Counseling, Lay

The widespread use of paraprofessionals or lay counselors gained momentum especially during the 1960s. This occurred because of a shortage of professionally trained personnel to cater to a steadily increasing demand for mental health services, especially from the socioeconomically disadvantaged population (Tan 1991a).

Lay counseling has become a significant part of Christian ministries today, especially in the context of the local church, but it extends to other contexts like parachurch organizations and mission groups. Since lay-counseling services are usually offered free of charge, it is also an important means of delivering mental health services, particularly to those who cannot afford to see mental health professionals. In some states in the United States it may be necessary to use terms like lay helping, lay caring, lay helpers and lay caregivers, rather than lay counseling and lay counselors, because of particular licensing laws that limit the use of the term counseling or counselor to those who are professionally trained and licensed (usually with at least a master’s degree). But can laypeople do this work effectively?

Effectiveness of Lay Counseling

Over the last twenty years several important reviews of the research literature have attempted to determine whether paraprofessional helpers are as effective as professional therapists (Tan 1991a; Toh and Tan). The results were somewhat equivocal, with no clear indication of which group appeared superior. The majority of studies, however, indicated that lay counselors are often as effective as professional therapists. What is not so clear is “the conditions under which their contributions can be maximized—the types of interventions and patients for which this resource is most appropriate” (Lorion and Felner, p. 763).

A similar observation was offered more recently by researchers in the area of therapeutic effectiveness (Lambert and Bergin, p. 171). An even more recent review found that more trained and experienced therapists tended to have better therapy outcomes than less trained and experienced therapists, but the differences were modest (Stein and Lambert).

In summary, the question of the comparative effectiveness of these two groups is still not fully settled. This outcome brings to mind a statement made by Jerome Frank in 1982 after reviewing the therapeutic components shared by all psychotherapies: “My own hunch, which I mention with some trepidation, is that the most gifted therapists may have telepathic, clairvoyant, or other parapsychological abilities. . . . They may, in addition, possess something . . . that can only be termed ‘healing power’ ” (Frank, p. 31).

So while training and research are important, we need to perhaps pay attention to therapists’ qualities that go beyond credentials. Paraprofessionals (that is, those without the training, education, experience or credentials required to be professional therapists) may also be therapeutic if they have been identified with this healing power and trained to utilize this potential.

Given the empirical support behind the usefulness of lay or paraprofessional counselors, the idea of utilizing them as mental health providers has been accepted and championed by some mental health professionals and researchers. The rationale for their position is sound: (1) their effectiveness has been regularly documented; (2) the need for mental health services cannot be met by professional therapists alone since current estimates suggest that only 20 percent of diagnosable mental disorders obtain treatment; (3) because managed health care is becoming more prominent in medical care in the foreseeable future and an estimated 37 million Americans do not have insurance coverage at all, a cost-effective treatment offered by paraprofessionals may be valid or appropriate with perhaps mild versions of a disorder or as adjuncts to professionally administered approaches; and (4) many people already consult nonprofessionals such as clergy and physicians (Christensen and Jacobson).

The Rise of Christian Lay Counseling

Several other studies involving Christian paraprofessionals have also begun to document the effectiveness of Christian lay counselors (Tan 1991a). The most recent and well-designed study to date was a controlled outcome study that evaluated the effectiveness of Christian lay counselors working at a church-based program (Toh and Tan). These lay counselors were selected and trained for one year by professionals. Supervision after the training was also provided by professionals. Incoming counselees were screened at intake, and only individuals with temporary adjustment disorders subject to short-term, solution-focused counseling were candidates for this lay-counseling program. Individuals with suggested diagnoses of character or serious personality disorders were referred to a network of professional counselors associated with the church. The treatment group comprised twenty-two subjects, who received ten sessions of individual lay counseling, while twenty-four subjects were in the no-treatment, waiting-list control group (the majority of these randomly assigned counselees were later found to be highly committed Christians who attended church often and regularly). The results indicated that the treatment group reported significantly more improvement than the control group on all outcome measures and maintained their therapeutic gains one month after termination.

For this reason, and given the increasing demand for affordable mental health services, Christian lay-counseling programs should also be considered as a viable mental health service to churches and the community at large. The potential for church-based counseling is enormous. The church is a large, benevolent community, with unique resources in prayer and the Scriptures for those who are open to the spiritual dimension, a facility often absent from secular approaches.

