Cognitive Biblical
Therapy Coursework
Counseling Through God’s
Transformative Word
Course 2, Chapter 4
Chapter 4
Scoring the Analysis Questionnaire for Agape Love
a. Setting and Collecting Fees
b. Payment Policies
c. Insurance Payments
d. Compiling AQAL Results
e. Graphing AQAL Results
Important Note: Answering the section questions is a great
way to prepare for the end of the chapter quiz.
Quiz Requirement: A score of 75% is necessary to continue to the next chapter.
Account Access: You must be signed into the coursework page (which is separate from the main CBT website) to take the quiz and advance.
Course 2, Chapter 4
Counseling Fees and Graphing Results
Setting and Collecting Fees
One last form for gathering information from the client is the Financial and Fee form which explains the amount that you charge for each counseling session. See the blue link as an example of one of the past forms used by the counselors of the BCCM ministry. Ultimately, you will need to assess your financial obligations and resources to calculate what you should charge for counseling. Some thoughts in general are that you set a level of payment that fits your being a professional. It will convey to the client the value of your time and expertise, which will impact the perceived value of help the client gets. Interestingly, if people don't pay much for a thing, they don't value it much. If they don't see you valuing yourself and your skills that you've acquired and God's given you, they won't have much of a commitment to the counseling process. What I noticed over the eight years of counseling was as my cost increased, the type of client changed. At the lower the cost, more people wanted an audience (someone to hear their story), rather than someone who was committed to change.
You may have to work with God to overcome your own insecurities, your fear the clients won't come. It's a growing, maturing process for you as a counselor. The first option is the sliding scale which is based on the client’s income. For example, in the Midwest, earning under $50,000 in a year, then the charge is $55 per session, and if they earn over that, then the counseling fee can be anywhere from $65 - $100 per session. I also allow them to charge up to only two unpaid sessions at any time. When they come for the third session, they have to pay for at least one session. I have developed a policy statement that includes the cost that I give the person when I send them a brochure to make sure that they understand this. Sometimes, I talk to them over the phone, or my first contact with them to make sure they know what the charges are.
Payment Policies
Without a policy for collection and a level of payment, it is unlikely I will earn a proper income, pay for my office expenses, carry some people on account, and give some counseling for free. In the first seven years of counseling, I lost around $20,000 in uncollected fees. To remain in private practice, you have to be as good a business person as you are a counselor. Without good business practices, you will go bankrupt and we have to close your practice. Additionally, it's very discouraging to have worked really hard seeing and accommodating a lot of people, and your total income at the end of the week leaves you short and unable to pay your expenses. You really are worthy of your hire, as the scripture says, but it won't happen by magic. You have to set the policy and get comfortable asking for payment at the end of the session. Have options ready if they forget money to pay you. “Would you like me to send you an envelope? Would you like me to bill you this week?” You must determine beforehand how you will deal with this issue. As you mature enough you will be consistent in the collection of your fees.
Another option is that churches support people. When a church supports a client, it must be determined prior to the session. I have made arrangements with the pastor, and the amount paid and the process for directly billing the church. If the client is having weekly sessions, you want to bill them every couple of weeks, because churches usually take a month to pay a bill. If you have 30- 40% of your clients supported by churches, this lag time can create $3,000- $4,000 in outstanding debt. This means your operating capital isn't there to cover expenses. Consistent billing will provide a consistent income. You will get money each week in the mail.
Insurance Payments
Insurance payment is another option. Insurance companies vary greatly in the requirement of the counselor to qualify for payment. About half of the companies will pay me because I have a PhD. Some companies will pay, if you're licensed by the state. It also varies by the state. Insurance companies have no policies that are uniform. One company told me they paid 80%, which sounded great, of up to the cost of a session with a limit of $60. So, if I bill them $100, I'm going to get $60: that's the max. Some companies pay 100%, some pay 80%. Others pay 50 or 60 percent. You will need to contact the insurance company directly and ask specific questions like: “Who qualifies? Do I have to have a PhD? Is a license enough? What are your limits? How many visits can they have in a given year? Do you pay for mental health?
