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Different Approaches in Christian Therapy

Laure-Marie Carignan
April 2015

If you’re considering Christian therapy as a way of helping you through an individual, couple, or family issue, it may be helpful to do a bit of research. Not all therapists understand Christian therapy the same way, nor do they all use the same approaches. Here’s an overview of 3 different general approaches that might help you in finding the best Christian therapy approach for you.

Approach A

The professional therapist who happens to be a Christian:

This is a bit like the mechanic who happens to be a Christian – you may choose a Christian mechanic to work on your car in order to encourage that person because you share a faith basis, or because you assume the person will be honest and in general will try to do the best job possible. But there is not likely to be a specifically “Christian” way of repairing your car, and in that sense, you are expecting the mechanic to provide a service which is solely dependent on training and expertise

In the realm of counselling and therapy, this may also be possible. There are professional therapists who happen to be Christian but who are not trained to integrate Christian faith explicitly into the process of therapy. They may pray at the beginning of a session, but little else occurs that demonstrates explicitly Scriptural or Christian interventions.

Methods used by the professional therapist who happens to be a Christian:

This therapist would usually be proficient in a number of empirically-validated professional approaches, and may or may not screen interventions as to their compatibility with Scripture. It would be important to verify specific practices which may be relevant to your situation, and to inquire as to how the therapist may adjust interventions to be appropriate for your own Christian faith or negotiate how it might be possible to integrate your beliefs into the process. It would also be important to ask about the therapist’s personal philosophy around issues related to your situation, as there is considerable variation among professional therapists on issues such as the permanence of marriage or even a basic philosophy of Christian living.

Approach B

The biblical counsellor who deals with clinical issues:

In this realm, we find counsellors who are trained within a biblical framework but who are not necessarily licensed to practise under specific guidelines of a professional college, such as the recently established College of Registered Psychotherapists of Ontario. In light of current legislation in Ontario, it is important to understand that there is no recourse for a person whose condition deteriorates under the practise of an unlicensed counsellor.

Methods used by the biblical counsellor who deals with clinical issues:

One form of biblical counselling which is very prominent in some Christian circles, called nouthetic counselling, was developed by Jay Adams in the 1970’s.1 This form of counselling, which is usually directive, advises the client to organize thoughts and actions according to the counsellor’s understanding of a biblical model, which often excludes truth outside of Scripture for dealing with clinical issues. One example may be the consideration that clinical issues such as depression or anxiety arise solely from non-confession of sin. Critics of the nouthetic model tend to focus on the exegetical problem of applying certain passages of Scripture without considering the context in which those passages were written, or how the interpretation of those passages are influenced by one’s theological perspective.2 Most notably, the inherent notion in nouthetic counselling that the book of Proverbs “advocates a system of counselling”, is not accepted by Biebel and Koenig (2004).3

One other concern which arises with respect to nouthetic counselling, or various other trends in biblical counselling that exclude professional training, has to do with underlying assumptions and intervention methods that tend to interact with all counselees in virtually the same way. For some trained therapists and indeed for many clients, the lack of diversity in approaching a counselee as a unique individual may be seen as problematic. We have only to look to Jesus and his interactions with the Syrophoenician woman on the one hand4 and with Simon Peter after his denial of Christ on the other hand5 to appreciate how He dealt with each person individually, knowing exactly what kind of interaction they needed to grow in saving faith. There are clients for whom a very directive (advice-giving) form of counselling is appreciated and helpful. There are others who find non-directive counselling frustrating, as this is “client-driven” according to what seems important at the moment, but relies very little on a treatment plan or goals. It is important in choosing a biblical counsellor, as with a professional therapist, to discuss the methodology which will be used.

Approach C

The professional therapist who explicitly integrates Christian faith into the practise of therapy:

This therapist is professionally trained and licensed to provide psychotherapy and/or couple and family therapy, but also has sufficient biblical training to discern what treatment approaches and methods are compatible with Scripture, and what Scriptural truths are particularly relevant to a given situation. A certain maturity in Christian faith and biblical knowledge is required to be able to effectively integrate faith into the therapeutic process.

Methods used by the professional therapist who explicitly integrates Christian faith into the practise of therapy:

At the outset, this type of therapist would want to understand elements of the client’s faith journey that speak to the issue at hand, and what specific aspects of faith the client would like to integrate into the therapy. Sometimes, for example, clients specifically request that prayer and discussion of Scripture be part of the process.

Although some of this may be discussed from the perspective of denomination or theological considerations, the more relevant aspects for therapeutic purposes usually pertain to the client’s relationship with God. For this purpose, there may be a focus on the client’s “God concept” versus their “God image”. A person’s “God concept” has to do with theology, an “intellectual definition of God”, or even “what I think I ought to believe about God”; whereas the “God image” has more to do with how a person experiences and relates to God on the basis of what they’ve internalized.6

An explicit integration of Christian faith into the therapy process might explore the distress created by a discrepancy between “God concept” and “God image” if this distress is part of the overall issue the client is facing. Such a process would strengthen the client’s “God image” and also what is known as one’s “attachment to God”. Considered by Hall (2004) in his Central Organizing Principles to be psychologically relevant7, one’s “attachment to God” has to do with emotional safety in key relationships throughout our lifetime, and how this is reflected in and influenced by our relationship with God.

For clients who have suffered from insecure attachments as children in their relationships with their primary caregivers, professional psychotherapy offers methodology which can compensate for these losses. When such therapy explicitly integrates Christian faith to compensate for attachment losses in the client’s attachment to God, there can be profound and significant change that impacts on such clinical issues as depression and anxiety.8

Other ways in which Christian faith may be explicitly integrated into the therapy process include finding faith-based reframing of negative cognitions (thoughts and perceptions) in cognitive-behavioural therapy (CBT), or the use of Scripture as part of a visualization or meditation to deal with anxiety. In application with emotionally-focused therapy (EFT), narrative, object-relations or Gestalt-type therapy, very powerful work can be done when explicitly integrating the presence of God into the process, so that the client can emotionally reframe painful experiences with God. Theophostic ministry, which focuses primarily on the personal encounter with the Spirit of Jesus Christ, while not considered by its founder Ed Smith as counselling, is the basic principle behind the above-mentioned integration of the presence of God into the therapy process.9


1Biebel, D., and Koenig, H. (2004), New Light on Depression, Grand Rapids: MI. Zondervan, p. 157
2Ibid, p. 158
3Ibid, p. 159
4Mark 7:24-30
5John 21:15-17
6Lawrence, R.T. (1997). Measuring the Image of God : The God Image Inventory and the God Image Scales. Journal of Psychology and Theology 25(2), p. 214
7Hall, T.W. (2004). Christian Spirituality and Mental Health: A Relational Spirituality Framework for empirical research. Journal of Psychology and Christianity, 23, pp. 66-81
8Beck, Richard and McDonald, Angie (2004). Attachment to God : The Attachment to God Inventory, Tests of Working Model Correspondence, and an Exploration of Faith Group Differences. Journal of Psychology and Theology, 32(2), pp. 92-103.
9Biebel, D., and Koenig, H. (2004), New Light on Depression, Grand Rapids: MI. Zondervan, p. 156, 162