A Summary and Critique of Nouthetic (Biblical) Counseling

A Summary and Critique of Biblical (Nouthetic) Counseling

Henry A. Virkler, Ph.D., Professor of Counseling (Now retired)

Palm Beach Atlantic University

Latest revision: 2023

Clarification of terminology: The term “biblical counseling” is used both by Larry Crabb and by the advocates of the nouthetic counseling to describe their theories. Both Crabb and nouthetic counselors use this title because they believe their counseling approach rests on a solid biblical foundation. Without taking a position on this issue of who can legitimately claim this title, in this paper “biblical counseling” will be used synonymously with “nouthetic counseling” to refer to the approach developed by Jay Adams and those who have adopted his approach.

The historical background of nouthetic counseling: Jay Adams, the founder of nouthetic counseling, was born and raised in Maryland, 18 and child of non-Christian parents. He became a Christian at 18 and started attending a Presbyterian church. He earned a Bachelor of Divinity from Reformed Episcopal Seminary (Bachelor of Divinity or Master of Divinity are the standard degrees for those entering the pastorate), followed by a Master’s degree in Greek.

After entering the ministry, Adams had his first crisis counseling experience, which he relates in the Preface to Competent to Counsel (1970). A man came to him facing impending death. Adams believed he failed to help the man, and decided he needed to become a more effective counselor.

Adams taught for 17 years at Westminster Seminary. As he read Freud and Rogers, he became convinced that what they were calling “sickness” was what Scripture called “sin.” He spent two months with O. Hobart Mowrer, who had developed an approach quite antithetical to the psychotherapy of the time (this was the 1960s). Mowrer taught that people feel guilty, not because of an overly-harsh superego (as Freud had asserted), but because they are guilty. To become healthy, he encouraged confession, accepting responsibility, and changing one’s behavior. Mowrer had been raised in the church but had abandoned his faith in the supernatural. He emptied Scriptural terms of any vertical dimension but did develop a moral model of psychotherapy that in several ways paralleled the moral model developed by William Glasser (Reality Therapy).

Based on his understanding of Scripture and the influence of Mowrer, Adams moved from a medical model of mental illness to a moral model. During this time he also earned a Ph.D. in Speech at the University of Missouri and an STM in Systematic Theology. He started the Christian Counseling and Educational Foundation (CCEF) in Laverock, Pennsylvania, which continues to serve as an educational and promotional center for nouthetic counseling.

Adams eventually moved to the California branch of Westminster, and for many years continued to write extensively about nouthetic counseling and serve as editor for a journal called initially The Journal of Pastoral Practice (now renamed The Journal of Biblical Counseling). He has written approximately 100 books and pamphlets on various aspects of nouthetic counseling. There are now several other authors who have written books on nouthetic counseling or supportive of the basic approach of nouthetic counseling, including Wayne Mack, Howard Eyrich, John MacArthur, Martin and Deidre Bobgan, John Broger, Ed Bulkley, and William Playfair. He completed his earthly journey on November 14, 2020. He was 91 years old.

Schools that have strong nouthetic counseling emphases include Westminster Theological Seminary (both the Philadelphia and Escondido campuses), The Master’s College and Seminary, Biblical Theological Seminary, and Southeastern and Southwestern Baptist Theological Seminaries. Non-seminary-related educational programs that teach this approach include the Biblical Counseling Foundation (Rancho Mirage, CA), Faith Baptist Counseling Ministries and the National Association of Nouthetic Counselors (both of Lafayette, IN), and the Christian Counseling and Educational Foundation (Laverock, PA).

The primary sources, unless otherwise noted, for the first part of this summary of nouthetic counseling are Competent to Counsel (Adams, 1970), The Christian Counselor’s Manual (Adams, 1973), and Introduction to Biblical Counseling (John MacArthur and Wayne Mack, Eds., 1994).

An excellent review of the history of nouthetic counseling is provided by David Powlinson in “Biblical Counseling in the Twentieth Century (Chapter 3) in Introduction to Biblical Counseling (MacArthur & Mack, 1994).

In the last several years a second generation of biblical counselors (a name they now prefer over nouthetic counselors) has arisen. While they maintain considerable continuity with the emphases and core beliefs of nouthetic counseling, they also differ in some of their thinking and emphases.

This first section will describe classical nouthetic counseling as taught by Jay Adams, and I will use the phrase nouthetic counseling to describe these ideas. The second generation of biblical counselors are not monolithic in their thinking, but in the second section of this summary I will describe some of the ways in which their thinking and writing has been changing from historical nouthetic counseling. I will also refer to their ideas by the phrase biblical counseling.

I. Presuppositions

A. Adams believes that humanistic theories have little to offer because they put human beings in the center of their theory rather than God. Because they start without recognizing the proper starting place for theories about humans, it is foolish to look outside the Bible to study the nature of humans.

B. Nouthetic and biblical counselors believe that the Bible is authoritative, relevant, and comprehensively sufficient to handle every counseling problem, based on II Timothy 3:16-17 and II Peter 1:3 (Adams, multiple places; MacArthur and Mack, 1994, p. ix, 57, etc.).

1. II Timothy 3:16-17 says: “All Scripture is God-breathed and is useful for teaching, rebuking, correcting and training in righteousness, so that the man of God may be thoroughly equipped for every good work..”

2. II Peter 1:3 says: “His divine power has given us everything we need for life and godliness through our knowledge of him. . .” (italics added)

C. Nouthetic counselors make a clear differentiation between biblical counseling and Christian psychology, endorsing nouthetic counseling and rejecting Christian psychology. They reject the concept of integrating psychology and theology.

D. Nouthetic counselors reject the concept that psychological problems are caused by unmet needs, indwelling demons, unhealthy learning experiences, genetic predispositions, or inborn temperaments. Sin is the cause of human problems (MacArthur and Mack, 1994, p. 58).

E. Preaching and counseling are essentially the same activity: the differences are that counseling is directed at one individual at a time and focuses on the specific problems that individual is presenting, while preaching focuses on a group of individuals. The content, however, is the same.

F. Nouthetic and biblical counselors believe that the epistemological model of apprehending truth through general revelation and special revelation is flawed–only the latter category (special revelation, i.e., the Bible) can be accurately termed revelation. Therefore all “truths” discovered by humans through the study of the natural universe (often called “general revelation,” as in studies by scientists, physicians, psychologists, educators, etc.) should not legitimately be called “revelation” and as such are of questionable validity (pp. 68-78).

G. Nouthetic counselors believe that apart from salvation, no amount of counseling can resolve basic problems (p. 140). The nonbeliever cannot be counseled biblically (i.e., to move in biblical directions). All you can do is try to prepare them for salvation (p. 167). Counselees who are avowedly non-Christians must be told there is no true hope for them until they are born again (p. 199).

H. Nouthetic counselors believe that the basis of nearly every counseling problem is a doctrinal problem (p. 146).

I. Counseling is essentially discipleship training (p. 148).

J. Counselors should constantly confront clients with the demand to honor and glorify God (pp. 160-161).

K. We should look to the first man—Adam—before the Fall to see our potential. Christ is now our model of what a healthy human being should look like.

II. Theory of Structure

A. Adams believes humans have both a material and a non-material part.

B. He believes that the Gnostic view of humans (the spirit is good, the body is evil) is not biblical (this is a view implied in the theories of both Bill Gothard and Charles Solomon). Adams believes that our spiritual being is as cursed as our material being.

C. Calls his theory “duplex” rather than dichotomous because he wants to stress the unity of the two parts, while still remaining ontologically a dichotomist.

D. MacArthur and Mack’s (1994) book suggests that the dichotomous view has become the standard for the movement (see pp. 376-377). Nouthetic counselors believe that we are composed of a body and a soul/spirit. This assumption (that humans are only composed of two parts—there is no soul (psyche)—that is distinct from the spirit) is the basis for their later arguments that there is no category of psychological problems that are distinct from spiritual problems. Based on a duplex (or dichotomous) view of human beings, they argue that all problems are either bodily (physical) problems or spiritual problems; there is no valid category of “psychological” problems.

III. Theory of Motivation

A. Choice of lifestyle

1. There are two basic lifestyles humans can choose. The feeling-oriented lifestyle is one that is motivated by doing what feels good, or what one believes will feel good. The commandment-oriented lifestyle is one that is focused on glorifying God.

2. Adam and Eve could choose to live a feeling-oriented way of life or a commandment-oriented life toward God. They chose the former, and with that decision brought about the Fall.

B. Motivation through rewards (incentives) and punishments

1. Note that Adams uses the concept of reward in a very different way than most behavioral psychologists. Most psychologists view rewards as something behavioral (e.g., food, attention, something physically pleasurable, etc.) that increases the likelihood that the behavior it followed will be repeated.

2. According to Adams, our primary reward should be the knowledge that our life is pleasing to and glorifies God. Thus for Adams his idea that a reward is something cognitive, a concept that would not be compatible with Skinnerian behaviorism.

C. Motivate clients through modeling (as in Bandura) rather than through Skinnerian reinforcement

1. We as parents, church leaders or counselors should motivate by example. A given behavior can be put into practice only when you see it done.

2. Adams doesn’t agree with a Skinnerian approach to motivation for three reasons:

a. There is no confrontation with the Word

b. There is no dependence on the Holy Spirit

c. There are no absolute standards of right and wrong.

IV. Theory of Development

A. Personality is the sum total of all that one is through nature (genetic potentials) and nurture (life experience). Personality development depends on a person’s willingness to be shaped by God.

B. Habits

1. Habits are a foundational part of Adams’ theory of development. His understanding of habits is based on the theories of William James and Gordon Allport.

