NDSU Department of Child Development and Family Science
North Dakota Department of Human Services
December 1999
Donald E. Newberry and John D. Tyler
University of North Dakota
For information contact
Donald E. Newberry, Ph.D.
Northeast Human Service Center
1407 24th Avenue S.
Suite 108
Grand Forks, ND 58201
(701) 795-3121
Two factors that may influence an individual's choice of a counseling resource are the type of problem and the religious orientation of the counselor. This study examined how these factors influence the preferences of psychology students for psychologists or clergy as counseling sources. Psychologists were preferred for depression, severe mental illness, an impulse control problem and, by a small margin, for marital difficulty.
Expectations of what would take place in counseling, and judgements of the appropriateness of several interventions in counseling, were also examined.
Respondents considered clergy and psychologists to differ in what they would do in counseling and in what was deemed appropriate for them to do.
Two factors which can influence choice between pastoral or psychological counselors are the nature of the problem for which help is sought and the help seeker's beliefs about the values of the counselor. Quackenbos, Privette, and Klentz (1985) found that secular therapists were preferred for help with severe mental illness, alcoholism, drug addiction, and weight problems, but clergy were preferred for marriage and family problems. Similarly, nearly half a century ago Gurin, Veroff, and Feld (1957) reported that most individuals preferred mental health professionals for help with nervous disorders, but favored clergy for marital and life adjustment disorders.
Results such as these have led to examinations of why the public discriminates between the two sources based on the problem to be dealt with in counseling. The answer to this appears to be concerns over values, and the extent to which values and religious beliefs will be respected and used for guidance in counseling. In a literature review covering the years 1974 to 1984, for example, Worthington (1986) found that religious clients fear having their values changed and being misunderstood or misdiagnosed. This description of concerns has also been expressed by King (1978), and found to influence Christian's attitudes toward counselors (Keating and Fretz, 1990). The latter study examined Christian's attitudes toward counselors that differed on acceptance of religion. They found that Christians held the most negative anticipations toward secular counselors and the least negative anticipations toward Christian counselors.
Differences in their understanding of mental health between clergy and mental health professionals, mostly psychologists, psychiatrists, and social workers, has been described by authors such as Newberry and Tyler (1997) and Bergin (1980). Put simply, and very generally, mental health professionals are trained in and work from naturalistic, deterministic models of human behavior. Clergy, however, have continued to work from a theological perspective. Interestingly, research on mental health value differences between psychologists and clergy has indicated that, overall, they are similar in their mental health values (Newberry & Tyler, 1997).
In this study we looked specifically at how type of problem influences the choice of a clergy person or a psychologist. It was expected that problems likely to involve value judgements of right and wrong, as well as family values, would be considered more appropriate for the clergy than for psychologists. In this study these consisted of marital conflict and writing bad checks. It was also hypothesized that problems considered value free, depression and a psychotic disorder, would be considered more appropriate for a psychologist than for clergy.
We also examined expectations of what would occur in counseling and the judged appropriateness of several counseling interventions as a function of whether the counselor was a psychologist or clergy member. Here, it was hypothesized that clergy would be expected to work with religious understandings and beliefs while psychologists would not.
Subjects
Respondents for this study consisted of introductory psychology students at the University of North Dakota. Students were given extra class credit as an incentive to take part in the study. One hundred thirty one females and 62 males participated. Materials and Procedure
This study was done using the Judgements and Background Questionnaire (JBQ) constructed for this study. Due to this being the initial use of this instrument, information on it's reliability was limited. However, the large sample size allowed the sample to be split into two different groups whose responses could be compared. The two groups never differed by more than one point on the Likert type scale used, suggesting scores did not greatly vary between the two subsets of responses.
It was expected that the validity of the JBQ could be established by comparing results with those of other studies of similar nature. In other words, the results should find differences similar to those reported by researchers identified in the literature review. This was the case, as the following shows.
