Atlas›Domain VII · Transpersonal, psychedelic & altered states›Guide 031
Guide VII-031

Biblical (nouthetic) counselling

Jay E. Adams1966
A 21 · L 72 · M 727 interventions in the Trinity explorer1 described for recognition only
Client cardCompare
[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: Jay E. Adams's original nouthetic counselling, as set out in Competent to Counsel (1970) and The Christian Counselor's Manual (1973), as summarised by secondary sources with page references; current practice from the Association of Certified Biblical Counselors (ACBC, formerly NANC); the later CCEF "biblical counseling" variant (Powlison, Welch, Lane and Tripp) is flagged where it differs. Sources: Adams's books are described here only through a table of contents and secondary summaries, so steps resting on those summaries say so [uncertain]. Primary or organisational sources include: CCEF's "Three Trees" model (heat, thorns, cross, fruit) via ACBC's review of Lane and Tripp's How People Change; ACBC's Standards of Conduct on medical care, hospitalisation, referral and confidentiality; ACBC's own published suicide guidance (Truth in Love episodes 96 and 176); the facts and holding of Nally v. Grace Community Church (1988); and that the "1994" work Virkler cites is MacArthur and Mack's Introduction to Biblical Counseling, not an Adams title. No standard session count or frequency, and no step-by-step ACBC or CCEF suicide protocol, is published in the sources used [uncertain]. [source: Kellemen 2023; Fraser 2012; Virkler 2023; Competent to Counsel TOC; Zondervan Academic product pages; ACBC TIL 96; ACBC TIL 176]

What it is. Nouthetic counselling is a pastoral, church-based form of Christian counselling. The Presbyterian pastor and Westminster Theological Seminary professor Jay Adams developed it between 1966 and 1970 and launched it with Competent to Counsel (1970). He drew partly on a 1965 fellowship with O. Hobart Mowrer, though Adams denied being Mowrer's disciple. CCEF (Christian Counseling & Educational Foundation, near Philadelphia) was founded in 1968. NANC was founded in 1976 to certify counsellors and centres and is now ACBC. Many in the movement now prefer the name "biblical counseling". [source: Kellemen 2023; Fraser 2012, p. 128]

The name comes from the Greek nouthesia/noutheteo (admonish). Adams described it as lovingly confronting people, out of deep concern, to help them make the changes God requires. [source: Kellemen 2023 quoting Adams]

Core idea of change (as the model holds it). Adams held that Scripture is sufficient for counselling. On his view, most non-organic personal problems are moral and spiritual, rooted in sin and sinful habit, rather than illness. Change comes when the counsellor directly confronts the person with what Scripture requires and the person repents and confesses. The person then deliberately replaces sinful habits with godly ones ("put off / put on", dehabituation and rehabituation) through concrete homework, inside the church community. Feelings are expected to follow changed behaviour. These are the tradition's theological claims and are attributed to it here, not stated as fact. [source: Virkler 2023 summarising Adams 1970, 1973; Fraser 2012, p. 133]

Note for a licensed psychotherapist [synthesis]. The founders built this model as an alternative to psychotherapy, not an add-on. Adams argued that psychologically trained people have no legitimate place in counselling and that pastors should do it [source: Virkler 2023]. ACBC's abuse guidance calls CBT and other secular models incompatible with biblical counsel [source: ACBC Committed to Care]. A therapist using it inside a secular licence therefore has three real issues to address:

  • Scope. The method is directive moral and religious instruction.
  • Informed consent. The client must know they are getting faith-based directive counsel, not standard psychotherapy.
  • Value-imposition rules. The client must have explicitly chosen a Scripture-based frame.

ACBC certification is an association credential. How it relates to state licensure is [uncertain]. This guide describes the method as its organisations publish it. Section 5 reports documented concerns.

2. Framework

Adams's model has no numbered phase protocol. It is organised around four activities that he took from 2 Timothy 3:14–17 [source: Fraser 2012, p. 129, citing Christian Counselor's Manual pp. 95–97]:

  1. Teaching / judging. Establish the biblical standard that applies to the problem.
  2. Convicting. Help the counselee see where life falls short of it.
  3. Correcting / changing. Repentance, confession, reconciliation.
  4. Structuring / training in righteousness. Build the new pattern by practice until it becomes habitual.