2. According to Adams, habits are initially conscious acts that are repeated enough times that they eventually occur automatically and unconsciously. Habitual living is a God-given ability–we couldn’t live without routine.

3. Adams’ biblical basis for this theory is II Peter 2:14 “being trained in godliness” (godly habits). If humans practice what God wants them to do, the obedient life (commandment-oriented lifestyle) becomes part of them.

4. Sanctification can be understood as putting off the feeling-oriented lifestyle and putting on the commandment-oriented one.

V. Theory of Individual Differences: Adams doesn’t develop an explicit theory of individual differences. A theory of individual differences is implicit in his writing. There are four basic concepts that form a rudimentary theory of individual differences:

A. Spiritual state: unbelievers versus believers

B. Specialized group: (each group has typical problems they will present)

1. Children: will usually present with problems related to parents and teachers.

2. Older children and young singles: will usually present with problems related to parents and the opposite sex.

3. Older singles: Major problem–resenting not being married.

4. Married people: problems with spouse and in-laws.

5. Older people: loneliness.

6. Handicapped persons: self-pity and resentment toward God.

7. Knowing what group people are in helps us recognize what problems they are likely to have.

C. Spiritual gifts (Adams’ theory of spiritual gifts is most fully developed in The Christian Counselor’s Manual, 1973, Chapter 30).

1. Human beings have one or more gifts.

2. Counselors should help counselees

a. Realize everyone is gifted

b. Discover what their gift(s) are

c. Find a proper place for the exercise of their gift

d. Recognize their gift is to be exercised for the benefit of the whole body of believers

e. Help the counselee appreciate his or her own gift(s).

D. Sins and dodges:

1. We are all sinners. We attempt to dodge the guilt and effects of our sins in various ways.

2. The combination of our sins and our dodges are an important component making up our unique personality style.

E. Thus people differ from one another because of their spiritual state, the group they are in, the spiritual gifts they have (and how they view and use those gifts), the sinful patterns they engage in, and the way they deal with or attempt to dodge the effects of their sins.

VI. Theory of Health: As with many other counseling theories developed in the 1960s and before, Adam’s major focus is on developing a theory of pathology rather than a theory of health. He would probably say that a healthy person is one who is committed to living a commandment-oriented lifestyle out of love for God.

VII. Theory of Pathology

A. Adams believes the medical model of mental illness is both inaccurate and ineffective.

B. He would summarize the medical model of mental illness in the following way:

1. Patients have psychological illnesses that are analogous to physical illnesses.

2. They are not responsible for their illnesses.

3. They are not responsible for getting well on their own.

4. They need the expert care of a physician (or in this case a psychiatrist or psychologist).

C. In contrast, the primary assertions of the moral model of Mowrer and Glasser (which is basically adopted by Adams) include:

1. Patients’ problems are moral.

2. Their problem is not an overly-strict conscience, but that they repeatedly violate it.

3. Patients suffer from real guilt (not false guilt).

4. To get better, patients must stop blaming others and accept responsibility for their own behavior.

5. Clients’ problems will be solved, not by ventilation of feelings, but by confession of sin.

D. Adams believes there is an iatrogenic (physician-caused) pathology caused by the medical model

1. By causing abolition of conscience standards, counselors only make guilt worse.

2. By removing feelings of responsibility, counselors remove hope of being able to change.

E. An overview of Adams’ theory of the etiology of emotional problems.

There are three possible sources of problems:

1. Physical causes: e.g., injury, disease, or genetic causes

2. Demonic

3. Hamartiagenic (sin-caused)

4. There is no category of psychologically-caused abnormal behavior, i.e., problems caused by our past history or by psychological processes that operate below the level of conscious awareness (and therefore beyond the control of the person).

a. People (aside from those with organic problems), are in psychiatric hospitals because of their unforgiven and unaltered sinful behavior (Adams, 1970, xvi).

b. People are responsible for their behavior. They get in trouble because their behavior is irresponsible. Freudian therapy fails to help because it provides a pseudoscientific rationale which irresponsible people use to continue to justify their behavior.

c. The cause of human problems is either organic or sin, but not mental illness (1970, p. 29). What they have are unsolved personal problems.

d. People have dysphoric feelings (e.g., anxiety, depression, anger) because of their sinful behavior. Feelings flow from actions (1970, p. 93). People feel guilty because they are guilty (1994, p. 104).

5. Everything non-organic is spiritual (i.e., the result of personal sin): Counselors need to recognize we’re engaged in spiritual warfare.

a. However, Adams believes demon possession is rare. Adams subscribes to the amillennial theory that Satan and his demons were bound, bruised, curtailed and restrained at the time of Christ’s death and resurrection (Rev. 16:14; 20:7-10, II Thess. 2:9-12). Satan and his demons are prohibited from wholesale deceit now.

b. Demonic oppression or possession doesn’t happen now for Christians because Satan and the Holy Spirit can’t co-exist, although oppression or possession can occur in non-believers.

c. Adams believes that labeling problem behavior in Christians as the result of demonic oppression or possession is incompetent counseling. It leads to the following results:

(1) Since problems are due to sinful behavior of people, giving them an incorrect diagnosis of the cause of their problems complicates the issue.

(2) It produces hopelessness and despair.

(3) It shifts the focus from the clients’ responsibility to that of demons.

6. Hamartiagenic (non-demonic) causes of pathology

a. Adam and Eve’s choice of a feeling-oriented lifestyle rather than a commandment-oriented lifestyle led to the Fall. The same choice leads people today to reject God and the principles He has given to us in Scripture.

b. Rejection of God’s principles causes internal and external consequences.

c. In order to deal with the painful internal consequences (depression, guilt, anxiety) we develop patterns of avoidance (these function, according to Adams, similarly to defense mechanisms, i.e., they allow us to function even though we are experiencing anxious feelings, but they operate at a more conscious level, and therefore humans are responsible for what they do with them).

d. In order to deal with the painful external consequences we develop ways to shift the blame–dodges or blameshifting [cf. how Adam and Eve engaged in dodges– Adam attempted to shift the blame to Eve (and to God for creating Eve), and Eve attempted to shift the blame to the serpent].

e. Problems can be identified at three levels

(1) Preconditioning problem: the underlying habit pattern.

(2) Performance problem: the present behavioral manifestation of the long-term habit. This can be either doing something one shouldn’t be doing, or not doing something one should be doing.

(3) Presentation problem (presenting problem): the presenting behavior or feeling that results from the performance problem. For example, Ginny has learned to be passive-aggressive in her intimate relationships (the preconditioning problem), which causes angry conflicts in her marriage (performance problem), and she comes to counseling complaining of depression (the presenting problem).

7. Example: The Case of Leo Held (see Adams, 1970, p. 26). This is the story of a man who had a series of interpersonal difficulties–with neighbors, fellow-drivers, and co-workers, which eventually ended in a shooting spree. He might be diagnosed today as having paranoid personality disorder. Adams raised the question of whether Held’s problem was that he had a legitimate psychological illness, or was it that he had developed the sinful habit of nursing resentments? Adams opts for the second explanation.

8. Second example: Steve (Adams, 1970, pp. 31-32). Steve was a college student who spent too much time on activities other than his studies, then began to act bizarrely to distract attention from his poor grades. He was diagnosed with catatonic schizophrenia. Adams concluded that Steve was simply trying to camouflage his irresponsible behavior (not studying enough) by acting as if he had a serious mental illness.

9. Third example: Mary (Adams, 1970, pp. 33-35). Mary was diagnosed with manic-depressive illness (now called Bipolar Disorder). Adams concluded that this was just a cover for her guilt about an adulterous relationship with her neighbor.

10. In all three examples Adams seems to be suggesting that people act as if they have some serious mental illness in order to cover some sinful or irresponsible behavior in which they have engaged.

VIII. Theory of Cure

A. Adam’s model of cure follows from his view of pathology. There are three main elements:

1. Counselees have problems resulting from sin that must be resolved God’s way.

2. These problems must be resolved by verbal confrontation using the Scriptures.

3. The resolution must be done out of love for counselees, and to help them love God and enjoy Him in their lives

B. Counseling is essentially helping clients become sanctified (grow spiritually) (Adams, 1970, p. 73).

C. The Holy Spirit is the source of all genuine personality change that involves the sanctification of the believer (p. 21).

D. To be led by the Spirit (Ga. 5:18) means to be led by the teachings of Scripture (nouthetic counselors would reject hearing directly from the Spirit (through either the gifts of the Spirit or through something such as healing of memories or journaling) as either not being for today (in the case of gifts of the Spirit) or as being too mystical (as in healing of memories or journaling).

E. The biblical counselor should focus on what the counselee is doing, not why. Asking counselees why they are doing something gives them opportunities to engage in ego defenses, dodges, and blame-shifting.

F. The biblical counselor should use authoritative instruction–directive, nouthetic techniques.

G. The goal of biblical counseling is love from a pure heart, a good conscience, and a sincere faith.

H. Depressed people whose symptoms fail to show any sign of a biochemical root should be counseled based on the assumption that they are depressed by guilt (Adams, 1970, p. 126).

I. “Mental breakdowns” are really breakups (cited by Adams with approval from Dabrowski, Positive Disintegration). Breakdowns are an opportunity to restructure response patterns in a healthier way than ever before (p. 171).

J. The counselor should help the counselee identify desire-oriented decisions and reject them in favor of commandment-oriented decision-making. The client must be taught to ask not “What do I want?” but “What does God want?” (Adams, 1973, p. 122).

