Including God in psychotherapy: strong vs. weak theism.

Slife, Brent D. ; Stevenson, Tiffani D. ; Wendt, Dennis C. 等

The authors first attempt to conceptualize theistic psychotherapy by discussing the relationship between theism and naturalism. Many psychologists have assumed that naturalism and theism can be combined in various ways, so the authors review the more prominent of these combinations at the outset. They argue not only that these mixtures are "weak" (i.e., they restrain God in some way) but also that they ultimately assume naturalism is incompatible in many ways with theism. The authors compare "weak" theism with a "strong" theism that does not restrain God or rely on naturalistic assumptions. This comparison is elaborated by distinguishing a published example of strongly theistic psychotherapy from three common types of weakly theistic psychotherapy, with corresponding examples from the theistic literature.

Recent efforts to introduce spiritual and religious elements into psychology have opened the door to theistic approaches to psychotherapy (Miller & Delaney 2005; Richards & Bergin, 2004, 2005). Many researchers and psychotherapists have attempted to incorporate theistic features into psychotherapy, including prayer, moral values, and scripture readings (Richards & Bergin, 2004). However, several scholars have argued that a strong notion of theism rarely penetrates very deeply into the theories and practices that are labeled theistic (cf. Griffin, 2000; Jones, 2006; Richards & Bergin, 2005; Slife & Melling, 2006; Slife & Reber, 2009). These scholars have made various arguments that the naturalistic worldview of traditional science has deflected thoroughly theistic conceptions, even among those who personally embrace religion and/or spirituality. If this contention is true, then it has important implications for the progress of theistic approaches in the discipline. Indeed, it begs the question: what is a thoroughly theistic approach to psychological conceptualization and intervention?

Beginning to address this question is the purpose of the article. We first attempt to conceptualize theistic psychotherapy by discussing the relationship of theism to naturalism. Many psychologists have assumed that naturalism and theism can be combined in various ways, so we describe the more prominent of these combinations at the outset. We argue not only that these mixtures are "weak" (i.e., they restrain God in some way) but also that they ultimately assume naturalism is incompatible with theism in many ways. We then compare "weak" theism with a "strong" theism that does not restrain God or rely on naturalistic assumptions. This comparison is elaborated by distinguishing a published example of strongly theistic psychotherapy from three common types of weakly theistic psychotherapy, with corresponding published examples.

THEISM AND THEISTIC PSYCHOTHERAPY

In order to clearly define theism, especially in a science such as psychology, we must first understand its relation to the fundamental worldview of traditional science--naturalism. As the historian of psychology Thomas Leahey (1991) put it, naturalism is "science's central dogma" (p. 379). It directs psychologists to appeal to and study only natural events and processes, not "supernatural" events and processes, to understand and explain psychological phenomena (Collins, 1977; Griffin, 2000; Gunton, 1993; Leahey, 1991; Richards & Bergin, 2005; Russell, 2002; Smith, 2001). As we will discuss, this dualism of natural and supernatural can itself be problematic, but the point here is that the naturalism at issue in this article, whether it is labeled metaphysical or methodological, (1) makes the pre-investigatory assumption that God is not necessarily needed to conceptualize, conduct, or explain scholarship and psychotherapy in psychological science.

The relation between this form of naturalism and theism is controversial, with many scholars contending the two worldviews are incompatible (e.g., Collins, 1977; Gunton, 1993; Leahey, 1991; Richards & Bergin, 2005; Smith, 2001) and many others treating these two worldviews as completely, if not primarily, compatible (e.g., Brown, Murphy, & Malony, 1998; Griffin, 2000; Russell, 2002; Wacome, 2003). Most agree that there are important differences. Naturalism typically assumes that the natural, physical processes of the world, such as natural laws and physical principles, operate autonomously and are currently sufficient to account for all relevant natural phenomena, including phenomena of interest to psychologists (Collins, 1977; Griffin, 2000; Leahey, 1991; Nelson, 2006; Reber, 2006; Richards & Bergin, 2005; Slife & Whoolery, 2006). Theism, on the other hand, traditionally supposes that these laws are not sufficient alone; theism, by definition, assumes that God is also important in understanding the world, perhaps even the psychological world. For this reason, these world-views have two different types of explanations. One assumes God is at least a necessary condition for psychological events, and the other denies this assumption--logical incompatibility, at least on this issue (Griffin, 2000; Hunter, 2007; Philipchalk, 1987; Plantinga, 2001; Richards & Bergin, 2005).

The main source of controversy is that many people, including many psychologists, have presumed that the two worldviews are compatible on most other assumptions. This presumption is understandable, considering that there are seemingly two great sets of truths in modern Western society--the truths of science, which typically assume naturalism, and the truths of religion, which often assume theism (Smith, 2001; Taylor, 2007). The notion that such truths are ultimately unified has led many to assume that the two world-views are compatible, even if this compatibility is rarely made explicit. It is not surprising, then, that many psychotherapy researchers and practitioners would likewise presuppose that theism and naturalism are essentially compatible. After all, many psychologists are professionally or personally committed to naturalistic science and believe in God, or at least have clients who do. Thus, psychologists have often assumed that it is possible to conceptualize psychotherapy approaches that are true to both the naturalism of traditional science and the theism of many religions.

For us to clarify the relation between naturalism and theism, we need to look at the main ways in which this compatibility has been conceptualized. Before doing so, we should note that the naturalism/theism issue is not a debate about different worlds-the natural and the supernatural. It is, rather, a debate about different worldviews or philosophies (Richards & Bergin, 2005; Slife, Mitchell, & Whoolery, 2004; Taylor, 2007). The former (worlds) typically concerns the existence or importance of spiritual factors or variables, which we do not discuss in this article, whereas the latter (worldviews) is about two intellectual frameworks with different sets of assumptions. A root issue, then, and a primary focus of this article is the question: are the two interpretive frameworks of naturalism and theism compatible and thus combinable for some integrated form of theistic psychology?