If they pay for mental health, you will need to determine the client’s diagnosis using the Diagnostic Statistical Manual (DSM) for Mental Health Disorders, in the most current edition. This is a series of diagnoses that's been developed by the American Psychiatric Association. You can buy these through bookstores that are educationally based. You will find a diagnosis like 300.02 which is a number code for a generalized anxiety disorder. And then you have to have a CPT (Current Procedural Terminology) code, which is a five-digit number. This starts with an initial treatment code, like 90837 which is for 50, to 60 minutes’ worth of therapy in an ongoing setting. All this information must be included in an initial application form, and again on every invoice after that. Foer example, if you charge $100 and they pay 80% then they're going to send you a check for $80. I’ve learned to charge the client more (usually$10) because of my time for completing and submitting the form. I tell people, you must pay each session, and when insurance companies pay, I will write you a check to you. So now I've got $80 check, of which I keep $10 for myself, and I give a check for what the insurance company paid minus the $10 per session fee for completing the forms. This is an involved and complicated process that must be addressed at the first session. Many say they have coverage, and not have the foggiest idea what that coverage is. Don't go any further than your second session, before this is settled.
Providing free counseling is also an option. I provide about 10% of my counseling for free to those who are not able to find funds to pay and are very committed to change and healing. I do this because I want to give back to the Lord, to Jesus, because of the healing and changes he has made in me. And the reason it's a small percentage is if you give away more than of your counseling than you can afford, the money won't be there to cover your expenses and stay financially solvent. Of these options: self-pay on a sliding scale, church pay or church support, insurance and free counseling you will get a mixture of these different billing rates that fits your practice. If you are paid a wage by a church, I suggest you still charge the client something, to give back into the church. I’ve found that totally free counseling usually is less effective. So, you want to get a balance here of what you do.
Fully answer the following question from the content you just read and submit your answer to find your score and Dr. Dan's answer to the question.
Where do the totals come from that represent each facet of the composite analysis questionnaire scores?
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Dr. Dan's Answer:
The analysis questionnaire score sheet, vertical column on the left-hand side of the sheet marked A-T/S, B-T/S, etc.
Compiling Analysis Questionnaire Results
We're going to take a look now at the Agape Love Analysis Profile of Biblical Norms , also know as the Analysis Profile form which has a large graph on the first page. At the bottom of that form is a list of specific Biblical norms (A-P). The Biblical norms came from the word studies in 1 Corinthians 13:4-8. Patience is a Biblical norm. Kindness is a norm, etc. At the top should be a place for the client’s name and then this paragraph:
“The following composite graph and individual graphs depict the specific elements of a Biblical norm.
The Biblical norm of your individual analysis, questionnaire score, and the difference between the two will be
shown on these graphs. This information will then be utilized for discussion in the counseling setting”.
Questions 38 & 39. The purpose of this graph is to show the client the level of his understanding about each Biblical norm such as patience, kindness and so on. It's also to show a goal, which is, what would patience and kindness be like in its purest form? And that's going to be what we are working toward, the highest score that a person can get. It also shows the contrast between the highest score and where the client scores are in relation to it. The client’s actual scores are from the answers on the Analysis questionnaire. To get the Total Score for each element of Agape love the scores for all of the questions for A are added together by adding the scores across the row by the letter A. Each element will need to be totaled and recorded next to its letter on the far-left column through letter P.