K. Comparison with other forms of counseling

1. Adams claims that counseling theories include implicit, if not explicit, theological stances

2. Rogerianism, for example, teaches that God is not needed in solving humanity’s problems, at the core humans are essentially good, the solution to human problems lies in the realization of our own inner potential, and the goal of counseling is to make human beings autonomous. All of these are theological statements.

3. Adams asserts that Freudianism and behaviorism also include implicit or explicit theological stances.

4. Important conclusion: Adams believes that the counseling methodology grows out of the counseling philosophy: therefore we must reject both.

a. “The non-directive role violates the pastors’ convictions, his conscience and his calling. He acts as if God had nothing to say to the counselee” (1970, p. 78).

b. “Rogerianism, therefore, must be rejected in toto. Every remnant of this humanistic system exalting man as autonomous must be eradicated. The basic premises lead to the methodology. Reject the one and you [must] reject the other” (p. 103).

L. Who should be counseling?

1. Adams believes that II Timothy 3:16-17 teaches that Scripture gives us all the data necessary for the Christian to be fully equipped for Christian living.

2. Scripture says nothing about psychological problems. What we have labeled psychological problems, Scripture labels as sin. Man’s problems are moral ones, not psychological ones. Therefore counseling should be done by the pastor. Psychologically-trained persons have no legitimate place in counseling (Adams, Answers to Questions, pp. 15-18).

IX. Therapeutic Techniques

A. Get basic biographical data using the Personal Data Inventory (1994, pp. 387-390).

B. Get concrete data about problems

C. Stress what the counselee is doing rather than why (asking Why questions invites clients to rationalize).

D. Distinguish preconditioning, performance and presentation (presenting) problem.

E. Take a behavioral history to identify habitual (particularly unbiblical) response patterns.

F. Problems must be assessed and solutions offered based on God’s perspective, not from the client’s (Reason: We tend to evade looking at the consequences of our sin by minimizing, dodging, and blame-shifting).

G. Adams states: “The more directive I became (simply telling counselees what God required of them), the more people were helped. Spelling out and getting commitments to Biblical patterns of behavior after an acknowledgment of and repentance for sin seemed to bring relief and results” (1970, p. xiii; 1973, pp. 16-17).

H. “His [the pastor’s] Christian presuppositions must at all times control the interview” (1970, p. 86).

I. “The Book of Proverbs exhorts the young man to listen to others rather than depend upon his own ideas: ‘Do not rely on your own insight’ (3:5). Words could hardly be more anti-Rogerian” (1970, p. 99).

J. Check the counselee’s motivation: Ultimately it must be loving obedience done because God says this is what should be done.

K. Insist on obedience regardless of how one feels.

L. Restructure the way a counselee talks: The recommended biblical counselor responses (CR) to typical counselee statements (CE) are given below: (From Adams, 1973, p. 451):

CE: “I can’t!”

CR: “Do you mean you can’t or won’t?” or “God says that you can.”

CE: “I have done everything that I could.”

CR: “Everything? What about . . . .”

CE: “I’ve tried that but it didn’t work.”

CR: “Did you really try? How many times? For how long? In what way? How consistently? (Get the details: “[P]recisely, what did you do?”)

CE: “No one believes me, etc.”

CR: “Can’t you think of one person who does? How about some more?” or, “I believe you . . . .”

CE: “I could never do that.”

CR: “Never is a long time. Really, how long do you suppose it might take you to learn? By the way, if you think hard enough you will discover that you have learned to do a number of things that are just as hard (or harder). Take for instance . . . .”

CE: “If I had the time, I’d do it.”

CR: “You do. We all have 24 hours each day; it all depends on how you slice the pie. Now let’s work on drawing up a schedule that honors God.”

CE: “Don’t blame me . . . .”

CR: “Are you saying you’re not responsible?” God says . . . .”

M. If the client is reluctant, tell him or her “You can’t say can’t” (1970, p. 131) (based on I Cor. 10:13).

N. Confession is an important technique in biblical counseling

1. Unconfessed sin can cause psychosomatic problems and guilt.

2. Confession brings pardon and relief (James 5:14).

3. The process should be: repentance, confession, reconciliation.

4. Confession may be to God, elders, or person(s) sinned against.

5. The counselor should be careful not to minimize the counselee’s sin or let the counselee’s confessor do likewise.

6. Roleplay in the counseling session what should be said.

O. Dealing with unbiblical behavioral patterns through dehabituation/rehabituation (Adams, 1973, pp. 191-216):

1. Become aware of what you are doing through “log lists” and chart keeping: “Own it.”

2. Discover the biblical alternative and ask God’s forgiveness: “Disown it.”

3. Structure your life so that change can occur. The counselor should give concrete homework every session.

4. Break links in the chain of sin

5. Get help from others: identify one or more people to whom to be accountable.

6. Stress the whole relationship to Christ, not simply this specific behavior.

7. Practice the new pattern.

8. Check with the counselee to see how he or she is doing.

P. Dealing with transference: If counselee transfers perceptions and behavioral patterns from parents or other people onto the counselor, the counselor should confront this directly and expect an apology (see Adams, 1970, pp. 101-102).

Q. For child lying: Wash out mouth with soap.

R. Prayer

1. Does not stand alone.

2. Prayer should be combined with changing one’s thought patterns and behavior.

S. Daily devotions

1. This is a way of maintaining proper contact with God.

2. It is the first step in problem-solving.

T. Family Conference Table (1973, pp. 233-244) (this appears to be a nouthetized version of the Adlerian Family Meeting)

1. Open and close with prayer

2. Family members begin with confession

3. Have a secretary to keep record of commitments family members make

4. No arguing allowed

5. Eventually the table comes to symbolize communication

U. The cliff-hanger: Solving part of the problem in session, and leaving the counselee to solve the rest as homework.

V. Multiple counseling: Adam’s term for counseling with the whole family system.

W. Team counseling: having multiple counselors in a session with one counselee. Adams allows no more than four counselors to work with one client simultaneously.

X. Adams does not believe in group therapy: “Group therapy that is predicated upon the principle of ventilating anger in order to get something off one’s chest is totally out of accord with the verses just cited [Prov. 14:29 and 29:11]. Ventilating sinful feelings is simply unbiblical” (1970, p. 221).

Y. Termination occurs when clients spontaneously begin to solve problems on their own.

X. Changes that Are Occurring Within the Second Generation of Biblical Counselors

A. As mentioned earlier, the second generation of biblical counselors are not monolithic, so they do not agree on all of the following issues, but here are some of the general changes they are verbalizing.

B. This discussion is drawn primarily from:

1. The Biblical Counseling Movement After Adams by Health Lambert (2012)

2. Multiple articles from CCEF Now (2012)

3. Affirmations & Denials: A Proposed Definition of Biblical Counseling by David Powlinson, 2010.

4. Psychology & Christianity: Five Views: Second Edition, edited by Eric Johnson (2010)

5. Introduction to Biblical Counseling, edited by John MacArthur and Wayne Mack (1994)

C. Since the number of articles written by biblical counselors written in the last twenty-five years is massive it is impossible to do a comprehensive analysis of all that has been said or written by these second generation biblical counselors. This is an attempt to summarize some of the major thoughts and changes proposed by these authors and biblical counselors.

D. Commitments that are Unchanged: Even though there are some modest changes in emphasis among second generation biblical counselors and Adams, there is also high respect for him as the founder of the biblical counseling movement, and many of his ideas remain the foundation for second-generation biblical counseling. Biblical counselors continue to affirm these ideas that were articulated by Adams:

1. All counseling is a theological enterprise: All counseling takes place within the context of some theological worldview, whether recognized by the counselor and client or not. That theological worldview may be one that says God does not exist, or that if he exists he’s really not relevant to the counseling process, or one that says every event in our lives should be viewed from the context that God is working in our lives. Even some Christian counselors who sincerely believe in God in their personal lives rely almost exclusively on their secular counseling training when they counsel, and rarely if ever include discussion of God and his perspectives in their counseling. Thus they function almost identically to secular therapists, even though they are sincere Christians themselves. Biblical counselors agree that God in Christ is the fundamental reality in all counseling (Lambert, 2012, p. 45).

2. If all counseling is a theological enterprise, then the most important training for those who wish to be counselors is theological training. Almost everyone who teaches biblical counseling has a Masters of Divinity degree.

3. The Bible is the authoritative source of wisdom and is sufficient to help people with any problem that requires counseling: thus the Bible should be the primary training manual for counselors (Lambert, p. 45). There are, in the writings of second generation biblical counselors, occasional references to secular counseling resources, but the vast majority of their writing and teaching is drawn from the pages of Scripture.

4. The church has the inescapable responsibility to do counseling. The only question is whether church leaders will do it well or poorly.

5. Biblical counselors continue to disagree with the concept that there are two ways that God reveals his truth–natural revelation (science) and special revelation (Scripture). Even though most Christian theologians and scholars have used this dichotomy as a two-fold way in which God reveals his truth to mankind, biblical counselors do not agree that truth discovered through the use of science and logic (what has historically been called “natural revelation”) should be called “revelation.” Since it depends on human discovery and logic, which is inescapably distorted by humans’ sin nature, it does not deserve to be called revelation. The only thing that deserves to be called “revelation” is Scripture, and the only counseling principles and methods that can be fully trusted would be those drawn from Scripture.

6. Biblical counselors remain committed to the idea that the Bible is the source of wisdom about how to change, and that Jesus Christ is the source of the power to change (Lambert, p. 24).