The JBQ inquired about the respondent's education, age, and religious affiliation. Subjects were asked to rate themselves on scales measuring religious liberalism versus fundamentalism, amount of participation in religion, the influence of religion in the individual's life , and how similar respondents felt their values were to the values of clergy and psychologists. All ratings were made on a Likert type scale with values ranging from zero to six. Low scores indicated low fundamentalism, participation in religion, perceived influence of religion, and perceived differences in values.
The remainder of the JBQ consisted of vignettes, presented in random order, describing students with an impulse control problem (bad checks), a marital problem, a problem with depression, and a delusional, hallucinatory disorder. For each vignette respondents were asked to rate separately for psychologists and clergy the likelihood or the appropriateness of several interventions or responses (see Tables 2-3). Ratings were made on a Likert type scale, ranging from zero to six, where low scores indicated little likelihood or appropriateness. In addition, for each of the vignettes respondents were asked what the individual described in the vignette should do about the problem, and who the most appropriate help source for the problem would be. This was done by providing the choice options listed in Table 1.
Table 1. What to do about the problem/appropriate professional.
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Severe
Impulse Mental
What to Do? Depression Marital Control Illness
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- - - - Percentage Endorsing - - - -
Professional 69.9 79.8 56.0 86.0
Family/friend 23.3 11.4 34.0 9.3
Deal with it
Alone 0.0 3.1 1.6 .5
Other 4.1 3.6 6.7 2.6
No answer 2.7 2.1 1.7 1.6
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Most Appropriate Professional
Psychologist 79.3 54.4 86.5 91.7
Clergy 18.1 42.0 8.8 5.7
No answer 2.6 3.6 4.7 2.6
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Table 2. Likelihood of actions in Counseling.
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Psychologist Clergy
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M SD M SD
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Understand the true cause 4.83 .72 3.56 1.00
of the problem
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Understand what the student 4.50 .85 3.38 1.04
is experiencing
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Inquire about the student's 1.94 1.14 5.35 .86
religious background
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Use religious language and 1.26 .94 5.29 .90
concepts
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View religious beliefs as 1.15 1.11 1.59 1.67
mental illness
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Attempt to change the 2.75 1.48 3.65 1.28
student's values
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Attempt to change the .96 .92 3.05 1.62
student's religious beliefs
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Encourage the student to 1.46 1.27 1.51 1.44
behave inconsistently with
their values or religious beliefs
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Enable the student to fully 4.37 .98 3.54 1.07
resolve the problem
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Note. Higher scores indicate higher likelihood.
Table 3. Appropriateness of actions in counseling.
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Psychologist Clergy
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M SD M SD
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Inquire about the student's 2.16 1.47 4.98 1.18
religious background
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Use religious language 1.41 1.42 4.90 1.20
and concepts
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View religious beliefs as .93 1.10 1.22 1.58
mental illness
----------------------------------------------------------
Attempt to change the 2.51 1.59 2.91 1.58
student's values
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Attempt to change the .89 .94 2.22 1.68
student's religious beliefs
----------------------------------------------------------
Encourage the student to 1.14 1.26 1.18 1.40
behave inconsistently with
their values or religious beliefs
----------------------------------------------------------
Note. Higher scores indicate higher appropriateness.
Respondents reported a mean age of 22.12, SD = 6.00, years with M = 13.60, SD = 1.37, years of education. Sixty nine percent of the sample was either Catholic or Lutheran. Respondents reported moderate levels of fundamentalism M = 3.36, SD = 1.54, in their religious beliefs and moderate levels of influence of religion M = 3.32, SD = 1.59, in their lives. They reported low participation in religious activities M = 1.53, SD = 1.39. They reported moderate similarity in values to clergy M = 3.03, SD = 1.48 and psychologists M = 2.62, SD = 1.29.
Psychologists were judged the most appropriate professional help source for all of the vignettes (see Table 1).