Attempted Compatibility

Two categories of conceptions are typically considered the primary candidates for compatibility: deism and dualism. Deism is the notion that God created the world, along with its natural laws, but that God is no longer involved in the world (except perhaps in extraordinary instances), allowing its natural laws to operate autonomously (Griffin, 2000; Taylor, 2007). This approach would seem to affirm the existence of God without compromising the demands of naturalism. Because God does not interfere in the world after its original creation, according to deism (Taylor, 2007), the autonomous operation of natural, physical laws is not disrupted and science can proceed without considering God's activity (Slife et al., 2004, p. 37).

The second common category for attempting to harmonize theism and naturalism is dualism. According to variations on this conception, the world is divided into two spheres, one that is spiritual or supernatural and the other that is natural. God would be involved in the spiritual sphere, but not the natural (Plantinga, 2001; Slife & Richards, 2001; Wacome, 2003). This way, the natural sphere is fully explainable through natural laws, while still allowing for a spiritual sphere in which God is important (Taylor, 2007). There are many variations on dualism, from Descartes' soul/body dualism to natural/supernatural distinctions to "god of the gaps" approaches (Hall, 2004; Plantinga, 2001). In all these dualistic variations, theistic explanations are useful for "mysterious" or "miraculous" events (in the soul or the supernatural) that cannot be explained by natural laws (Griffin, 2000).

These dualistic and deistic approaches demonstrate that it is certainly possible to talk about God in relation to naturalism. The question remains, however: how satisfactory are these attempts at integrating the fundamental assumptions of naturalistic and theistic worldviews? In addressing this question, we first need to consider whether important assumptions of these worldviews are being integrated at all. Although deistic and dualistic explanations certainly include theistic and naturalistic assumptions, it appears that the two world-views are semantically confined to unrelated corners of the world. For the deist, God and natural laws are never actively involved in the world at the same time; for the dualist, the two are never actively involved in the same place.

Incompatible Assumptions

This lack of integration may suggest that there is an important sense in which theism and naturalism are incompatible. If the two were compatible, then why would explanations that expressly attempt compatibility need to be compartmentalized into separate autonomous realms, with neither requiring the other for explanation? The answer to this question may lie in the assumptions that each of the two worldviews presumes. Although these worldviews are often viewed as having many common assumptions about the world (e.g., both assume that order or regularity exists in the world; D'Souza, 2007; Taylor, 2007), this type of commonality would not preclude the possibility that they differ on many other assumptions, such as whether God is currently and actively involved in the natural world.

What would these differing assumptions mean? Perhaps most importantly, there is always a relationship among worldview assumptions; otherwise, they could not coherently imply a "worldview." If, for example, a currently active God is a fairly superficial assumption, or an assumption that is already compatible with the other assumptions of a worldview, then it can be "added on" without disturbing the ongoing system of thought, and thus other assumptions, such as order. If, on the other hand, the assumption of a currently active God is central and pervasive, not superficial or an "add-on," then the inclusion of this assumption changes the nature of the other assumptions, sometimes radically. Although the labels of other assumptions may not change (e.g., label of "order"), their meanings could be qualitatively different, such as the difference between a law-governed and thus essentially mechanistic and determined order (naturalism), and a God-inspired and thus divine and obedient order (theism; Nelson, 2006).

It is this latter relation among assumptions--that God is not merely an add-on--that we believe prompts the compatibilist to restrict theistic and naturalistic worldviews to separate times and places in deism and dualism. In other words, the inherent incompatibility of the two worldviews means that the only approach to "integrating" them is to recognize their incompatibility and confine them to separate corners of the universe. We realize that this incompatibility may be surprising to some, considering that naturalism is often seen as a "relatively nonpartisan and objective philosophy" that is compatible with theism (Slife et al., 2004, p. 35). However, it is telling that wherever naturalism is--in nature or following its original creation-God's activity is considered unnecessary. With deism, God's activity was needed to create the natural laws, but once created, the operation of these laws does not require God's current activity. With dualism, God's current activity is limited to the spiritual realm, presumably being inactive or superfluous in the natural realm. In either case, naturalism is incompatible with theism, insofar as it assumes that God is not currently needed to explain the natural world (Griffin, 2000).

A naturalist might challenge this incompatibility by contending that God is not only the creator of natural laws (deism) but also the upholder of them. With this conception, God is continually involved, but involved in a lawful manner that is consonant with naturalism. Understanding this conception, of course, hinges on the meaning of terms such as "lawful." Many theists would also view God as involved in the regularities of the world. However, if lawful is meant in the conventional sense of naturalism (Slife, 2004), this conception is little more than another add-on approach to compatibility--adding God on to natural laws. As Griffin (2000) and other scholars have argued, the notion that God merely upholds natural laws does not allow God to be "active" in any meaningful theistic sense because merely upholding laws does not allow God to act otherwise than the laws. Because this ability to "act otherwise" is the basis of any freedom of action, God can enjoy no such freedom. Moreover, God cannot uniquely minister or modify divine actions in the light of changing circumstances, because naturalistic laws of nature are the same for everyone, regardless of their situations. The bottom line is that such add-ons never "integrate" or make compatible theism and naturalism.

It is not surprising, then, considering psychology's commitment to naturalism, that God is rarely mentioned in psychology textbooks (Miller & Delaney, 2005; Slife & Reber, 2009). These textbook authors may argue that the absence of God is a reflection of a neutral or unbiased methodological position on theism, that is, they are neither affirming nor denying God (see Slife & Nelson, 2006; Slife & Whoolery, 2006). However, Porpora (2006) has shown that this position is akin to a "methodological atheism," in which God is not required in the application or interpretation of psychological (naturalistic) methods (p. 57). Still, God is required for a theist; hence, the denial of this requirement is itself be a type of bias, and thus violates the supposed neutrality. The logical incompatibility of "required" and "not required" highlights, once again, an incompatibility of naturalism and theism. The result, considering psychotherapy's commitment to naturalism, is that God's current activity is either severely limited or irrelevant.