7. It appears that biblical counselors continue to believe that significant change can only occur if a client becomes a Christian. For example, Mack says: “Those counselees who are avowedly non-Christians must be told that there is no true hope for them until they are born again by the Spirit of God (John 3:3, 36)” (MacArthur and Mack, 1994, p. 199).

8. Some of the primary leaders in this second generation of biblical counselors would be David Powlinson, Ed Welch, Paul Tripp, and Wayne Mack.

E. Changes between Adams and second generation biblical counselors: the modest changes that have occurred include both theoretical ones and methodological ones. Lambert (2012, pp. 45-46) describes those changes using the following taxonomy: Second generation biblical counselors:

1. Have emphasized the development of ministry to those who are suffering as well as those who are sinning. The primary focus of Adams’ writings were on how to counsel those who were having difficulties because they were sinning: second generation biblical counselors have also focused on how to counsel those who are suffering.

2. Have developed a deeper understanding of human motivation. Adams’ theory of motivation was primarily behavioral: second generation biblical counselors have attempted to develop a deeper understanding of how human motivation works.

3. Have emphasized the development of a more collegial, collaborative counseling relationship. Adam’s counseling style was predominantly formal, authoritative, and confrontational: second generation biblical counselors tend to emphasize a more loving, compassionate counseling approach.

4. Have attempted to talk less confrontationally with counselors who use other counseling approaches. Adams’ tended to interact with people, even Christians, who embraced other theories in a very confrontational, black-and-white way. Second generation biblical counselors have been more likely to be more kind and gracious in their conversations with proponents of other theories.

5. In the sections below we’ll look at each of these changes in more depth.

F. Recognizing both sin and suffering

1. Adams primary emphasis in his writings and counseling was to identify the sin the counselee was engaged in and confront that sin.

2. Second generation biblical counselors have not abandoned the idea that people sometimes come to counselors because they have sinned and that sin is producing consequences. However, they also recognize that sometimes people come to counselors because they are suffering from the sinful behavior of others, or sin in the world, or other reasons. And they also believe that people come to counseling because of a combination of both.

3. Adams occasionally defended his position, saying that he recognized that suffering was also a cause of human problems. However, these statements were very brief and rare, and he never emphasized or developed a methodology to work with clients who came to the office because they were suffering. For example, in The Christian Counselor’s Manual, there is only one reference to misery and one reference to suffering, and there is no discussion of how to minister to suffering, hurting people (Lambert, p. 201).

4. Second generation biblical counselors draw attention to the fact that large sections of Scripture do recognize that suffering is a significant part of human experience: therefore if we are going to be balanced biblical counselors we need to have a recognition and a methodology for dealing with clients who are suffering as well as for clients who are sinning.

5. Several of the leaders in the second generation of biblical counselors–Powlison, Welch, Lane and Tripp have all written extensively on the theological basis for recognizing clients as sufferers and the need to develop ways to minister to such clients (Lambert, 2012, pp.50-66).

G. A Deeper Understanding of Motivation

1. Adams primarily understood sinful behavior as the result of practicing sinful behavioral habits.

2. His counseling methodology was something he called “dehabituation” (stopping the sinful habit) and “rehabituation” (practicing a new God-honoring habit in its place).

3. Second generation biblical counselors differ from this emphasis by saying it is important to understand the motivation behind the sinful behavior–why the person is sinning. (Adams heavily criticized the concept of asking “Why?,” asserting that it gave the client an opportunity to rationalize their behavior.)

4. Second generation biblical counselors such as Powlinson, Welch, and Schwab that sin in Scripture is not simply behavioral patterns that have become habits. Sin arises from the heart (e.g., Mark 7:21, Galatians 5:15-21, 1 Timothy 6:10). Some of these writers make two criticisms of Adams’ theory of motivation:

a. It comes out of the secular behaviorism of O Hobart Miller and William Glasser and

b. It does not include some important biblical concepts, namely, the fact that we are motivated by internal processes, and changing ourselves (or helping our clients change themselves) must include changing those internal processes and motivations, rather than just substituting more godly behaviors for sinful ones.

c. In his later writings Adams does recognize that this internal emphasis is missing in his early writings (something Adams did not frequently do), but he left it to second-generation biblical counselors to develop this concept.

5. Some of the concepts regarding this deeper understanding of motivation are summarized below.

6. Powlinson talks about the fact that every human being worships something. We can center our worship on God, or we can center it on something else (pleasure, acquisition of money or things, attractiveness, power, or popularity, etc.).

7. In the Old Testament God talked often of idolatry, which in those times often focused on external, physical idols. In the New Testament the emphasis shifted to internal idols, such as the ones mentioned in the paragraph above. Powlinson has called these “idols of the heart” and this has become a major paradigm shift in second generation biblical counseling. To help a person change it is crucial to not just work on changing the external behavioral habits, but to help the person identify and change the internal idol (or goal) that is producing that behavior.

8. Welch talks about the fact that many times our anxieties, depression, or addictions come because we are worshiping one of these internal idols of the heart, and when our attainment of that idol is blocked we become anxious, depressed, or resort to some addiction to deal with the feelings generated when we aren’t successful in achieving the goal inspired by our idol.

9. There are many biblical texts to support this deepened theory of motivation. One among many that speak to this issue is Jesus’ discussion with the Pharisees in Mark 7:18-23. They were living with the assumption that external behaviors were what contaminated a person. He instead confronts that thinking and says that what comes out of men’s hearts is what contaminates him.

10. This new paradigm about human motivation also changes second generation biblical counselors methodology. Instead of focusing on dehabituation and rehabituation (a behavioral emphasis), Powlinson talks about “X-ray questions”–questions that ask the client to look at the motivations behind their behavior (Lambert, 2012, pp. 66-80).

H. Continuity in Methodology

1. In Competent to Counsel Adams laid out the conceptual ideas that were the framework for nouthetic counseling.

2. A few years later he laid out his thoughts about counseling methodology in his book The Christian Counselor’s Manual.

3. Adams and second generation biblical counselors agree on the importance of listening and careful data gathering. Nouthetic and biblical counselors base this idea of careful listening on passages such as Proverbs 18:2-3, James 1:19, and Hebrews 4:14-16.

4. In Introduction to Biblical Counseling Wayne Mack recommends the use of the Personal Data Inventory (essentially an intake questionnaire) that is the same one that Adams introduced almost 25 years earlier.

5. Powlinson says (in Speaking the Truth in Love) that counselors should ask two categories of questions:

a. What is happening in the client’s life, and

b. What does God have to say about the situation the client is facing?

6. This approach continues the thinking of Adams without significant change.

7. Secondly, there is much continuity between Adams and second generation biblical counselors in emphasizing the importance of biblical instruction

8. Adams strongly objected to the non-directive approach of Carl Rogers and thought that pastors/counselors should be directive and help clients understand God’s instructions. This too remains an important focus of second generation biblical counselors.

9. Thirdly, Adams and second generation biblical counselor agree that it is not enough for counseling to result in new insights–the end result should be changes in one’s behavior. To this end, homework assignments and followup on those homework assignments by the counselor have been and remain an important part of this counseling (Lambert, 2012, pp. 81-86).

I. Changes in Methodology

1. Adams’ model for counseling was quite authoritative and formal. There is a movement in second generation biblical counselors to a more personal, sensitive style. Powlison says: “The most characteristic biblical counseling relationship is a long-term friendship, consisting of mutually invited counseling and generating dependency on God as well as constructive interdependency on one another. The authoritative short-term intervention is the emergency, life-saving measure (Crucial Issues in Contemporary Biblical Counseling,” Journal of Pastoral Practice 9, no. 3 (1988): 65-66.).

2. In another place Powlison even more directly criticized Adams’ method when he says: “Adams tells me I need compassion, identification and mutuality, but he teaches and models rebuke, proclamation, and authority. He calls me to balance, but doesn’t teach me how” (“Review of Hebrews, James, I and II Peter, Jude, by Jay E. Adams,” Journal of Biblical Counseling, 15, no. 1 (1996): 64.

3. Lambert (2012) identifies six changes in methodology that are found among leaders of the second generation of biblical counselors, each of which they ground in Scripture:

a. Counseling that treats counselees in the same way one would treat a family member (e.g., 1 Timothy 5:1-2)

b. Counseling that communicates to the counselee that the counselor affectionately cares for them (illustrated in Jesus’ life and teaching).

c. Counseling that is sacrificial (e.g., 1 Thess. 2:7-8)

d. Counseling that is sensitive to where the person is emotionally. Adams was trying to draw a clear contrast with Rogerian person-centered therapy, where Rogers taught that people have the truth within them, and it will express itself if the counselor shows unconditional acceptance. However, in his rejection of Rogerianism and person-centered counselors, he reacted so strongly that he confronted clients with biblical truth without listening to and understanding their pain. Mack takes an example from Adams’ Christian Counselor’s Casebook and specifically criticizes Adams’ approach as being insensitive–Adams immediately confronted the client about where he thought her behavior was unbiblical without taking the time to hear her perspective and build a relationship with her (Introduction to Biblical Counseling, pp. 173-175). Mack shows an awareness of things such as attending skills, empathy, process and timing that is not seen in the writings of Adams (ibid, pp. 175-181). He mentions the use of what have been called “facilitative conditions” or “core conditions,” identifying them by the names “compassion, respect, and sincerity” citing biblical passages and verses rather than empirical research to justify their place in counseling.

e. Counseling that sees the counselor as a fellow sinner and sufferer, and

f. Counseling that addresses suffering before sin (pp. 90-99).

J. Differences in How Biblical Counselors Talk with Other Christian Counselors

1. Jay Adams was never willing to set aside his combative, aggressive tone when talking with Christian counselors who believed in integrating Christian theology and psychology.

