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Looking at the Past and Present of Counseling

Shidonna Raven Garden and Cook

Article 02.25.2010
Source: 9 Marks
Feature Photo Source: Unsplash, Rachel Strong

The following is an interview with David Powlison

LOOKING AT THE HISTORY OF BIBLICAL COUNSELING

9Marks: Are there significant points of commonality between biblical counseling in the past, such as the Puritan approach, and proper biblical counseling today?

David Powlison: The church forgets things. The church rediscovers things. But when it rediscovers something, it’s different because it’s always in a different socio-cultural-historical moment, and different forces are at work.

Caring for the soul, which we try to do in biblical counseling, is not new. Two of the great pioneers in church history would be Augustine and Gregory the Great. Even secular people will credit Augustine’s Confessions as pioneering the idea that there is an inner life. Augustine did an unsurpassed job of tearing apart the various ways in which people’s desires become disordered.

Gregory wrote the earliest textbook on pastoral care. He pioneered diverse ways of dealing with a fearful person, a brash and impulsive person, an angry person, an overly passive person. He broke out these different struggles and sought to apply explicitly biblical, Christ-centered medicine—full of Christ, full of grace, full of gospel, and full of the hard call of God’s Word to the challenges of life.

The Puritans represent a second era of great riches in the area of pastoral care, and the question is often asked about CCEF’s relationship to the Puritans. People are more familiar with them because we still read them. You think about people like Richard Baxter, whose Christian Directory offers a treatise on everything from melancholy to domestic violence to addictions. Now, the Puritans use a different language set. There are certain ways that their studies are not as nuanced and sophisticated as ours, but there is a tremendous correlation of current wisdom for pastoral care in the cure of souls.

I would say that we have commonalities and discontinuities with the Puritans. In terms of commonalities, we share a way to understand people and their problems as well as a way to address their problems candidly and thoroughly in a God-centered manner. The living God sees our problem, weighs it, and has something to say about it. That commonality is what makes us Christians.

Discontinuities, I think, come in large part because of cultural context. What’s interesting about the current rediscovery of biblical counseling is that it’s the first time the church has had to grapple with doing counseling when there’s a very powerful competitor in the wider culture. Historically, no one did counseling except the church. People were too busy making crops grow and making babies and making war. But the modern world does have time to do it.

The modern psychologies present a tremendously stimulating, informative, and threatening challenge. These psychologies are stimulating because they push us to ask questions that we may not have already considered. They’re informational because they are very observant. They’re threatening because they are a self-conscious alternative to the church and would love to take over the care of souls. They’re willing to do our job for us, letting us be a religious club that does good works while they deal with the deep stuff and the long stuff.

That being said, the church is the place where we should think about what makes people tick and how the human heart can be renewed.

Maybe a brief way to illustrate it would be to point to Jonathan Edwards’ A Treatise Concerning Religious Affections. It’s a master work of empirical, thoughtful study on how people respond to God and how their emotions, affections, loves, and experiences can be distorted or greatly ordered. If you look at the courses CCEF has produced in the last couple of decades, you could say that we have been working in this direction. But we have to engage the problems in case studies in a much more fine-grained way. I think that is because of the provocative stimulus that living in a psychologized culture offers to us.

The psychologies are the great challenge to us. And the church can respond to these challenges either by syncretism—a kind of reverse conversion where we let the psychologies call the shots—or by doing something better than the culture. It’s that “doing it better” that’s actually our mission.

LOOKING AT COUNSELING IN CHURCHES TODAY

9M: What most discourages you about the way churches are approaching the field of counseling and discipleship?

DP: Counseling is about what? The cure of souls. How can we understand people and their life circumstances? We do so through the eyes of God as revealed in Scripture. We need to redefine the word “counseling” from the start, because when churches think about counseling these days, their first impulse is not the right impulse. They either mimic what the world does inside itself or they refer people out to the world.

The word “discipleship” is essentially a synonym for counseling. Maybe we could nuance it and say that counseling biblically is a more problem-centered form of discipleship. But that is just playing with words because discipleship means helping people change into the image of Jesus Christ. And that’s what counseling is. That’s what transformation is. That’s what sanctification is.

