By Theresa Egger

I. Definition

 Dementia is a syndrome wherein an individual experiences inhibited cognitive functioning to the extent that it interferes with daily life. Dementia is not synonymous with aging and it is distinguishable from the inevitable consequences of aging which include dulled senses and occasional forgetfulness.[1] Dementia is not a disease. Rather, it is a syndrome meaning that it is a group of symptoms which occur together. [2] Additionally, dementia is not synonymous with Alzheimer’s. Alzheimer’s is one specific disease that causes dementia. This means that everyone who has Alzheimer’s disease has dementia, but not everyone with dementia has Alzheimer’s. Although the term dementia is never found in Scripture, the Bible is living and active and therefore still offers relevant truths for this situation (Hebrews 4:12). First, Genesis 3 tells us that illness is the result of the fall. Like all physical disorders, this is not part of God’s original design. Because of sin, bodily decay and ultimately death are inevitable. Additionally, Scripture offers instructions for how the believer should respond to dementia. Finally, God’s Word offers hope for those who have been affected by this illness.

The secular world’s primary treatment for dementia is medication.[3] Healthy dieting is also often encouraged either to reverse or prevent dementia. [4] There are also several therapies intended to help the individual with dementia improve their memory or feel more comfortable. Examples include reminiscence therapy, music therapy, reality orientation and aromatherapy.[5]

In the past, individuals with dementia were referred to as senile however today, dementia has replaced the term senile.[6] The first edition of the DSM referred to dementia as a “chronic brain syndrome associated with senile brain disease.”[7] In the DSM-II it was considered an “organic brain syndrome.”[8] The DSM-III relabeled dementia as an “organic mental disorder.”[9] Interestingly, however, the DSM-IV categorized dementia as a cognitive disorder dropping the term “organic” because it implied that there are mental disorders which don’t have a biological base.[10] Finally, the DSM-V has dropped the term dementia all-together and renamed it a major neurocognitive disorder.[11]

II. Evidence of the Problem


  1. Impairment in abstract thinking.
  2. Impaired judgment: inability to reason and make logical decisions.
  3. Other disturbances of higher cortical function such as language and motor skills.
  4. Personality change: Individuals with dementia may become angered more easily or irritable.

Dementia is a physical problem and therefore there is always a physiological cause. Examples of potential causes:[13]

  1. Alzheimer’s disease[14]
  2. Frontotemporal dementia (Pick’s disease).
  3. Traumatic brain injury.
  4. Lewy Body Dementia.
  5. Vascular Dementia/Binswanger’s disease.
  6. Brain tumors
  7. Parkinson’s disease.
  8. Huntington’s disease.
  9. Creutzfeldt-Jakob disease.
  10. HIV-AIDS.
  11. Normal-pressure hydrocephalus.
  12. Degenerative dementia of old age.

III. Examining the Heart

Dementia is not a spiritual problem but a physical one. Thus, the individual with dementia does not need to be encouraged toward repentance and heart change unless there have been sinful manifestations that have resulted from the dementia. For example, individuals with dementia may become angered more easily than they did prior to developing this illness. However, this does not mean that the dementia is causing the angry outbursts. A person’s body cannot cause them to sin.[15] Rather, anger is most likely a heart issue that was present before the illness, but has now been publically manifested because they are no longer able to hide it.[16] In these instances a potential heart theme to consider is control. While addressing sin in an individual with dementia will be much more complicated, the biblical instruction to lovingly confront our brother or sister in sin still applies (Matthew 18:15-17; Galatians 6:1-3).

Another issue that often arises within the discussion of dementia is the salvation of the individual with dementia. Is the person with dementia able to make the confession of faith which Romans 10:9 states is required for salvation? First, we must remember that the Gospel is profound yet simple enough for a child to understand (Matthew 18:3; Mark 10:15). Furthermore, we must trust that God is sovereign over an individual’s salvation. If God has elected that person for salvation, they will be saved (Romans 8:30). Thus, we should continue evangelizing and trust God with the results (Romans 10:14). Finally, if the individual with dementia did make a confession of faith and exhibited fruits of repentance prior to their illness, we can trust that God will keep His promise to preserve them until the end if they are truly His (Ephesians 4:30).[17]

IV. Biblical Solutions

Because dementia is a physical problem, the majority of counseling will involve coming alongside of the caregiver.[18] For this reason, the following counseling agenda has been focused towards providing hope and biblical instruction for the primary caregiver of the individual with dementia.

  1. The counselor should seek to build involvement with the counselee by praying for her and showing genuine compassion. This can be done by listening well and seeking to be a friend.[19] Because of the nature of the situation it will also be helpful to offer to help with meals, home care and even house chores. Show the counselee you love them by offering to help in practical ways.
  2. During the inventory process the counselor should ask questions in three areas. First, ask questions regarding the physical well-being of the individual with dementia. This will help you gain a better understanding of the situation. Secondly, ask questions about the caregiver’s well-being. It is essential that we minister to them as whole people because the physical and spiritual components influence one another.[20] Finally, ask questions about the caregiver’s spiritual health. Ask her to share her testimony. Can she verbalize the Gospel? Ask about Scripture-reading, prayer and church attendance. This will help you know where she is at spiritually and enable you to discern whether she is a strong believer who simply needs to be encouraged, or if she is an unruly counselee who needs to be admonished (1 Thessalonians 5:14).
  3. Instilling hope in the counselee will be absolutely crucial for the counseling process. This hope should be founded on God’s promises contained in His Word. Because dementia is an illness, offer comfort from passages which assure believers that there will be a future resurrection. Revelation 21:4 assures us that in the eternal state there will be no more pain or death. Additionally, the promises of God’s presence with His people can provide invaluable hope and comfort during difficult seasons (e.g. Psalms 94:14; Matthew 28:20; Hebrews 13:5).
  4. Interpretation will involve discerning what the counselee is responsible for. Because Dementia is a physical problem, there is not sin to be repented of in this initial diagnosis.[21] There may, however, be some sins that have arisen in response to this trial. This must be addressed in counseling.
  5. Instruction should be offered in the area of sufferology. Suffering is the result of living in a fallen world. Therefore, the counselee is not responsible for the trial but how she responds. Additionally, because the individual with dementia is very forgetful and frequently repeats themselves, patience is one area that will likely need to be addressed. Point the counselee to 1 Corinthians 10:13 which reminds us that God won’t let us be tempted beyond what we are able.[22]
  6. During inducement, it will be crucial to point the counselee back to the example of Christ. It might be helpful to do a study on love and point the counselee to Christ who loved the church by sacrificing His own life. The parable of the unmerciful servant in Matthew 18 is another good passage which reminds us of the forgiveness that God has extended to us which is our motivation to forgive others.
  7. Homework should include prayer, repentance (1 John 1:9) and Bible study. Potential passages to do Bible studies on are 1 Corinthians 13, Philippians 4:4-8, and Hebrews 4:14-16.
  8. Finally, integration will be absolutely essential for the caregiver. Encourage your counselee to get involved in a small group at church. The church will be able to provide practical help as well as spiritual encouragement and accountability for the counselee during this tiring season. God has given believers the body of Christ to help one another in this way (1 Thessalonians 5:14).

Recommended books

Adams, Jay E. How to Handle Trouble God’s Way. Phillipsburg, NJ: Presbyterian and Reformed Pub, 1982.

Deane, Barbara. Caring for Your Aging Parents: When Love Is Not Enough. Colorado Springs, Colo.: NavPress, 1989.

Drew, Holly Dean, and Theological Research Exchange Network. “Counseling the Caregiver: Addressing the Biblical Responsibility and care of Aging Parents,” 2002.

Fitzpatrick, Elyse. Women Counseling Women. Eugene, Or.: Harvest House, 2010.

Welch, Edward T. Blame It on the Brain: Distinguishing Chemical Imbalances, Brain Disorders, and Disobedience. Resources for Changing Lives. Phillipsburg, N.J.: P & R Pub, 1998.

Welch, Edward T. Counselor’s Guide to the Brain and Its Disorders: Knowing the Difference between Disease and Sin. Grand Rapids, Mich.: Zondervan, 1991.




[1] Ed Welch. Blame it on the Brain. (Phillipsburg, N.J.: P & R Pub, 1998), 71.

[2] Consumer Dummies. Alzheimer’s and Dementia for Dummies. (Hoboken, NJ: John Wiley and Sons, 2016), 8.

[3] Kenneth Partridge. The Brain. (New York: H.W. Wilson, 2009), 114.

[4] Neal D. Barnard. Power Foods for the Brain. (New York, NY: Hachette Book Group, 2013)

[5] Consumer Dummies. Alzheimer’s and Dementia for Dummies. 150-155

[6] Welch. Blame it on the Brain. 70

[7] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 22

[8] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-II. 24

[9] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-III. 107

[10] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 123

[11] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-V.

[12] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-III-R. 107

[13] Marshall Asher and Mary Asher. The Christian’s Guide to Psychological Terms. (Bemidji, Minn.: Focus Pub, 2014), 56.

[14] Ed Welch. Counselor’s Guide to the Brain and Its Disorders, (Grand Rapids, Mich: Zondervan, 1991), 108.

[15] Elyse Fitzpatrick. Women Counseling Women. (Eugene, Or.: Harvest House, 2010), 127

[16] Welch. Blame it on the Brain. 78-79

[17] Wayne Grudem. Biblical Doctrine. (Leicester, England: Inter-Varsity Press, 1004), 337.

[18] Welch. Blame it on the Brain. 63

[19] Stuart Scott and Heath Lambert. Counseling the Hard Cases. (Nashville, Tenn.: B & H Academic, 2012), 182.

