Scott Rogers says that as he was driving down a Georgia back road in March 1994, he tuned to a Christian radio station and heard a representative of the Minirth-Meier/New Life Clinics (MMNLC), America’s largest Christian psychiatric company, discussing child abuse and inviting listeners to call the company’s toll-free phone number if they needed help.
The program, Rogers says, had a deep impact on him. “They were talking about my unresolved issues, and I impulsively pulled over and called,” says the 27-year-old, citing his physical abuse as a child.
But instead of receiving comfort and encouragement, Rogers alleges he was pressured to seek costly inpatient treatment and then drawn into “62 days of hell” at the hands of social-service agencies investigating a report that he had confessed to abusing his own children. Although Rogers was eventually cleared of abuse charges, he has filed a malpractice suit against MMNLC.
The Rogers case is becoming a potent symbol within the Christian counseling field because of how it highlights one of the industry’s most sensitive challenges: the balancing act between ministering to the needy and making a profit. It has taken on a larger life because two religious gadflies have made Rogers into a poster boy of sorts in their campaign against Christian psychiatry and counseling.
Milwaukee-based Christian radio show host Vic Eliason and Dallas-based chaplain Ray Hoekstra of International Prison Ministry have waged a long-running crusade against the growing Christian mental-health industry, especially against MMNLC, whose prestige and size-more than 600 employees in 25 inpatient units and 55 outpatient units-make it a sizable target.
“This whole industry is a multimillion-dollar racket,” says Hoekstra, who has pressured broadcasters to drop the MMNLC program. Broadcaster Eliason, who had a 1993 run-in with MMNLC over his alleged unauthorized sale of MMNLC radio program tapes, declined an interview with Christianity Today, but is not new to controversy, having launched critical campaigns against other Christian leaders (ct, May 16, 1994, p. 38).
MMNLC President Stephen Arterburn inherited the Rogers conflict when his eight-year-old New Life clinic bought Minirth-Meier in 1994. But he defends the way the firm reacted to the Rogers case in that counselors are legally required to notify state officials in instances of suspected child abuse.
“We handled this matter in a textbook fashion,” he says. “Our company isn’t perfect,” says Arterburn. “I was prepared for us to say we had made a mistake in this situation and make amends, but we did nothing wrong.”
The case likely will go to trial next year. Arterburn says there was no profit motivation to have Rogers seek counseling, because its Atlanta facility, unlike other MMNLC clinics, is not-for-profit.
Arterburn says Rogers’s pain actually has been prolonged by Eliason’s crusade. He says, “This family is merely an instrument with someone who has an agenda and is not really concerned about their welfare or their recovery.”
IMAGE OF GREED? Industrywide, MMNLC is not the lone focus of criticism. Others have raised questions about the marketing methods of Christian mental health professionals.
“Our field is in a period of crisis,” says Gary Collins, president of the American Association of Christian Counselors (AACC). “Some of the inpatient programs give an image of greed and make people feel that companies get people in a hospital and keep them there until their insurance runs out, and then they let them go.”
There are other difficulties as well. The revolution in managed health care is having a profound effect on the ways counselors do business, forcing many to find quick-fix solutions to complicated psychological problems. Industry statistics show that the average length of stay for inpaients dipped to eight days in 1996, down from 30 days in 1990.
In addition, a few Christian psychiatrists and counselors open themselves for added criticism because of their involvement in the controversial areas of repressed memory treatment, healing touch, and hypnosis therapy for ritualistic abuse and multiple-personality disorders.
Yet, in spite of criticism and controversy, the Christian counseling business has experienced explosive growth. Arterburn reports that June 1996 has been the firm’s biggest month ever, including 500 inpatient admissions, 7,600 outpatient clinic visits, and 8,200 conference attendees.
Ten-year-old Rapha, another major player in Christian mental health with 63 programs nationally, has doubled in size in the last 18 months. “While much of the Christian mental-health care has declined and been embroiled in controversy, Rapha has stuck to its basic message and seen tremendous growth,” says Timothy Gilmour, Rapha spokesperson.
AACC’s Collins says, “There’s no more exciting time to be in this field.” His organization’s membership has swelled to 17,500, although not all are licensed counselors.
