The healing cycle: a Christian model for group therapy.

Hook, Jan Paul ; Hook, Joshua N.

Group therapy has long been used as a modality of treatment for a wide range of psychological problems and research has accumulated that supports its efficacy and effectiveness (Yalom, 1985). There is some evidence that incorporating religion and spirituality (R/S) into therapy may affect the outcome of therapy for religious clients (Hook et al., 2010; Shafranske, 1996; Wade, Worthington, & Vogul, 2007; Worthington, Kurusu, McCullough, & Sandage, 1996). It has been argued that adapting therapy to the personal characteristics of clients such as religious affiliation may be helpful (Worthington & Sandage, 2002).

There have been relatively few attempts to integrate R/S into group therapy (Cornish & Wade, in press). Most of these efforts have taken a secular version of group therapy for a specific problem, and have incorporated R/S into the secular therapy (e.g., Christian group therapy for unforgiveness, Rye & Pargament, 2002; Christian group cognitive-behavioral therapy for marital issues, Combs, Bufford, Campbell, & Halter, 2000; spiritual group therapy for eating disorders, Richards, Berrett, Hardman, & Eggett, 2006).

The Healing Cycle is a model for group therapy that is designed for use in interpersonal process therapy groups. The Healing Cycle is different from 12-step groups such as Alcoholics Anonymous (AA, 2001), which is a group context for intrapersonal healing that does not encourage explicit interpersonal interaction (i.e., no cross-talk). This explicit interpersonal interaction is a core mechanism of change in the Healing Cycle model. This model has been utilized in therapy groups with clients who have serious psychological problems, as well as in process groups run by lay leaders in church ministries. The model is general in that it does not target one specific psychological disorder. Rather, it is a process that describes how people can heal from a variety of emotional problems.

The Healing Cycle is distinctly integrative. It is compatible with a Christian worldview, and integrates Scripture at each step of the process. It also incorporates psychological principles from a variety of theoretical orientations, most notably cognitive, behavioral, and interpersonal theories. The overall style and process of the group is interpersonal, and draws heavily on Yalom's (1985) theory and research on group psychotherapy. The Healing Cycle is circular and consists of six steps (see Figure 1): grace, safety, vulnerability, truth, ownership, and confession. The final step facilitates further experiences of grace, and the cycle continues. For each step discussed below, we present skills that the group leader can use to help group members successfully navigate each step. The skills are developmental in that they build upon each other. We illustrate each step of the Healing Cycle with a case example. All identifying information has been changed to ensure confidentiality.

Grace

The first step of the Healing Cycle is the experience of grace. Grace is foundational to the experience of Christian spirituality. The Christian doctrine of grace teaches that God forgives humans of their sin and offers unmerited kindness and love to those who acknowledge their need for God (McMinn, Ruiz, Marx, Wright, & Gilbert, 2006). The Bible teaches that God gives us grace no matter where we are in the process of healing. We are first saved by grace (Ephesians 5:8). It is through grace that God heals us from brokenness and enables us to stand in relationship with Him (Psalms 40:2, Romans 5:2). An important aspect of our spiritual growth is learning to live in grace (2 Peter 3:18).

[FIGURE 1 OMITTED]

Group members often present to a therapeutic group experiencing very little grace. In fact, group members are generally experiencing a high amount of shame and guilt that accompanies their emotional pain. Leaders of a beginning group often face a troubling problem. Group members do not present to the group with an understanding and experience of grace, thus it is difficult for them to share their thoughts, feelings, and experiences in a group setting, and they remain stuck. Something is needed to jumpstart the healing process.

Group leaders can explain the concept of grace to group members, but often such explanations have limited utility, especially for group members who are hurting. It is more important for group leaders to offer grace to group members through their interactions. An attitude of grace can be difficult to convey, and we believe it has more to do with an underlying heart attitude and personal understanding of grace rather than a formula of words to say. Thus, it is important for group leaders to understand their own experiences of brokenness and grace, so that leaders are able to extend that same grace to members of the group. Indeed, the apostle Paul wrote that God comforts us in our troubles so that we can comfort those in trouble with the comfort we have received from God (2 Corinthians 1:3-5). If group leaders do not have a good understanding of how they are broken, and how they have experienced grace through God and through others, it will be difficult for them to offer an experience of grace to group members.