Weak versus Strong Theism

These understandings of God's activity (or inactivity) allow us to distinguish between two forms of theism in psychology--weak and strong. The adjectives "strong" and "weak" do not mean "good" and "bad"; rather, they are philosophical or conceptual distinctions that indicate the extent or degree to which some assumptions or ideas are applied to the particular conceptual system. The adjectives "hard" and "soft" are frequently used in a similar manner, as in hard or soft naturalism (e.g., Griffin, 2000; Habermas, 2008). Deistic and dualistic psychotherapy approaches can be described as "weak" forms of theism, in that God's active influence in the world is presumed to be relatively weak. Weakly theistic approaches limit God in some way in terms of time and space. These limitations are often a result of attempts to combine theism and naturalism.

A strongly theistic approach, by contrast, would not automatically place limitations on God's active influence in the world. Consider, for example, Plantinga's (2001) understanding of a strong theism: "God is already and always intimately acting in nature which depends from moment to moment ... upon divine activity" (p. 350). In this sense, a strong theism would not necessarily require that God be unlimited (e.g., self-limitations would be permitted), but the strong theist would require that God not be limited a priori in a particular way. God's activity would be seen as potentially unlimited at any given time and at any given place, including the here and now of a psychotherapy session.

From a strongly theistic perspective, a potentially unlimited God is an assumption made, not a variable to be measured. God's activities could perhaps be operationalized, just as the manifestations of unobservable natural laws and principles have been operationalized. However, recall that these conceptual frameworks are worldviews, not variables per se. Strong theism, in this sense, asks the question: What if psychotherapy were to begin with the assumption of a potentially unlimited and active God? This "beginning" would apply to the formulation of method as well as theory and practice (Slife & Reber, 2009). In other words, what if God truly mattered in the "here and now" of psychotherapeutic events, rather than merely in the "there and then" of the supernatural or creation of the world (dualism and deism)?

CONCEPTUALIZING STRONGLY THEISTIC PSYCHOTHERAPY

From this core starting point, a strongly theistic approach to psychotherapy would need to be explicitly conceptualized in the non-naturalistic assumption of an active God, rather than the naturalistic presumption that God's activity is not directly relevant. Again, the issue here is conceptualization of psychotherapy, not God's involvement in therapy. We readily grant that God could be involved in psychotherapy, regardless of whether the conceptualization included this divine influence. Moreover, the issue is not about whether strong theism makes for better (or worse) psychotherapy than weak theism. We are concerned, instead, about what a conceptualization of a strongly theistic psychotherapy would be like, if it is even possible.

One of the primary challenges of this conception is that a strongly theistic therapist would not accept the God assumption as a mere "add on" to naturalistic psychotherapy theories and practices that are (incorrectly) presumed to be theologically neutral. By denying deistic and dualistic conceptions, a strongly theistic approach cannot commit to the a priori assumption that there is a portion of the world that is independent of God's influence. This does not mean that a strongly theistic therapist would have to view God's activity as a sufficient cause or condition of all events; it could certainly hold that other psychological factors are also necessary, including, for example, a client's own will. God, in this sense, would have to be viewed as at least one of several necessary conditions--part of a larger whole, but as necessary as any other part to understand the whole and all the other parts or factors (Taylor, 2007). Indeed, the reluctance to speak of or affirm God's potentially necessary activity is itself a theological position that strong theism is not willing or able to take, especially since this assumption cannot be merely an add-on assumption.

Another issue that distinguishes weak and strong theism concerns peripheral aspects of theism, auxiliary characteristics that are often correlated with theism but do not require an active God to explain or understand. Peripheral aspects might include certain moral or ethical values such as altruism, compassion, and humility (VanderStoep, 2003; Sperry & Shafranske, 2005; Jones, 2006); philosophical assumptions such as free will, holism, and transcendence (Richards & Bergin, 2005, chap. 4; Vander-Stoep, 2003); or "spiritual" activities such as meditation, mindfulness, and forgiveness (Hardman, Berrett, & Richards, 2004; Krejci, 2004). Although these characteristics can be closely related to theism, conceptually and historically, they are not uniquely or inherently theistic (Taylor, 2007). Even something as theistically charged as prayer can be presumed to operate according to "change mechanisms" that consider God's possible involvement to be irrelevant (e.g., prayer is part of a naturalistic mechanism that facilitates the correction of thinking errors). From a theistic perspective, however, God's involvement is not irrelevant; prayer and other peripheral aspects have a unique meaning from their relation to a God who is already present and functionally active (see Slife & Ellertson, 2004; Slife & Melling, 2006).

Given the centrality and necessity of an active God for a strongly theistic psychotherapy, we would expect strongly theistic researchers and practitioners to be upfront and explicit about God's activity in the psychological world. Yet, it is surely true that the therapeutic theories and practices which are considered theistic do not routinely feature God's activities in the psychological literature (cf. Slife & Ellertson, 2004; VanderStoep, 2003). The authors of these theories and practices might claim to assume a strong theism, and thus a currently active God, without being explicit about it. They might know, for example, that editors or reviewers are not open to this kind of "God talk," especially perhaps in American Psychological Association and other mainstream journals and publications. We are open to this possibility, of course, and hope that other authors will comment on their own experiences. Nevertheless, as understandable as this omission is, we feel obligated to note it violates the spirit of strong theism, where God's centrality is too important to be left to silent assumption, especially in explicitly "theistic" renderings of psychotherapy. Here, the very nature of the subject matter, we believe, requires the author to be clear about the therapeutic conditions that involve divine influences.

This issue is especially relevant in a secular discipline like psychology, where the disciplinary presumption is that God is not considered to be involved, unless the conceptualization states otherwise. One should also be wary of the common misconception that a lack of explicit talk about God is a sign of neutrality. Unless this core assumption is clearly reflected at all levels of theory, method, and practice, one cannot assume that an approach is either theistic or a true alternative to the current naturalistic and secularist models of psychotherapy.

