We both love how Matthew has taken the concept of sin and given a breath of fresh air to the topic. You must read this book because in its pages you will finally gain a biblical perspective on sin and what it takes to free yourself from the bonds that so easily entangle!

Gary and Michael Smalley
Smalley Relationship Center
When mental illness afflicts a loved one, how can we understand what is happening and respond appropriately? This biblically-literate and scientifically-informed book offers helpful insight, encouragement, and practical advice. For pastors and for those who hurt for those who hurt, Matthew Stanford offers sensitive and welcome guidance.

David G. Myers, Ph.D.
Professor of Psychology, Hope College and author of Psychology Through the Eyes of Faith.

Wednesday, April 28, 2010

Developing a Mental Health Ministry

As part of my work with the Center for Family and Community Ministries at Baylor University I have been working on material for churches describing how to start a mental health ministry. As an example of what such a ministry might look like below is the description of the counseling / mental health ministry at my own church written by Kelli Hepner and Vicki Smyer.

Mental Health Ministry-Antioch Community Church, Waco, TX
Vicki Smyer spent a decade working as a marriage and family therapist in private practice before she entered the somewhat uncharted realm of professional counseling within a church setting. Vicki joined the staff of her church, Antioch Community Church in Waco, TX, after they recognized a need for individual and family counseling within the congregation. The ministry that evolved sought to strike a balance between a counseling center and pastoral guidance. Through the use of trained congregants, the church now offers a biblical approach to counseling/pastoral care. This approach incorporates the use of lay persons, trained counselors, and professionals in order to meet the emotional, mental, and spiritual needs of its members. The cornerstone of this ministry is reliance upon the Holy Spirit as the Counselor. Vicki says, “Change doesn’t really happen when you talk to someone. It happens when you experience God in a powerful way.”

Goals of the Ministry
Antioch Community Church desires “to see men and women manage the rough waters of life in the context of a loving and wise community of believers.” The church wants “people to be set free from sin patterns, to walk in healing of emotional wounds, and to enjoy healthy relationships with family and friends.”

The ministry seeks to:
• Reach out to the hurting within the congregation with resources and support
• Utilize lay leaders to provide for the needs of church members
• Equip members of the church to provide pastoral care/counseling
• Promote healing through the work of the Holy Spirit

Funding the Ministry
The funding for this ministry is minimal. Vicki’s salary is paid out of the church budget for staff members. Her office is located within the church building along with the other staff. As lay ministers and volunteers provide the remainder of the counseling, there is no additional cost to the church.

Recruiting Volunteers
The process for selecting team members for this ministry is very intentional. The volunteers are specifically chosen and trained. The first group of volunteers, who are called Life Group leaders, is composed of the regular leaders of the church’s small groups who interact consistently with congregants. Therefore, they are the first line of defense when crises arise. A second tier of volunteers are the Pastoral Care Team, leaders who are given regular training on how to help people with such issues as depression, grief, relationships, conflict management, addictions, etc. Some of these individuals hold a professional degree in counseling, although most are laymen.

Structure of the Program
The model of this ministry is three-pronged (with a possible fourth step). Life Group leaders are naturally the first ones to address any issues that arise as members are already familiar with them. If the situation is especially difficult, section leaders step in to provide backup help in pastoral care. If the problem is more serious, the church will provide three free counseling sessions with Vicki, a Licensed Professional Counselor. It is expected that church members are involved in Life Groups and use their leader as their first resource.

If the problem is outside the scope of Vicki’s expertise, chronic, or a serious mental illness, Vicki will make an outside referral to a professional in the community. The ministry is designed to handle acute crisis management, not long-term therapy.

Promoting the Program to the Community
The program is for individuals who are already members of the church. It is not designed to be a community outreach but an outreach to the individuals struggling within the congregation. If someone from the community calls seeking assistance, Vicki will provide a referral to another counselor or social service organization.

Program as Evangelism
The foundation of this ministry is reliance upon the Holy Spirit as a Counselor and based on the belief that “the Holy Spirit comes with His gifts of wisdom and discernment and healing to personally tend to his children who are suffering.” Scripture is heavily incorporated into the counseling process as a tool in the healing process. The program is a response to the Biblical mandate to carry the burdens of Christian brothers and sisters.