[20] Ibid., 213.

[21] Welch. Blame it on the Brain. 63

[22] Fitzpatrick. Women Counseling Women.  247

Reactive Attachment Disorder (RADs)

By Julie DeVore

I. Definition:

The Reactive Attachment Disorder (RADs) is characterized by a difficulty in forming healthy attachment in relationships.

II. Biblical Perspective

The Reactive Attachment Disorder is marked by a lack of attachment and trust which leads to destructive behavior. Children who struggle with RADs must learn to trust God. They must be comforted as sufferers and held accountable as sinners.

Scripture speaks to the child who has experienced great neglect and emotional pain. Scripture comforts the sufferer through the attributes of God. The pain children experience from neglect is not their own fault. However, when pain from neglect leads a child to not trust God, be self-autonomous and disobedient, they must be called to repentance.

The counselor must distinguish suffering from sin, and counsel each accordingly. One suffers because he struggles to attach due to neglect; however, one sins when he allows this detachment to cause him to disobey.

Scripture that comforts the sufferer:

  1. Psalm 139 – Promises that their birth was purposeful and planned by God.
  2. Genesis 1:27 – Created valuable in the image of God.
  3. 3 Corinthians 1:3 – God Comforts us
  4. Psalm 10:14, 17-19 – God defends the Fatherless; God is the Perfect Father.
  5. Romans 8:27-29 – God works all things for good.
  6. Romans 8:31-39 – Nothing can separate us from God’s unconditional love.
  7. Hebrews 4:14-16 – God grieves and sympathizes with our weakness.
  8. Philippians 4:6 – God is our peace.

Scripture that challenges the sinner:

  1. Romans 3:23 – Everyone has sinned in some manner.
  2. Proverbs 3:5-6 – God is to be trusted.
  3. Psalm 37: 3-7 – Confess sin of self-reliance.
    1. Trust in the Lord
    2. Delight yourself in the Lord
    3. Commit your way to the Lord
    4. Be still before the Lord and wait patiently
  4. 1 John 1:9 – Confess sin, God forgives.

III. Secular perspective

Definition: Reactive Attachment Disorder is defined in the DSM-V as “[1]a consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers…” A child diagnosed with RADs “[2]minimally seeks comfort” and “Minimally responds to comfort.” The DSM explains that they have “[3]Persistent social and emotional disturbance…” The lack of relationship and attachment forms because a “[4]child has experienced a pattern of extremes of insufficient care…” This is insufficient care from neglect, and lack of basic needs such as food, comfort and stimulation. RADs may be [5]described as “persistent” if it has been present longer than 12 months. The [6]DSM describes this condition as uncommon, occurring in less than 10% of neglected children. Therefore, not every neglected child has RADs, but neglect is the definitive factor of someone who may be diagnosed with RADs.

In 1994, the DSM divided Reactive Attachment Disorder into two specific phenotypes:

  1. Inhibited – [7]persistent failure to initiate and to respond to most social interactions in a developmentally appropriate way.”
  2. Disinhibited – [8]Predominant disturbance in social relatedness is indiscriminate sociability or lack of selectivity in the choice of attachment figures.”

There are [9]three criteria that distinguish RADs from other disorders: Attachment, Timing & Cause.

  1. Attachment – “[10]There is a lack of attachment, exhibited by disturbed social relatedness.”
  2. Timing – The “[11]onset of symptoms of abnormal behavior begins prior to age five.” RADS is distinctive because it stems from abuse and neglect that occurred before the age of 5 years old.
  3. Cause – The cause of RADs is rooted in neglect.

Secular Therapy Methods: 

Because the problem with RADs is attachment, the therapy goal is relearned attachment. Catherin Cain, author of Attachment Disorders: Treatment strategies for traumatized children teaches that “[12]children with RAD need to go through these developmental stages [Trust and Autonomy] a second time in order to experience them in a healthy way…”

  1. Dependence and Love Therapy: The American Psychiatric Association teaches that “[13]Children with RAD need to become as dependent upon the adult as a newborn infant is, in order to rebuild the bonds of trust … ” Linda Rice explains that “[14]the child with RAD needs to return to this state of dependency and rely on the caregiver for everything. The caregiver should decide what the child will eat and what the child will wear … ask permission to eat, sleep, use bathroom, or play.”
  2. [15]Holding Method – In this method, therapists encourage forced attachment by encouraging the caregiver to hold the child until child resists. They encourage pressure which creates discomfort in the infant. They are seeking to force a response from the child.
  3. Re-Birthing Method – Reenact giving birth for an adoptive child to promote attachment with the foster mom. However, Candace a [16]10-year old girl died by suffocation in the “rebirthing” method.

IV. History

The Reactive Attachment Disorder is a newly recognized Psychological Label. It was first described in 1980 in DSM-III as “pathogenic care.” In 1994 the DSM-IV Subdivided RADs into inhibited & disinhibited phenotypes. Then in 2013 the DSM-V broke the category into two different Disorders: Reactive Attachment Disorder of Infancy and Early Childhood and Disinhibited Social Engagement Disorder.

V. Evidence of the Problem

Linda Rice, author of Parenting the Difficult child explains that RADs children are some of the hardest people to counsel. Rice synthesizes some of the common [17]characteristics of RADs:

  1. Lack of eye contact
  2. Lack of ability to give and receive affection on parents’ terms
  3. Demanding, clingy
  4. Indiscriminately affectionate
  5. Superficially engaging and charming
  6. Lying
  7. Poor friendships
  8. Abnormal eating
  9. Theft
  10. Destructive to self or others
  11. Learning delays
  12. Cruel to animals
  13. Poor impulse control
  14. Intense control battles
  15. Hypervigilance/hyperactivity

VI. Etiology

            The main spiritual problem that must be addressed is the child’s lack of trust in God. Then the counselor can begin moving the child to put off his old habits and put on new as their life is being renewed (Colossians 3). However, trust in God must be first. Otherwise, we are encouraging behavior modification instead of internal heart change (James 1:16).

While there are some physical causes that affect RADs, they do not excuse the spiritual need of trust for God. Neglect has caused it to be difficult for a RADs child to trust God and others. However, this does not excuse their lack of trust in God.  

Studies have shown that the neurons also play a quintessential role in the development of a child. Catherine Cain, author of Attachment Disorders: Treatment Strategies for Traumatized Children explains that, “[18]the more the child is exposed to during the early years of life, the more the brain structure the child will have to work with in later years. This is why early childhood experiences are so important. If not used, the neurons are eventually depleted. By the time the child is ten, half of the original one thousand trillion neurons are gone. It is as if the brain is preprogramed with more neurons than we could ever possibly use so that the brain has the ability to adapt to whatever environment it is born into and then discard what it does not need.” Cain further explains that learning is accomplished through patterns in the brain. However, “[19]a chaotic environment, or one that is not predictable, makes it difficult for the brain to figure out patterns it needs in order for these behavioral patterns to form.” Because of this, “[20]a young child left in a poor environment with minimal stimulus during the first two years of life does not stand a chance against a child raised in a rich environment with lots of experiences and sensory input.” Therefore, neglect and neurons do in fact play a major role in the physical causes of RAD.  However, while they should be considered, they should never be the sole resource. A counselor must take in both the physical and spiritual elements of an individual.

VII. Examining the Heart

Possible Heart Themes:

  1. Lack of Trust
  2. Self-Preservation
  3. Autonomy
  4. Fear
  5. Disobedience
  6. Anger
  7. Bitterness

Possible Heart Idols:

  1. Control
  2. Self – Reliance

VIII. Biblical Solutions

The core of counseling must be rooted in Scripture. As Biblical counselors we believe that Scripture is sufficient to counsel every need (1 Timothy 3:16-17). Linda Rice, in her book Parenting the Difficult Child describes five common factors in Reactive Attachment Disorder. Using these 5 labels can help inform our biblical counseling (see Appendix 1).

She recognizes that RADs stems from Neglect. When a child suffers from neglect, Biblical counselors must emphasize the comfort and love of God. The counselor teaches identity in Christ (Psalm 139 & Genesis 1:27) and God’s sovereignty. He is Comforter (1 Corinthians 1:3), Perfect Father and Defender (Psalm 10); He works all for good (Romans 8:27-29), and nothing can separate us from his love (Romans 8:31-39). God comforts the sufferer.

The next stages are Lack of Trust and Self Preservation/Autonomy. The child has “learned” from their neglect experience that people are not trustworthy. Therefore, they trust themselves. We must lead them to the perfect, trustworthy God. He will not fail them. We are commanded to trust Him (Proverbs 3:5-8). Failure to trust God is a sin that must be addressed.

The final stages are Emotions and Habituation. The RADs child lives off emotions and forms destructive habits. Change must take root from within the desires of one’s heart (James 1:16). Old habits must be put off, they must be renewed, and new habits must be put on. (See Colossians 3:5-17).


This cycle of Neglect to Lack of Trust/Autonomy to Emotions to Habituation forms habits that are hard to break. Rice explains that it is [21]difficult to change because:

  1. If desire doesn’t change, we don’t change
  2. Because its hard/uncomfortable
  3. Habits are hard to break

But we believe that hope for change is possible through the power of Christ and Scripture.  (Ephesians 5:8 and Jude 1:24-27).














[22]Appendix 1:






Recommended Resources:

Asher, Marshal and Mary. The Christian’s Guide to Psychological Terms. USA, 2014.

“Biblical Answers for Attachment.” n.d. Faith Therapy. 19 February 2019.

Cain, Catherin Swanson. Attachment Disorders: Treatment Strategies for Traumatized Children. Lanhand : Jason Aronson Publishing, 2006.