In our evangelical culture, the word discipleship tends to mean some kind of structured program—learning how to have a quiet time, learning what your gifts are, learning certain facts about the church. All of those are great and certainly a part of discipleship. But the essence of discipleship is that the disciple is becoming like the master, and the master is someone who trusts God and loves people. If we are people who trust ourselves and use people, there is a gap. Discipleship is actually meant to bridge that gap so that people who trust themselves learn to trust God, and people who use other people learn to love other people.

This personal ministry—or inter-personal ministry—isn’t just from the pulpit or even small group. It’s climbing into one another’s lives. Part of CCEF’s mission is to convince local churches of these things and then to help churches take hold of a counseling and discipleship that is really worthy of the name.

LOOKING AT CCEF

9M: Speaking of CCEF, what is CCEF trying to do that’s unique?

DP: For starters, we’ve got one of the world’s best mission statements: Restoring Christ to Counseling and Counseling to the Church. Let’s think about that first part—restoring Christ to counseling. Christ is not in most of the counseling that’s in our world, because people do not understand the human dilemma. They don’t understand what suffering really means. They don’t understand the forces of enculturation. They don’t understand the nature of sin or the nature of our desires. And they don’t understand that Christ is the one who immediately, intrinsically, relevantly speaks to what people have been dealing with.

Every Bible-believing church on the planet would agree that we ought to preach Christ. But how many people have the idea that we need to counsel Christ? What does that mean? When you preach, you exposit the Scriptures and show how Christ applies. But when you counsel Christ, the process is typically going to be bottom up, not top down. You start by getting to know a person. You love the person. You get to know their world. They know you care. They have reasons to trust you. Once you’ve done this, you have a better idea of how to make the gospel of the one true living God immediately relevant to their lives.

The second part of our mission is restoring counseling to the church. The church ought to be a place where we “go deep” and “hang in long” in one another’s lives. “Deep” and “long” don’t tend to be qualities that are found in the church of Christ. Hence, people are willing to pay money to others who will never lead them to the Savior of the World. But that must change.

CCEF is also unique even within the wider biblical counseling movement in two more ways. One is what I call “R&D”—a research and development purpose. We don’t believe that saying “biblical counseling” means that we have figured it all out. We are a work in progress. We have a core commitment to push, to develop, to build, to tackle a new problem.

Second is an evangelistic purpose. We try to think through how to reach those who disagree with us. How can we reach both the Christian community and a non-Christian community with the relevant counseling oriented message that is christocentric?

CCEF has five full-time faculty members who share a wonderful synergy, in part because you have people who all have a dual expertise—a primary commitment to Bible and theology, coupled with some other expertise. Our director, Dr. Tim Lane, was a pastor for years. He brings a sensitivity to how counseling ministry links to the other aspects of church life.

Dr. Mike Emlet is an M.D. who had a family practice for years. He’s the scientist who brings an awareness of mind-body issues like psychiatric diagnosis and medications.

Dr. Ed Welch has a PhD in neuro-psychology and a burning interest in the nuances of actual counseling moments and how counseling actually happens.

Winston Smith stays very current with the psycho therapeutic world. He has given his life to issues of marriage and family and group dynamics.

My graduate work (besides Bible and theology) was in the history of psychiatry, history of science, and history of medicine.

I am only just speaking of the faculty and not speaking of various members of the much wider counseling staff who have various interests. It’s a very rich environment with a common commitment to biblical counseling.

LOOKING AT POWLISON’S OWN WORK

9M: Can you give us a quick introduction to your two booksSpeaking Truth in Love and Seeing with New Eyes?

DP: The books I’ve written are labors of love. They are very personal.

You will notice that in the title of Speaking Truth in Love there is no “the” in the title. That’s very intentional because biblical truth is not just the truth with a capital “t.” The Bible also gives us what is true with a lower case “t”—truth about what is happening in our lives. The living God gives us truth that is once for all, unchangeable, incarnate, and written, and that is always true and real and candid and direct. Speaking Truth in Love is both. In counseling it’s both. If you’re speaking to someone who is depressed, and you want to speak truth in love, you don’t just proclaim the glories of God. You talk about the experience of depression. You talk about what he or she is going through. You talk about what may be motivational factors. You talk about the one who is the truth and the God who is true in his Word. So counseling is about bringing “big T Truth” and “little t truth” together into conversational, counseling ministry, implying a give and take. You want to deal with the life that’s on the table.