Overall ratings of the likelihood of events, and the appropriateness of events, were evaluated using MANOVA mixed designs. The type of problem to be addressed and the help source (clergy or psychologist) were within subjects factors for both MANOVAs. Gender was a between subject factor.
Due to the power of the repeated measure design, differences as small as .5 on the scales were statistically significant differences. However, statistically significant differences at times do not constitute "real world" differences. Therefore, differences on measures were only treated as significant if they were at least 1 scale point in magnitude. Response sets were included in the analysis based on the completeness of information provided.
On the likelihood cluster a main effect for help source was found (Pillais's Trace (9, 166) = .89, p <.001), indicating that the help source influenced what respondents thought likely to happen in counseling. An interaction was present between help source and problem (Pillais's Trace (27, 148) = .93, p < .001). This indicated that responses varied when the respondents considered, together, both the help source and the problem to be dealt with in counseling.
No main effects for gender or problem were found, indicating these, by themselves, did not affect responses. On the appropriateness cluster a main effect of help source (Pillais's Trace (6, 174) = .82, p <.001) was found, indicating appropriateness of interventions was considered to vary by the help source.
Overall expectations of the likelihood of events happening in counseling and the judged appropriateness of such events, irrespective of the problem to be addressed, are given in Tables 2 and 3.
On the likelihood items the help source effect was followed up by repeated measure ANOVAs. Psychologists were considered more likely than clergy to understand the cause of the problem (F(1, 187) = 244.66, p < .001) and to understand what the student was experiencing (F(1, 187) = 188.01, p < .001). Clergy were considered more likely than psychologists to inquire about the student's religious background (F(1, 188) = 1246.33, p < .001), to use religious language (F(1, 187) =1824.74, p < .001), and to attempt to change the student's religious beliefs (F(1, 187) = 324.31, p < .001).
The interaction between help source and problem was followed up by repeated measure ANOVAs for each problem. For "understanding the cause of the problem" psychologists were seen as more understanding than clergy with the delusional disorder (psychologist M = 4.97, SD = .981, clergy M = 2.88, SD = 1.38, (F(1, 189) = 322.94, p < .001), impulse control disorder (psychologist M = 4.72, SD = 1.02, clergy M = 3.27, SD = 1.38, (F(1, 189) = 164.18, p < .001), and depressive disorder (psychologist M = 4.93, SD = .941, clergy M = 3.86, SD = 1.26, (F(1, 189 ) = 100.38, p < .001). No difference was found for the marital problem.
Psychologists were seen as more likely than clergy to "understand what the student was experiencing" for the delusional disorder, (psychologist M = 4.66, SD =1.03, clergy M = 2.80, SD = 1.35, (F(1, 189) = 252.89, p < .001) and the impulse control disorder (psychologist M = 4.32, SD = 1.16, clergy M = 3.13, SD = 1.34, (F(1, 189) = 122.27, p < .001), with no significant differences found for the marital or depressive disorders.
On the likelihood of changing values question psychologists differed from clergy only on the depression problem (psychologist M = 3.65, SD = 1.70, clergy M = 2.62, SD = 1.86, (F(1, 190) = 67.16, p <.001). For the likelihood of resolving the problem question psychologists differed from clergy only for the delusional problem (psychologist M = 4.45, SD =1.11, clergy M = 2.97, SD = 1.38, (F(1, 189) = 191.99, p < .001).
On the appropriateness cluster the help source effect was followed up by repeated measure ANOVAs. It was judged appropriate for clergy, but not psychologists, to inquire about religious background (F(1, 183) = 618.17, p < .001) and to use religious language (F (1, 183) = 946.36, p < .001). It was judged less inappropriate for clergy to change religious beliefs than for psychologists (F (1, 183)= 160.03, p <.001).