Starting a Lay-Counseling Ministry

The first step is to recognize the biblical basis for lay counseling (e.g., see Romans 15:14; Galatians 6:1-2; Col. 3:16; 1 Thes. 5:14; James 5:16) and its therapeutic potential. In 1 Peter 2:5, 9, Peter affirms the priesthood of all believers: the work of ministry is not only for the pastor and church staff but for all Christians (see Laity). In line with these and other passages that speak about the development and use of believers’ spiritual gifts to build up the church (for example, Romans 12; 1 Cor. 12; Ephes. 4; 1 Peter 4), there should be training of appropriately gifted laypeople in various church ministries, including lay counseling.

The second step is to choose an appropriate model of lay-counseling ministry. To do this, the goals of the ministry must be identified. Who are the people to be reached, and what resources are available to provide this service? The program subsequently would be enhanced if an ethos, or distinctive character, was established by giving it an appropriate name.

There are basically three major models of lay-counseling ministry (Tan 1991a): the informal, spontaneous model; the informal, organized model; the formal, organized model. In the informal, spontaneous model, lay counselors may or may not receive any systematic training in counseling skills. Yet counseling may take place in spontaneous and informal interactions that already exist in natural settings, such as restaurants, homes, classrooms, neighborhoods and businesses, as well as in religious, social and community meeting places. In this model ongoing supervision or formal organization and direction of counseling attempts are not provided. In the informal, organized model, informal or natural lay counseling takes place but in the context of a well-organized, regularly supervised and intentional helping ministry or activity where training is provided for the lay counselors. In the formal, organized model, lay counseling is conducted in an organized and well-supervised way (including training of lay counselors) but in more formal settings, such as a church counseling center, community clinic, agency or hospital.

The third step is to obtain full support for the idea and model of lay-counseling ministry selected from the pastors, pastoral staff and church board. Such a ministry should be seen as an extension of pastoral care and counseling in the church and as an essential part of the priesthood of all believers.

The fourth step is to screen and select appropriately gifted and qualified lay Christian counselors from the congregation. Important selection criteria should include the following: spiritual maturity; psychological stability; love for and interest in people (including empathy, genuineness, warmth and respect); appropriate spiritual gifts for helping relationships (such as the gift of encouragement mentioned in Romans 12:8); some life experience; previous training or experience in people helping (desirable but not essential); age, gender and ethnic/cultural background relevant to the clientele of the lay-counseling program; availability and teachability; and ability to maintain confidentiality (Tan 1991a).

Guidelines for screening potential lay counselors include (1) a brief written statement about his or her reasons for being interested in lay-counselor training and involvement in a religious context (this statement should also include agreement with the doctrinal positions or beliefs of the local church in order to function well in that context); (2) letters of recommendation from two or three people who know the potential lay counselor well; (3) an interview with the appropriate leaders of the lay-counseling program; and (4) psychological testing, if conducted by qualified and licensed mental health professionals (Collins). The fifth step is to provide an adequate training program for the lay counselors. The final step is to let the lay counselors see actual counselees, but with ongoing supervision and further training provided.

Training and Supporting Lay Counselors

Training programs vary widely in approaches (for example, Rogerian, psychodynamic, cognitive-behavioral, systems), modalities (for example, individual, couple, family or group) and length (from several weeks to several months). Most programs, however, include a minimum of twenty-four to fifty or more hours of training in basic listening and helping skills (Tan 1992). The number of trainees is usually limited to relatively small numbers (for example, ten to fifteen) with regular training sessions (for example, weekly or biweekly for two to three hours each time).

In any good training program for lay Christian counselors, the following content areas should be covered: basic Bible knowledge, especially that which is relevant to people-helping ministries; knowledge of counseling skills (with opportunities for experiential practice); understanding of common problems (for example, depression, anxiety, stress or spiritual dryness); awareness of ethics and dangers in counseling; and knowledge of the importance and techniques of referral.

A good training program also usually includes the following components: clear, practically oriented presentations; reading assignments; observation of good counseling skills modeled or demonstrated by the trainer or professional counselor; experiential practice, especially through role-playing. Most training programs emphasize basic counseling skills (for example, listening and relationship building), but some have also provided training in more specific counseling methods, such as cognitive-behavioral and problem-solving interventions, marriage and family counseling and even insight-oriented skills (Tan 1992).