Question 40 & 41. The next step is to transfer the Total Scores to the form titled Analysis Profile. That form has a graph on the first page followed by 15 pages of smaller graphs with the Biblical norms listed for each element of Agape love. The first page of this form is a large graph with A -P along the bottom axis, and numbers 0 – 25 along the left side. The Total Scores will be put on this graph using a dot to indicate where the A – P axis meets the score axis. For example, if the Total Score for A is 15, a dot would be placed where those lines (A and 15) intersect. All of the Total Scores should be transferred this way continuing from B through P. When all of the Total Scores have been plotted on the large graph, use a ruler or straight edge to make a line from A to B, then from B to C and so on until all the dots from left to right are connected. You will have a line graph with high scores and low scores. These Total Scores are critical for the analysis of this information. From the analysis you will gain understanding of the person's spiritual concepts and personality type. In Course 3 you will learn how to interpret the highs and lows and the shape of the line as we proceed through the course.
Question 42. Using the same form, Analysis Profile, each element has a graph showing the scores of the individual concepts on the following pages. Starting on page 2 you will find a different graph that has a place for each of the answers for the first element, Patience. Using the Score Sheet again, transfer each answer to the questions for A or Patience from row A (questions 1, 16, 31, 46 and 61) to the blanks along the bottom of the graph. The graph can be completed once you have all of the scores transferred from the Score Sheet. Next go to page 3 and record the scores for B or Kindness form the B row (questions 2, 17, 32, 47, and 62) on the Score sheet. Continue transferring all of the scores of the answers to the individual pages through P or Never Fails.
Fully answer the following question from the content you just read and submit your answer to find your score and Dr. Dan's answer to the question.
Page one of the analysis questionnaire form contains a composite graph of the individual analysis questionnaire scores. What purpose does this graph serve for the client?
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Dr. Dan's Answer:
The composite graph serves to show the client his/her scores, it shows the goal of a perfect score of 25 points. It locates the greatest areas of difficulty in relation to Agape love at the beginning of the counseling process for the client.
Fully answer the following question from the content you just read and submit your answer to find your score and Dr. Dan's answer to the question.
Where do the totals come from that represent each facet of the composite analysis questionnaire scores?
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Dr. Dan's Answer:
The analysis questionnaire score sheet, vertical column on the left-hand side of the sheet marked A-T/S, B-T/S, etc.
Fully answer the following question from the content you just read and submit your answer to find your score and Dr. Dan's answer to the question.
What do the letters A through P represent across the horizontal axis at the bottom of the composite score graph?
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Dr. Dan's Answer:
Each facet of Agape love is lettered — A = patience, B = kind, C = envy, etc. — and is represented by the letters across the bottom of the composite analysis questionnaire graph.
Fully answer the following question from the content you just read and submit your answer to find your score and Dr. Dan's answer to the question.
The vertical axis is numbered from zero to twenty-five on the graph. Why is this numerical reference utilized on the composite graph?
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Dr. Dan's Answer:
Each answer has a potential maximum score of five points. Each element of Agape love has a total of five questions concerning that element within the analysis questionnaire. The vertical axis is broken down into twenty-five separate reference points so that the total score per element can be displayed on the composite graph to the client.
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The area directly under the bar graph displays a set of numbers. What do these numbers signify?
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Dr. Dan's Answer:
The numbers present the numbers of the questions which actually represent the specific element of Agape love and the scores of the client per that question.
Graphing the Questionnaire Results
Question 43. Once you have all of the individual scores transferred to the pages A – P, you will begin to mark the bar graph with the individual question scores. You're going to plot your score per question on this bar graph so that you can see exactly what you did or didn't know. On the left side of the page, you will see the increasing numbers from 0 – 5. The hash marks above each individual question score guides you to the place to mark on the line graph. For example, if your score for Question 1 is 4, you would place a mark on the hash near the number 4 which is the actual value. The next question is 16 and you repeat the same marking procedure as you did for question 1. Continue placing your actual scores on the bar graph. Placing your scores accurately will get good visual results. On the next page, is the graph for Kindness. Do the same and place the individual scores on the graph as you did for Patience.