Group leaders should work to develop the skills of understanding their own experiences of brokenness, grace, and healing. Group leaders can spend time journaling and reflecting upon these experiences. For example, as you reflect on your life, what were some of your most significant experiences of hurt and brokenness? What was your reaction to these experiences? In what ways have you experienced grace from God in the midst of your brokenness? In what ways have you experienced grace from others? What were some barriers you faced in experiencing grace? How did you work through these barriers? What unfinished work do you still have to do to fully experience grace in these areas of your life?

As group leaders work to understand their own experiences of brokenness and grace, they are better able to offer an experience of grace with group members through their interactions. Group leaders can communicate kindness and caring through their words and gestures. Group leaders can accept group members as people who are hurting and in the process of healing, and give them space and time to work on their issues. Group leaders can communicate forgiveness and acceptance when group members struggle or fail to meet their goals. Group leaders can even share parts of their stories of brokenness to convey to group members that we are all working together toward healing.

Case example. As I (JPH) reflect on my deepest area of brokenness, I think about my family of origin. I grew up in a Christian missionary family. My basic needs were met. However, there were times that I wondered if my parents were more committed to the mission field than they were to me. My dad traveled a lot and was not home much. When I was six years old, I began to attend boarding school. I was in and out of boarding schools throughout high school. In fact, after my freshman year of high school, I did not see my parents again until after I graduated. I developed the belief that I had to do life on my own. I struggled to make intimate connections with others. I got to the point where I was not sure I even wanted to develop intimate connections with others, because that would mean I would have to rely on them and then maybe get abandoned.

When I was placed in painful situations, my tendency was to isolate and not reach out to others. I remember one of the most painful experiences in my life occurred when my son was born. My wife and I had been eagerly anticipating his birth. However, when he was born he had some birth problems. I remember feeling scared, out of control, and alone. My tendency to isolate rather than reach out for help from others caused further pain. I was alone in my pain.

As I gained insight into my patterns of responding to hurts, I was better able to realize the barriers that kept me from experiencing healing grace. I recognized that my belief that I had to do life alone set me up to not want to trust other people (or even God), because I was afraid that I might be abandoned. Even when I was hurting, I refused to reach out to others. But at some point, I began to realize that this way of living did not work. Isolating myself did not help me work through my problems. It just made me feel more upset and alone in my pain.

Insight was helpful, but even more important was my experience of grace. For example, my brother visited me when I was in the hospital with my son. I also had a colleague who had a child that also had birth difficulties. They listened to me and comforted me in my time of pain. Through others I began experiencing the healing effects of grace. Through these experiences I began to challenge the messages that I needed to do life on my own. I began to believe that I could be in relationship and that these relationships could be healing.

From my experiences of brokenness and grace I began to be more effective in extending grace to others. For example, it is very common for group members who are hurting to be hesitant to share their brokenness, and to isolate and mistrust others in the group. In my group work with men who struggle with sexual addiction, it is very common for group members to think that their experience of sexual brokenness is worse than others. As a result of their shame and fear of being judged and rejected because no one is as "bad" as them, they hesitate to share. From my own experiences of brokenness and shame, I connect with their struggle. I may choose to disclose some of my own difficulties with sharing, and I might speak about how taking the risk to face my fear has opened the door for healing. By extending grace through sharing some of my story, men feel encouraged to share their own stories. Then I follow their stories by continuing to extend grace. I affirm their courage to share and accept their experience without judgment. I am able to extend grace congruently because of my own experience of grace.

Safety

As group members begin to experience grace in the context of the group, they will begin to feel safe in both their relationship with the group leader and with other group members. It is difficult for group members to share their feelings in a setting in which they feel afraid. It is important that group leaders take proactive steps to help group members feel safe. The apostle John wrote that there is no fear in love, but that perfect love drives out fear (1 John 4:18). As group leaders extend grace or the perfect love that John writes about, group members will feel less afraid and experience safety.

One important way to ensure safety for group members is to develop skills in creating and maintaining boundaries. Strong boundaries create structure in which group members can feel safe to share their pain. We recommend that leaders structure their groups with the following boundaries: confidentiality, no judgments or criticism, no advice giving, do your own work, it is okay to pass, do not dominate, and have consistent attendance.