From this basic conceptualization of strong theism, we can summarize four general requirements of a strongly theistic psychotherapy. First, God's activity would not be limited a priori to a particular time (deism) or sphere (dualism) but would be potentially unlimited any place and time. Second, God would not be seen as an optional "add on" to otherwise secular and/or naturalistic therapies and explanations; rather, God's activity would be a core and permeating constituent of the worldview and assumptions that guide psychotherapy research and practice. Third, peripheral aspects of theism, though possible implications of God's presence, would be insufficient in themselves and only theistically meaningful in light of an active God. Fourth, the assumption of God's activity would be clearly reflected in the therapy at all levels of theory, method, and practice.

Strong Theism in Practice: The Alldredge Academy

Many psychologists may question whether strong theism is even possible in a pragmatic sense, perhaps seeing these requirements as unrealistic for professional practice. It is one thing to conceptualize a strongly theistic approach; it is quite another to see it in practice. Here, the first author was fortunate to develop a relationship with the Alldredge Academy, a West Virginia school for troubled youth that seemed to meet the general requirements of strong theism (above) in its therapeutic approaches. This relationship led to a report of the theory and methods of the Academy through the case of an actual client (Slife et al., 2004), so as to provide an illustration of how a strongly theistic conceptualization might be manifested in a therapeutic approach. We briefly describe the Alldredge Academy's approach here to demonstrate how strong theism can form the conceptual basis of a therapeutic community's theory and methods, at least as the Academy existed at the time of the 2004 article. (We understand that this Academy is now under new management.)

First, unlike weak theism, the Alldredge Academy does not automatically limit God's activity to a certain time or place. Rather, God is seen to be already present in the world and is potentially involved at all times and in all places--the first of the four requirements of strong theism. God's activity is conceptualized to be the center of therapeutic change; indeed, no change is possible without "the Source," All-dredge's term for God (Slife et al., 2004, p. 41). The term "Source" is used to accommodate several widely varying theistic traditions--an accommodation based on the strongly theistic assumption that God can be active in the lives of all people. At every stage of Alldredge's therapeutic model, instructors "assume the Source is already present; their only job is to facilitate 'spiritual' experiences and loving relationships that help the students to sense and acknowledge the Source" (p. 46). Because the Source is already assumed to be present, there is no need for interventions that presume God's activity is limited to a certain time or place (weak theism).

As a second requirement of strong theism, God's influence is conceptualized "all the way down" at Alldredge rather than viewed as an add-on to naturalistic theories and practices. In other words, the Academy's practices cannot be made naturalistic without fundamentally changing the way they are performed. For example, in the "Mountain Search and Rescue" phase of the therapeutic program, "instructors routinely assemble the group for a moment of silence." The ultimate purpose of this practice, like all other Alldredge practices, is to "help students to sense and acknowledge the Source" (Slife et al., 2004, p. 46).

Although there is no question that weakly- and non-theistic approaches could advocate or practice a moment of silence, the rationale and meaning of this practice, as explained to Alldredge students and understood within the therapeutic system, would be quite different. A non-theistic approach, for example, might advocate a moment of silence for the self-benefit of clear thinking (see Slife et al., 2004, pp. 46). On the other hand, the aim of such practices for the Academy is not the student's self-benefit; it is ultimately for the sake of the Source, which implies in this context the mission of the Search and Rescue team (pp. 50-51). In this respect, God is not simply added onto an otherwise naturalistic practice, but rather is inextricably connected with the practice. Indeed, the very conceptualization and development of this practice, like all Alldredge's theories and practices, is guided from the conceptual beginning by the non-naturalistic core assumptions of strong theism (p. 41).

Similarly, the Alldredge Academy includes activities and values that can be viewed as peripheral aspects of theism. Alldredge students, for example, are encouraged to engage in "spiritual" activities such as meditation and prayer. Unlike weak and non-the-jstic accounts, however, these aspects are viewed as meaningful only in light of an active God working through them-the third requirement of strong theism. As a result, these aspects are understood and, to some degree, performed differently (e.g., prayer content). The same can be said for values endorsed by the Academy, such as love, integrity, hope, and valor. These values are only understood in light of an active God. In fact, "instructors model these values and facilitate experiences that aid the students in coming to their own values by and through the Source" (Slife et al., 2004, p.43).

As a fourth and final requirement of strong theism, the assumption of God's necessary activity is clearly reflected at all levels of theory, method, and practice. Alldredge instructors see God as "uniting all their therapeutic interventions" (Slife et al., 2004, p. 46). For each phase of therapy, "the fellowship of the Source" (p. 52) is not seen as simply one possible benefit of the Academy, but rather its ultimate purpose, as well as the active power of a divine necessary condition that runs through everything. According to this report on the Alldredge Academy, there is no intervention, however small or implicit, for which an active God is not considered necessary or even central. This clear and pervasive reflection of strong theism is not surprising, because the Academy explicitly avoids the assumptions of naturalism (Slife et. al, 2004).

If the Alldredge Academy embodies a viable application of a strongly theistic approach, then the question of whether this conception can be translated into practice would seem to be answered: psychologists can conceptualize and implement strong theism in their practices. Some therapists may desire to see a strongly theistic example that is more conventional, in the sense of outpatient or individual work, rather than a therapeutic community such as the Alldredge Academy. In this case, we are aware of other possible examples of strongly theistic therapies that might meet these desires (e.g., Jankowski, 2003; Olthuis, 2006). The Alldredge example was chosen because its literature explicitly contrasts strong theistic with naturalistic approaches, both theoretically and practically. Moreover, our primary purpose here is to show that a strongly theistic approach to therapeutic intervention is possible. Of course, its mere possibility says nothing about its effectiveness. Still, for a strong the theist explicit inclusion of God in the formulation and practice of therapy cannot help but facilitate effectiveness. All formulations and practices that exclude God, even to some degree, are incomplete and inadequate by theistic definition.