2. Despite several attempts by various people to build bridges between Christian counselors and nouthetic counselors, Adams remained so “irascible and sectarian” that several Christian integrationists such as John Carter, Bruce Narramore and Larry Crabb eventually expressed their unwillingness to attempt further dialogue with Adams (Lambert, p. 104).

3. In contrast, leaders of the second generation of biblical counselors such as Powlison, Welch, and Tripp, while still maintaining their belief in the superiority of biblical counseling over integrative approaches, have attempted to have a much more cordial relationship with integrationists.

K. Have Biblical Counselors Changed in Their Beliefs in the Sufficiency of Scripture?

1. Jay Adams was very clear that he believed that Scripture gives the counselor everything they need to counsel.

2. There is a debate between Eric Johnson (Foundations for Soul Care, 2007) and Health Lambert about whether there has been a shift on this doctrine. Johnson believes that second generation biblical counselors have been more willing to recognize that psychology can provide helpful information to counselors, while Lambert argues that second generation biblical counselors continue to affirm the sufficiency of Scripture.

3. Powlinson’s comment that follows seems to express the belief of Adams’ and of second generation biblical counselors: “Do secular disciplines have anything to offer to the methodology of biblical counseling? The answer is a flat no (emphasis added). Scriptures provide the system for Biblical counseling. Other disciplines–history, anthropology, literature, sociology, psychology, biology, business, political science–may be useful in a variety of secondary ways to the pastor and the biblical counselor, but such disciplines can never provide a system for understanding and counseling people” (Quoted by Mack in Totally Sufficient, pp. 50-51).

4. As I read these two opposing views of what second generation biblical counselors believe (i.e., Johnson’s versus Lambert’s), I think this can be resolved in the following way: I believe that second generation biblical counselors believe that Scripture provides a totally sufficient framework for addressing every counseling problem and that they also believe it can provide many helpful details by which to do counseling, but that they are willing to accept that psychological research can sometimes provide additional helpful details to use within that Scriptural framework. If you have the time and interest to read those authors yourself you can decide whether you agree with this way of resolving this difference of opinion.

A Critique of Nouthetic or Biblical Counseling

Note regarding this critique: The first portion of this critique focuses on traditional nouthetic counseling as taught by Jay Adams and by those who continue to use his teachings as the basis for their counseling. The second portion includes my thoughts on biblical counseling–the teaching found in second-generation nouthetic counselors (they prefer the term biblical counselors), such as Powlinson, Welch, Lane, and Tripp.

Explanation of symbols: A + before a statement indicates that this is a point I agree with. A - before a statement indicates that this is a point I disagree with, and will usually contain an explanation of why I believe that assertion is incorrect. A ± before a statement indicates that I agree with part of the statement and disagree with another part.

TRADITIONAL NOUTHETIC COUNSELING

Presuppositions

One of the foundational presuppositions of biblical counseling is that the Bible has comprehensive, sufficient answers for every counseling problem (based on II Timothy 3:16-17 and II Peter 1:3), and that therefore no additional data from the field of counseling and psychotherapy is necessary. It is important to read these two passages in their historical and grammatical context to see if that is what they are teaching.

– II Timothy 3:16-17 states: “All Scripture is God-breathed and is useful for teaching, rebuking, correcting and training in righteousness, so that the man of God may be thoroughly equipped for every good work.” Adams says that this verse teaches that the Bible has all the information the pastor needs in order to counsel. Further training in counseling is unnecessary and may be detrimental because of unbiblical underlying presuppositions found in psychology.

However, the text is only talking about the training of pastors (the phrase "man of God"–anthropos theou–means pastor). Furthermore, the Apostle Paul defines what the Word will equip the pastor to do. It will equip him to (1) teach correct doctrine, (2) rebuke incorrect doctrine, (3) train in right behavior, and (4) correct wrong behavior.

This does not mean that Scripture will teach pastors how to conduct weddings, funerals, board meetings, church business meetings, organize or deliver sermons, or many other things, including counseling. At the seminaries where Adams has taught, he used a number of other textbooks besides the Bible to train pastors for these other functions. Therefore II Timothy 3:16-17, correctly interpreted, is not claiming that the Bible is a complete counselor-training manual for pastors or for others who are called to the ministry of counseling. As Crabb has noted, the Bible contains many important truths that are foundational for effective Christian counseling. But just as it does not claim to contain all the truth necessary for physical healing, neither does it claim to contain all the truth necessary for psychological or interpersonal healing. II Timothy 3:16-17 is saying that the Bible contains all the theological information necessary to fully train a pastor to teach correct doctrine and rebuke false doctrine, and to train in right behavior and rebuke wrong behavior. It does not claim that he will not need other textbooks to train him about other facets of ministry, including counseling.

– Similarly, II Peter 1:3 states: “His divine power has given us everything we need for life and godliness through our knowledge of him who called us by his own glory and goodness.” This verse is also used by biblical counselors to assert that the Bible contains everything we need to know in order to counsel. Note the explanation of this verse given by the theologians who wrote the NIV Study Bible: “God has made available all that we need spiritually through our knowledge of him. If indeed II Peter was written to combat an incipient Gnosticism, the apostle may be insisting that the knowledge possessed by those in apostolic circles was entirely adequate to meet their spiritual needs. No secret, esoteric knowledge is necessary for salvation” (1985, p. 1899). Thus, when viewed in context, neither II Timothy 3:16-17 nor II Peter 1:3 claim that the Bible is a comprehensive counseling manual.

– A second questionable assumption is the assertion that the basis of nearly every counseling problem is a doctrinal problem. There are at least two strong arguments that can be made against the validity of this position. First, there are many Christians who have impeccable doctrine, but who nevertheless make their spouses and children miserable. Second, many of those Christians who come for counseling know their doctrines correctly but have struggled for years to make their lives conform to that doctrine. It seems clear from these two examples that knowing doctrine correctly does not mean a Christian will have no counseling issues.

– Nouthetic counselors teach that counselors should constantly confront clients with the demand to honor and glorify God (MacArthur and Mack, 1994, pp. 160-161). It is true that Christians should attempt to honor and glorify God. But constantly confronting them with the demand to do so will probably be counterproductive. When people experience the Lord’s healing and grace in their lives they will often desire to honor and glorify him. But a counselor constantly confronting them with this demand is likely to cause resentment and resistance. Scripture teaches that when we are told we have to do something, our normal response is to rebel (Ro. 7:7-8). In contrast, when we experience God’s love, we desire to love in return (I Jn. 4:19).

Theory of Personality Structure

+ Adams makes the important point, from a Christian perspective, that a personality theory needs to include one's relationship to God as a significant part of understanding human personality. (Most secular counseling theories totally ignore the divine-human relationship, implicitly suggesting that it is unimportant, or view it as a projection of an immature person who has not developed the capacity to accept one’s aloneness in the universe.)

+ Adams also clearly separates himself from the Gnostic view that the body is bad and the spirit is good.

+ Thirdly, Adams stresses the functional unity of the body (material part) and the spirit (immaterial part) of human beings.

– Although Adams stresses the functional unity of body and spirit, he remains ontologically a dichotomist, that is, he believes that humans are composed of two different essences. It is clear from biblical studies of the last forty years that the biblical authors were writing from a holistic perspective, and that the dichotomous view of human beings came out of secular Greek philosophy. Biblical counselors are strong to assert that they accept nothing secular but derive their theory totally from biblical data. Therefore it is surprising that they reject a theory of personality structure coming consistently from the biblical authors in favor of one coming out of secular Greek culture.

– Adams claims it is foolish to look outside the Bible to study human personality. This takes away an important source of information about human functioning and is inconsistent with his own statement that psychology is useful for describing what is there.

Theory of Motivation

+ Adams makes a positive contribution by his stress on personal responsibility in developing one's lifestyle.

+ It is also valuable for people to consider the spiritual implications of their lifestyle choice (a commandment-oriented versus feeling-oriented lifestyle).

+ Adams shows the significant differences between a Skinnerian and a biblical view of motivation.

– Considering all motivation to come from one of two motivational tendencies seems to be overly-simplistic. The biblical counseling model doesn't deal with the facts that (1) many times we are motivated by needs that operate below the level of conscious awareness, (2) the effects of past experiences (especially traumatic events) shape motivational drives, or (3) preconscious cognitive assumptions (e.g., mistaken beliefs) often effect how we believe we can best meet our needs.

– Adams also doesn't give adequate recognition to the fact that often commandment-oriented living is not motivated by a desire to please God. For example, the legalism of the Pharisees of Jesus' day was designed primarily to win the approval of men (Mt. 6:5). In a similar way, some of the rigid legalism found among Christians today, while externally it looks like commandment-oriented living, may not be motivated by a genuine desire to love and serve God with one's life.

– Adams and the writers who wrote Introduction to Biblical Counseling (1994) identify themselves with traditional Reformed theology (Calvinism). Some Reformed theologians (e.g., B.B. Warfield) espouse a theory called cosmic determinism, the belief that everything that happens in the universe is determined by God. The majority of Reformed theologians today, probably the group with which Adams would identify himself, believe in a more limited form of determinism called soteriological determinism. Briefly, this theory hypothesizes that God determined (elected) in eternity past those who will become believers. Those whom he elected will be irresistibly drawn to Him, and they will undoubtedly persevere in the faith throughout their lives. Those whom God does not elect cannot possibly come to God. This view, theological determinism, contrasts with Arminianism, which is the view that God makes his grace available to all and allows people to choose to accept or reject that grace.

