Christians adopt various models for pastoral counseling. Before we begin looking at the practical application of counseling, we really should question what our theory of Christian counseling should be—assessing a few standard approaches.
(1) Only Scripture: Nouthetic Counseling
On one extreme, we find “nouthetic counseling.” The Greek word noutheo means “to correct” or “admonish.” Thus admonition of immoral behavior rests at the center of this view. The most popular example of this approach would be Christian counselor Jay Adams in his book Competent to Counsel (1970). Adams writes, “Nouthetic confrontation, in its biblical usage, aims at straightening out the individual by changing his patterns of behavior to conform to biblical standards.”
Adams (who holds to a strict VanTillian and Reformed view) believes that scientific discovery can help the Christian counselor, but it shouldn’t be trusted. He writes, “Because non-biblical systems rest upon non-biblical presuppositions, it is impossible to reject the presuppositions and adopt the techniques which grow out of and are appropriate to those presuppositions.” Instead of seeing believers as having a sinful nature, Adams holds that the Greek word sarx refers to our sinful body. He writes, “When Paul speaks of the body as sinful, he does not conceive of the body as originally created by God as sinful… but rather the body plunged into sinful practices and habits as the result of Adam’s fall.” Regarding the mentally ill, he writes,
What then is wrong with the ‘mentally ill’? Their problem is autogenic; it is in themselves… Apart from organically generated difficulties, the ‘mentally ill’ are really people with unsolved personal problems.
The idea of sickness as the cause of personal problems vitiates all notion of human responsibility… People no longer consider themselves responsible for what they do wrong.
While changing our actions is our goal, this isn’t a sufficient approach to achieve that goal. We would agree with the goal of this form of counseling, but not its methods. Sin is far more complicated than simply changing behavior, and while admonition has its role, we need to have a more complex solution to help others with it.
(2) Consistent with Scripture: Christian Psychology
On the other extreme, other Christian counselors hold that our counseling model should simply be consistent with Scripture. That is, we should develop a paradigm that works, as long as Scripture doesn’t contradict whatever we discover.
While this view is admirable in some respects (because it tries to incorporate truth in the realm of psychology), it moves too far to the opposite extreme. The Bible teaches how to be relationally, emotionally, and spiritually centered; thus our model should arise and emerge from Scripture—not merely be consistent with it. Consider if a parent left their teenager home alone for the weekend, warning them, “Do not throw any parties in the house while we’re gone!” When they return, they find that the teenager didn’t throw a party in the house, but threw a party on top of the house—on the roof. Technically, this is consistent with the parent’s instructions, but it doesn’t at all fit with the parent’s will for their kid.
(3) Emerging from Scripture: The views of Dr. Larry Crabb
We agree with the view of Dr. Larry Crabb in his book Understanding People. Crabb received his PhD in clinical psychology from the University of Illinois, and he is a well-known Christian counselor who holds to a high view of Scripture as well. He writes,
Revelation must be the basis upon which we develop and defend our counseling ideas… It is my view that counseling models must demonstrate more than mere consistency with Scripture; they must in fact emerge from it.
The difference between “guided by” and “consistent with” is enormous. The theorist who is guided by the Bible more fully acknowledges its authority. Someone who depends for guidance on another source and then seeks to maintain biblical consistency will tend to regard the Bible merely as helpful. The product of the latter way of thinking should not properly be called “biblical.”
Nature was not designed to be a textbook on life. The Bible was. The problems people bring to a counselor always involve a malfunction in life: anxiety that keeps agoraphobics indoors; depression that takes the joy and meaning out of living; compulsions that drive people to do things which interfere with normal functioning—all obstacles to effective living. If counselors are supposed to help people live their lives as life was meant to be lived, and if the Bible is the book where God tells us how to solve our problems in order to live, then it follows that we should expect the Bible to provide more help to counselors than the scientific study of nature.
Human problems, in this view, are best understood as defensive attempts to handle the pain of fear and tension in significant relationships. By responding to each other defensively, we minimize the chances of gaining the closeness we legitimately want. The result is a profound loneliness that strengthens our determination to protect ourselves from the hurt we fear. People are caught up in a vicious cycle of hurt, defensive retreat, more hurt, more retreat.
Under this view, our counseling model should arise from Scripture. While Scripture doesn’t answer every question about how to counsel others, it answers the primary questions of love, significance, relationships, and identity. Based on this framework, we ground our core counseling theory on biblical teaching, while incorporating psychological and medical studies to supplement this central approach.
 Adams, Jay. Competent to Counsel: Introduction to Nouthetic Counseling. Grand Rapids, Michigan: Zondervan, 1970. 46.
 Adams, Jay. Competent to Counsel: Introduction to Nouthetic Counseling. Grand Rapids, Michigan: Zondervan, 1970. 102.
 Adams, Jay E. More Than Redemption. Phillipsburg, NJ: Presbyterian and Reformed. 1979. 160.
 Adams, Jay. Competent to Counsel: Introduction to Nouthetic Counseling. Grand Rapids, Michigan: Zondervan, 1970. 29.
 Adams, Jay. Competent to Counsel: Introduction to Nouthetic Counseling. Grand Rapids, Michigan: Zondervan, 1970. 5.
 Crabb, Larry. Understanding People: Deep Longings for Relationship. Grand Rapids, MI: Zondervan, 1987. 29.
 Crabb, Larry. Understanding People: Deep Longings for Relationship. Grand Rapids, MI: Zondervan, 1987. 38.
 Crabb, Larry. Understanding People: Deep Longings for Relationship. Grand Rapids, MI: Zondervan, 1987. 43.
 Crabb, Larry. Understanding People: Deep Longings for Relationship. Grand Rapids, MI: Zondervan, 1987. 83.