THREE TYPES OF WEAKLY THEISTIC PSYCHOTHERAPY APPROACHES

The existence of both the conception and practice of a strong theism begs an intriguing question: what approaches that claim to be theistic are strongly theistic? Again, we hasten to remind our readers that the adverb "strongly" is philosophical, as in strong (or hard) naturalism (e.g., Griffin, 2000). Our distinction between strong and weak is not meant to distinguish between good and bad psychotherapy or good and bad theology. It is intended only to clarify the construct of theism, especially as it might apply to "theistic" forms of therapy. This aim of clarification is also the reason we proffered a concrete example of strong theism in the Alldredge Academy.

At this juncture, the same purpose prompts us to describe (below) three concrete types of weak theism: compartmentalized, peripheral, and inconsistent. To illustrate each type, we describe a published work that may exemplify some of the features associated with the specific type. We offer these illustrations, again, for the sake of clarity and further development; they are not intended to represent the theistic literature. (2) We would argue that these are prominent categories of weak theism, but we do not claim that no others exist or that only weak theism exists in this literature. We would welcome other types and examples of either weak or strong app to aches.

1. Compartmentalized Theism

For the first type of weak theism, compartmentalized theism, the therapist's private theistic beliefs are "compartmentalized" from his or her professional theories and practices. These therapists may consider themselves to be strong theists personally, perhaps disclosing their religious affiliation and/or theistic beliefs in order to attract or build rapport with theistic clients. However, their professional theories and explanations do not reflect strong theism as a core philosophy, and, in fact, are often identical to secular and naturalistic approaches. We are open to several secular practices being virtually indistinguishable from certain strongly theistic practices (e.g., caring), but the author's explanation or theory about how these practices change or heal clients should not be identical, given the incompatibility of strong theism and naturalism.

A possible example of compartmentalized theism is Lovinger's (1996) "denominational framework" for psychotherapy with religious clients. Lovinger, who identifies himself as Jewish (p. 352), asks therapists to understand how various religious denominations impact the 'attitudes, values, and worldview[s]" of their clients (p. 328). His approach is similar to psychotherapists who seek understanding and sensitivity toward "ethnic, socioeconomic, and cultural influences" (p. 327). Considering that a denominational impact might include theistic beliefs, Lovinger's approach implies a degree of openness and respect for the client's beliefs about God.

Similar to many therapeutic approaches to cultural sensitivity, however, Lovinger's approach does not advocate that the cultural or religious beliefs form the theoretical foundation for the therapeutic system. Therapeutic systems are frequently presumed to be relatively neutral to cultures or religions, and thus not biased against them. Yet, as we have described in our discussion above, this presumption is problematic because all interventions are premised upon theoretical presuppositions that are value-laden and thus biased in some way or other (Rychlak, 1981; Slife, Williams, & Barlow, 2001). No therapeutic theory is neutral or unbiased.

If Lovinger's therapeutic approach is not unbiased, then what is the nature of its biases? Even if we presume that Lovinger has a personal bias in the favor of strong theism (e.g., as a practicing Jew), this does not necessitate that his therapy approach is strongly theistic as well. He could have professional and personal "compartments," where he uses naturalistic theories of change and healing that he learned in his professional training, but he uses strongly theistic understandings in other parts of his life. No conventional therapeutic approach assumes the necessity of God's influence in its mechanisms of change, so the practice of a conventional approach, as Lovinger advocates, is not guided by a strongly theistic theory.

Nor can Lovinger merely "add on" a client's (or his) God to a conventional approach, merely because it is important to the client (or him). We do not doubt that "God talk" can occur in the content of a conventional therapeutic conversation; indeed, this addition may help the client relax and relate (e.g., using language that is familiar to the client). Still, to practice the process of conventional therapy is to practice as though God's influence is unnecessary to the mechanism of client change. Lovinger essentially admits this lack of necessity when he claims that "psychotherapy with religious clients is not essentially different from nonreligious clients" (p. 353). Unless he uses a strongly theistic approach with nontheistic clients, Lovinger's understanding of the process of therapy is likely to presume either a weak theism or a naturalism. In this way, the distinction between content/process is similar to the distinction between personal/professional; God is involved in one or the other "compartment" but not both, reflecting the dualism discussed above.

2. Peripheral Theism

The second type of weak theism, peripheral theism, shares many of the same basic qualities as compartmentalized theism. The major difference, however, is that this second type includes what we have called (above) "peripheral aspects of theism" within the context of therapy, such as prayer and forgiveness. As described, these peripheral aspects can be conceptualized either as requiring an active God or as working through more conventional psychological mechanisms, and thus not requiring an active God. In peripheral theism, therapy strategies may include and even focus on these peripheral aspects, but their relation to or need of an active God is not part of their undemanding or significance.

One possible example of peripheral theism is Krejci's (2004) case study of an "anger-filled" (p. 100) religious couple, in which Krejci incorporates spiritual themes and activities into a marital therapy approach. Krejci is a practicing Roman Catholic with a "private practice at a local Roman Catholic church" (p. 87). His therapeutic orientation is "influenced by both humanistic and cognitive-behavioral approaches to psychotherapy" (p. 87). In his case study, Krejci's approach includes several peripheral aspects of theism such as prayer, forgiveness, spirituality, and "faith beliefs" (pp. 95, 101). However, he does not mention or even imply that this approach or these aspects require an active God in an understanding of their effectiveness.

Here, of course, we have to allow the possibility that Krejci is merely towing a particular rhetorical line in his report and avoiding theistic language. Krejci's approach could even be viewed as similar to the Alldredge Academy's approach, which also focuses on empathy and altruism--commonly considered to be peripheral aspects of theism (cf. Richards & Bergin, 2005). As we have discussed, however, these aspects and the change mechanisms by which they are presumed to operate can be understood in many other ways than theistic. Our main point here is that the mere inclusion of these aspects does not ipso facto imply a strongly theistic psychotherapy. God is not a "peripheral" aspect of prayer or forgiveness for the strong theist. If God is centrally involved and even required for these aspects to be meaningful, then good scholarship requires the explication of this involvement in a published description of the therapy.

