Book Review: Cognitive Behavioral Therapy for Christians with Depression

As a beginning therapist some years ago, I worked in a school environment seeing children, adolescents, and their families for behavioral and mood disorders. I could guarantee almost every week that I would be working with a student and his or her family who regarded Christianity as a firm belief system in their lives. Thankfully, Michelle Pearce, PhD, wrote Cognitive Behavioral Therapy for Christians with Depression: A Practical Tool-Based Primer because she recognizes the need for therapists, believing or non-believing, to have an understanding of how therapy with Christian clients differs from therapy with non-believing clients.

She does a great job summarizing the Christian faith for mental health professionals who struggle to understand the principles of the religion. She begins her book by explaining why it is essential to help Christian clients suffering from depression explore their faith while also learning about the CBT approach. She explains that the Christian form of CBT (Christian Cognitive Behavioral Therapy, CCBT) incorporates not only Christian principles, but also a foundation of scriptural passages to help Christian followers challenge their inaccurate thoughts and alter their negative thinking patterns. Christian clients would need a therapist who can not only implement therapeutic tools and encourage positive self-talk, but someone who can help them understand their feelings, thoughts, and behaviors from a faith-based Christian worldview.

For instance, Christian clients would need to feel comfortable speaking with a therapist about the Devil and what he believes Satan is doing in his life. For example, a client who suffers from night terrors or sleep paralysis accompanied by nightmares may believe that the sleep paralysis and nightmares are Satan’s way of tiring her, discouraging her, or attacking her. A therapist who is not insightful about this mindset and worldview may make the client feel misunderstood, scoffed at, or completely alone, so it is extremely important to have an understanding of how Christianity plays itself out in the lives of faith-believing clients.

Pearce also focuses on collaboration with clergy and pastors to help clients overcome their challenges. In Chapter 2, Pearce states, “Clergy can advise therapists on alternative ways of thinking and behaving that are in accordance with the theology of the client’s religious tradition. With the clergy’s input, our client might not feel the same need to defend her faith to her therapist, who she may already believe is biased against religion.”

Another important point that Pearce makes is that meditation and “renewing” the mind (changing negative thoughts using CBT) will be different for Christian clients than for non-believing clients. For example, renewing the mind by changing negative thoughts into positive thoughts will most likely not be powerful to Christian clients who are taught to renew their mind by using and memorizing scripture. Renewing of the mind for Christians will occur through religious practices such as attending sermons or inspirational seminars, praying, and meditating on scriptural passages. Non-believing therapists will need to understand the importance of these things in the lives of believing clients and their families.

In Chapter 5, Pearce focuses on implementation of Christian principles into the ABC model. For example, she uses a modified version of the ABC model (antecedents, behaviors, and consequences) coined by Albert Elis which identifies triggers, unhelpful behaviors, and the consequences of those behaviors. This chapter also focuses on cognitive distortions and theological concepts that can be used to challenge them. Overall, each chapter provides an easy-to-understand approach on implementing CBT-based tools.

Unfortunately, there are some concepts and scriptural passages discussed in the book that cause me to question if this book would be sufficient for non-believing therapists or therapists who may not fully understand the Christian faith and its biblical principles. For example, Pearce does a great job with integrating scripture and explaining it. However, it is possible that a non-believing therapist can become confused and perhaps even discouraged by the discussion of scripture and theological concepts. Theological concepts can be challenging for Christian believers much less non-believers, and Pearce’s book seems more applicable to therapists who understand scripture and Christian principles enough to share and discuss them with clients.

Fortunately, for those therapists who are familiar with Christian principles, Pearce’s book is a dream come true. It is amazing to have access to a book that not only implements faith-based principles, but also uses CBT tools modified for the Christian client.

Cognitive Behavioral Therapy for Christians with Depression: A Practical Tool-Based Primer
Templeton Press, September 2016
Paperback, 248 pages
$19.95