So the book asks how such a counseling ministry or conversational ministry can proceed. The first half of the book is a series of case studies on counseling methodology. The second presents a series of case studies or perspectives on how the church can organize and think about a counseling ministry.

The burden of my other book, Seeing with New Eyes, is that God has a point of view on human life. I mean, it sounds like the most obvious thing in the world once you say that, but the counseling world has been almost blind to the fact that God has a point of view on counseling issues. It presents an endeavor that is obviously from outside the church. Even counseling inside, the church is often unhinged from God’s point of view. But God has a point of view. He made the world. He judges it. He evaluates it. He redeems it. He invades it. He challenges it. He destroys it. He has a point of view on whatever happens in human life.

Not only that, God has revealed his point of view. He has told us how he sees things. On the one hand, the heart is deceitful and opaque. On the other hand, he has told us how to evaluate it. You can illustrate this point by considering the most profound psycho dynamic theories—the Freuds, the Jungs, the Adlers, and so forth. At some level, they are exactly right in their descriptions. They can observe the sorts of forces at play in the human heart— the “power drives” or “spirituality instincts” or “sexuality instincts” at play. At the same time, they don’t know how to make sense of these forces. Their theories never get to the most profound depth of the human heart because they never see the religious dynamic taking place beneath all these forces and instincts.

What other ways have we departed from God? How do you find your way back? How has capitalism / profit impacted the way we see healing and health?

Share your comments with the community by posting them below. Share the wealth of health with your friends and family by sharing this article with 3 people today. As always you are the best part of what we do. Keep sharing!

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HHS: More than 2M patients affected by breaches reported in October

The data comes amidst new reports that cybercriminals are using industry-standard encryption methods to enact attacks that bypass detection.
By Kat Jercich
November 16, 2020 09:58 AM
Source: Healthcare IT News

A person stands with a laptop in a room with technology
Source: Healthcare IT News
Shidonna Raven Garden and Cook

The U.S. Department of Health and Human Services released a snapshot this past week detailing breaches reported to the Office of Civil Rights in October.

In total, more than 2 million individuals had their records exposed by the 58 reported breaches, though it is possible that the same patients were affected by multiple incidents.  

It’s worth noting that the Secretary must, by law, post breaches of unsecured protected health information affecting 500 or more individuals – meaning breaches affecting fewer than that were not listed.   

WHY IT MATTERS  

According to HHS, slightly more than a third of the breaches reported in October took place over email, and about 40% took place over a network server.  

Three of the breaches occurred within an electronic medical record – including an incident at the Mayo Clinic involving a now-fired employee inappropriately accessing reportedly sensitive photographs.   

Although the breaches were all reported in October, they did not all take place last month. The largest breach – affecting more than 800,000 patients of Luxottica of America Inc., which operates vision care facilities – appears to have occurred in August, according to suits filed against the company.

More details about each breach were not included in the HHS list. However, a 2020 State of Encrypted Attacks report published by the Zscaler ThreatLabZ research team this past week found that cybercriminals are using industry-standard encryption methods, paired with malware, to enact attacks that bypass detection.

“Cybercriminals have created sophisticated attack chains that start with an innocent-looking phishing email containing an exploit or hidden malware. If an unsuspecting user clicks, then the attack moves into the malware installation phase, and ultimately to the exfiltration of valuable corporate data,” wrote report authors.  

The team found a whopping 260% increase in SSL-based threats in the last nine months, with 1.6 billion identified and blocked threats specifically targeting the healthcare industry.

More than 30% of SSL-based attacks hide in collaboration services such as Google Drive of Dropbox. And ransomware is on the rise: the Zscaler team reports a 500% increase in ransomware attacks over encrypted channels since March 2020.  