Adams and his followers claim to be Reformed (deterministic) in their theology, that is, God determined from eternity past who was going to be saved, and human beings have absolutely no say in the matter. However, the entire emphasis in their counseling theory is on exhorting people to choose God's way of life and reject one's own sinful inclinations. This constant emphasis on choosing (theological voluntarism) is more compatible with Arminian than Calvinistic theology. Neither Adams nor his followers explain, at least in their primary works on counseling, how they reconcile being determinists in their professed theological stance and voluntarists in their counseling stance.

Theory of Development

+ Adams views personality as the sum total of all one is through nature and nurture, which recognizes the influence of both genetic predispositions, learning experiences, and the interaction between the two. His concepts of habits, habituation, and dehabituation are simple, easily-grasped frameworks for pastors and clients.

– Biblical counseling needs a more complete model of development that addresses how individuals develop intellectually, emotionally, morally, and spiritually. By failing to develop a model of psychological development they do not have an adequate way of explaining why a committed 16-year-old Christian who has been a believer for three years is different in spiritual maturity than a committed 45-year-old Christian who has been a believer for the same length of time. The sanctification process, to fully explain Christian growth, must include more components than simply the development of habits.

Theory of Individual Differences

+ While Adams does not explicitly develop an integrated model of why people are different, there are several ideas that he develops which may be combined to form such a model. These include a person's spiritual state (believer versus unbeliever), what developmental group they belong to, their spiritual gifts, and their specific sins and dodges (ways they avoid dealing with their sinfulness). His ideas on spiritual gifts are sound and practical.

– Two major criticisms of Adams' theory of individual differences are that it is not comprehensive enough and that it is not unifying enough. Regarding comprehensiveness, there are probably more factors than these four that influence or determine why we become the unique persons we are. Regarding unifying factors, if human beings are choosing beings as Adams continuously emphasizes, then there preferably should be some central component within our personality that chooses why we develop one lifestyle and not another–we will not simply be the combination of several sources of variation. For example, Adlerians talk about a mistaken belief that leads to a particular lifestyle. McGee does something similar. This theory lacks a sense of why and how people develop the lifestyles (personality styles or schemas) that they do.

Theory of Health

– While Adams would probably say that the healthy person is one who chooses a commandment-oriented lifestyle out of a desire to love and obey God, he does not seem to have explicitly elaborated a view of healthy human functioning. His emphasis has been on explaining why people are unhealthy.

– One can be concerned that Adam’s model of Christian living and counseling could easily lead to an overuse of suppression and repression to deal with the psychological processes that come from our sin nature. There is a significant difference between repressing our awareness of sinful desires versus recognizing them and yielding them to the Holy Spirit for his transformation. Biblical counseling does not adequately differentiate between the Christian life which appears healthy because of external behavioral obedience, versus a Christian life where the individual is fully aware of his sinfulness, and regularly chooses the path of obedience.

Theory of Pathology

+ Adams has made a clear statement of a hamartiagenic view of pathology, and has tied his view to Scripture. He has focused on the importance of people being responsible for their behavior at a time (late 1960s, early 1970s) when most secular and Christian mental health professionals had adopted the medical model of mental illness (i.e., that people with mental illness were sick and were not responsible for their behavior). His concept that the ego defense mechanisms are people's responses to the consequences of sin is interesting.

+ In a sense, Adams has two related developmental views of sin-caused pathology. These are:

(1) A preconditioning problem (a long-term habitual way of dealing with stress)

↓

performance problem (the present manifestation of that habitual behavior pattern)

↓

presentation problem (the unhappy emotions people feel because of their unhealthy behavioral patterns).

(2) The choice of a feeling-oriented lifestyle

↓

rebellion against God's laws

↓

patterns of avoidance (internal ego defenses used to shield ourselves from the emotional results of our disobedience)

↓

dodges and blameshifting (external behavior by which we attempt to dodge responsibility for our problems and shift the blame to someone else.

– From a Christian standpoint, to assert that abnormal behavior has a sinful component can be accepted: since everyone is a sinner it is likely that sin is a component in much of our behavior. However, to assume that all abnormal behavior that is not biologically caused is a result of sin is questionable. For example, is the anxiety that a shy person has in social situations because of lack of social skills best understood as sin? What about the confusion of a child who is being double-binded by his or her parents? Or the emotional distress a child feels when triangulated between his divorcing parents? Or the fear a student has because of lack of good test-taking skills? Or the depression an abused wife feels because of fear of future beatings but who sees no way out for herself and her children?

– In a related way, to say that schizophrenia is a perceptual problem but not a mental illness seems to be an underestimation of the severity of this disorder. People with schizophrenia have identifiable organic and functional differences within their brains, which produce a variety of both positive and negative symptoms. Positive symptoms include auditory and visual hallucinations, delusions, and sometimes grossly disorganized speech and behavior. Negative symptoms include affective (emotional) flattening, loss of fluency and productivity in thought and speech, and loss of goal-directed initiative. This is much more than just a perceptual disorder.

– Adams' discussion of the case of Steve (described in Competent to Counsel, pp. 31-32) seems questionable. This college student was diagnosed as having catatonic schizophrenia, yet turned out to be faking his illness because he did not want his academic failures to be discovered. While it is possible to fake any physical or mental illness (something called either factitious disorder or malingering depending on the purpose of the person who is doing the faking), Adams seems to be wanting his readers to conclude that the majority of mental illness involves faking psychiatric symptoms. Yet the percentage of those diagnosed with serious mental illnesses such as schizophrenia or bipolar disorder who are later recognized as faking is a very small percentage of actual cases, not the majority of those who have these serious mental illnesses.

– Similarly, the person who is in a manic psychosis because they have bipolar disorder is likely to have serious difficulties in their perceptions, judgment and behavior. They are likely to experience delusions (for example, that people are inserting thoughts into their mind, or able to read their thoughts), command hallucinations (where they hear auditory commands to do things they normally would not do), need very little sleep, exhibit very poor judgment, are unable to stay on task, and become very irritable if they are limited in any way. They are also likely to have highly elevated sexual drives during the manic period and act out these drives in ways they would never do when in their normal state. Many of these behaviors are sinful, but the person in a manic psychosis is doing these things for very different reasons than a person who would do these same behaviors as a result of a rationally-considered decision. Adams' suggestion that manic-depressive illness is just another excuse for sinful behavior (1970, pp. 33-34) fails to recognize that bipolar disorder is recognized as a genuine biologically-based disorder throughout the world.

– Adams states that emotions follow from behavior. If you behave badly, you will feel badly. If you behave responsibly, you will feel good. Adams says that depressed persons whose symptoms fail to show any sign of a biochemical root should be counseled based on the assumption that they are depressed by guilt (Competent to Counsel, p. 126). While it is sometimes true that emotions sometimes follow from behavior, this is neither a comprehensive nor a complete view of emotions. To use depression as an example, there are at least eight other sources of emotions and emotional states.

First, we know that some people inherit a genetic predisposition to either unipolar and bipolar depression. Secondly, people develop basic assumptions about the world (for example, that the world is a basically trustworthy or basically untrustworthy place) based on their experiences during the first years of life (see theories of Adler, Erickson, or Jerome Frank, etc.). Those basic assumptions and perceptual sets (now called schemas or core beliefs by cognitive behaviorists) cause them to selectively attend to some stimuli and not to others, and also determine how they interpret the meaning of those stimuli.

Thirdly, those interpretations cause many of the feelings that they experience, not the responsibility or irresponsibility of their behavior at that moment in time.

Fourthly, the healthiness of the social system within which one lives also influences one's feelings. Being part of an enmeshed, highly critical family will cause one to be depressed no matter how responsible one's behavior is.

Fifthly, being regularly subjected to verbal, physical or sexual abuse will cause depression, even if one is doing nothing wrong themselves.

Sixthly, lacking the skills to perform or interact effectively in one's social, academic or work environment can cause someone to be depressed, regardless of their desire to live responsibly.

Seventhly, there are a large number of hormonal and endocrine dysfunctions that can cause depression.

Eighthly, some depressions are the result of grief (e.g., losing a loved one by death, losing a marriage, one's health or one's ability to be productive, losing part of one's body as a result of an accident or disease, etc.).

When people feel badly because of their own bad behavior they should be asked to look at the advantages and disadvantages of continuing their present behavior but let us give up the simplistic notion that bad personal behavior is the cause of all negative emotions.

– Adams seems to teach that people are responsible for all their behavior, even those behaviors committed in the midst of a psychosis, since he does not believe in the validity of mental illness. In contrast, most cultures of the world recognize that there are certain states of extreme mental illness where people's capacity to choose is diminished, and therefore their responsibility for their actions is comparably diminished (e.g., the McNaughten Rule).

We might conceptualize degrees of responsibility on a continuum. At one end would be those actions that are chosen with full awareness, and for which the person is fully responsible. Further along the continuum might be those actions that are propelled by cognitive processes, some of which happen below the level of cognitive awareness. The Christian "overtaken in a fault" (Ga. 6:1) might be an example. He or she may not have consciously decided to sin but was seduced into sin by Satan working below the level of conscious awareness. While he still may face the consequences of his sin, if he or she shows an attitude of repentance the church might respond to him differently ("restore him gently") than they would to the person who intentionally and with premeditation chose to sin (cf. 1 Cor. 5). One of the purposes of secular and Christian therapy is to make unconscious processes conscious, so that people have increased capacities to consciously choose how they will behave.