Emlet, Michael R. “Loving Others as Saints, Sufferers and Sinners (Part 2).” The Journal of Biblical Counseling (2018): 40-65.

Hollinger, Kevin. Rative Attachment Disorder: Helping Adoptive Parents Think Biblically About Attachment. Westminster Thological Seminary, 2007. Thesis.

Rice, Linda J. Parenting the Difficult Child. USA: SeedSown Press, 2012.

Works Cited

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Washington: American Psychiatric Association, 1994. Fourth edition.

—. DSM-V. Washington, DC: American Psychiatric Publishing, 2013.

Cain, Catherin Swanson. Attachment Disorders: Treatment Strategies for Traumatized Children. Lanhand : Jason Aronson Publishing, 2006.

Hollinger, Kevin. Rative Attachment Disorder: Helping Adoptive Parents Think Biblically About Attachment. Westminster Thological Seminary, 2007. Thesis.

Rice, Linda J. Parenting the Difficult Child. USA: SeedSown Press, 2012.

The Holy Bible – ESV. Illinois: CrossWay, 2011.

Wilson, Samantha. “Attachment Disorders: Review and Current Status.” Journal of Psychology (2001): 37-.


[1] (American Psychiatric Association) 265

[2] (American Psychiatric Association) 265

[3] (American Psychiatric Association) 265

[4] (American Psychiatric Association) 265

[5] (American Psychiatric Association) 266

[6] (American Psychiatric Association) 265

[7] (American Psychiatric Association) 116

[8] (American Psychiatric Association)116

[9] (Rice) 15

[10] (Rice) 15

[11] (Rice)15

[12] (Cain) 151

[13] (Cain)151

[14] (Rice) 151

[15] (Wilson) 11

[16] (Hollinger) 40

[17] (Rice) 51

[18] (Cain) 27-28

[19] (Cain) 31

[20] (Cain) 34

[21] (Rice) 51

[22] (DeVore, 2019) & (Rice) – This figure I created while reading Parenting the Difficult Child.

David Powlison

By Thomas Watson

CCEF’s Former Executive Director, Senior Editor of the Journal of Biblical Counseling

I. Biography

  1. Early life
  2. Birth
  3. When: December 14, 1949
  4. Where: Honolulu Hawaii, United States
  5. Parents: Peter A. and Dora M. Powlison
  6. Spouse: Nancy H. Gardner
  7. Children: Peter Powlison, Hannah Powlison, Gwenyth Powlison
  8. Death: June 7, 2019

David Powlison was a Presbyterian author and biblical counselor; he is the executive director to CCEF, the senior editor of the Journal of Biblical Counseling and is a member of the counsel of the Gospel Coalition. He has been practicing counseling for over 30 years. His work is credited for bridging the gap between the secular psychiatric philosophy and biblical schools of counseling. He has written many books and articles on subjects such as sexual sin, anxiety, and grief.

David Powlison was born on December 14, 1949 to Peter and Dora Powlison on the island of Honolulu of Hawaii in the United States. He and his wife, Nancy H. Gardner, had 3 children, Peter, Hannah, and Gwyneth Powlison (TGC, PTLGOS).

At the age of 25, Powlison was working at McLean Psychiatric Hospital in the mental health department, in Belmont Massachusetts, when Christ convicted him of sin and brought him to repentance (CW, HGSD). After his conversion, while working in the Psychiatric Hospital as a mental health worker, Powlison started observing the constant suffering of the patients, that had little to no hope for change or healing. Powlison became “disillusioned with secular psychologies.” He found one individual quite interesting while working there, a man who was a mental health worker with no aspirations for high education. This man was building relationships with the patients, holding them accountable to their choices, and not blaming their behavior primarily on mental disorders. This induced the patients to react differently and ask for this particular man when they were in distress. The difference between what this man and the rest of the faculty practiced help lead Powlison to believe that the theories were fundamentally at odds and went to study theology at Westminster Theological Seminary (WTS; WSTIC).

Powlison started his education at Harvard University, with a Bachelor of Arts in 1971 then pursued a MDiv from Westminster Theological Seminary 1980. In 1986 he received his Master of Arts from the University of Pennsylvania. Then went on to get a PhD from the University of Pennsylvania in 1996 his subject of study—history of science and medicine, with an emphasis on the history of psychiatry (PB, DAP).

II. Education

  1. AB, Harvard University, 1971
  2. MDiv from Westminster Theological Seminary 1980
  3. MA University of Pennsylvania, 1986
  4. PhD from University of Pennsylvania, 1996
    1. History of science and medicine, primarily history of psychiatry.


III. Significant life events that impacted person

IV. Theological Views

  1. Presbyterian

V. Works/Publications

  1. Books

Anger: Escaping the Maze – 2000

The Biblical Counseling Movement: history and Context – 2010

Breaking the Addictive Cycle: Deadly Obsessions or Simple Pleasures? – 2010

God’s Grace in Your Suffering – 2018

Good and angry: Redeeming Anger, irritation, Complaining, and Bitterness – 2016

How does Sanctification Work? – 2017

Jax’s Tail Twitches: When you are Angry – 2018

Making All Things New: restoring Joy to the Sexually Broken – 2017

Pornography: Slaying the Dragon – 1999

Power Encounters: Reclaiming Spiritual Warfare – 1994

Seeing with new eyes” Counseling and the Human Condition through the Lens of Scripture – 2005

Speaking Truth in love: Counsel in Community – 2005

Zoe’s Hiding Place: when you are Anxious – 2018

Power Encounter: Reclaiming Spiritual Warfare – 1994

Controlling Anger Responding Constructively when life Goes Wrong – 2008

I’m Exhausted: What to do When You’re Always Tired – 2010

Pleasure – 2005

Competent to Counsel? The History of a Conservative Protestant Biblical Counseling Movement – 2008

2. Pamphlets

Anger: Understanding anger – ?

Coming Clean: Breaking Pornography’s Hold on You – 2012

Controlling Anger: Responding Constructively When Life Goes Wrong – 2012

Domestic Abuse: How to Help – 2001

Facing Death with Hope: Living for what Lasts – 2008

God as Father: When Your Own Father Failed – 2005

God’s Love: better Than Unconditional – 2001

Grieving a Suicide: Help for the Aftershock – 2010

Healing After Abortion: God’s Mercy Is for You – 2008

I Just Want to Die: Replacing Suicidal Thoughts with Hope – 2008

I’m Exhausted: What to Do When You’re Always Tired – 2010

Innocence Lost: Rebuilding after Victimization – 2012

Journal of Biblical Counseling, 28-1 – 2014

Journal of Biblical Counseling, 28-2 – 2014

Journal of Biblical Counseling, 28-3 – 2015

Journal of Biblical Counseling, 29-1 – 2015

Journal of Biblical Counseling, 30-1 – 2016

Journal of Biblical Counseling, 30-2 – 2016

Journal of Biblical Counseling, 30-3 – 2016

Journal of Biblical Counseling Must Reads on Anger – 2013

Journal of Biblical Counseling Must Reads On Redeeming Psychology – 2013

The Journal of Biblical Counseling Must Reads: On Apologetics –

The Journal of Biblical Counseling Must Reads: On Counseling in the Church –

The Journal of Biblical Counseling Must Reads: on Methodology –

The Journal of Biblical Counseling Must Reads: on Model –

The Journal of Biblical Counseling Must Reads: on Sexuality –

Journal of biblical Counseling, Volume, 26 #3 – 2012

Journal of Biblical Counseling, Volume 27 #1 – 2013

Journal of Biblical Counseling, Volume 27 #3 – 2014

Journal of Biblical Counseling 18-1 – 1999

Journal of Biblical Counseling 18-2 – 2000

Life Beyond Your Parent’s Mistakes: The Transforming Power of God’s Love – 2010

Overcoming Anxiety: Relief for Worried People – 2012

Pre-Engagement: Five Questions to Ask Yourselves – 2000

Real Love: Better Than Unconditional? – 2012

Recovering from Child Abuse: Healing and Hope for Victims – 2008

Renewing marital Intimacy: Closing the Gap Between You and Your Spouse – 2008

Sexual Addiction: Freedom from Compulsive Behavior – 2010

Sexual assault: healing steps for Victims – 2010

Stress: Peace amid Pressure – 2004

Stressed Out: becoming Peaceful on the Inside – 2012

When Cancer Interrupts – 2015

When You Are Worried: Finding Reasons for Peace – 2012

Why Me?: Comfort for the Victimized

Worry: Pursuing a Better Path to Peace – 2004

You Make Me So Mad! Managing Your Anger – 2012

3. Articles

An Open Letter to the Suffering Christian – 2018

An Open Letter to Those Nonchalant about Their Sexual sin – 2017

An Open Letter to those Debilitated by their Sexual Sin – 2017

An Open letter to those apathetic about their sanctification – 2017

An open letter to those frustrated by their progress in sanctification – 2017

A Conversation Between David Powlison and Winston Smith

Why do we Pray?

Emmanuel shall come to you

Helping those who are angry with God


God is changing us – but how?

Sanctification is a Direction

What is the Ultimate Goal of Sexual Renewal?

Is Sexual Renewal a Simple or Complex Process?