In practice, the course runs through these elements (the order is reconstructed from the sources listed in each item):

  • Pre-intake. The counselee completes the Personal Data Inventory (PDI). The current ACBC practice described by Moorhead also includes a pre-reading pamphlet and an encouraging message before the first meeting. [source: Competent to Counsel back matter; ACBC TIL 555]
  • First session.
    • Life story and testimony.
    • Questions to check the counselee's understanding of the gospel.
    • Giving hope.
    • First homework.
    Adams held that an unbeliever should be evangelised first, because he regarded full nouthetic counselling as possible only with believers. [source: ACBC TIL 555; Competent to Counsel TOC ch. VIII "Hope"; Fraser 2012, p. 129]
  • Data gathering and interpretation (early sessions, then continuing).
    • Gather concrete facts from all parties.
    • Ask "what" rather than "why".
    • Classify the problem at three levels: presentation, performance, preconditioning.
    • Identify blame-shifting ("dodges").
    [source: nouthetic.org; Virkler 2023]
  • Instruction and confrontation (each session).
    • The counsellor is directive and teaches what the relevant texts require.
    • Current ACBC practice is one priority theme per session, taught for about 5–15 minutes as a dialogue.
    • Most session time goes to reviewing homework.
    [source: Virkler 2023; ACBC TIL 555]
  • Repentance, confession, reconciliation. [source: Virkler 2023]
  • Dehabituation and rehabituation (the bulk of the work).
    • Log lists.
    • Put off / put on.
    • Restructuring life and schedule.
    • Accountability partners.
    • Practice and report back.
    [source: Virkler 2023 citing Adams 1973, pp. 191–216; Fraser 2012, p. 133]
  • Termination. Ends when counselees begin solving their own problems biblically. [source: Virkler 2023]

Format.

  • Individual, or joint for couples and families. Couples are seen together whenever both will come. [source: nouthetic.org]
  • Team counselling with up to four counsellors is permitted. [source: Virkler 2023]
  • "Multiple counselling" and a parent–teacher–student conference format are described. [source: Competent to Counsel TOC chs. X–XI]
  • Concrete homework is set every session. [source: Virkler 2023]
  • The counsellor sits at a desk, takes notes, keeps a Bible to hand, writes out assignments and gives handouts. [source: nouthetic.org]

Session count and frequency. No source states a standard number of sessions, session length or frequency [uncertain]. The publisher pages for Adams's two main books and the Institute for Nouthetic Studies' About page give none [source: Zondervan Academic product pages; INS About page]. Moorhead (ACBC) mentions observing a 12-session plan used by another counsellor, and questioning it [source: ACBC TIL 555]. Virkler quotes Powlison (1988) that the most characteristic biblical counselling relationship is "a long-term friendship", with the authoritative short-term intervention as the emergency measure [source: Virkler 2023, citing Powlison 1988, pp. 65–66]. Weekly sessions with homework in between are a reasonable working default, but that is an inference, not a documented standard [synthesis].

Criteria for moving on.

  • Move from data gathering to instruction once the concrete facts, including those from other parties, are clear enough to name the biblical issue. [source: nouthetic.org, Prov 18:13 principle]
  • Move from confession to rehabituation once the counselee owns the behaviour as their responsibility. [source: Virkler 2023]
  • End when progress is recorded, has generalised to other areas, and the counselee can do the process unaided. [source: Competent to Counsel TOC ch. IX; Virkler 2023]

More detailed criteria are not documented in the sources [uncertain].