“A notable change in many of these ransomware family variants during the past year has been the addition of a data exfiltration feature. This new feature allows ransomware gangs to exfiltrate sensitive data from victims before encrypting the data. This exfiltrated data is like an insurance policy for attackers: even if the victim organization has good backups, they’ll pay the ransom to avoid having their data exposed,” wrote the report authors.

THE LARGER TREND  

Cybercrime has taken on a renewed danger in the COVID-19 era, with already-strained hospital employees vulnerable to making mistakes such as clicking on phishing links in emails. 

Meanwhile, HHS, along with the Federal Bureau of Investigations and the Cybersecurity Infrastructure and Security Agency, issued a bulletin late last month warning of “increased and imminent” cyber threats to hospitals.

“Ransomware attacks on our healthcare system may be the most dangerous cybersecurity threat we’ve ever seen in the United States,” said Charles Carmakal, chief technology officer of cybersecurity firm Mandiant, in a press statement.

ON THE RECORD  

“The consequences [of a cyberattack] can be grave. If an attack happens in the middle of a surgery, whatever machines are being used could go down, forcing medical staff to fall back on manual methods,” said Juta Gurinaviciute, chief technology officer at NordVPN Teams, in a statement.

“MRI machines, ventilators, and some types of microscopes are computers too. Just like our laptops, those computers come with software that the developers have to support,” said Gurinaviciute. “When the machines become old and outdated, the people who made them might stop supporting them. That means that old software can become vulnerable to attacks.”

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.

What are your thoughts on this article? How has it changed the way you manage your healthcare records? Why? Why not?

Share your comments with the community by posting them below. Share the wealth of health with your friends and family by sharing this article with 3 people today. As always you are the best part of what we do. Keep sharing!

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McKinsey to pay $573 million to settle claims over opioid crisis role: source

FEBRUARY 3, 20218:33 PM
By Nate Raymond
Source: Reuters

(Reuters) – Consulting firm McKinsey & Co has agreed to pay at least $573 million to resolve claims by 40-plus U.S. states related to its role in the opioid epidemic and advice it gave to OxyContin maker Purdue Pharma, according to a person familiar with the matter.Slideshow ( 2 images )

The settlement is with 43 states, the District of Columbia and three territories, the person said on Wednesday. Several attorneys general said they planned announcements on the opioid epidemic on Thursday.

They included Vermont’s attorney general, T.J. Donovan, whose office said it would announce its participation in the first multi-state opioid settlement “to result in substantial payment to the states to address the epidemic.”

Washington Attorney General Bob Ferguson said he had reached a separate, $13 million settlement with McKinsey that was on top of the reported multi-state agreement.

McKinsey did not respond to requests for comment.

McKinsey previously came under scrutiny for its role advising Purdue Pharma and the wealth Sackler family that owns the drugmaker.

A lawsuit by Massachusetts Attorney General Maura Healey alleged McKinsey advised the Sacklers on how to “turbocharge” opioid sales.

Purdue filed for bankruptcy in 2019 as part of a proposed settlement it valued at $10 billion to resolve lawsuits alleging its painkiller marketing helped fuel the epidemic.

More than 3,200 lawsuits are pending, seeking to hold drug makers, distributors and pharmacies responsible for an opioid addiction epidemic that according to U.S. government data resulted in 450,000 overdose deaths from 1999 to 2018.

The lawsuits accuse drugmakers of deceptively marketing opioids and distributors of ignoring red flags indicating the prescription painkillers were being diverted for improper uses. They deny wrongdoing.

The states and local governments have been also in negotiations for settlements with drug distributors Cardinal Health Inc, McKesson Corp and Amerisourcebergen Corp and drugmaker Johnson & Johnson.

Reporting by Nate Raymond, Rama Venkat and Eric Beech; Editing by Leslie Adler and Raju Gopalakrishnan

Indeed we have heard many stories of patients being mis-prescribed and over-prescribed leading to poor health outcomes and in this case a crisis of addiction and the surrounding poor health outcomes that ensue often because of health care fraud. Do you know someone struggling with an addition? How did they become addicted? What are your perceptions and why? Would you recognize health care fraud if you saw it?

Share your comments with the community by posting them below. Share the wealth of health with your friends and family by sharing this article with 3 people today. As always you are the best part of what we do. Keep sharing!

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