At the far end of this continuum would be those who, in the midst of a severe mental illness, such as a psychotic episode where they are experiencing strong command hallucinations, might commit acts normally punishable by a death sentence. Because of the McNaughten Rule, they might be considered as having committed those acts during a time when they possessed diminished capacity to choose their behavior, and therefore during a time when they would be viewed as having diminished responsibility. The fact that the insanity defense is sometimes used when the person was not psychotic and was responsible for their behavior does not affect the possibility that some people legitimately deserve to be tried under the umbrella of the McNaughten Rule. Those convicted of offenses committed while psychotic may be institutionalized for a variety of reasons–to receive treatment, for the protection of society, and to underscore the importance of maintaining oneself on proper medication so that there is not a recurrence of the psychotic state that produced the violent behavior.

To summarize, our behavior is not always consciously chosen. Except in psychotic states, we are responsible for our behavior, including that which is produced as a result of unconscious processes. One of the purposes of counseling is to make more of those unconscious processes conscious, and so increase a person's degree of self-control.

– Adams' amillennial view that Satan and his demons were bound at Christ's resurrection would be questioned by many who do not believe an amillennial view best explains the biblical data. In the words of another minister and writer, Satan seems (to many Christians) to be alive and well on planet earth.

Similarly, there are many missionaries who disagree with Adams' assertion that Christians cannot be oppressed by Satan or his demons today. Merrill Unger, a highly respected evangelical theologian, also took this view in the first edition of his book Demon Possession in the World Today. He received so many accounts from missionaries around the world to the contrary that in the second edition of his book he publicly reversed his earlier statement, and said that he now believes that Christians who return to a life of sin or who speak without proper respect about Satan and his demons (Jude 8-10) may leave themselves open to demonic oppression even today.

– Adams quotes with approval from Dabrowski's Positive Disintegration that mental breakdowns are actually breakups–chances to restructure response patterns in a healthier way (Competent to Counsel, p. 171). This may be true for the neurotic breakdowns, at least for those where people receive good, supportive and insight-oriented therapy so that they recognize unhealthy components of their previous lifestyles and are able to learn healthier alternatives. This is probably less true for psychotic breakdowns. Having a major break with reality is very unsettling for most people. Some never recover fully. Others may recover gradually and painfully over a period of time, but very few who have psychotic breakdowns emerge healthier than they were before.

Theory of Cure and Therapeutic Techniques

+ Adams has rightly emphasized that all counseling theories have an implicit theology. Likewise he emphasized, many years before most were doing so, that counseling is a value-informed enterprise. He has encouraged pastors that they do not need to refer all clients, an idea that was being taught in many seminaries in the 1960s. He has emphasized that there is a moral, voluntary dimension to psychopathology. He has drawn attention to the implications of the doctrine of God's sovereignty as a means of inspiring hope in counseling. He stressed, at a time when few Christian counselors were doing so, that there should be a spiritual goal in counseling, that is, growth in godliness.

– Adams makes the questionable assumption that the Greek verb noutheteo (noun = nouthesia) should be the major paradigm for Christian counseling. Noutheteo means “to warn, advise, admonish, i.e., to exert influence on another's nous (mind).” Therefore Christian counseling should primarily be admonishment, warning, and advising.

Noutheteo is used only 8 times in the New Testament, and nouthesia only 3 times. In contrast, parakaleo is a word that suggests a much more nurturing, supportive kind of counseling. Parakaleo means to summon, invite, ask, implore, exhort, comfort, and encourage) and is used 109 times in the New Testament. The noun form, paraklesis, is used 29 times.

Noutheteo and Parakaleo are not, as Mack asserts, identical in their meaning. Noutheteo primarily does refer to admonishing or exhorting another person. Parakaleo also includes this, but also includes the concepts of comforting, encouraging, empathizing, supporting, and teaching. The fact that parakaleo and paraklesis are used approximately twelve times more frequently than noutheteo and nouthesia (138 versus 11 uses) suggests that parakaleo should be considered the more primary paradigm for Christian relationships. The practical implication of this is that biblical counseling should not be primarily looking for someone’s sin, and then admonishing them to turn from it. Sometimes biblical counseling will include this activity. But biblical counseling should also include, when appropriate, supporting, nurturing, empathizing, caring for, and guiding or teaching people better ways to live or respond.

The well-known classic article called Jesus' Style of Relating by David Carlson demonstrated that while Jesus confronted the self-righteous, he also gently taught those who wished to understand, and spent much of his time comforting the burdened and weary. Thus Jesus' style of relating encompasses and models the breadth of parakaleo, more than being primarily nouthetic confrontation.

– Adams asserts that counselors should not ask "Why" questions (since they invite the client to come up with rationalizations for their behavior), but only "What are you doing?," and then confront the behavior if the counselor believes it is out of line with God's standards. It is true that asking a "Why" question could serve as an impetus to create rationalizations, but this criticism reflects a misunderstanding of the process of therapy. Therapists generally believe that the first step in helping people change their behavior is helping them understand the beliefs that are producing the present behavior. They then help their clients reexamine whether or not those beliefs are valid. The "why" question does not come out as judgmental, but as an invitation to understand oneself at a deeper level. Of course, if a counselor were to ask "Why" questions in a judgmental way, he is likely to produce the kind of defensiveness and rationalizations Adams predicts, but this is not the way well-trained counselors ask the question "Why?"

– Relatedly, Adams seems to misunderstand the clinical purpose of empathy. According to theorists such as Carkhuff and Egan, empathy serves to build a trusting relationship where the client feels comfortable sharing himself, even the parts of himself that he believes are unacceptable. Rogers, who was one of the first therapists in the twentieth century to emphasize the therapeutic benefits of empathy, believed that people get "stuck" because there is a discrepancy between what they are actually experiencing and what their consciousness allows them to experience. Since they're out of touch with their actual experience, they can't effectively deal with whatever is troubling them. Empathy, particularly for theorists since Rogers such as Carkhuff and Egan, does not mean affirming that all the client thinks or feels or desires is correct, but means creating an environment where the client can feel safe examining all of his experience, as the first step in changing those parts that are unhealthy.

– Adams' unwillingness to allow "Why" questions to be part of the therapy process, or to provide an empathic environment where clients feel comfortable sharing deeply, can short-circuit the process of deep biblical counseling for several reasons. First, God tells us in many places throughout the Old and New Testament that he is not just concerned with external behavioral compliance, but with why we are doing what we are doing (e.g., Mt. 15:8, Jn. 4:23-24). Second, God clearly understands that we have sinful thoughts and motives, and that these reach to the very depths of our personality (Jer. 17:9). A judgmental counselor will probably only cause a client to suppress or repress negative thoughts or feelings or motives, rather than acknowledging them and then working them through. The common theme I have gotten from clients who had been to a nouthetic counselor was that the nouthetic counseling style tended to coerce them into external behavioral compliance, without allowing or encouraging them to understand what was producing the unbiblical thoughts, feelings and behavior they were experiencing.

– Adams has failed to develop a substantial biblical personality theory to underlie his theory of cure. While it might be possible to produce a theory of change without a theory of personality, having a theory of personality helps us understand why our theory of change works. The question is, "Does Scripture give us a theory of personality?"

There is the basis for a personality theory in Scripture. Briefly, that theory is that our perceptions (how we perceive) is the basis for our thoughts, our feelings, our motivations, and our behavior. Nous is the word that refers to our perceptual set, or our mind-set. This mind-set includes not only how we perceive the world, but what we view as important, and the collection of attitudes we have about ourselves and our relationship to the world as a result. Biblical passages include “Let this mind(set) be in you, which was also in Christ Jesus” (Phil. 2:5). Or “Those who live according to the sinful nature have their minds set on what that nature desires; but those who live in accordance with the Spirit have their minds set on what the Spirit desires” (Ro. 8:5). There are dozens of verses that refer either to a corrupt and depraved mind-set or to a mind-set that is in the process of being renewed.

The way we perceive the world forms the basis for all other personality functions. At conversion there is a perceptual reorganization; our old mind-set is superceded, at least potentially, by a new set of attitudes. This perceptual set (our assumptive world) is not normally in our conscious awareness: it is usually preconscious or unconscious. It is usually brought to conscious awareness in a nurturing, supportive environment where we feel comfortable relaxing our ego defenses and looking carefully at our own assumptions.

– If the above is true, Adams' model of counseling is deficient on at least two grounds relative to this: (1) failure to deal with the perceptual set that underlies behavior and feelings really amounts to failing to deal with the root problem--the mind-set (or set of attitudes) that constitutes what the Bible calls the "old man." (2) Adams' confrontational counseling style makes it highly unlikely that he will ever create the kind of nurturing environment where a person's defenses would relax enough to examine one's perceptual set and be able to discuss it (since confrontation tends to make our ego defenses tighten rather than relax).

– Adams' approach to counseling may tend to overuse and misuse advice-giving as a therapeutic technique. There is an appropriate use of education–primarily when there is information the client needs, doesn't have, and can't obtain easily. Advice can be overused or be less than maximally therapeutic when (1) the counselor doesn't take long enough to understand the full extent of the problem, (2) the counselor tells the client things he already knows or has already tried, (3) the counselor tells the client something when the client is not emotionally ready to accept it, or (4) the counselor tells the client advice which the client would be more likely to apply if he "discovered" the insights or solution himself.

Think about the difference in clinical impact of the following two statements: (1) “Jim, you must forgive your wife.” or (2) “Jim, what do you think Jesus wants you to do with the feelings you have now toward your wife?” Is the second approach less biblical than the first? Which approach is more likely to cause Jim to begin to let go of the angry feelings he has toward his wife?

Advice-giving in counseling is based on two mistaken assumptions about the counseling process. One of those is the assumption that if people are simply told the right thing to do, they will do it. Especially where there is a history of much pain or anger or fear, as there often is in situations where people come for counseling, simply telling people what to do often produces little behavioral change.

