I had previously shared this post reflecting my opinion that Christian parents are best served by seeking mental health services from professionals who reflect excellence, regardless of their personal beliefs. Today, I’ll share a couple of significant exceptions to that rule.

The condition that most frequently (and appropriately) leads parents to seek me out because I’m publicly identified as a psychiatrist and a Christian is Obsessive-Compulsive Disorder (OCD).

All too often, I’ve seen non-Christian counselors or therapists misinterpret obsessive thoughts involving sexual content in kids from Christian homes. This type of obsession frequently involves the fear that they (against their will) will be compelled to engage in some sexual behavior they and their families clearly see as wrong. Another example of this type of obsession are kids who love their parents but develop obsessive thoughts that they’ll be compelled against their will to kill or severely injure them.

I’ve seen therapists fail to recognize the underlying problem (obsessive thinking) and produce unnecessary anxiety in the child or teen by trying to persuade them that there’s nothing wrong with the behaviors they dread. An ability to understand the family’s value system and worldview is helpful in such situations in understanding why the thought is so distressing…qualifying the thought as an obsession. By definition (see below), obsessions aren’t pleasant.

Another situation in which parents of Christian kids should appropriately seek out a therapist with a Christian background occurs when a significant faith component exists to emotions, thoughts or perceptions that are a focus of concern to the parents. For example, I have a kid who comes to our practice with recurring obsessive thoughts involving the fear that his salvation isn’t genuine, or that he’ll lose his salvation if it is genuine. Another such situation occurs when kids express the belief that God speaks to them or share a specific experience in which they thought God was speaking to them. The professional without an understanding of the child’s or family’s beliefs may not ask the types of clarifying questions necessary to distinguish genuine religious experiences from psychosis associated with mood disorders, thought disorders or substance abuse.

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Here’s a partial list of criteria for Obsessive-Compulsive Disorder from the DSM-5:

A. Presence of obsessions, compulsions or both:

Obsessions as defined by (1) and (2):

1. Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted and that in most individuals cause marked anxiety or distress.

2. The person attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion)

Compulsions as defined by (1) and (2):

1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.

2. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.

B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. The obsessive-compulsive symptoms are not attributable to the physiologic effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

D. The disturbance is not better explained by the symptoms of another mental disorder.

Updated May 23, 2014

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Key Ministry has assembled resources to help churches more effectively minister to children and adults with ADHD, anxiety disorders, Asperger’s Disorder, Bipolar Disorder, depression and trauma. Please share our resources with any pastors, church staff, volunteers or families looking to learn more about the influence these conditions can exert upon spiritual development in kids, and what churches can do to help!