Tuesday, April 20, 2010


Dr. Benjamin Rush, a founding father of the United States and a signer of the Declaration of Independence, is credited with first describing alcoholism as a “disease” in 1784. Prior to Dr. Rush’s writings on addiction, drunkenness was viewed as a moral defect and solely a matter of choice. Rush believed that the alcoholic lost control of his behavior or had what he called “an illness of the will”. He identified the properties of alcohol, rather than the individual's choice, as the causal agent. He also proposed that alcoholics could be treated by weaning them off of their addiction using less potent substances (similar to the way that methadone is used for heroin addiction today) and that total abstinence was the only effective cure.

Over a lifetime, many people use substances that have the potential for dependence, but most people do not become dependent. What is it that causes recreational substance use in some people to become uncontrolled, compulsive drug taking in others? The answer may have to do with how our brains respond to pleasure and rewards.

Have you ever wondered why you enjoy certain activities and aren’t particularly interested in others? Things you enjoy are rewarding to you. In other words, they bring you pleasure, a sense of well-being and reduced stress. All thoughts and behaviors have some biological component, and reward and pleasure are no exception. God has created within our brain a system that brings about a pleasurable experience when it is activated. Because we enjoy pleasurable experiences, we are more likely to repeat actions that activate our reward system. Many things can activate our reward system, from food to sex to alcohol and illicit drugs. For instance, food has been shown to increase activity in the reward system by 45 percent, whereas amphetamine and cocaine increase the activity by 500 percent. Commenting on this result, my graduate school pharmacology professor once said, “Cocaine takes your brain to a place it was never supposed to go, a place you will always try to get back to.”

Imagine a person with a dysfunction in his or her reward system that causes the system to be under activated. Things are not as rewarding to that individual as they are to the normal person. In neuroscience we call this condition Reward Deficiency Syndrome. Reward Deficiency Syndrome can result from an inherited genetic abnormality or from environmental factors such as trauma or stress. Research has shown that individuals with Reward Deficiency Syndrome begin to seek out experiences that will increase activity in their reward system. If they experiment with alcohol or illicit drugs, initially they find the pleasurable experience they were seeking. But after some time, which will vary across individuals and substances, a vicious cycle develops in which the consumption of alcohol and/or illicit drugs is no longer a choice or a pleasure but a necessity. The person becomes physically dependent on the substance and must take the drug to keep from experiencing painful and sometimes life-threatening withdrawal symptoms. While the positive, pleasurable state produced by the drug may have motivated initial use, continued use results in another motivation: relieving the negative, painful consequences of not using the drug.

While brain chemistry clearly plays a part, the underlying biological causes of the substance use disorders are much broader than any one neurotransmitter system. The reward system I have described above involves a number of brain structures, including the hypothalamus, amygdala, ventral tegmental area, substantia nigra, and nucleus accumbens. The nucleus accumbens, a structure deep within the middle of the brain, is considered by neuroscientists to be the brain’s central reward center. The cells in this brain structure are activated by the neurotransmitter dopamine (DA). When DA is released in the nucleus accumbens, the results are increased feelings of well-being and reduced stress. Substances such as alcohol, cocaine, heroin, PCP, marijuana, and nicotine all cause DA to be released in the nucleus accumbens, and thus they are potentially addictive. In addition, the neurotransmitters serotonin and GABA (gamma-aminobutyric acid) also appear to play a role in the brain’s reward system. Substance abuse and dependence involve a complex interaction between the physiological effects of drugs on the brain’s reward system and the learning of compulsive patterns of drug-seeking behaviors, both of which have a biological basis.

Research suggest that, much like the other behaviors I have discussed thus far, a genetic predisposition for addiction can be inherited from one’s parents and grandparents. Several studies have found that the child of an addicted parent is about four times more likely than the general population (where the risk is 1 in 12) to develop substance abuse or dependence themselves. This holds true even if the child of the addicted parent is adopted early and subsequently raised by adoptive parents who do not use alcohol or drugs.