The rapid growth and the volatile mix of money and ministry, however, have caused disagreement in some quarters over goals. In January, Frank Minirth reached a separation agreement with MMNLC cofounder Paul Meier and Arterburn to leave the company and become sole proprietor of the Minirth Clinic, an outpatient clinic based in the same Richardson, Texas, building where Minirth and Meier opened their first clinic in 1976.
For now, the three men will continue to collaborate on writing and speaking projects. Minirth’s departure has altered the company’s radio programs. Minirth now hosts his own program on Dallas station KCBI, while Meier and Arterburn have added doctors Henry Cloud and John Townsend to their national program.
In announcing the separation, Minirth said, “Our focus will be on Jesus Christ. Our emphasis will also be on ministry. The ministry should always take priority over business.”
THEOLOGY AND THERAPY: As the American appetite for self-improvement, self-esteem, and family values has grown, Christian counselors have been more than willing to serve up an enticing array of religiously themed books, music, seminars, and other products for a Christian audience.
Popularizers such as authors James Dobson, Tim LaHaye, and Larry Crabb convinced a whole generation of evangelicals that God cared about their psyches as well as their souls, opening the door for a marriage between theology and therapeutic thought. Today, Christian counseling is an expanding segment of America’s $200 billion mental-health industry. It has provided urgently needed help to many believers for whom the traditions, rituals, and comforts of the church have been found inadequate in counteracting the stresses, anxieties, and isolation of modern life.
Christian therapists and counselors, in spite of their following among rank and file believers, have been subject to stern disapproval from some leading biblical scholars, church pastors, and theologians.
These analysts allege that Christian therapists are unbiblical in their counseling methods, that they undermine the local pastor’s authority, and that they have unwittingly altered the Christian message away from confession of sin and the need for salvation toward the pursuit of self-actualization.
AACC President Collins sees three categories of those who disapprove:
Concerned. Reasoned critiques have come from evangelical thinkers such as Os Guinness and Paul C. Vitz, who acknowledge that Christian psychotherapy does some good but argue that it encourages idolatry and narcissism while shifting the emphasis from God’s sovereignty to our own personal comfort and self-esteem.
“An ego-centered, ‘let-me-feel-good’ self-esteem can ignore our failures and need for God,” writes Vitz, New York University psychology professor and author of Psychology as Religion (Eerdmans, 1994). “At its best, psychology is a stepping stone-we should use it to move on.”
Collins says that while much of secular psychology rejects the Christian faith as meaningless or potentially harmful, Christian counselors show a respect for the reality of God’s work in the lives of people.
Critics. John MacArthur, Jr.’s Our Sufficiency in Christ (Word, 1991) and Dave Hunt and T. A. McMahon’s The Seduction of Christianity (Harvest House, 1985) charged that much of Christian psychology was really a false and heretical faith that runs counter to essential Christian beliefs. Likewise, Martin and Deidre Bobgan, the self-published authors of Prophets of Psychoheresy, a critique of James Dobson, and Twelve Steps to Destruction, say Christian counselors present a “man-centered gospel rather than a Christ-centered gospel.”
Collins counters that therapy is a neutral technique that can be based either on Christian beliefs or on anti-Christian principles. Collins says biblically based counseling is an extension of traditional pastoral ministries of healing, sustaining, reconciling, and guiding.
Crusaders. MMNLC critics Eliason and Hoekstra focus generally on two areas, arguing that Christian counseling is opportunistic and motivated by money. Second, they allege that psychology and psychiatry are inherently unchristian in origin and intent. Collins says that Christian counseling professionals generally practice high standards and are meeting an important need for believers. He says most Christian mental-health professionals believe the practice of psychology or psychiatry can be firmly rooted in biblical truth.
Yet Collins admits the field has long-standing problems, many of them resulting from poor training. “There are a number of people who have graduate school training in psychology, but Sunday-school training in theology,” he says. Training and continuing education are a primary focus of AACC efforts to improve the quality and professionalism of its members.
Another perennial criticism has revolved around Christians’ efforts to integrate biblical principles with mainstream psychology’s often antagonistic stance toward religious belief and practice. Critics complain that pragmatic approaches toward integration resemble a haphazard “take the best but leave the rest” approach that results in an odd patchwork of therapies and methods.