The boundary of confidentiality states that the group leaders and members will not share the identities or work of other group members outside of the group. The boundary of no judgments or criticism states that it is not okay to judge or criticize others during the group (Matthew 7:1). The boundary of no advice giving states that it is not okay for group members to make recommendations for other group members. Although generally well-intentioned, advice giving is usually not helpful, and also creates a dynamic in which one group member is superior to another. The boundary of do your own work states that group members should focus on sharing and discussing their own hurts and issues, rather than focus on judging the issues of others. Matthew 7:1, 3-5 is an important passage supporting the boundaries of not judging or advice giving, but rather doing one's own work. Jesus said, "Do not judge, or you too will be judged...Why do you look at the speck of sawdust in someone else's eye and pay no attention to the plank in your own eye? How can you say, 'Let me take the speck out of your eye,' when all the time there is a plank in your own eye? You hypocrite, first take the plank out of your own eye, and then you will see clearly to remove the speck from the other person's eye" (Today's New International Version). The boundary of passing states that if group members are not ready to share about an issue, it is okay for them to pass and wait until they are ready. The boundary of not dominating states that it is not okay for one person to take over the entire group; each person should have time to share. The boundary of consistent attendance states that group members should come to every session on time, and inform the group leaders in advance when they need to miss a session.

Boundaries should be explained to the group at the beginning of the first session. Each member should agree to keep each of the boundaries. The group leaders could print out a sheet that lists each boundary, and have each group member sign the paper. If the group is an open group, new members should be informed of the group boundaries and agree to them before they join the group.

In addition to explaining the group boundaries and eliciting agreement, group leaders must learn blocking skills to reinforce group boundaries when violations occur. Group leaders should block or stop boundary violations when they occur in a kind yet firm manner. Allowing boundary violations to occur without blocking them will destroy the safety in the group. When boundary violations occur, we recommend a three-step process: interrupt, reinforce boundaries, and redirect. When boundary violations occur, it is essential for group leaders to interrupt the process. It is often difficult for group leaders to interrupt group members. Leaders may worry that interrupting a group member may cause conflict in the group or stop the process. After interrupting the group member, group leaders must reinforce the boundaries by clearly stating the boundary and reminding the group that the purpose of the boundaries is to create safety for group members. After reinforcing the boundaries, it is helpful for group leaders to bring the person making the boundary violation back into the group and redirect group members to do their own work. When redirecting it is often helpful to invite group members to talk about what they are experiencing and why they broke the particular boundary.

Case example. I (JNH) was leading a co-ed therapy group for general psychological problems. During one session, Michael informed Elizabeth, who had been struggling with depression and social isolation, that he had talked with his roommate about her problems and that his roommate would like to meet her if she was interested. At that point, I spoke up, interrupted the group process and reminded Michael (as well as the rest of the group) that one of the boundaries we had agreed to was confidentiality, that we would not discuss the issues of other group members outside of the group. Michael responded that he had not revealed her name. Misunderstandings about boundaries are common and need to be clarified by the group leaders. I responded by saying that not revealing the identities of group members was an important part of the boundary of confidentiality, but that the boundary also applied to discussing the issues of other group members. Michael was responsive to this challenge, and he responded by apologizing to Elizabeth and renewing his commitment to the boundaries. After working through the boundary issue, I redirected Michael by asking what he was feeling toward Elizabeth that had prompted the conversation with his roommate.

Vulnerability

As group members begin to experience grace and feel safe in the group setting, the hope is that they will become increasingly vulnerable in sharing their experiences, thoughts, and feelings. As group members share in greater depth, they are able to explore their problems and receive validation and feedback from the group leaders and other group members.

There are several skills that group leaders can develop to increase vulnerability in the groups they lead, including self-disclosure, listening, validation, and linking skills. Self-disclosure by therapists has been a controversial issue (Hanson, 2005). Concerns about self-disclosure include taking the focus away from the group member, being too directive, and using the group member to work through one's own issues. We tend to agree with Wright (2000), however, that using oneself in group therapy (including vulnerable self-disclosure) can be powerful. We have often noted increased sharing has occurred following a vulnerable self-disclosure by a group leader. However, self-disclosure must be purposeful. One guideline is that leader self-disclosure must be done for the benefit of the group. Possible benefits include modeling how to share in a vulnerable way, or how to give feedback to a group member's experience or feelings. Leader self-disclosure that is not done for the benefit of the group (e.g., working through a personal issue) is best reserved for discussion with a colleague or one's own therapy.