As might be expected, a significant amount of genetic addiction research has focused on genes that are associated with the brain’s dopamine system. Alcoholism researcher Ken Blum and his colleagues have shown that a defect in the gene that codes for the dopamine D2 receptor is associated with the presence of substance use disorders. There research found that an individual with such a genetic defect has a 74% chance of developing Reward Deficiency Syndrome. It is important to remember that unlike diseases such as hemophilia, sickle-cell anemia and cystic fibrosis, which are caused by a defect in a single gene, behaviors like addiction are genetically complex and are likely to result from defects in many different genes.

Tuesday, April 13, 2010

Jesus Center Benefit

For those in the Chico, CA area I will be the guest speaker at the Jesus Center benefit dinner this Saturday, April 17th (6:00pm). My talk will be titled Viewing Mental Illness and Homelessness Through the Eyes of Faith. Here is a link to a local article with information about the event.

Monday, April 5, 2010

Broken Lives

Adultery (infidelity as the media calls it) has been in the news a lot recently. Senator John Edwards, Governor Mark Sanford, Tiger Woods, Sandra Bullock’s husband Jesse James all choose to break their marital vows for momentary pleasure and as we have unfortunately all seen, thanks to the media, proven that the effects of sin are far reaching. The suggestion that an individual only hurts himself through his poor choices is simply not reality (Exodus 20:5; 34:7). Hidden sin is destructive; it undermines relationships and debilitates families. Once exposed, sin produces a violent shockwave that damages everyone in its path. In many instances the resulting physical, psychological and spiritual wounds are so deep that they will be felt for a lifetime. This post is about the results of adultery; an innocent woman and her children whose lives have been broken by a selfish, sinful choice. As I listened to her story, I was reminded of how desperately we need a Savior, and I pray that as you read it, you also will be.

Like all little girls, Susan had dreamed of what her life would be like when she grew up. Those dreams often included the picture perfect family: a handsome and strong husband who would love her forever and beautiful, healthy children that they would raise together. When Susan met Kevin in college, she believed that those dreams were beginning to come true. He was everything she had dreamed of … handsome, strong and athletic. Kevin was part of a college military training program that was preparing him for service after graduation in the elite Navy SEALs.

Although raised in a strong Christian home, Susan was living the “normal” college life of too many parties and too much drinking when she met Kevin who was living the same way. Susan described their dating relationship as “up and down”. “Kevin was very hot and cold. Some days his affection was all consuming. He couldn’t get enough of me, he couldn’t see me enough, talk to me enough or be with me enough. He was also overly jealous. Other times he would ignore me and say ‘I don’t know if really I love you”. Susan’s parents were concerned about her relationship with Kevin and cautioned her against marrying him. “They had seen how he treated me and they also questioned his Christian commitment.” They dated for two years before getting married in their senior year. Susan became pregnant and shortly before they both graduated she gave birth to their first child, a daughter.

After graduation they moved to California so that Kevin could begin training for his service in the Navy. “The first year after graduating was great. I had the husband that ever woman wanted and together we had the perfect family.” After one year in California, the family moved to Virginia, and Kevin began his service. “He went from being home everyday to being gone over 200 days out of the year. He also started to be hot and cold much like he had been when we were dating in college. Sometimes he would call or be home and smother me with love and attention, while other times he was distant and cold. He never missed our daughter when he was away. Once he even told me after being away for several months that he had not missed us. He was drinking heavily and would regularly visit strip clubs with the other men in his unit when he was gone.”

It was during this difficult time in their marriage that Susan became pregnant and gave birth to their second child, a son. Much like their first child Kevin didn’t really want the baby and was absent and distant as a father. “I was so depressed, especially after the birth of our son. Kevin would call and say that he didn’t love me anymore and that he didn’t want to be married. I felt worthless and started blaming myself for our problems. I was also starting to have thoughts about hurting myself, so I called my parents for help.” Susan’s father drove to Virginia and moved her and the children back home. “I stated having recurrent nightmares that Kevin would abandon us; I feared that I would be unemployed and unable to care for my children.” Within the first month of living with her parents, Kevin began calling. “He said he wanted me back. He wanted to fly me to Spain to be with him. When I asked him why he had said such hurtful things before, he just said, ‘I don’t know.’”

