Clinical Psychology and Secular Therapy with Dr. Caleb Lack

Dr. Caleb W. Lack Ph.D, Professor at the University of Central Oklahoma, speaks about clinical psychology and the misconceptions about secular therapy.

Caleb W. Lack, Ph.D. is a licensed clinical psychologist, an Associate Professor of Psychology at the University of Central Oklahoma, and the Director of the Secular Therapist Project. Dr. Lack is the author or editor of six books (most recently Critical Thinking, Science, & Pseudoscience: Why We Can’t Trust Our Brains with Jacques Rousseau) and more than 45 scientific publications on obsessive-compulsive disorder, Tourette’s Syndrome and tics, technology’s use in therapy, and more. He writes the popular Great Plains Skeptic column on skepticink.com and regularly presents nationally and internationally for professionals and the public about clinical psychology and secular therapy. Learn more about him here.

Scott Douglas Jacobsen: What are common misunderstandings about secular therapy?

Dr. Caleb Lack: I think that many people, especially the religious, would hear “secular therapy” and think that it would only be something that a non-believer would engage in. In fact, all of the evidence-based therapies that we have for mental health problems such as depression, anxiety, and the like are “secular”, or developed without the use of supposedly supernatural aids and interventions. Almost all therapists who are religious (as opposed to “religious therapists”) use secular therapy in their practice. In other words, they are not using prayer, or exorcism, or invoking some religious concepts to heal a person of their mental health problems. Instead, they are using our “secular” therapy techniques.

Dr Caleb W Lack, Clinical Psychology, TedX, Secular Therapy — Dr Caleb W Lack speaking at the TedX ‘Teaching Outside The Box’ event. Image source: YouTube.

Jacobsen: Is secular therapy more effective than prayer, ritual, attendance in places of worship, AA, and 12-step for recovery and improvement of general wellbeing?

Lack: That’s a good question that’s difficult to answer. We know, for instance, that regular meditative practices can provide a huge boost to well-being, as can regular social interactions. If your meditative practice is prayer and your regular social interactions are church-based, there’s nothing wrong with that at all. You’re likely to be healthier than someone who doesn’t do those things. However, you’re not more likely to be healthier than someone who regularly engages in mindfulness exercises and engages in regular outings with their bowling club or board game playing friends. In other words, it’s the type of things you do (e.g., positive social interactions), not whether they are secular or religious in nature.

On the topic of AA and 12-step programs, it’s a bit easier to answer, and I actually did a debate on this subject last month. Overall, our most evidence-based treatments for substance abuse and other problematic compulsive behaviour (which is what AA and the 12-steps focus on) are all secular in nature. Self-help group-based programs like SMART Recovery or Moderation Management don’t use any religious overtones or practices. Despite this, they show much better outcomes than AA, especially when paired with individualised therapy such as motivational interviewing or cognitive-behavioural therapy.

Jacobsen: How does clinical psychology provide complementary tools for secular therapy, assuming different domains given different titles for them?

Lack: Related to what I mentioned before, all evidence-based therapies are secular in nature. That doesn’t mean that clinical psychologists like myself who aren’t religious can’t work with people who are, or that clinical psychologists who are religious don’t work with those who are not. There’s a significant amount of research taking place that looks at how we can adapt particular evidence-based therapies to those of particular faiths. I’m actually leading a clinical round table at a major national conference later this year on that topic, and we have panellists speaking about how CBT can be most effectively used with patients who are Jewish, Christian, Muslim, and non-religious.

What our clinical outcome research does is inform us what the most effective techniques are to help a person who has a particular form of psychopathology or a specific behavioural, cognitive, or emotional difficulty. Once we have those basic understandings down, we can then work on developing modifications of those for other groups, whether by age, developmental level, racial/ethnic background, or religious belief.

Jacobsen: If someone believes in a god, does any evidence exist to support better mental well-being in the clinical psychology literature? If any, is this outweighed by any opposing literature? Or is the evidence pretty neutral for belief or non-belief?

Lack: There’s actually large amounts of literature examining this very issue! Most of the early work appeared to show that being religious was a protective factor, meaning that it helped your overall well-being to stay higher (like this major review article). However, more recent work has dug deeper into this area, and has found that it’s not actually the “religious belief” that’s providing this boost. Instead, newer research has found no differences between the religious and non-religious. Other studies that have compared mental health outcomes point to the strength of a belief system, regardless of if it is religious or non-religious, as the best predictor of positive mental health. It actually appears that the positive effects of religious belief in early studies is due to social engagement and being in supportive groups, and has nothing to do with religious belief, but instead with the trappings that often accompany it. So, if you’re an atheist who has a supportive community you belong to, you’re just as well off as a religious person in the same. If you don’t have that, you need it! That’s why the work that larger national groups such as Recovering from Religion, Oasis, or Sunday Assembly and local organisations (such as Oklahoma Atheists, where I am) is so important, as it helps build those communities.

Secular Therapy, Group Therapy, Psychology — Research has shown that social support networks are among the most important factors in the therapy process. Image source: Wikimedia Commons

Jacobsen: What is the consensus view in the clinical psychology community of those who believe in ghosts and angels, and prayer and speaking in tongues? Are these viewed as coping mechanisms for stress and anxiety, as delusions, as core to mental well-being, and so on?

Lack: Generally speaking, a key component of any definition of someone who is suffering from a mental disorder or psychopathology is that the symptoms they are experiencing have to be causing them distress, or impairing their ability to function in their environment. So, if someone believes in intercessory prayer, speaks in tongues, or other things and it’s not causing them problems in their environment, or emotional or cognitive distress, most mental health professionals would say “Okay, that’s fine. Come back if they are making you feel scared or worried, or causing conflicts with the people around you.”

I will say, though, that some new research coming out of my lab indicates that paranormal beliefs outside of the “typical religious belief” spectrum is related to higher levels of mental health problems, although it’s someone we need to do much more research on.