Listening skills help to increase vulnerability in group members because group members will often increase sharing when they feel that they have been truly heard and understood. The group leader must possess and model strong listening skills, and also teach group members to listen to each other. There are several aspects to developing good listening skills, including being attentive to the group member who is sharing, paraphrasing content, clarifying content, and summarizing content (Egan, 1994).

Validation skills build on listening skills by helping to draw out affect and emotional sharing. When group members share an experience, thought, or feeling, group leaders should explicitly validate the sharing. For example, the group leader could respond to a group member's sharing by thanking the group member and acknowledging that it took a lot of courage to share. The group leader can also use empathy to address the feelings that were shared. We believe that it is especially important for group members to access their feelings if they are to do deep work. A helpful acronym to identify feelings is SASHET (Morris & Morris, 1985; sad, angry, scared, happy, excited, tender).

Linking skills increase vulnerability by helping group members see that they are not alone in their emotional pain. Linking is very powerful and provides connections between group members. Linking helps to create a sense of universality, which is one of the factors that Yalom (1985) found was most critical in helping people change in groups. Linking allows group members to help "carry each other's burdens" (Galatians 6:2). Group leaders can create links by asking direct questions to the group after someone has shared. For example, after a group member shares a story, the group leader might ask the group questions such as "Does anyone else experience the same thing?" or "Who else can connect with--?" Group members often direct their stories either to the group leader or the group as a whole. The group leader can redirect group members to direct their sharing to a particular group member. This helps the group process to be more interpersonal in nature. Group members can also express why they are picking a particular group member to share with. In this way, group leaders establish a structure that encourages the linking process.

Case example. I (JPH) was co-leading a sexual addiction group for men. After Sam shared his story about how he had acted out sexually the previous week, I asked the group, "Can any of you relate to Sam?" When Joe said yes, I invited Joe to share his connection with Sam. Joe said that although he did not act out last week, he has a similar experience when he does act out. In this way Sam felt connected to Joe and less alone in his self-disclosure. He then became even more vulnerable and was able to share more about his story, including his feelings of fear and anger towards himself about acting out. I validated his feelings and commented about the courage he had to jump in and share. Other group members added their feedback, linking their experiences with Sam.

Truth

As group members vulnerably share their experiences, thoughts, and feelings in a context of grace and safety, they will begin to discover truth about themselves or their situations. In addition, they are also likely to be able to hear truth from both the group leaders and other group members. Jesus taught that his followers would know the truth, and that the truth would set them free (John 8:32). In most therapeutic groups, group members want more than a place to share their experiences, thoughts, and feelings. Group members often have issues they are working through and problems they would like to resolve. They are looking for feedback from others. Accurate and helpful feedback is an important aspect of helping people heal from emotional problems. However, speaking the truth is not enough. Paul taught that we should speak the truth to one another in love (Ephesians 4:15). Group members will likely have heard truth spoken to them from family members, friends, or pastors. However, rarely will they have experienced truth spoken to them with an attitude of love. Truth spoken too soon without love detracts from the safety of the group, leads to increased hurt, and inhibits the healing process.

Group leaders must develop skills to share truth with an attitude of love, as well as coach other group members to do so. There are two types of truths that are often shared in group: content truths and personal truths. Content truths involve observations about a group member's thoughts, feelings, or behaviors. For example, after a depressed group member shares, a group leader might note the connections between the group member's pessimistic thoughts and feelings of sadness, or the congruence or incongruence of the group member's body language with their verbalization of sadness. Personal truths involve group leaders or members sharing how another group member's story has affected them. Listening to other group members may bring up a specific thought or feeling, or it may trigger a personal story or issue.

The manner in which truth is shared is important. Sharing truth in an unloving way can damage safety in the group. Group leaders must remember several of the boundaries that are in place to ensure safety, including no judging, criticism, or advice giving. When sharing truth, it is important to ask group members if they would like feedback. Sometimes group members are not ready or willing to hear feedback about a particular issue. In this case, it is better to wait until group members are ready. When sharing truth, it is important to communicate kindness and concern for the group member, and stay connected with the group member. Truths must be communicated tentatively, and it is important to check in with group members to see if they agree with the truth.