Susan’s visit to Spain went well, and when she returned to the States, she and the children quickly moved back to Virginia. Susan told me that during this difficult time she started crying out to God to restore her marriage. “I had moved far from my faith. Since getting married, I had tried several times to get involved with a local church, but Kevin was never supportive. I decided that I was going to give my all to God. I started praying regularly and attending a bible study. I also (wrongly) blamed myself for our marital problems and dedicated myself to being a better wife.”

After a short time in Virginia, the whole family moved to California, so that Kevin could attend the Navy’s language school. “Everything changed for the better. Kevin was always home while he was going to school. He became the perfect family man. He showed more attention to me and the kids. He was drinking less, and we were attending church as a family. I started thanking God; I really believed that my prayers had been answered. God was restoring my family. It was the happiest time of my whole life.” After a year of language school, Kevin left for a six month deployment. “I had to choose whether to stay in California during Kevin’s deployment or move back in with my parents. I wisely chose to move back to my parents’ house. It was Christmas time when Kevin came back. He was like a different person. He was angry, depressed and drinking heavily. He made it clear that he didn’t want to be with our family. After three days, he said he needed some time alone, so he left to go skiing. He was away from us for six months and after three days he left. I now know he went to meet a girl, but at the time, I didn’t know what was going on.”

Kevin moved back to California while Susan and the children chose to stay with her parents. “On the phone everything would seem great. He would say that he loved me and that he missed me. He would visit us about once every six weeks. When he visited, he showed no emotion. He was like two different people.” Susan started getting counseling to help with her depression. She also continued to fast and pray for her marriage. “In desperation, I remember begging God to release me from my marriage. I knew that I couldn’t live like this forever.”

It was soon after that Susan received a call from an old college friend who lived in New York. “She said that she had heard Kevin and I were getting a divorce, and she just wanted to check on me. I told her I didn’t know what she was talking about. She then told me about Kevin’s girlfriend. I immediately called Kevin, and he of course denied that there was another woman. I knew he was lying, so I searched through our old cell phone bills, found a suspicious number and called her. She said that Kevin had not told her that he was married. While she did know about the kids, Kevin had lied and told her that he had a great relationship with them and was a dedicated father. I told the woman that we had a family and she needed to back off. She told me that she loved Kevin and was not going to stop seeing him. I confronted Kevin again after I spoke to the woman and he no longer denied the affair. He just said, ‘What do you want me to do?’ Then he hung up on me.

I had always held out hope that he would change, but it was at that moment I finally realized that he was never going to change. My marriage was over. My nightmare was coming true and I felt worthless. It was the lowest point of my life.”

Soon after Susan filed for divorce, and Kevin did not contest it. “He just walked away like we never existed.” The divorce has finalized 13 months ago, and Susan says Kevin has visited the children sporadically. “He comes around maybe once every couple of months. My four year old son has no relationship with his father. Our daughter who is nine longs to know her father. She gets so excited when she knows he is coming to visit only to be disappointed by his lack of interest and affection. She has problems expressing her feelings as a result.”

I asked Susan how the affair and divorce have affected her. Struggling to speak through a flood of tears she said, “It would have been better if he had died during a mission, at least then we could have moved on. Right now I’m just existing, nothing more. I’m depressed and angry. This has changed my view of God. My faith has been shaken. I can’t pray anymore. I haven’t had a quiet time in six months. I now see God as cold and distant. To me God seems more interested in furthering his kingdom than concerning Himself with the problems in my life. Kevin did us wrong and he walked away with no consequences. We are the ones that are suffering. Why would God allow that?”

I hope that this story has put a more personal face on the devastating effects of adultery. It is important to understand that Kevin openly professed Christ as Savior at one point in his life, yet he was drawn away, enticed by his own lusts and desires. He chose the pleasures of sin over his wife, children and faith. This story demonstrates that sin is an ever-present problem even in the church today. It is time that we, the body of Christ, move away from the “us vs. the world” mentality. This mindset has crippled our ministry to the world and to one another. Instead we need to seek to develop a truly transparent and open community of faith, fully dependent on the transforming power of Christ. In such a community, men and women do not struggle in silence with sinful lusts and desires, but openly share and confess (James 5:16) to a body willing to carry one another’s burdens (Galatians 6:1-2).