5 Sources of True Change

The Many Ways God Changes Us

4. Interviews

The root of sinful anger

Ten Ways Not to Waste Your Cancer

Making All Things New: Restoring Pure Joy to the Sexually Broken

God, Psychology, and Christian Care of the Soul – Panel Discussion

God, Psychology, and Christian Care of the Soul, Part 1 – David Powlison

God, Psychology, and Christian Care of the Soul, Part 2 – David Powlison

God, Psychology, and Christian Care of the Soul, Part 3 – David Powlison

Gospel Coalition’s David Powlison battling stage 4 pancreatic cancer



VI. Influence on Biblical Counseling

  1. Bridging the gap between sin and psychopathology, Powlison believed that “sin is the core of psychopathology.” Sin skewed your goals and perception of God and the world. Powlison looked at Ecclesiastics 9:3 and saw that there is “madness in our hearts while we live.” His point is that whatever the physiological or environmental influences may be, such as genetic predispositions and cultural values, all factors must be held together. This idea is in contrast to the idea of blaming environment or only one factor. That the root of all sin and mental illness comes directly from the persons heart (CCEF, RBSP).

VII. Bibliography

David Powlison – “Why I Chose Seminary for Training in Counseling” , (WTS WSTIC) August 2017

David Powlison – “on the relationship between sin and psychopathology” , (ccef, RBSP) April 2016

PraBook Biography: :David A. Powlison” World Biographical Encyclopedia, Inc ,(PB, DAP) Accessed May 2019

Dr. David Powlison, “How God saved David Powlison From Destroying Himself” , (CW, HGSD) May 2017


External Links




Wayne Mack

By Oksana Zherebnenko


I. Known For

Wayne Mack has been identified as a seminal contributor to the Biblical Counseling movement. He studied and taught biblical counseling and Christian living in numerous universities. Mack has served on the board of the Association of Certified Biblical Counselors (ACBC) and on the board of the Fellowship of Independent Reformed Evangelicals (FIRE). Mack has spoken at various counseling seminars and has also helped establish biblical counseling programs in the United States and in South Africa.

II. Biography

Wayne Mack was born on June 7, 1935. His hometown is Carlisle, Pennsylvania but he lives in Pretoria, South Africa for the majority of the year with his wife, Carol (@WayneMack, Facebook, April 30, 2019). Wayne married Carol in 1957 and they have four adult children and thirteen grandchildren [1].

Wayne Mack received a bachelor’s degree from Wheaton College. He then received a Master’s of Divinity (MDiv) from Philadelphia Seminary and a Doctorate of Ministry (D.Min) from Westminster Theological Seminary.  He has studied psychology at LaSalle University. He also studied counseling, theology and the church at Eastern Baptist Seminary, and theology at Wheaton graduate school and Trinity Theological Seminary [1].

III. Theological views

Wayne Mack is a promoter of nouthetic counseling. Within nouthetic counseling there are three main ideas: 1) Scripture is necessary when confronting a counselee about their problems 2) Counseling is always done to the benefit of the counselee and 3) The counselee is striving to change in order to be more like Christ, who is the standard [2]. Wayne Mack is marked by a dedication to the Word of God and all of his work is immersed in Scripture [3]. Mack does not write as a philosopher who explains theological epistemology, but instead he teaches as a pastor would, explaining how to help people according to a biblical framework [4].

IV. Works/Publications

Wayne Mack has written 27 books on biblical counseling and Christian living.  His books include Strengthening Your Marriage, Homework Manual for Biblical Living, Anger and Stress Management God’s Way, and Humility: A Forgotten Virtue. His article entries have been published in Reformation Today, The Journal of Pastoral Counseling, The Journal of Biblical Counseling, and The Master’s Journal. He has a number of audio and video messages on counseling and Christian living distributed by Nouthetic Media [5].

V. Influence on Biblical Counseling

Wayne Mack has taught college and graduate school courses in biblical counseling at various bible colleges and seminaries. He has conducted biblical counseling seminars and conferences all over the world. Wayne and his wife moved to Pretoria, South Africa to teach biblical counseling to pastors. Wayne Mack supervised the development of the Master of Arts Biblical Counseling program at The Master’s University in Santa Clarita, CA. He is a charter member of ACBC and he helped found ACBC Africa. He served on the board of FIRE and is on the Board of Directors of Publicaciones Faro de Gracia. He works with Strengthening Ministries Training Institute to distribute books, audio and video tapes on counseling to churches and Christians all around the world [1].

VI. Bibliography

“About Dr. Wayne Mack,” Strengthening Ministries International, accessed April 28,


“About Wayne Mack,” Nouthetic Media, accessed April 28, 2019,

Adams, Jay E. “What is ‘Nouthetic’ Counseling,” Institute for Nouthetic Studies,

accessed April 28, 2019,

Lambert, Heath. 2011. The Biblical Counseling Movement After Adams (Foreword by

 David Powlison). Wheaton, IL: Crossway.


“What others have to say about Strengthening Ministries,” Strengthening Ministries

International, accessed April 28, 2019,

  1. Strengthening Ministries International, “About Dr. Wayne Mack”
  2. Institute for Nouthetic Counseling, “What is ‘Nouthetic’ Counseling”
  3. Strengthening Ministries International, “What other have to say about Strengthening Ministries”
  4. Lambert, The Biblical Counseling Movement After Adams, Ch. 4.
  5. Nouthetic Media, “About Wayne Mack”



Anxiety (Generalized Anxiety Disorder)

By Julie Golan

I. Definition

Biblical perspective

The Bible would describe anxiety as a sinful worry, often about the future (Matthew 6:25-34; Philippians 4:6). There are references in Scripture to good kinds of fear, however. The fear of the Lord, for example, is something that the Bible instructs all people to have (Deuteronomy 10:12, Psalm 33:8, Matthew 10:28). Additionally, there is biblical concern that is not sinful, which Paul uses to express genuine care, particularly in the body of Christ (1 Corinthians 12:25, 2 Corinthians 11:28-29, Philippians 2:20).

The majority of Scriptural texts mentioning anxiety or worry are in reference to sinful practices. In Matthew 6, Jesus instructs: “do not be worried about your life, as to what you will eat or what you will drink; nor for your body, as to what you will put on” (Matthew 6:25). He goes on to explain God’s provision for “the birds of the air” and “the lilies of the field”, demonstrating how much more He will provide for those who are His own (Matthew 6:26-30). Concluding, Jesus says, “So do not worry about tomorrow; for tomorrow will care for itself. Each day has enough trouble of its own” (Matthew 6:34). In Philippians, Paul commands the church to “be anxious for nothing, but in everything by prayer and supplication with thanksgiving let your requests be made known to God” (Philippians 4:6). Peter also speaks on anxiety, instructing the recipients of his letter to cast “all your anxiety on Him, because He cares for you” (1 Peter 5:7). The previous verse explains that doing so is an act of humility before the Lord (1 Peter 5:6-7). Before sending Israel into the promised land, God commanded Joshua to “Be strong and courageous! Do not tremble or be dismayed, for the Lord your God is with you wherever you go” (Joshua 1:9). Here, God reminded Joshua of His faithful character and promises, by which there was no need for fear. Again, God reminds those in Israel “with anxious heart” that they need not fear because of God’s promise for ultimate deliverance (Isaiah 35:4). Furthermore, there are many examples in the Psalms where believers have expressed deliverance from fear and that they need not fear because of God’s character and promises (Psalm 23:4, 27:1, 56:3-4, 118:6).

Secular Perspective

In a broad sense, the DMS 5 anxiety as “the anticipation of future threat”.[1] However, there are many different manifestations of anxiety within the realm of psychology. The DSM 5 separates anxiety into seven broad categories: separation anxiety disorder, selective mutism, specific phobia, social phobia, panic disorder, agoraphobia, and generalized anxiety disorder, substance/medication-induced anxiety disorder, anxiety disorder due to another medical condition, other specified anxiety disorder, unspecified anxiety disorder.[2]

Secular treatment for anxiety will primarily be done through medication and psychotherapy. The Harvard Mental Health Letter provides almost 10 different types of medication that can help anxiety and suggests three different types of psychotherapy.

II. History

Fear has existed since the fall, when Adam and Eve hid from God in the garden because they knew their nakedness (Genesis 3:8-10). In terms of anxiety, some have suggested that “Ancient Greek and Latin authors reported cases of pathological anxiety, and identified them as medical disorders” as early as the 3rd-4th century B.C.[3] In modern psychology, Sigmund Freud “coined many of the terms used for various anxiety disorders” in the early DSM books.[4] Beginning with a 1894 article [5], Freud became the first major psychologist to distinguish different types of anxiety. From his work came the popularization of panic attacks, obsessiveness, and phobias.[6] “Freud’s early work unified under the umbrella of ‘anxiety’ a variety of previously distinct syndromes or symptoms that had been associated with broader conditions.” [7] His work paved the way for the “diagnostic revolution of 1980.” [8] Up until this point, there was still a broad understanding of anxiety. However, the introduction of the DSM 3 in 1980 brought about a “large variety of distinct and categorical definitions of anxiety” unlike anything prior.[9] Since, developments and diagnoses of anxiety have only increased.

III. Evidence of the Problem

Generalized anxiety disorder (GAD) is “characterized by a pattern of frequent, persistent excessive anxiety and worry that is out of proportion to the impact of the event or circumstance that is the focus of the worry”.[10] Diagnostic criteria include finding it difficult to control worry, impaired functioning, and physical symptoms such as restlessness and irritability. To be diagnosed with GAD, an individual must be experiencing these symptoms regularly for a minimum of 6 months.