Case example. As I (JPH) work with men who struggle with sexual addiction, a common experience I have observed is that men have difficulty sharing their feelings. Feelings of sadness, fear, or tenderness may not have been validated growing up. When a man shares one of those feelings, his words are not always congruent with the way he speaks. For example, a group member might share that he is sad or angry, but do so with a smile on his face. I speak the content truth by saying, "I hear you saying you were sad when that happened, but as you said it, you were smiling. Can you say what that smile is about?" The group member might respond by saying that he feels uncomfortable or vulnerable because he has never really shared his sadness before. He does not know how to share sadness or how that feeling will be received. I will encourage him to share the feeling again, this time without the smile. If the group is safe, the group member will probably try again. As he works on sharing his sadness he will become more congruent and clear in his communication. He will also experience the freedom of speaking his truth in the context of love. The result is often further insight and emotional growth.

Ownership

Ownership occurs when group members take responsibility for their truth and acknowledge their contribution to the cause or maintenance of their problems. After King David sinned with Bathsheba and was rebuked by the prophet Nathan, David's response was to take ownership of this truth (2 Samuel 12:13a, Psalms 32:5a). Group members must be able to take ownership of their own problems. When group members take responsibility for their part in their hurts and problems, they are able to make changes. Group members cannot change what they do not own.

Taking ownership of their truth is often difficult for group members because it is scary. It is much easier for group members to make excuses or blame others for their problems. There are several skills group leaders can develop to encourage group members to take ownership of their problems. Some of the skills previously discussed also apply to ownership. For example, group leaders can model ownership of their own problems through self-disclosure. Also, when group members do take ownership for a problem, this brave step must be heard, validated and encouraged by the group leaders.

There are times when group members need extra help to own the truth about their problems. Three skills that are especially helpful to facilitate ownership in groups are (a) teaching group members to own the stories they make up, (b) laddering to access core stories, and (c) working with group members' projections. Group members will often make up stories about themselves or the causes of their problems. These stories are similar to core beliefs in cognitive therapy. These stories may not be accurate, and many stories involve blaming others rather than taking ownership or responsibility. Group leaders can help group members understand that the stories they make up may not reflect reality. This is such an important point that we encourage group members to use 'story language.' For example, a group member who is working through a marital problem might be coached to say, "My wife and I got in an argument about finances yesterday. The 'story' I am making up is that she doesn't think I am able to take care of our money."

Sometimes it is difficult for group members to understand and communicate the stories they are making up. Laddering, a technique adapted from consumer research (Reynolds & Gutman, 1988), can be an effective technique for accessing group members' stories about themselves. Laddering involves a series of questions that ask why a particular situation is important or a problem for the group member. For example, a group member is struggling to trust her husband because of a past affair. The group member gets very angry when her husband arrives home late from work. The group leader asks about her anger and how this is a problem for the group member. The group member responds with blame, believing that her husband is having another affair. A group leader using the laddering technique would continue the questioning process by asking how the husband having an affair would be a problem for the group member. This might elicit a deeper story from the group member, such as she does not think that the husband loves her. The group leader would ask again how that would be a problem. The group member might then take ownership of her story and say that she is afraid that she is not worthy to be loved. The core of a group member's story is often accompanied by an emotional response.

A third way to help group members own their truth is by working with group member projections. Often group members' stories are presented in group as projections on to other group members. Group members will blame others for the issues that they, themselves, are struggling with. Working with group members and their projections is an important way to help group members take ownership of their stories. Group member projections often cause conflict within the group. When group members make a judgment about another group member, the group leader must first stop the process using blocking skills. However, at this stage of the Healing Cycle, it is helpful to go further and invite group members to explore their judgments. Group leaders can encourage group members to explore which piece of the judgment is true for them. A common phrase we say is, "What you say may or may not be true about the other person that you are judging, but it is certainly true about you. What is it about for you?" Speaking truth and encouraging group members to take ownership of their problems are often especially challenging aspects of the Healing Cycle. In addition to developing the truth and ownership skills discussed, group leaders must remember to continue to use the previous skills of extending grace, creating safety, and encouraging vulnerability so that they can remain connected with group members even as group members are discussing difficult and challenging issues.

Case example. A group member in my (JPH) group accused another group member of being a "wimp" because he was afraid to confront a colleague about lying. The accusing group member received a defensive response. Immediately the group member that was challenged got angry and reacted. I stopped the conflict from continuing and invited the accusing group member to reflect on his judgment. "Are you willing to take a look at what you just said? What is that about for you?" I further added, "You called him a wimp for not confronting. Who are you afraid to confront? Where in your life are you a wimp?" The more energy there is behind the judgment, the more likely projection is occurring. The group member was initially reluctant, but he eventually acknowledged that he was afraid to confront his wife and was really angry at himself. Instead of owning his anger, it came out as a projection. When he owned his projection, he was able to address his own struggle and work on learning to challenge his wife. As he took ownership of his projection, the other group member that had originally been judged dropped his defensive posture and did some work around his fear of confronting his colleague.