Lay counselors should receive ongoing and regular supervision after their training and once they begin seeing counselees in helping relationships. As far as possible, the supervisor should be a licensed mental health professional. If the supervisor is not a licensed mental health professional, he or she must have access to such a professional as a consultant.

Most supervision sessions occur weekly for at least an hour, either individually or in small groups. The client load of counselors is also usually limited to only a few each week. An alternative supervision format that has been used involves biweekly supervision meetings of about two hours’ duration for small groups of lay counselors, with individual supervision provided when necessary.

Good supervision includes both skill training (that is, the supervisor teaching or modeling specific counseling methods or interventions) and some discussion of process issues or dynamics (that is, focusing on what is happening internally in the lay counselor and interpersonally between the lay counselor and the counselee). Some observation of the lay counselor’s actual counseling work is essential, whether it be through audiotapes or videotapes of counseling sessions, through direct observation through a one-way mirror or through cocounseling (where the supervisor and the lay counselor conduct the counseling together).

An awareness of legal and ethical issues related to both the supervision of lay counselors and lay counseling itself is crucial for those involved in these activities. For example, lay counselors should be taught to recognize the limits of their skills and knowledge and should know when and how to refer counselees to appropriate professionals. Lay counselors also need to obtain permission from their counselees, preferably by written consent, to share information from counseling sessions with their supervisors and others, especially if group supervision is used. Such information should be kept confidential by those involved in supervision sessions.

Christian lay counseling or people helping, including peer counseling (Sturkie and Tan 1992, 1993), has grown and mushroomed in recent years. It is a ministry that should be conducted in a Christ-centered, biblically based and Spirit-filled way, as well as ethically, effectively and efficiently, so that many lives can be touched and blessed, to the glory of God.

» See also: Discipleship

» See also: Emotions

» See also: Healing

» See also: Listening

» See also: Pastoral Care

» See also: Spiritual Growth

References and Resources

A. Christensen and N. S. Jacobson, “Who (or What) Can Do Psychotherapy: The Status and Challenge of Nonprofessional Therapies,” Psychological Science 5 (1994) 8-14; G. R. Collins, “Lay Counseling Within the Local Church,” Leadership 1, no. 4 (1980) 78-86; J. D. Frank, “Therapeutic Components Shared by All Psychotherapies,” in Psychotherapy Research and Behavior Change, ed. J. H. Harvey and M. M. Parks (Washington, D.C.: American Psychological Association, 1982) 9-37; M. J. Lambert and A. E. Bergin, “The Effectiveness of Psychotherapy,” in Handbook of Psychotherapy and Behavior Change, ed. A. E. Bergin and S. L. Garfield (4th ed., New York: Wiley, 1994) 143-89; R. P. Lorion and R. D. Felner, “Research on Mental Health Interventions with the Disadvantaged,” in Handbook of Psychotherapy and Behavior Change, ed. S. L. Garfield and A. E. Bergin (3rd ed. New York: Wiley, 1986) 739-75; D. M. Stein and M. J. Lambert, “Graduate Training in Psychotherapy: Are Therapy Outcomes Enhanced?” Journal of Consulting and Clinical Psychology 63 (1995) 182-96; J. Sturkie and S. Y. Tan, Advanced Peer Counseling in Youth Groups (Grand Rapids: Zondervan/Youth Specialties, 1993); J. Sturkie and S. Y. Tan, Peer Counseling in Youth Groups (Grand Rapids: Zondervan/Youth Specialties, 1992) 431-40; S. Y. Tan, “Development and Supervision of Paraprofessional Counselors,” in Innovations in Clinical Practice: A Sourcebook, ed. L. VandeCreek, S. Knapp and T. L. Jackson (Sarasota, Fla.: Professional Resource, 1992); S. Y. Tan, Lay Counseling: Equipping Christians for a Helping Ministry (Grand Rapids: Zondervan, 1991a); S. Y. Tan, “Religious Values and Interventions in Lay Christian Counseling,” Journal of Psychology and Christianity 10 (1991b) 173-82; Y. M. Toh and S. Y. Tan, The Effectiveness of Church-Based Lay Counselors: A Controlled Outcome Study (forthcoming).

—Siang-Yang Tan and Yiu-Meng Toh