IV. Etiology

According to the Harvard Mental Health Letter, GAD can occur due to other psychiatric disorders such as “substance use disorder or alcohol dependence”.[11] It also notes that “severe or constant stress can produce a hyperactive anxiety reaction”.[12] Spiritual causes for anxiety are often rooted in not trusting God, as suggested by Dr. John MacArthur in his book Anxious for Nothing.[13]

Spiritual symptoms of anxiety can include doubting God’s faithfulness to be true to His character and/or promises. Physical symptoms of GAD can include fatigue, trouble sleeping, trembling, nervousness, sweating, nausea, and irritability.[14]

V. Examining the Heart

One heart theme behind anxiety could include a desire for control. The person struggling with anxiety desires their circumstances to be different and is not meditating on and trusting in God’s sovereignty within the situation. An idol within a desire for control could include the worship of comfort. A sinful desire for comfort could tempt one toward anxiety for the future, health, safety, and more.

VI. Biblical Solutions

Jay Adams suggested the method of “eliminating fear by love”.[15] Essentially, transferring the focus off the one struggling and onto loving others, ultimately God. “Love toward God means focusing upon how one may trust, worship, and serve Him; love toward one’s neighbor likewise focuses upon a giving relationship to him”.[16]  Dr. John MacArthur suggests an agenda that has an emphasis on prayer, and in doing so practicing obedience to Philippians 4:6.[17]

Recommended Books

“Anxious for Nothing: God’s Cure for the Cares of Your Soul” by John MacArthur

“Overcoming Fear, Worry, and Anxiety: Becoming a Woman of Faith and Confidence” by Elyse Fitzpatrick

“Overcoming Anxiety: Relief for Worried People” by David Powlison


Recommended Homework Resources

A Homework Manual for Biblical Living by Wayne Mack

Discussion Guides in Anxious for Nothing by John MacArthur

Fear Homework Assignment Samples from The Institute for Biblical Counseling and Discipleship:



[1]Black, Donald W., and Jon E. Grant. DSM-5 Guidebook : The Essential Companion to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Publishing, 2014.

[2] Black, Donald W., and Jon E. Grant. DSM-5 Guidebook : The Essential Companion to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Publishing, 2014.

[3] Marc-Antoine Crocq. A History of Anxiety: from Hippocrates to DSM. The National Center for Biotechnology Information. 2015.

 [4] Marc-Antoine Crocq. A History of Anxiety: from Hippocrates to DSM. The National Center for Biotechnology Information. 2015.

[5] “The Justification for Detaching from Neurasthenia a Particular Syndrome: The Anxiety-Neurosis”.

[6] Horwitz, Allan V. Anxiety : A Short History. Johns Hopkins University Press, 2013, P 80

[7] Horwitz, Allan V. Anxiety : A Short History. Johns Hopkins University Press, 2013. P 80

[8] Horwitz, Allan V. Anxiety : A Short History. Johns Hopkins University Press, 2013. P 80

[9] Horwitz, Allan V. Anxiety : A Short History. Johns Hopkins University Press, 2013. P 6

[10] Horwitz, Allan V. Anxiety : A Short History. Johns Hopkins University Press, 2013. P 6

[11] Harvard Health Publishing. “Generalized Anxiety Disorder.” Harvard Health Blog. Accessed December 01, 2018.

[12] Harvard Health Publishing. “Generalized Anxiety Disorder.” Harvard Health Blog. Accessed December 01, 2018.

[13] MacArthur, John. Anxious for Nothing : God’s Cure for the Cares of Your Soul. Vol. 3rd ed, David C. Cook, 2012.

[14] Generalized Anxiety Disorder. Mayo Clinic.

[15] Jay Adams, The Christian Counselor’s Manual, 416.

[16]  Jay Adams, The Christian Counselor’s Manual, 416.

[17] John MacArthur, Anxious for Nothing, chapter 2.


By Hannah Giesbrecht

I. Definition:

Depression is defined as a mental health disorder characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life.

II. Biblical perspective

Depression comes in a variety of different ways and it affects different people differently. Depression can become a debilitating state that comes as a result of spiritual or physical infirmities. The Bible views depression as a trial, a time of suffering that, if viewed with an eternal perspective and treated in a biblically way, will ultimately increase our faith. Depression results as a lack of biblical hope and trust in God. However, depression can be the result of physical imbalances, so regular doctor’s visits are crucial for someone who may be struggling with depression. Our physical body does affect our spiritual and mental health. Depression is characterized by hopelessness, joylessness, guilt, shame, sadness, and worthlessness. Whenever anything or anyone other than God is the focal point of our worship and desire, this kind of idolatry impacts our behavior, our thoughts and our emotions. Romans 5:14 says, “For whatever was written in former days was written for our instruction, that through endurance and through the encouragement of the Scriptures we might have hope.” The Scriptures are sufficient for our every need and that includes battling depression; God’s Word is overflowing with truth that brings hope and peace.

Counseling that skillfully employs and applies God’s Word is a necessary duty of Christian life and fellowship. Scripture is superior to human wisdom and the Word of God is a more effective discerner of the human heart than any earthly means. Our Heavenly Father is the only effective agent of recovery and regeneration. All the treasures of wisdom and knowledge are found in Christ Himself. It is the job of biblical counselors to point counselees to the everlasting hope found in Christ and His Word, because Scripture is sufficient.

III. Secular perspective

  1. Diagnostic criteria for depression based on DSM-IV:[1]

Based on the 9-item depression module from the MINI participants are classified in the following way:

  • Major depressive episode: 5 or more symptoms, including of the key symptoms.
  • Sub-threshold depressive symptoms: 2-4 symptoms, may or may not include a key symptom.
  • Non-depressed: 0-1 symptoms


  1. Depressed mood*
  2. Loss of interest*
  3. Significant weight loss or gain or decrease or increase in appetite
  4. Insomnia or hypersomnia
  5. Psychomotor agitation or retardation
  6. Fatigue or loss of energy
  7. Feelings of worthlessness or excessive or inappropriate guilt
  8. Diminished ability to think or concentrate, or indecisiveness
  9. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or suicide attempt or a specific plan

*key symptoms

  1. Depression is the persistent feeling of sadness or loss of interest that characterizes major depression can lead to a range of behavioral and physical symptoms.

Therapies recommended to those with depression:

  1. Cognitive Behavioral Therapy
  2. Behavior Therapy
  3. Psychotherapy

Secular treatment consists of antidepressants. Medication often prescribed to depression patients includes:

  1. Bupropion
  2. Venlafaxine
  3. Mirtazapine
  4. Duloxetine
  5. Amitriptyline

Recommended specialists:

  1. Clinical psychologist
  2. Psychiatrist
  3. Primary care provider (PCP)
  4. Emergency medicine doctor

IV. History

Many scholars think that depression was first recognized as early as the time of the Ancient Greeks. The Greeks thought the disease was due to an imbalance in the four basic bodily fluids, or humors. Later, Aretaeus of Cappadocia noted that sufferers were dejected and stern, without any real cause. The name given to depression then was known as Melancholia, which was a far broader concept than today’s depression. In the 11th century, Persian physician Avicenna described melancholia as a mood disorder. Avicenna’s work, The Canon of Medicine, alongside the work of Hippocrates and Galen, became the standard of medical thinking in Europe. In the 18th century, German physician Johann Christian Heinroth argued that melancholia was a disturbance of the soul due to moral conflict. The term depression was derived from the Latin verb deprimere, which means, “to press down.” In the 19th and 20th centuries, English psychiatrist Henry Maudsely proposed a general category of affective disorder. Depression and reactive depression came to refer to a mood and not a reaction to outside events. In the 21st century, humanistic theories of depression have represented a forceful affirmation of individualism.

Depression has also been called clinical depression, major depression and major depressive disorder. Current treatment of depression implies that depression is a biomedical disease, which is why most psychiatrists prescribe antidepressants. The expert panels for treating depression (Depression Guideline Panel 1993; Katz and Alexopoulos 1996; Ballenger et a. 1999; WHO Collaborating Centre for Mental Health Research and Training 2000) recommend a clinical approach can be summarized as follows. Providers should:

  1. Recognize the presenting symptoms of depression and its causes.
  2. Make an explicit diagnosis of depression.
  3. Educate the patient and family, and stress that depression is treatable.
  4. Engage the patient and family in choosing treatment.
  5. Assess patients’ progress regularly.

Usually, treatment of depression begins with a patient visiting a health-care provider and reporting symptoms that suggest a mood disorder. Oftentimes the emotional symptoms of depression are hidden behind physical symptoms like complaints of fatigue.

V. Evidence of the Problem

Common themes and patterns observed in the lives of those who have been diagnosed with depression are extreme sadness, anxiety, listlessness, and feeling blue. Those who struggle with depression are often fatigued, over time becoming restless and irritable. Sleep is often restless, tossing and turning all night. Nightmares occur frequently, making restful sleep even more difficult. Another common theme is utter hopelessness. Many of those who are depressed are also suicidal. Depression is a despair that consumes you.

Severe depression can be debilitating, and there are several key expressions, recognizable as symptoms of depression. some cases where the activity level is as minimal as possible. Depression can have severe long term effects on one’s daily functions, as well as relationships with friends and families. Guilt and feelings of worthlessness overcome the counselee. Everything is negative, dwelling on past sad experiences, sins, failures and disappointments. Minor problems become major problems as one imagines the worst possible scenario. Some people lose unhealthy amounts of weight, while some people struggle to eat at all. People lose interest or pleasure in what used to interest you. Many people have trouble concentrating, feeling as though thoughts and movements have been slowed down; like your brain is fuzzy and in slow motion.[2] Depression takes a big toll on one’s physical self as well as one’s spiritual self. Many believers struggle to pray when they are feeling depressed.

VI. Etiology

Depression is an issue that affects people physically and spiritually. There isn’t an over arching “rule of thumb” for theories of depression. It manifests itself differently in different people. However, hope is found in the Person of Jesus Christ, not a pill. Sometimes the source of the problem is physical, then spiritual, sometimes vice versa. There are several spiritual symptoms and physical symptoms that can be seen in most cases of depression.