Confession

After group members have taken ownership of their problems, confession is an important next step in the healing process. Confession is the process of verbally acknowledging one's ownership of their problem. For Christian group members, it is helpful to confess to God. The apostle John wrote that if we confess our sins, God is faithful to forgive our sins and purify us from unrighteousness (1 John 1:9). After David took ownership of his sin to Bathsheba, he immediately confessed his sin to God and was forgiven (Psalms 32:5b).

Although confession to God is important, it is equally important to confess to other people. Confession to other people is helpful because it makes both guilt and forgiveness concrete (Kettunen, 2002). In our work with men struggling with sexual addiction (Hook, Hook, & Hines, 2008), group members will often say that they have confessed their struggle to God; some have confessed to God hundreds of times. But rarely have they confessed their struggle to others. There is something powerful and real about making a confession to another human being. Indeed, the apostle James teaches that we should confess our sins to each other and pray for each other so that we may be healed (James 5:16, emphasis ours).

There are skills that group leaders can develop to encourage the process of confession in groups. Some of the skills previously discussed also apply to confession. For example, group leaders can model confession of their own problems through self-disclosure. When group members truly take ownership of their problems, confession naturally follows. Group leaders can encourage group members to pick a person in the group to be in relationship with as they confess. As group members confess, group leaders can encourage them to share the stories they have made up about themselves and others, as well as their feelings. Group leaders can encourage the receiver to accept the confession. Receivers can paraphrase the confession and share their own feelings. If the recipient was the person hurt by the confessor, forgiveness may be an appropriate response.

After a group member has gone through the confession process, group leaders might invite the group member to make a commitment to change. True confession often leads to a commitment to turn from the old behavior and live life differently. Group members can be encouraged to put off the "old self" and put on the "new self" (Ephesians 4:22-24). A group setting is an excellent place for a commitment to change to occur because fellow group members can help keep the person committing to change accountable for their change.

Case example. Continuing the above example, I (JPH) was able to invite the group member who made the judgment to confess his judgment to the other group member. The group member explained that his judgment was really about himself, and he apologized. The confession was received and reconciliation occurred between the two group members. This led to greater connection and intimacy. Commitments were made by both men to support each other in their individual work to face their fears of challenging others. This process of confession was healing for both parties and resulted in a further experience of grace.

Grace

After a group member works through the process of confession, the group leader can encourage other group members to respond to the confessor by sharing their feelings and responses. If group leaders have set the tone by creating an atmosphere of grace and safety, group members will often respond to the confessor with grace. Group members might feel tender toward the confessor. Perhaps the process of confession has triggered something for other group members, and other group members may begin to share. As group members experience grace from the group leader and other members in their time of vulnerability, healing occurs. This cycle continues: Grace creates an atmosphere of safety. Safety encourages vulnerability, which creates a context for truth. Truth that is owned by individuals and confessed leads to emotional healing.

Conclusion

The Healing Cycle is a Christian model designed to promote healing and growth from emotional problems in a small group therapy setting. The foundation of the Healing Cycle is the experience of grace. We believe this experience of grace is necessary for group members to begin working through emotional pain and make positive changes in their lives. This model fits nicely in a small group therapy context because group members are able to receive grace not only from God, but also from the group leaders and fellow group members.

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Jan Paul Hook

The Arlington Center

Joshua N. Hook

University of North Texas

Correspondence regarding this article should be addressed to Joshua N. Hook, Ph.D., University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX 76201; joshua.hook@unt.edu

Authors

Jan Paul Hook (Ed.D. Counselor Education, Northern Illinois University) is a licensed clinical professional counselor (LCPC) and approved supervisor (AAMFT). He works at the Arlington Center in Arlington Heights, IL. Jan also teaches Human Sexuality and Career Counseling at Trinity International University. His interests include sexual addiction, group therapy, couple therapy and men's issues.

Joshua N. Hook (Ph.D. Counseling Psychology, Virginia Commonwealth University) is an Assistant Professor of Counseling Psychology at the University of North Texas. His research interests include forgiveness, humility, religion/spirituality, couple therapy, and treatments for alcohol abuse/dependence and sexual addiction.