As an example, Krejci (2004) uses a "model of forgiveness" In which he views forgiveness as a sequential process of ceased resentment followed by understanding, empathy, and altruism (p. 96). It would not be difficult to understand this model from the naturalistic tenets of his orientation, using humanistic and cognitive behavioral principles. This kind of naturalism is also likely because Krejci (2004) did not develop his model as a uniquely theistic approach (p. 96). As he explains, religious aspects were incorporated into his model because they were important to the clients--to help them build "something positive" into their marriage (p. 100)--not because they brought God into play and were necessary for change.

We understand that therapists might view God as playing a vital role in their theory of change but not necessarily explicate this role in the therapy session itself. Similar to other health-care professionals (e.g., physicians), therapists rarely articulate their theory of change with their patients, so strongly theistic professionals would probably not differ in this regard. However, good scholarship would dictate that all the vital conditions of healing be explicated in a formal or published description of a case. Krejci could explain, for example, how God's enabling grace helped couples to forgive one another. Such an explanation would allow the reader to understand all the conditions the therapist considers necessary to the healing process.

3. Inconsistent Theism

The final type of weak theism is probably the closest of the three types to strong theism, Unlike compartmentalized and peripheral theism, this third type of psychotherapy clearly advocates the vital and present activity of God, not just in privacy or in peripheral aspects. Rather, this divine influence is proclaimed to some degree in published accounts of the theories, methods, and practices of this third type. Moreover, these publications are often sensitive to the problems of a secularized or naturalized psychology from a theistic perspective (e.g., Bartz, 2009; Hardman et ah, 2004; Richards & Bergin, 2004, 2005). For these reasons, this third type of weak theism may bear a striking resemblance to the strong theism of the Alldredge Academy.

However, we consider this type to be weakly theistic and label it inconsistent theism because there are many other aspects of the therapy's theories, methods, and practices that do not require or even relate to an active God. In this sense, inconsistent theism is an attempt to combine--within the context of therapy--the incompatible assumptions of naturalism and theism, resulting in a dualistic form of weak theism where God's activity is limited to a certain realm or set of factors. The theistic components of therapy are thus inconsistent with the naturalistic components. One could say, of course, that compartmentalized and peripheral theism also are inconsistent in certain respects (e.g., the therapist's private beliefs are inconsistent with the naturalistic assumptions of therapy). However, the term "inconsistent" here (for the third type) refers to inconsistencies among the elements of psychotherapy per se.

A possible example of inconsistent theism is Hardman et al.'s (2004) article about "an integrative, multidisciplinary inpatient treatment program for women with eating disorders" (p. 55). In their description of this approach, the authors are explicitly theistic, claiming, for example, that "relationships with self, God, and others are interconnected and need to be addressed and included together in successful therapeutic change" (p. 56). In addition, when Hardman et al. provide a case study of an individual patient, God's activity is seen as integral to this change, including the patient receiving "personal spiritual witnesses that God loved her" and feeling "deep reassurances of God's love come into her heart and mind" (p. 67). In fact, when such patients "open their hearts to God's love and healing presence, then psychotherapists simply become facilitators and witnesses to a healing process that transcends ordinary psychological change processes" (p. 71). These statements are remarkably similar to the way the All-dredge Academy staff conceptualizes its facilitating role with an already present and active God (Slife et al., 2004, p. 46).

On the other hand, these strongly theistic explanations are inconsistent with many of Hardman et al.'s (2004) specific theories and practices of change, for which God is not clearly included or even implied. This inconsistency is possibly due to the authors' integrative approach, which "followed the recommendations of numerous professionals that spiritual interventions should not be used alone, but integrated with standard psychological and medical interventions" (p. 59). This approach is surely reasonable, given many common ways of understanding theism and naturalism, and also is innovative in light of the overwhelming dominance of naturalistic psychotherapies. Nonetheless, the approach is still dualistic because it assumes that spiritual interventions are somehow separable from the nonspiritual interventions of psychology and medicine. In other words, there is a spiritual realm and a nonspiritual realm, as though God is not involved in the nonspiritual or naturalistic. In this sense, the authors' approach is integrative only because both types of interventions are permitted, not because the authors formally consider God to be vital to both types.

In this respect, the spiritual portion of Hardman et al.'s (2004) therapy, in which God's activity is clearly described, could be viewed as an "add on" to the naturalistic theories and methods that are presumably seen as neutral to God's activity. We say "presumably," because if the authors viewed God's activity as incompatible with these naturalistic theories and methods, then they would be less likely to conceptualize the spiritual components as coherently integrated with the nonspiritual components such as medicine. We are aware that medicine, such as medical evaluations and prescription drugs, is not typically viewed as spiritual, so we can readily understand Hardman et al.'s (2004) reasoning. Yet, this is the challenge and provocative nature of strong theism; it does not allow for the weak theisms of either dualism or deism. It would assume that God is a necessary condition even in the successes of medicine.

CONCLUSION AND DISCUSSION

In conclusion, we have attempted to clarify how naturalism and strong theism rest upon incompatible assumptions concerning the potential activity of God. Strong theism, we have argued, requires God's activity; naturalism denies this requirement. This incompatibility is rarely appreciated in psychology because naturalism is widely considered a relatively neutral or unbiased philosophy concerning God (Slife &C Reber, 2009). Consequently, naturalistic therapies are often viewed as not conflicting with the beliefs of theistic clients or theistic therapists. Even if some therapists recognize the incompatibility of this one assumption-the requirement of an active God-they may suppose that other assumptions, such as order and truth, are compatible.