  1. Spiritual symptoms
    1. Hopelessness
    2. Continual lack of peace
    3. Not trusting in God
    4. Feelings of despair
    5. Discouragement
    6. Disappointment
    7. Despondency
    8. Lack of motivation
    9. Difficult to focus
    10. Diminishing prayer life

2. Physical symptoms

  1. Restlessness, unexplainable unhappiness
  2. Drastic change in weight
  3. Headache
  4. Brain fog
  5. Blurred vision
  6. Excessive crying
  7. Sadness
  8. Lack of concentration
  9. Irritability
  10. Social isolation


VII. Examining the Heart

  1. Heart themes
    1. Incorrect view of the faithfulness of God
    2. Hopelessness
    3. Incorrect view of the sovereignty of God
    4. Fear of man – guilt that others will think of you differently if they knew you struggled with depression.
    5. Lack of trust in the Lord (control)

2. Idols of the heart

  1. Pride
  2. Control,
  3. Self – reliance,
  4. Comfort
  5. Selfishness


VII. Biblical Solutions

  1. Counseling Agenda

Depression of one of the common temptations of man. 1 Corinthians 10:13 says, “No temptation that have overtaken you but such as is common to man.” One of the first steps a counselee can make towards change is admitting that God is capable of helping overcome depression. Another practical step a counselee can take is to commune with God through His Word. Lamentations 3:17-24 says, “I still dare to hope when I remember this: The faithful love of the Lord never ends! His mercies never cease. Great is his faithfulness; his mercies begin afresh each morning. I say to myself, ‘The Lord is my inheritance; therefore, I will hope in him’” God is faithful, capable, sovereign, eternally good and we desperately need hope every day of our lives! Christians struggling with depression need to fix their eyes on the Lord, the Author and Perfecter of faith. Romans 8:28 says, “And we know that for those who love God all things work together for good, for those who are called according to his purpose.” There is a reason and a purpose for the trial of depression, but believers are called to depend on Him through it all. Hebrews 6:19 says, “We have this as a sure and steadfast anchor of the soul, a hope that enters into the inner place behind the curtain.” Christ is our sure and steadfast anchor, which offers hope through Him and His Word.

Recommended Resources:

Adams, Jay E. A. The Theology of Christian Counseling. Grand Rapids, MI: Zondervan,


Adams, Jay E. The Christian Counselor’s Manual. Grand Rapids, MI: Zondervan, 1973.

Bridges, Jerry. Trusting God: Even When Life Hurts. Colorado Springs, CO: NavPress.

Busenitz, Nathan. Living A Life of Hope. Uhrichsville, OH: Barbour Publishing, 2003.

Lane, Timothy S., and Paul David Tripp. How People Change. Greensboro NC: New

Growth Press, 2008.

Somerville, Robert B. If I’m A Christian, Why Am I Depressed? United States of

America: Xulon Press, 2014.

Welch, Edward T. Depression: Looking Up from the Stubborn Darkness. Greensboro,

NC: New Growth Press, 2011.

Welch, Edward T. Depression: The Way Up When You Are Down (Resources for

Changing Lives). Greensboro, NC: New Growth Press, 2011.

Tada, Joni Eareckson. A Place of Healing: Wrestling with the Mysteries of Suffering,

Pain, and God’s Sovereignty. Colorado Springs, CO: Wolgemuth & Associates,

Inc. 2010.

Mack, Wayne A. Out of the Blues: Dealing with the Blues of Depression and Loneliness.

Minnesota: Focus Publishing, 2006.

Mack, Wayne A and Deborah Howard. It’s Not Fair! Finding Hope When Times Are

Tough. P & R Publishing: 2008.

Adams, Jay. What Do You Do When You Become Depressed? Phillipsburg, NJ:

Presbyterian and Reformed, 1975 (pamphlet).

Bridges, Jerry. Trusting God. Colorado Springs, CO: NavPress, 1989.




Recommended homework resources

Sample 1(taken from Robert Somerville’s book: If I’m a Christian, Why Am I Depressed?[3])

Somerville recommends journaling what you’re going through, as you’re learning and growing.

  • Journal a paragraph or two describing the anguish you feel.
  • Write out 1 Corinthians 10:13 in your journal and on a 3×5 card.
    • Memorize it.
    • On the back of the card write out a prayer, paraphrasing the verse as a prayer back to God. It might look like this: “Father, I thank You that You are faithful and that all our problems are common to man. I thank You that You never give us a temptation, test, or trial that is greater than we can handle. I thank You that You always provide a way through the problem so that we can handle it. Lord, as I face my depression today help me to look for the way out that You have provided so that I might be able to endure.”
    • Review the card and pray it back to God several times each day.
  • Read 1 Corinthians 10:13, Hebrews 4:14-16, and 1 John 1:9 and answer the following questions on each verse:
    • What has God promised you?
    • What hope and encouragement do you get from these three passages?
    • How will you respond to God’s promises in your situation?



[1] Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, by the American Psychiatric Association.

[2] Somerville, Robert B. If I’m A Christian, Why Am I Depressed? United States of America: Xulon Press, 2014.

[3] Somerville, Robert B. If I’m A Christian, Why Am I Depressed? United States of America: Xulon Press, 2014.

Biblical Counseling

By Jill Freeman

I. Overview

Biblical counseling is defined by its commitment not only to the inerrancy but also the sufficiency of Scripture to counsel people through life. While the psychological counselor would say that the Bible does not address many modern-day problems[1], Biblical Counseling boldly proclaims that “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.”[2]

However, this stands in contrast not only with secular psychology but with integrationist “Christian psychology”.[3] MacArthur notes, “In recent years…there has been a strong and very influential movement within the church attempting to replace biblical counseling in the church body with ‘Christina psychology’—techniques and wisdom gleaned from secular therapies and dispensed primarily by paid professionals. That is, they quote Scripture and often blend theological ideas with the teachings of Freud, Rogers, Jung, or whatever school of secular psychology they follow.”[4] These integrationists would claim that biblical counseling believes “God has allowed human beings to discover truth in almost every filed of human study except psychology.”[5] However, our ultimate source of truth must always be the Bible. Paul is pretty clear when he says, “See to it that no one takes you captive through hollow and deceptive philosophy, which depends on human tradition and the basic principles of this world rather than on Christ.”[6] Bulkley asks, “Am I misreading Paul? Is he in error to suggest that we can find all wisdom in Christ?”[7]

MacArthur gives a list of ideas that “many Christians are zealously attempting to synthesize with biblical truth”[8]:

Human nature is basically good.

People have the answers to their problems inside them.

The key to understanding and correcting a person’s attitudes and actions lies somewhere in that person’s past.

Individuals’ problems are the result of what someone else has done to them.

Human problems can be purely psychological in nature, unrelated to any spiritual or physical condition.

Deep-seated problems can be solved only by professional counselors using therapy.

Scripture, prayer, and the Holy Spirit are inadequate and simplistic resources for solving certain types of problems.[9]

            In contrast, the truly biblical counselor would not affirm these anti-biblical truths. But, are we then throwing away the whole of psychology? MacArthur answers this by saying that “Certainly it is reasonable for people to seek medical help for medical problems…It is also sensible for someone who is alcoholic, drug addicted, learning disabled, traumatized by rape, incest, or severe battering, to seek help in trying to cope with their trauma…In extreme situations medication might be needed to stabilize an otherwise dangerous person.”[10] However, he points out that these are not the norm and should not be the norm for dealing with spiritual problems.[11]

If biblical counseling is not these things, what is it? MacArthur defines the common commitments of Biblical Counseling below:

  • God is at the center of counseling.
  • Commitment to God has epistemological consequences.
  • Sin, in all its dimensions
  • The gospel of Jesus Christ is the answer.
  • The biblical change process which counseling must aim at is progressive sanctification.
  • The situational difficulties people face are not the random cause of problems of living.
  • Counseling is fundamentally a pastoral activity and must be church-based.[12]

Macarthur notes that “These seven commitments have unified the biblical counseling movement … but there are numerous other issues that demand clear biblical thinking and firm commitment…”[13]

II. History & Impact

The Biblical Counseling movement sprang up in the 1970’s; “that rediscovery is linked primarily to the life and efforts of one man: Jay E. Adams.”[14] Adams became a believer in high school and in college earned a Bachelor of Arts in classics and a Bachelor of Divinity. In 1952, Adams was ordained and pastored for the next thirteen years; yet he was troubled by his inability to help people solve their problems.[15] Then, in 1965, Adams began a fellowship program with O. Hobart Mowrer, who influenced Adams greatly as he observed Mowrer dealing with people’s problems as moral issues. Although Mowrer did not follow a biblical approach,[16] through working with him, Adams was persuaded to begin much study on the conscience, guilt, anthropology, and change.[17] In 1970, after much study, “Adams’ personal rediscovery of biblical counseling initiated a widespread rediscovery for the entire church.”[18] Powlison notes that, “The publication of Competent to Counsel (CtC) in 1970 marked the inception of a discernible nouthetic counseling movement and triggered lively controversy in the evangelical community.”[19]

