more about them in coming years. These willdramatically affect the counseling process itself, thus increasing both thepossibilities for innovation and the perils of misuse. Examples of these Wave 3technologies include videoconferencing, Internet services, and using virtualreality in treatment of anxiety disorders. Videoconferencing, also known asteleconferencing, allows two-way communication through TV monitors. Thoughearly prototypes required satellite connection between TV monitors,telecommunications can now be transmitted more economically through telephonelines and Internet connections.

These recent advances have made videoconferencing increasingly affordableand, as a result, we are seeing a surge in telehealth (using the methods ofvideoconferencing to provide health services from a distance). Telehealth holdspromise for reaching underserved areas with needed medical and mental healthservices. Have you heard of Headworks? How about Russell RazzaquesCyberAnalysis Clinic? Emotions Online? Counseling CafÃ©? McAnally OnlineChristian Counseling? Pastoral Consultation Services? You guessed itthey areall counseling services available over the Internet. You can even pay to havehypnotherapy over the Internet (how does that work?). Whether we are skeptics,enthusiasts, or somewhere in between, we must acknowledge that onlinecounseling is here and growing quickly. Virtual reality combines computerhardware and software to simulate real life experiences by presentingcomputer-generated graphics and sounds that are a response to the movements andresponses of the individual using the software. Virtual reality has alreadybeen used to treat the fear of heights and to help clients learn appropriatesocial skills, and more applications will be forthcoming. Like geneticengineering in medicine, Wave 3 technologies have the potential to shake theethical foundations of our professions while simultaneously creatingpossibilities of great good.

*Perils*

Are these waves of technology the serene whitecaps of seascape on canvas, orare they pummeling tidal waves destined to destroy us? I suggest these waves oftechnology are good, like ocean waves, so long as we respect their danger.Among the dangers are potential ethical problems and the risk of slipping intoa technology of healingmentality as Christian counselors.

*Ethical Problems*

Is it ethical to FAX confidential client information to another counselorsoffice? Should therapy records be stored on a computer network? If I loseclient information because my computer disk crashes, have I behavedunethically? Is it ethical to provide weekly counseling by telephone? Shoulde-mail be used for clinical supervision? Is a licensed counselor in Nebraskaeligible to provide services via the Internet to someone in Alabama? The answerto these questions can be answered with a big shrug. No one seems to know. Mycolleagues and I recently surveyed 1,000 practicing psychologists, asking themto respond to 40 different behaviors related to technology. The 420 respondentswho returned completed questionnaires indicated how often they engaged in eachbehavior and their beliefs about the ethics of each behavior.3 Here is wherethe big shrug comes inrespondents did not know if most of the behaviors wereethical or not. Over half of the 40 items received equivocal ratings on theethics scale.

This, of course, is a monumental problem. Our technologies have grown fasterthan our ethical guidelines and, as a result, we don’t have professionalstandards to know if something is ethical or not. So what are we to do asChristian counselors? The second best thing we can do is to get busy craftingethical standards for how we will handle these emerging technologies. We shouldget started! The best we can do is to follow the words of Jesus, commonly knownas the Golden Rule. In everything, do to others what you would have them do toyou; for this sums up the Law and the Prophets(Matt. 7:12). Put another way,how would I feel if I were the client in this situation? Would I feelcomfortable having my counselor retrieve messages from an answering machine ifother support staff were also listening? Would I want my confidential therapyrecords stored on a network, even if the records were password protected? WouldI want to receive counseling services via a 900 number or over the Internet?While these questions defy simple answers, they are worth considering.

*Technology of Healing*

Perhaps the greatest danger we face as technology begins to saturate thework we do is what a colleague of mine has referred to as the technology ofhealing.4 Just think about all the professional forces we have swirling aboutusmanaged care, empirically-validated treatment procedures, manualizedtreatments, short-term interventions, and now technological innovations. Allthese forces have potential for good, but each can deceive us into thinkingthat counseling works primarily because of the techniques and technologies weemploy. One client has a phobia, so what do we do? Systematic desensitization.Another has a clinical depression, so we apply cognitive therapy fordepression. What if a client in Argentina wants our services? Soon we can usethe Internet or telehealth to provide help. Technology and techniques .

We must be careful, or else we will stumble into the fallacy that we arecalled to deliver the right techniques at the right time. Techniques areimportant in counselingaccounting for as much as 15% of the reason why peopleget better. 5 But we are not just technicians. We are called to relationshipsthat heal. Approximately 30% of counseling effectiveness is due to theso-called common factorsa counselors ability to connect and empathize with theclient. If we learn techniques or value technology at the expense ofrelationship, we have taken one step forward and two steps back. Henri J.M.Nouwen recounts an ancient East Indian proverb in which four brothers eachlearn a new science.6 They come together at an appointed time and place todemonstrate their knowledge. Online counselor is always available tohelp you out.

The first takes a bone fragment from the jungle floor and uses his scienceto create flesh. The second uses his science to put hide on the animal. Thethird puts limbs on the creature, and the fourth breathes life into the nascentbeast. Without thinking through the consequences, the brothers have created ahungry lion that devours them before vanishing into the jungle. It is a storyabout technology and healing. The technologies we create can devour us if we donot respect their destructive power. We must cling to our calling whileembracing the possibilities that technological advances bring. Online counseling is always available tohelp you out.

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Technology and Christian Counseling: Possibilies and Perils

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