Our conclusion, however--after examining prominent understandings of this compatibility--is that the necessity of God is not an add-on assumption for the strong theist. It is an altering assumption, implying that its inclusion changes the meanings, sometimes dramatically, of even supposedly common assumptions such as order and truth (Slife & Reber, 2009; Taylor, 2007). Because of this more general incompatibility, many types of theistic psychotherapy may be weakly rather than strongly theistic. We have attempted to clarify this distinction by contrasting the strong theism of the Alldredge Academy with three types of weak theism: compartmentalized, peripheral, and inconsistent. It is our hope that these categories of weak theism, along with their illustrations, will aid those who are interested in constructing psychotherapies that are either strongly or weakly theistic. Again, this article does not speak to the efficacy or ethical issues that may surround this distinction; our interest is clarification only, both at the conceptual and practical levels.

Before closing, we need to discuss two concerns that some readers may have regarding this clarification. First, we suspect that some psychotherapists will claim that what we have identified as strong theism is simply too strong or radical (for science, psychology, therapy, or whatever). One form of this claim is that strongly theistic therapies, such as the Alldredge Academy, are not really therapies. This tack attempts to resolve the issue through definitional fiat: only naturalistic forms of therapy are therapy, However, we do not understand why a discipline would restrict itself to only one category or philosophy of healing, especially if it cares about effectiveness. Why not allow strong theism to take its place in the market of potential ideas and strategies? We freely admit that strong theism is radically different from the naturalistic theories, practices, and methods that dominate psychology; this difference is part of our main thesis. For this reason, we can readily understand why many theistically oriented therapists may desire or need to practice a more compatible type of weakly theistic therapy. We simply suggest that it ought to be represented appropriately, both to clients in therapy and readers of scholarly publications.

As a second concern, some professionals may argue that not every client will agree with the assumptions and biases of a theistic approach, which is surely an important point. It is also important to note, however, that this point applies with equal force to naturalistic approaches. Naturalism is itself a set of assumptions and biases about which many clients, both theistic and non-theistic, might not agree (Richards & Bergin, 2004). For this reason, we believe it is ethically imperative to identify the conceptual assumptions of all psychotherapies in order to provide clients with the information needed to allow some type of informed consent. A lengthy discourse would rarely be necessary. As mentioned, therapists do not typically provide details about their model of change. Still, we suspect that many theistically inclined clients will be interested to know that many conventional therapy theories are not unbiased with respect to their theism (Slife & Reber, 2009), and, in fact, do not include a currently active God in some portion of their conceptions. Without this type of informed consent, and perhaps even consumer education, psychotherapy becomes a kind of Trojan horse that surreptitiously employs worldviews of which clients are unaware.

REFERENCES

Bartz, J. D. (2009). Theistic existential psychotherapy. Psychology of Religion and Spirituality, 1, 69-80.

Brown, W., Murphy, N., & Malony, H. (1998). Whatever happened to the soul? Scientific and theological portraits of human nature. Minneapolis, MN: Fortress Press.

Collins, G. R. (1977). The rebuilding of psychology: An integration of psychology and Christianity. Wheaton, IL: Tyndale House.

D'Souza, D. (2007). What's so great about Christianity. Carol Stream, IL: Tyndale House.

Griffin (2000). Religion and scientific naturalism: Overcoming the conflicts. Albany, NY: SUNY Press.

Gunton, C. (1993). The one, the three, and the many: God, creation, and the culture of modernity. Cambridge, MA: Cambridge University Press.

Habermas, J. (2008). Between naturalism and religion: Philosophical essays. Cambridge, United Kingdom: Policy Press.

Hall, M. E. L. (2004). God as cause or error? Academic psychology as Christian vocation. Journal of Psychology and Theology, 32,200-209.

Hardman, R. K., Berrett, M. E., & Richards, P. S. (2004). A theistic inpatient treatment approach for eating disorder patients: A case report. In P. S. Richards & A. E. Bergin (Eds.), Casebook for a spiritual strategy in counseling and psychotherapy (pp. 55-73). Washington, DC: American Psychological Association.

Hunter, C. G. (2007). Science's blind spot: The unseen religion of scientific naturalism. Grand Rapids, MI: Brazos Press.

Jankowski, P.J. (2003). Integrating postmodern therapies and spirituality: A solution to the contemporary crisis of the self. Journal of Psychology and Christianity, 22,141-149.

Jones, s. L. (2006) Integration: Defending it, describing it, doing it. Journal of Psychology and Theology, 34, 252-259.

Krejci, M. J. (2004). Forgiveness in marital therapy. In P. S. Richards & A. E. Bergin (Eds.), Casebook for a spiritual strategy in counseling and psychotherapy (pp. 87-102). Washington, DC: American Psychological Association.

Leahey, T. H. (1991). A history of modern psychology. Engle-wood Cliffs, NJ: Prentice Hall.

Lovinger, R. J. (1996). Considering the religious dimension in assessment and treatment. In E. P. Shafranske (Ed.), Religion and the clinical practice of psychology (pp. 327-364). Washington, DC: American Psychological Association.

Miller, W. R., & Delaney, H. D. (Eds.). (2005). Judeo-Christian perspectives on psychology. Washington, DC: APA Books.

Nelson, J. M. (2006). Missed opportunities in dialogue between psychology and religion. Journal of Psychology and Theology, 34,205-216.

Nelson, J. M. (2009;. Psychology, religion, and spirituality. New York: Springer.

Olthuis. J. H. (2006). With-ing: A psychotherapy of love. Journal of Psychology and Theology, 34,66-77.

Philipchalk, R. P. (1987). Psychology and Christianity: An introduction to controversial issues. Lanham, MD: University Press of America.

Plantinga, A. (2001), Methodological naturalism? In R. T. Pennock (Ed.), Intelligent design creationism and its critics: Philosophical, theological, and scientific perspectives (pp. 339-362). Cambridge, MA: MIT Press.

Porpora, D. V. (2006). Methodological atheism, methodological agnosticism and religious experience, Journal for the Theory of Social Behaviour, 36, 57-75.