Recently, mainstream social observers have joined the chorus of critics. William J. Doherty’s Soul Searching: Why Psychotherapy Must Promote Moral Responsibility (Basic Books, 1995) has hit a hot button with a nation of people tired of psychotherapy’s perceived role in creating a subculture of victimology. “The crisis is over psychotherapy’s ability to speak to the profound social and moral problems of the day,” writes Doherty. “Are therapists making these problems worse by justifying the contemporary flight from personal responsibility, moral accountability, and participatory community?”
MARKET CHANGES: In the past few years, some of the biggest challenges to face the Christian counseling industry have resulted from revolutionary developments in the health-care industry.
Health maintenance organizations (HMO), which serve as the go-between for increasing numbers of American workers and health-care providers, emphasize “managed care” to keep costs under control. HMOs then pressure mental-health practitioners to shorten treatment plans and to discount their rates.
Responding to this challenge, for example, Rapha has modified its program for inpatient care from complete recovery to “stabilization,” followed by extensive outpatient services, some linked to church support groups. But not everyone is jumping on the managed-care bandwagon. One counseling practice that decided not to deal with health maintenance organizations was Associated Psychological Services of Pasadena, California. The business, founded in 1971 by Neil Clark Warren, grew to 15 partners and clinicians by the early 1990s. It ceased operations in 1995 rather than deal with the constraints and paperwork of the HMO system.
“For a variety of reasons, we decided we didn’t want to work with HMOs,” says Clifford Penner, who was a partner in the firm. “Some HMOs offered to pay only half of our traditional fees. Some limited patients to five or ten visits unless a patient was suicidal or psychotic. Others required one hour to process paperwork for every four to five visits.”
HMOs do not take into account the needs of the patients, according to Penner. “Problem-centered psychotherapy attacks specific problems like anorexia, drinking problems, or marriage problems, but it doesn’t help people get to know themselves better or get in touch with their feelings like a more insight-centered therapy would,” he says. “This problem-centered therapy parallels what’s happening in a lot of the giant churches, where a need-oriented approach is about people wanting to get through the next week, not about looking at the deeper issues.”
MMNLC’s Arterburn says managed care is not the beginning of the end for Christian counseling. In fact, Arterburn says a growing number of companies, including the giant U.S. Behavioral Health Care, are allowing their Christian policy holders to get Christian psychotherapeutic care.
There is a growing awareness of the validity of what we do,” says Arterburn. “We’re seeing more and more managed care companies agree that Christians are entitled to Christian counseling.”
But Christian counselors need not get on the managed-care bandwagon to stay in business. “Some of the more successful outpatient clinics we’re affiliated with are being barraged by managed-care offers,” he says. “But rather than signing up for managed care, they’re focusing on increasing the hours their clinics are open, making their services more accessible, increasing their marketing, and adding specialty counselors.”
WORKING WITHIN THE CHURCH: The AACC’s Collins is enthusiastic about the increasing partnership between counselors and the church. “Counselors are working in congregations, where they’re not only performing counseling but also training lay counselors and people helpers to be better able to bear one another’s burdens,” Collins says.
Rapha has a network of 3,500 churches in its RaphaCare program, which offers reduced fees to qualified church members. Also, Rapha’s MinsterCare, a two-week residential program, helps pastors cope with stress and burnout.
One of the shining examples of these partnerships is the Midwest Christian Counseling Center in Kansas City, Missouri, which was founded in 1957 by Southern Baptist pastor Jay Lofton Hudson. Today, clinical director John Larson says the center maintains close ties with pastors and churches in the region.
One way the center’s ten licensed psychologists help others is by donating counseling to people who need it but cannot afford it. Larson says the counselors donated 4,765 sessions in 1995, equaling $336,000 worth of billable hours or around 34 percent of their total counseling load.
But it does not stop there. The center also offers support groups and training for pastors, seminars on clergy sexual misconduct for church and ministry officials, seminars focusing on family and marital health, and counseling to the elderly and victims of sexual and physical abuse. It also runs a program, Street Psych, which trains urban pastors to identify and intervene in situations where there may be substance abuse, crime, violence, and family dysfunction.
Larson says counselors who can demonstrate a long-term commitment to serving their communities are in an excellent place to respond to society’s growing hunger for psychotherapy with a spiritual dimension.
“There’s a growing interest in spirituality, not necessarily Christian spirituality, but it is a more open approach and shows more respect for the particular faith perspectives people have.” Larson says. “The profession is finally waking up to what some of us have seen for years and years. Ours is a distinctive specialty, and one that really speaks to a need that many people have.”
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