The second mistaken belief, closely related to the above, is that the primary role of the counselor is to tell the client what to do. Experienced counselors are generally in agreement that an effective counselor is one who makes empathy statements and asks questions that enable clients to understand themselves more deeply, and then at the appropriate time, ask clients to identify for themselves the changes they are ready to make in light of their deepened self-understanding.

– Adams' model of psychopathology seems overly-simplistic. All behavior, both healthy and unhealthy, seems to be influenced by a variety of factors. These include physiological components, psychological components such as perceptual set, family upbringing, modeling that comes from family and other significant others, one's ego defenses, influences from our current social network, sin-based components, demonic influences, the conflict between our old and our new mind-set, and the interaction between all of these factors.

– Healing of unhealthy psychological components usually happens only in a nurturing context where a person can let down his defenses and examine himself at a deep level. Confession and turning from sin-based components can happen either in a confrontational or a nurturing context, but most people find it easiest to admit their failings in a nurturing environment. Thus a nurturing therapy relationship is more likely to produce healing in more people than is one that consistently uses confrontation.

Lastly, MacArthur and Mack (1994) asserted that, apart from salvation, no amount of counseling can resolve basic problems (p. 140), and that counselees who are non-Christians must be told that there is no hope for them until they are born again (p. 199), seems to go strongly against the empirical data. Thousands of well-designed research studies now show that secular counseling helps between 70 and 85% of people with a variety of psychological problems (e.g., A Guide to Treatments that Work, 1998). While secular counseling usually does not help a person move toward personal salvation, it has been shown to help a large percentage of people, whether they be Christians or non-Christians.

BIBLICAL (SECOND GENERATION) COUNSELING

Areas of Agreement

+ I agree with Stan Jones (in Psychology & Christianity: Five Views edited by Eric Johnson; 2010, IVP) when he said about David Powlison’s chapter on biblical counseling, “There is much of value here....” He then went on to make four important points where he agrees with biblical counselors:

(1) “we often insufficiently mine the riches of the Scriptures and the Christian tradition in our understanding of people and their problems,

(2) “we can also be insufficiently critical of secular assumptions and values embedded in the psychologies we embrace,

(3) “the value of certain approaches to psychology is often oversold; and

(4) “the damage done by the psychologizing of our culture and of the church is real” (p. 276).

+ I agree with biblical counselors that God’s Word and God himself provide a context for understanding all of life and for understanding the mental health problems that people face. While it doesn’t provide all the details for understanding every mental health problem, the context it provides is important.

+ I agree with biblical counselors that we as Christian counselors have often let secular psychological theories influence our counseling much more than we have used Scripture to influence our counseling.

+ I agree that Scripture probably has much more to offer us as Christian counselors than we have recognized in terms of (1) how deeply we are flawed, (2) how much wisdom Scripture has to offer about a wide range of problems people experience, (3) how much we use the wonderful implications of the fact that we are children of a loving, heavenly father in our counseling.

+ I agree with Powlison (Affirmations & Denials, www.ccef.org/print/758) when he said, “You either die to yourself and live for Another, or you live for yourself and die. It’s not about meeting your needs, but about turning what you think you need upside down” (p. 8).

+ I agree with Powlison’s comments when he said: “Carl Jung described a different aspect of the counseling dynamic. ‘Patients force the psychotherapist into the role of a priest and expect and demand of him that he shall free them from their distress. That is why we psychotherapists must occupy ourselves with problems which, strictly speaking, belong to the theologian’....Psychotherapists function as ‘secular priests,’ as the more self-conscious among them freely acknowledge.... Mental health professionals necessarily act as prophet-theologians, who define human nature and the meaning of life while typically excising God. They necessarily act as priest-pastors, who typically shepherd the human soul to find refuge in itself, in other people, and in psychoactive medication, because they construct a universe barren of the living God and his Christ” (Affirmations & Denials, pp. 10-11).

+ I agree with second generation biblical counselors that counseling that reflects the Bible’s full teaching about the human condition must focus just as much (or even more) counseling ministry on those who are suffering as on those who are sinning.

+ I agree with second generation biblical counselors in the need for a deeper understanding of motivation than Jay Adams’ writings gave us. David Powlison’s discussions of “idols of the heart” (e.g., that we all worship something—popularity, prestige, power, pleasure, physical attractiveness, etc.), and that when these idols of the heart are not met, they often lead to anxiety, depression, anger, or one of the addictions. We must look at what idols of the heart lie below the sinful habits that are expressed in external behavior.

+ I agree with second generation biblical counselors in the importance of having a less formal model of counseling than Adams’ taught, and instead create one that is more personal, sensitive and compassionate. Also, the importance of understanding a client’s struggles and empathizing with them rather than quickly confronting them when the counselor sees something that looks like sinful behavior.

+ I agree with second generation biblical counselors on the importance of entering into a mutually-respectful dialogue with other Christian counselors rather than the confrontive manner that Adams’ had. We can grow more by listening than we can by confronting.

Areas of Partial Agreement or Disagreement

± I agree with Adams and Powlison that the Bible has something to say to everyone, including those with schizophrenia, bipolar disorder, Asperger’s disorder, etc. For example, it is important to believe in God, to trust him for one’s salvation, to try to live life according to the 10 commandments, etc. However, I would disagree with them that what the Bible says comes anywhere close to providing a comprehensive plan for how to help them with those psychological disorders.

± “We deny that the processes and goals labeled self-actualization, self-fulfillment, healing of memories (emphasis added)...recovery, etc. describe valid aims of counseling, though they may evidence analogies to elements of biblical wisdom” (Affirmations & Denials, p. 5).

While I agree with parts of that statement, I don’t think he understands what healing of memories is, and how often it frees a person from past bondage and trauma and allows them to significantly deepen their relationship with God the Father and with Jesus Christ, which hopefully are the central goals of biblical counseling.

- I disagree with Powlison’s statement that “We deny that any form of determinism neuters moral accountability to God” (Affirmations & Denials p. 4).

Biblical counseling (as did nouthetic counseling) has explicitly aligned itself with Reformed Theology (Calvinism) which either affirms soteriological determinism (God determines who will and will not be saved) or cosmological determinism (God determines everything that happens in the universe, including every action of humans).

Powlison and other biblical counselors have never explained (at least in the documents I have read) how they can affirm divine determinism and human responsibility simultaneously. It is logically impossible for an individual human behavior to be determined and voluntarily chosen at the same time, despite Powlison’s assertion above.

Nouthetic and biblical counselors’ emphasis on clients choosing to accept Christ and choosing godly (rather than ungodly) behavior is more compatible with Arminian theology than with Reformed theology. As a matter of fact, it’s perfectly compatible with Arminian theology.

- “We affirm that the growth process for which counseling must aim is conversion followed by lifelong progressive sanctification within every circumstance of life” (Affirmations & Denials, p. 5)

However, not every client is willing to take Christ as their Savior or make him the center of their life at the point when they seek counseling. Christ did not say, before he healed someone, that they must first accept him as Savior and Lord. He instead ministered to them wherever they were spiritually, and in gratitude many of them accepted him as Savior and Lord after their healing. Should we not, as counselors, do likewise?

From a Christian perspective, counseling that does not include God nor help people make peace with God and obey his commandments is not complete counseling (we might agree with Adams and Powlison on this). But the reality is, not everyone is ready to make God the center of their lives. We have to be willing to help them where they’re at. And even though we might not think this will be the best and most complete help we can give, we should not declare that it is not counseling.

- Powlison’s unwillingness to call anything that is less than comprehensive care as care.

For example, we might consider comprehensive medical care as the situation where a physician gives a patient information about a healthy diet, about losing weight, about stopping smoking, about getting adequate exercise and the patient going out and doing all these things as comprehensive care.

However, most physicians who work with specific patients for any length of time realize that some patients will follow through on their suggestions, but many will not. Therefore instead of giving them the most comprehensive care that they could, they instead give them they guidance they can, and they treat the illnesses that come because the patient is unwilling to comply with certain suggestions that would make them healthier.

Would we assert that the physician is not giving medical care because the patient is unwilling to make all the changes that the physician knows would be best for the patient? He or she is still giving medical care, even though it is not all the care that could be given.

In a similar way, just because a counseling client is not willing or ready to accept the entire Christian message at a given point in time does not mean that it is not valid to call what they do receive as counseling.

− If Powlison really does believe in substantive engagement with and learning from psychology, is this significantly different from a view that believes in integrating psychology and theology, giving preference to theology whenever the assertions of the two fields disagree? What is the difference between “substantive engagement” and “integration”?

− Powlison says that he believes in substantive engagement and learning from psychology, and his writings show evidence that he has read secular psychology books. However, despite that awareness, there are very few instances when you see him using the specific methods that have been discovered by secular psychology. His comment quoted in the Summary of Biblical Counseling seems to indicate his ambivalence about substantive engagement and learning from psychology when he says: “Do secular disciplines have anything to add to the methodology of biblical counseling?” The answer is a flat no” (emphasis added). Time after time I would repeatedly write in the margins of his articles or articles by other second generation biblical counselors “Good point” but at the end of that same section be thinking “There are so many other insights or counseling techniques that could be incorporated into this section that are never mentioned.”

So my final point to this Summary and Critique of Nouthetic/Biblical Counseling is this: there are many important truths we can learn from this approach, especially if our training was primarily in secular institutions, but let’s combine those important insights with all the truths God has allowed human beings, even non-Christian human beings, to discover through the avenue of common grace.