Relationships between responses to specific questions on the JBQ were examined using Pearson Product-Moment Correlations. It was found that as education increased subjects were less likely to describe themselves as fundamentalists (r = -.16, p <.001). Fundamentalism, influence of religion, and participation in religious activities increased together (fundamentalism and influence of religion (r =.60, p < .001), Fundamentalism and participation in religious activities (r = .50, p < .001), influence of religion and participation in religious activities (p = .60, p < .001). As fundamentalism, influence of religion, and participation in religious activities increased subjects were more likely to report their values were similar to clergy (r = .38, p < .001, r =.36, p < .001, r = .25, p < .001, respectively) and less similar to psychologists. (r = -.14, p < .027, r = -.22, p < .001, r = -.28, p < .001, respectively)
The subjects in this study consisted mostly of Lutherans and Catholics, all of whom were college students. As such, generalization to other populations may not be warranted. However, these results are in agreement with other studies (Worthington, 1986) in finding that the public perceives differences between secular and religious providers of counseling services.
There were clear differences in what respondents considered likely to happen, and appropriate to happen, depending on whether the counselor was a psychologist or a clergy person. Clergy for example, were expected to inquire about religious beliefs and backgrounds, as well as to use religious language in their counseling, while psychologists were not. This suggests the public expects a theological approach to solving problems from the clergy, and a secular approach from psychologists.
While respondents considered it appropriate for clergy to inquire about religious beliefs, they did not consider it appropriate for either a clergy person or a psychologist to attempt to change religious beliefs or to encourage a client to act inconsistently with the client's religious beliefs.
This implies that psychologists and clergy are both likely to encounter strong resistance when working to change problematic behavior that people see as consistent with their religious beliefs. Many psychologists, when faced with this dilemma, have utilized clergy to deal with the conflict. In doing so they have assumed that clients will be more accepting of clergy's interpretation of theological beliefs and their behavioral expression than of psychologists. The current findings suggest this approach may be of limited utility.
While respondents did not consider basic religious beliefs to be something appropriate for counseling to challenge, they indicated that both psychologists and clergy were moderately likely to attempt to change a client's values. They also considered it moderately appropriate for either counseling source to do so. In providing counseling a value, such as personal responsibility for one's behavior, is often given as a reason for behavioral change. The findings of this study indicate the public perceives this as an appropriate approach.
This study found that psychologists were chosen over clergy as the most appropriate professional for all of the vignettes, including the marital problem. The latter differs from previously reported findings (Quackenbos, Privette, & Klentz, 1985). This may represent a growing public awareness of the type of problems that psychologists can address, or a more secular view of life's difficulties, including marital relations. Some support for both positions is found in respondents considering psychologists to be more likely than clergy to understand the cause of the problem for all but the marital vignette. However, it should be noted that the findings may be due to the respondents being enrolled in a psychology course. This study did not inquire as to why the respondents believed this to be the case, and the question provides ample opportunity for further research.
Bergin, A.E. (1980). Psychotherapy and religious values. Journal of Consulting and Clinical Psychology, 48 (1), 95-105.
Gurin, G., Veroff, J., & Feld, S. (1960). Americans view their mental health. New York: Basic Books.
Keating, A.M., & Fretz, B.R. (1990). Christian's anticipations about counselors in response to counselor descriptions. Journal of Counseling Psychology, 37 (3), 293-296.
King, R.R. (1978). Evangelical Christians and professional counseling: a conflict of
values? Journal of Psychology
and Theology, 6, 226-281.
Newberry, D.E., & Tyler, J.D. (1997). Mental health value differences between psychologists and Clergy. Counseling and Values, 41(2), 155-158.
Quackenbos, S., Privette, G., & Klentz, B. (1985). Psychotherapy: sacred or secular. Journal of Counseling and Development, 63, 290-293.
Worthington, E.L. (1986). Religious counseling: a review of published empirical research. Journal of Counseling and Development, 64, 421-431.
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NDSU Department of Child Development and Family Science
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