In the time leading up to the Biblical counseling movement, several factors stood as a backdrop to the movement. First, revivalism had sprung up, in which the primary goal was to draw a crowd and convert them to Christ.[20] Neither of these are bad things, yet revivalism tends to focus on the masses, conversion, and instant change, while Biblical counseling focuses on individuals, conversion and discipleship, and the change process.[21] Another factor which had major significance in relation to Biblical Counseling was modernism: “In this controversy higher criticism and Darwinism worked to undercut the confidence that many ministers and ordinary Christians had in the authority of the biblical text. The Bible’s teaching on the origins of the world, its understanding of the problems of people, and even the words of Scripture itself all came under fire.”[22] Modernism obviously played a major role in undermining the belief that Scripture is sufficient in counseling. In addition to this, the psychological revolution, including Wilhelm Wundt and Sigmund Freud propelled the culture into a greater need for truly Biblical Counseling. Lambert notes that Freud actually “argued for a class of ‘secular pastoral workers’ with the goal of secularizing the counseling task.”[23] Wundt’s belief that all psychological problems stemmed from physiological problems had great impact on the church, which began to follow Wundt’s persuasion that psychology was merely a scientific (and not theological) field.[24] Lambert notes, “The absence of theology in counseling was the order of the day when, in 1970, Jay Adams published Competent to Counsel. In that book and many others in the 1970s Adams sought to alert Christians to their failures in the area of counseling and began pointing the way to the resources laid out in Scripture for helping people.”[25]

In 1966, Adams started a counseling center with Gardner McBride, called the Christian Counseling and Educational Center (CCEC). Then in 1968, the ministry was expanded and the Christian Counseling and Educational Foundation (CCEF) was formed, which became a source not only of counseling, but also of training and published resources. CCEF continued to grow, hiring its first full-time employee in 1974, and expanding its sites across the country. Soon, “the need for a professional association became evident. Concerns for the growing group of practitioners included certification for biblical counselors, accountability for standards of biblical commitment and ethics, fellowship and interaction among biblical counselors, ongoing in-service training, and protection from lawsuits. To meet these and other needs, Adams joined with several men to found the National Association of Nouthetic Counselors (NANC) in 1976.”[26]

Since the founding of NANC (now known as the Association of Certified Biblical Counselors: ACBC), several other biblical counseling resources, ministries, and educational programs have sprung up. These include The Journal of Biblical Counseling (originally known as The Journal of Pastoral Practice), Faith Baptist Counseling Ministries (FBCM), and The Master’s University and Seminary. Meanwhile, several Christian organizations have continued down the path of secular psychology and integration, hiring psychologists and teaching psychology in their colleges and seminaries.

Powlison explains that, “The nouthetic counseling movement entered the 1980s full of optimism. Jay Adams’s ‘counseling revolution’ had enjoyed a rapid and clamorous expansion.” However, “Nouthetic counseling’s popularity plateaued by 1980. During the decade that followed, momentum stalled, while the evangelical psychotherapists enjoyed spectacular success in capturing the mind, the respect, and the institutions of conservative Protestantism.”[27] Yet, “around 1990, even as the therapeutic movement among evangelicals came into full flower, nouthetic counseling institutions began to grow, and doubts about psychotherapy became increasingly evident among conservative Protestants.”[28]


III. Works/Publications



Bulkley, Ed, Why Christians Can’t Trust Psychology. Eugene: Harvest House Publishers, 1993.

Lambert, Heath. The Biblical Counseling Movement After Adams (Forward by David Powlison). E-book. Wheaton: Crossway, 2011.

Macarthur, John. Counseling: How to Counsel Biblically., Nashville: Thomas Nelson, Inc., 2005.

Powlison, David. The Biblical Counseling Movement., Greensboro: New Growth Press, 2010.



[1]  Ed Bulkley, Ph. D. Why Christians Can’t Trust Psychology (Eugene: Harvest House Publishers, 1993), 258

[2] Ibid. 258, quoting 2 Peter 1:3 NIV

[3] As defended throughout Ibid.

[4] John MacArthur, Counseling: How to Counsel Biblically (Nashville: Thomas Nelson, Inc.), 3

[5] Bulkley, Why Christians Can’t Trust Psychology, 26: quoting Gary R. Collins, Can You Trust Psychology? (Downers Grove: InterVarsity Press, 1988), 94

[6] Ibid. 25 quoting Col. 2:8 NIV

[7] Ibid. 25

[8] MacArthur, Counseling: How to Counsel Biblically, 7

[9] List from Ibid. 7

[10] Ibid. 8

[11] Ibid. 8-9

[12] Ibid. 27-29

[13] Ibid. 29

[14] Ibid. 23

[15] Ibid. 21-22

[16] Ibid. 22. Also supported in: Powlison, The Biblical Counseling Movement (Greensboro: New Growth Press, 2010), chapter 2

[17] MacArthur, Counseling: How to Counsel Biblically, 22

[18] Ibid. 23

[19] Powlison, The Biblical Counseling Movement, 51

[20] Heath Lambert. The Biblical Counseling Movement After Adams (Forward by David Powlison)., E-book, (Wheaton: Crossway, 2011) chapter 1


[22] Ibid.

[23] Ibid.

[24] Ibid.

[25] Ibid.


[26] Ibid. 24

[27] David Powlison, The Biblical Counseling Movement, 201-202

[28] Ibid. 219


By Luke Brannon

Problem/Condition: Gluttony

  1. Definition
    1. Biblical Perspective: Gluttony
      1. The biblical term for overeating is gluttony (Prov. 23:2, 21; Prov. 18:7, Titus 1:12-13). Gluttony is the uncontrolled eating of food that is excessive and unnecessary. Gluttony or overeating occurs when a person eats to a level that is wasteful, unhealthy, and lacking self-control. Gluttony, in the Bible, is often related to laziness and excessive drinking of alcohol. Food is a gift from God, and God wants us to enjoy eating food with a spirit of thankfulness to Him (1 Cor. 10:31). However, it is important to understand that gluttony is condemned in the Bible. Believers must exercise self-control over their bodies to avoid falling into the sin of gluttony. Eating becomes gluttony when a person eats in an excessive manner which is unhealthy to his body and is lacking of self-control.
  2. Secular Perspective: Overeating
    1. The most general secular term for gluttony is overeating. Overeating includes any time that person eats more food than is needed for his/her body. Usually isolated instances of overeating are not recognized as a significant issue, but regular overeating is recognized as a major issue. There are several patterns of overeating that are classified as disorders.
    2. Bulimia Nervosa and Binge-Eating Disorder
      1. Both of these disorders describe compulsive and recurring binge eating sessions.[1] Bulimia Nervosa is the name for the disorder in which a person compulsively binge eats then uses methods such as induced vomiting or laxatives to expel the food. Binge-Eating Disorder is the title for the disorder in which a person compulsively binge eats, but does not take any measures to expel the food.[2] The secular world views these actions as disorders in which the person’s body and past is responsible for the person’s binge eating sessions.
    3. History of Overeating
      1. Overeating, or gluttony, has existed from very near the beginning of time. A biblical example of this can be found in Judges 3 and the story of Ehud and Eglon. Eglon, the king whom Ehud assassinates, is a described as being a very fat man (v. 17). This example, with countless other examples of overeating and overweight people in the past, clearly show us that gluttony is not a new issue. However, it is true that over the past several decades obesity has become a larger issue.[3]
    4. Evidence of the Problem
      1. The prevalence of gluttony in our world today is evidenced by the high rates of obesity. According to an article published by CDC Stacks, over the last 50 years the percentage of overweight people in the United States has remained quite steady, but the percentage of obese people has been greatly increasing.[4] This shows that excessive eating has been on the rise in America.
      2. Gluttony and obesity are connected with numerous medical and interpersonal issues. Gluttony causes numerous health issues such as diabetes, heart problems, and many others.[5] It also can encourage interpersonal issues such as depression, embarrassment, and hate of self.[6]
  • Etiology
    1. Physical Causes
      1. While physical causes are not solely responsible for gluttony, or what the secular world calls binge eating, they do play a role in enticing a person to overeat. Factors such as genetics, the way one’s body reacts to certain stimuli, or even metabolic damage from extreme dieting can make a person more prone to binge eating.[7]
    2. Spiritual Causes
      1. While a person’s body may encourage him to sin by gluttony, each person is still responsible for his own actions. For a person who struggles with gluttony, the most likely spiritual issue is a lack of self-control. A person who is gluttonous gives in to his bodily cravings. However, the Bible commands each person to exercise self-control over his/her body. In 1 Corinthians 9:27 Paul writes on self-control, “But I discipline my body and keep it under control, lest after preaching to others I myself should be disqualified.” Paul also writes in Galatians 5:16-17, “But I say, walk by the Spirit, and you will not gratify the desires of the flesh. For the desires of the flesh are against the Spirit, and the desires of the Spirit are against the flesh, for these are opposed to each other, to keep you from doing the things you want to do.” These verses show that fleshly desires must be defeated with Spirit-filled self-control.
    3. Physical Symptoms
      1. As mentioned above, gluttony can result in obesity which can lead to serious health issues such as heart problems, diabetes, and many others.
    4. Spiritual Symptoms
      1. Overeating can lead to depression and insecurity. A person who struggles with gluttony will often feel like a failure. They may begin to develop a fatalistic mentality in which they believe they are unable to overcome temptation in their lives. Discouragement and even apathy are often spiritual symptoms of gluttony.
    5. Examining the Heart
      1. The main heart issue behind gluttony is the worship of the comfort and pleasure that food brings. Often times a person who overeats will do so because of stress, anxiety, depression, or some other discomfort. The person who turns to food instead of the Lord for relief to their problems is placing his worship in the wrong place. A person who struggles with gluttony needs to learn to find his refuge in the Lord rather than in the comfort that food brings. In Psalms 121:1-2 David writes, “I lift up my eyes to the hills. From where does my help come? My help comes from the Lord, who made heaven and earth.” He also writes in Psalm 86:7, “In the day of trouble I call upon you, for you answer me.” David’s hope in hard times was found in the Lord. A person who places his trust in the Lord will not be let down, but a person who places his hope for security and satisfaction in food will only make his problems worse. Gluttony stems from a worship of the comfort and pleasure that food brings, but only worship of God will bring true satisfaction and peace.
    6. Biblical Solutions
      1. Counseling Agendas
        1. Kelly Jo Lynch in “Approaches to the treatment of Overeating in Christian Literature” writes that there are 5 key elements that must be present in a counseling plan for gluttony. The five components of biblical response to sin are “acknowledgement and confession of sin; repentance; receiving grace, mercy and power from God; confession of sin to others; and changed behavior.”[8] Any counseling plan for a person who struggles with gluttony must bring the counselee to a point where he recognizes gluttony as a sin and repents of it. He then must come to an understanding of God’s grace and rely on God’s power to overcome his sin. He should confess his struggle to others so that they can keep him accountable as he takes measures to change his behavior.