Reber, J. S. (2006). Secular psychology; What's the problem? Journal of Psychology and Theology, 34, 193-204.

Richards, P. S., & Bergin, A. E. (Eds.). (2004). Casebook for a spiritual strategy in counseling, and psychotherapy. Washington, DC; APA Books.

Richards, P. S., & Bergin, A. E. (2005). A spiritual strategy for counseling and psychotherapy (2nd ed.). Washington, DC: APA Books.

Richardson, F. C, Powers., B. J., & Guignon. C. B. (1999). Re-envisioning psychology: Moral dimensions of theory and practice. San Francisco: Jossey-Bass.

Russell, C. A. (2002). The conflict of science and religion. In G. B. Ferngren (Ed.), Science and religion: A historical introduction (pp. 3-12). Baltimore: Johns Hopkins University Press.

Rychlak, J. F.(1981). Introduction to personality and psychotherapy: A theory-construction approach (2nd ed.). Boston: Houghton Mifflin.

Slife, B. D. (2004). Theoretical challenges to therapy practice and research: The constraint of naturalism. In M. J. Lambert (Ed.), Handbook of psychotherapy and behavior change. New York Wiley.

Slife, B. D., & Ellertson, C. F. (2004). Dogma and dialogue: The interface of Christianity and psychology. Contemporary Psychology, 49, 677-679.

Slife, B. D., & Melling B. S. (2006). Psychological method and the activity of God: Clarifications and distinctions. Journal of Psychology and Theology, 34, 280-285.

Slife, B. D., Mitchell, L. J., & Whoolery, M. (2004). A theistic approach to therapeutic community: Non-naturalism and the All-dredge Academy. In P. S. Richards & A. E. Bergin (Eds.), Casebook for a spiritual strategy in counseling and psychotherapy (pp. 35-54). Washington, DC: APA Books.

Slife, B. D., & Nelson, J. M. (2006). Implications for the psychology of religion. Journal of Psychology and Theology, 34, 289-291.

Slife, B. D & Reber, J. S. (2009). Is there a pervasive implicit bias against theism in psychology? Journal of Theoretical and Philosophical Psychology, 29, 63-79.

Slife, B. D., & Richards, S. P. (2001). How separable are spirituality and theology in psychotherapy? Counseling and Values, 45, 190-206.

Slife, B. D., & Whoolery, M. (2006). Are psychology's main theories and methods biased against its main consumers? Journal of Psychology and Theology, 34, 217-231.

Slife, B. D., Williams, R. N., & Barlow, S. H, (Eds.) (2001). Critical issues in psychotherapy: Translating new ideas into practice. Thousand Oaks, CA: Sage.

Smith, H. (2001). Why religion matters: The fate of the human spirit in an age of disbelief. New York: Harper Collins.

Sperry, L., & Shafranske, E. P. (Eds.) (2005). Spiritually oriented psychotherapy. Washington, DC: American Psychological Association.

Taylor, C. (2007). A secular age. Cambridge, MA: Belknap Press.

VanderStoep, S. W. (2003). Science and the soul: Christian faith and psychological research. Lanham, MD: University Press of America.

Wacome, D. H. (2003) Evolutionary psychology. In S. W. Vander-Stoep (Ed.), Science and the soul: Christian faith and psychological research (pp 183-208). Lanham, MD: University Press of America.

(1) The question of methodological naturalism is: does the scientist have to assume the nonexistence of theistic entities to study only natural events and processes? In other words, can we assume a mere epistemological (or methodological) naturalism without also assuming an ontological or metaphysical naturalism? These questions get complicated, as we later show, but many scholars recognize that all epistemologies are underlain with ontological assumptions and vice versa (e.g., Nelson, 2009; Richardson, Fowers, & Guignon, 1999). Why, for example, would epistemological naturalists focus on just natural events and processes unless they assume, for the purposes of their investigation, that supernatural events and processes are not relevant, or do not functionally exist (ontology), for that study? Another way to put this is that if supernatural events and processes were considered to functionally exist in a difference-making way, and thus be important to the phenomena of study, then the methods derived from studying only natural events and processes would be considered inadequate to the task (Slife & Reber, 2009). The point is that the epistemological/ontological distinction is not an issue for the purposes of this article. All that matters is whether the particular conception assumes that God is not necessary (for conceptualizing, conducting or explaining studies), in which case it is considered naturalistic, or whether the conception assumes that God is necessary, in which case it is considered theistic.

(2) In particular, we should note that we constructed this typology largely on the basis of theistic psychotherapy article? and chapters -from mainstream psychology publishers: e.g.: APA). We recognize that the theistic psychotherapy literature is diverse and that differing typologies might he made, especially for publications where theological language and theories are more accepted or even encouraged. Still, we believe that our types and examples are helpful for distinguishing common aspects of weakly theistic psychotherapies, along with their differences from strongly theistic psycho therapies.

BRENT D. SLIFE

Brigham Young University

TIFFANI D. STEVENSON

University of Maryland

DENNAIS C. WENDT

University of Michigan

AUTHORS

SLIFE, BRENT, D. Address: Department of Psychology, Brigham Young University, Provo, UT 84602. Title: Professor of Psychology. Degree: Ph.D. Specializations: clinical psychology, philosophy of social science.

STEVENSON, TIFFANI, D. Address: Department of Family Science, University of Maryland, 1142 School of Public Health, College Park, MD 20742. Title: Doctoral student in family science. Degree: M.S.

WENDT, DENNIS, C. Address: Department of Psychology, University of Michigan, 530 Church Street, 2256 East Hall, Arm Arbor, MI 48109-1043. Title: Doctoral student in clinical psychology. Degree: B.S.

Brent D. Slife, Ph.D., Department of Psychology, Brigham Young University, Provo, Utah 84602, Tel: 801-442-3657; Fax: 800-442-0204; Email: slife@byu.edu