Question 44. When all of the individual scores have been put on the graphs A – P, simply draw a vertical line from the zero-base line up to whatever the score was. For example, if you got a four on question one, simply start at zero and draw a vertical line to the fourth hash mark which is only one from the biblical norm of 5. That's how patient a person is. Underneath the bar graph and individual score, are the AQAL concepts which come from the Word Studies, the Biblical Norms. These are the scriptural ideas or concepts for the questions. These concepts are used to distinguish the true concept of agape, love, patience, kindness from concepts the client has. This contrast shows them the source of their difficulty.
For example, on question 31 you got a two. A score of one or two on any of these signifies a lack of understanding which will cause difficulty in a relationship. There's something the client doesn't understand. We need to talk about this. Question 31 reads, “I can accept my spouse's choice, even if it's different from my own.” Your answer is “sometimes” when the very best answer is “almost always.” God is saying that you should almost always give another person (or yourself) a second chance and time to make the problem right with God’s help. You can show them the Word Study Scripture that explains this concept as their goal. And this may show a strong-willed spouse who always interrupts, or a spouse jumps to conclusions. Neither think, pray, but get upset. They each may be wrong, but they don't check it out. They need to stop, but don’t. They may be insensitive, but don’t know it. See, God's patience, which he'll give you, will show how to handle this much differently than what you're doing. This is a place of learning and changing. A place for prayer, thought, and application.
Question 45. Project 4: Please complete plotting your individual scores for all of the questions on the AQAL form, and draw in all the bar graphs. I will draw in the lines for the bar graphs for the first one, and give the client the option to do the rest not only to save my time, but to give the client the time to think about their scores.
This completes the second course about data collection. For Course 3 you need to keep your score sheets, your analysis profile form, and your questionnaire. We will go into much more depth looking at the questions, concepts, and Biblical norms. We will explain how to interpret the scores and determine the personality type. You will learn when to refer, how to tell if a client potentially has a mental illness, and when you should refer to a physician or psychiatrist. When you finish with Project 4, save it to use in Course 3.
Copyright 1987, 1990, 1993 by Daniel D. Wilkinson. All rights reserved. For more information concerning this material, write to:
The Biblical Christian Counseling Ministries, Inc., 2730 Radcliffe Dr., Florissant, MO 63031.
Any reproduction of this material without the express written consent of the author is prohibited. Printed in the U.S.A..
Fully answer the following question from the content you just read and submit your answer to find your score and Dr. Dan's answer to the question.
In viewing the bar graph, what does each hash mark signify as you start from one at the bottom of the vertical axis and go up to a value of five?
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Dr. Dan's Answer:
Each hash mark signifies one point with the maximum score — five points — signified by the extension of the vertical line to the top of the vertical axis.
Fully answer the following question from the content you just read and submit your answer to find your score and Dr. Dan's answer to the question.
The analysis questionnaire results form also contains a section entitled "Analysis Questionnaire Concepts." This material is displayed below the bar graph and the numerical results of the questionnaire. What purpose does this information serve during the counseling process?
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Dr. Dan's Answer:
These concepts are utilized to draw a contrast between the true concepts of Agape love, the misinformation that the client has brought to the counseling setting, and the spiritual condition of the client at the point of the initial session.
Project 4: Plot Your Analysis Questionnaire Scores
You have almost completed Course 2. By now, you should have a general understanding of the Cognitive Biblical Therapy methodology, the phases and processes and most recently the AQAL and Analysis Profile. Courses 3 and 4 will provide you with a much deeper knowledge and skill to use the CBT method to help people. If for some reason you are not able to start or take Course 3 and 4, please keep in mind, all of the CBT materials are copyrighted and you will need permission by the Biblical Christian Counseling Ministries, Inc. to use any of the materials. Further, CBT Coursework Certification is required to use the copyrighted materials. See the copyright under each chapter’s text for the copyright description. For further information, feel free to reach out to: cbtcoursework@gmail.com.
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