Recommended books

  1. Fitzpatrick, Elyse. Idols of the Heart : Learning to Long for God Alone. Second ed. Phillipsburg, New Jersey: P & R Publishing, 2016.
  2. Lynch, Kelly Jo, and Theological Research Exchange Network. “Approaches to the Treatment of Overeating in Christian Literature,” 2001.
  3. Mack, Wayne A, and Wayne Erick Johnston. A Christian Growth and Discipleship Manual. Homework Manual for Biblical Living, 3. Bemidji, MN: Focus Publishing, 1995.
  1. Pritchard, Ray. Man of Honor : Living the Life of Godly Character. Wheaton, IL: Crossway Books, 1996.

Recommended Homework Resources

  1. Adams, Jay E. The Christian Counselor’s Manual : The Practice of Nouthetic Counseling. The Jay Adams Library. Grand Rapids, Mich.: Zondervan, 2010.
  2. Mack, Wayne A. A Homework Manual for Biblical Counseling. Phillipsburg, N.J.: Presbyterian and Reformed Pub, 1979.









“Binge-Eating Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 5 May 2018,

Chambers, Natalie. Binge Eating: Psychological Factors, Symptoms and Treatment. New York: Nova Biomedical, 2009.

Fryar, Cheryl D., Margaret D. Carroll, and Cynthia L. Ogden. “Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960–1962 through 2015–2016,” 2018.

Lynch, Kelly Jo, and Theological Research Exchange Network. “Approaches to the Treatment of Overeating in Christian Literature,” 2001.

Ogunbode, A M et al. “Health risks of obesity” Annals of Ibadan postgraduate medicine vol. 7, 2009.

Parrillo, Vincent N. Encyclopedia of Social Problems. Thousand Oaks, Calif: SAGE Publications, Inc, 2008. P. 632

Tracy, Natasha. “Types of Eating Disorders: List of Eating Disorders.” HealthyPlace, Healthy Place, 10 Jan. 2012,

[1] Chambers, Natalie. Binge Eating: Psychological Factors, Symptoms and Treatment. (New York: Nova Biomedical, 2009). 24.

[2] Tracy, Natasha. “Types of Eating Disorders: List of Eating Disorders.” (HealthyPlace, Healthy Place, 2012).

[3] Parrillo, Vincent N. Encyclopedia of Social Problems. (Thousand Oaks, Calif: SAGE Publications, Inc., 2008). 632.

[4] Fryar, Cheryl D., Margaret D. Carroll, and Cynthia L. Ogden. “Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960–1962 through 2015–2016.” (2018). Table 3

[5] Ogunbode, A M et al. “Health risks of obesity” Annals of Ibadan postgraduate medicine vol. 7 (2009). 22-5.

[6] Ibid.

[7] “Binge-Eating Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 5 May 2018.

[8] Lynch, Kelly Jo, and Theological Research Exchange Network. “Approaches to the Treatment of Overeating in Christian Literature,” (2001) 59.


Jay E. Adams

By Ethan Berthiaume

I. Known For

Jay E. Adams is a reformed American Christian author who is best known for influential writings that helped found modern Biblical Counseling. He has written over 100 books, the most famous of which being Competent to Counsel. Jay Adams introduced the method of “nouthetic” counseling, which centers around conforming to scriptural principles for the purpose of spiritual growth. This method eventually became a movement which we know today as Biblical Counseling. Adams has been called a “father of Biblical Counseling” for his foundational influence on the methods and movements that shaped it (Powlison, 44).

II. Biography

Jay Adams was born to Joseph Edward and Anita Louise Adams in Baltimore, Maryland on January 30, 1929. He was married to Betty Jane Whitlock on June 23, 1952. They had four children: Holly, Todd, Clay, and Heather (“Jay E. Adams – Exodus Books”).

Jay became came to know Christ at the age of 15 after being gifted a copy of the New Testament by a friend. Adams became fascinated with God’s word, and he majored in Greek solely for the purpose of having an understanding what God’s word teaches (Adams, Ligonier Ministries).

Adams went on to study and receive formal theological and seminary training at several different schools. These include the Reformed Episcopal Seminary, John Hopkins University, Pittsburgh-Xenia Seminary, Temple University School of Theology, and the University of Missouri. He then went on to pastor at several churches alongside the East Coast in Pennsylvania and New Jersey. Adams began working as a professor at Westminster Theological Seminary in Philadelphia, and eventually became the director of the Doctoral program at Westminster Theological Seminary in California. Following this, he went on to plant churches in South Carolina, where he pastored until 1999 (“Jay E Adams, Ph. D.”).

Jay Adams first became interested in counseling early in his pastoral ministry after experiencing a difficult situation with the death of a man he failed to comfort in a difficult circumstance. After this, Adams asked the Lord to help him become effective in counseling ministry. While studying at the Temple University School of Theology, Adams took a course on psychological counseling. Here, he was discouraged by how foundationally speculative the methods were. Adams became more interested in the Biblical view of psychology while studying under Psychologist, O. Hobart Mowrer (1907-1982). Mowrer taught counseling techniques that integrated sin as an influence on mental health. While Adams did not entirely agree with all of Mowrer’s views, he became more fascinated with applying the Bible to the techniques of soul care. Adams continued to study and develop a model founded on Biblical principles known as “nouthetic counseling”. In 1970, he published his most famous work, Competent to Counsel, which argued that that all Christians can become fully equipped for the work and ministry of soul care if their methods were centered around biblical principles and views of man (Powlison, 35-45).

The publication of this book caused much controversy in the Christian community, as more and more pastors began to adopt Adam’s method of “nouthetic counseling” into their ministry. This movement eventually grew into what we now know today as Biblical Counseling (Powlison, 44).

Adams was honored at the first International Congress on Christian Counseling in 1988 in Atlanta as one of the three fathers of Christian Counseling, for his essential influence on the movement (Powlison, 43).

Jay Adams Retired in 1999 from pastoral ministry but has continued to write and lecture on Biblical Counseling. He founded the Institute for Nouthetic Studies (INS) in the year 2001. At the time of this publication, he currently resides in South Carolina and is still involved in teaching at INS (“Jay E Adams, Ph. D.”)

Jay Adams was revolutionary for his time, as psychology had taken a preeminent role in the art of soul care. Adams challenged the skeptical theories of psychology and developed a model that helped push the church towards scripture-based methods of helping people.

III. Important Theological Views

Nouthetic Counseling

Jay Adam’s most prominent, and certainly most well-known accomplishment is his method of nouthetic counseling. The word nouthetic comes from the Greek word noutheteō, which means to “instruct” or “admonish.” Adams himself states that this method is based upon three scriptural principles: concern, confrontation, and change. Adam’s most famous work, Competent to Counsel, goes in-depth with this method, describing the role of a counselor to encourage believers towards the repentance of sin. This method also includes the factor of the Holy Spirit, whom Adams believes is the sole source of true Biblical change in a believer’s life (Adams, Ligonier Ministries).

An important distinction of Jay Adams models is their rejection of psychological theories and models that contradict the Bible. This mainly has to do with the issue of sin as it relates to a believer’s behavior, a factor that is most often excluded from modern psychological models. Adams’ method of nouthetic counseling is distinct in that it holds to the Bible as the sufficient and authoritative tool for equipping believers for all things needed for life and godliness (2 Timothy 3:16-17).

IV. Works/Publications

Jay Adams has written over 100 books that relate to pastoral ministry and counseling. These have been translated into 16 different languages. The most famous and influential of published works are: Competent to Counsel (1970), The Christian Counselors Manuel (1973), A Theology of Christian Counseling (1979), Shepherding God’s Flock: A Handbook on Pastoral Ministry, Counseling, and Leadership (1974) (“Adams, Jay E. 1929- [Worldcat Identities]”.)



“Jay E. Adams – Exodus Books”. Exodusbooks.Com,

adams/2716/. Accessed 30 Nov 2018.

Adams, Jay. “Competent To Counsel: An Interview With Jay Adams By Jay Adams”. Ligonier Ministries. 2014. Accessed 30 November 2018

“Jay E Adams, Ph. D.”. Nouthetic.Org, Accessed 29 Nov 2018.

“Adams, Jay E. 1929- [Worldcat Identities]”. Orlabs.Oclc.Org, Accessed 30 Nov 2018.

Collins, Gary R; Johnson, Eric L; Jones, Stanton L (2000). Psychology & Christianity. Downers

Grove, IL, USA: InterVarsity Press. pp. 36–37. ISBN 0-8308-2263-1.

Powlison, David. The Biblical Counseling Movement. New Growth Press, 2010, pp. p. 35-44.

Ligonier Ministries, 2014, Accessed 1 Dec 2018.