CCEF variant. David Powlison described later biblical counsellors as having supplemented, developed, or even altered parts of Adams's model. Powlison pictured the "nouthetic part" as the fence around a broader "paracletic" (comforting) field. Welch distinguishes heart issues from brain issues, and Powlison developed the idea of "idols of the heart" [source: Fraser 2012, pp. 143–150]. CCEF's model of change, taught in its Dynamics of Biblical Change course and set out for a general readership in Timothy Lane and Paul David Tripp's How People Change (foreword by Powlison), is built on Jeremiah 17:5–10 and a "Three Trees" diagram (thorn bush, cross, fruit tree). Its four elements are heat (circumstances, painful or pleasant), thorns (sinful responses), cross (Christ's work and the gospel as the means of change) and fruit (God-honouring responses from a changed heart). It moves the focus from Adams's outward habit change to the heart's motives (see 4.25 and 4.25a) [source: Roy 2020 (ACBC review of How People Change); New Growth Press book page; CCEF course page]. The version described is the book's, as ACBC's reviewer summarises it; the course may differ [uncertain].

3. Guiding principles

  • Sufficiency of Scripture. The Bible is the counsellor's source of norms and methods. Practically: every assignment and teaching point is tied to a passage, and secular theories are not used. [source: Kellemen 2023; Virkler 2023]
  • Confrontation. Counsel comes from Scripture, not the counsellor's opinion. Practically: name the specific behaviour and the specific text. [source: Kellemen 2023]
  • Concern. Counselling is always for the counselee's benefit and carries a warm, familial tone. Practically: confrontation is offered as care, never as contempt. [source: Kellemen 2023]
  • Change. The aim is concrete change toward the biblical standard (Christ as "the Standard"). Practically: each session ends with a specific behavioural assignment. [source: Kellemen 2023]
  • Directive, authoritative stance. Adams rejected Rogerian non-directiveness and called the pastor "a paraclete, not a parakeet". He reported that the more directive he became, the more people were helped. Practically: the counsellor tells the counselee what Scripture requires and does not merely reflect. [source: Kellemen 2023; Virkler 2023 citing 1970, p. xiii]
  • Personal responsibility. Adams opposed what he called the medical model's removal of responsibility. Practically: expect the counselee to own their choices, and do not accept excuses for patterns they can change. [source: Kellemen 2023; Virkler 2023]
  • "What" not "why". Assessment looks at what the person is doing rather than at speculative causes. Practically: ask for behaviour, frequency, context and responses. [source: Virkler 2023]
  • Feelings follow actions. Adams held that "feelings flow from actions" (1970, p. 93). Practically: assign right action regardless of mood, and expect feelings to change later. Kellemen (2023) questions the physiology Adams used for this. [source: Virkler 2023; Kellemen 2023]
  • Habit as both problem and asset. Sin patterns are learned by repetition, and so is godliness. Practically: plan for repeated practice, not one-off insight. [source: Competent to Counsel TOC ch. XI; Virkler 2023]
  • Put off / put on. Stopping a sin is not enough; the biblical alternative must replace it. Practically: every "stop" goal is paired with a "start" goal. [source: Fraser 2012, p. 133]
  • Hear the whole matter first (Proverbs 18:13, 15, 17). Practically: gather facts from everyone involved before advising, and actively help people who struggle to recall them. [source: nouthetic.org]
  • No gossip about absent parties. Practically: when only one spouse attends, do not let the session become an indictment of the absent one. [source: nouthetic.org]
  • One thing at a time, record progress, generalise. Practically: work on one target per assignment, log it, then extend gains to other areas. [source: Competent to Counsel TOC ch. IX]
  • Attack problems, not people. This is the communication rule in family work. [source: Competent to Counsel TOC ch. X]
  • Whole-church involvement. Confrontation is the whole church's ministry. Practically: link the counselee to the local church for accountability and fellowship. [source: Competent to Counsel TOC ch. IV; Fraser 2012, p. 128; ACBC TIL 555]
  • Evangelism before counselling of unbelievers. Adams held this, as noted in section 2. [source: Fraser 2012, p. 129]
  • God-centred framing (current ACBC). Moorhead holds that "all counseling issues are worship issues". Practically: open with the counselee's purpose before God. [source: ACBC TIL 555]
  • Organic problems are medical. Adams divided causes into organic, demonic (rare) and sin-caused. He held that the pastor works "side-by-side with a physician". ACBC's Lambert states that decisions about starting or stopping medication belong to the prescribing physician. Practically: never advise on medication, and refer or coordinate. [source: Virkler 2023; Fraser 2012, p. 131; Lambert 2013]
  • Safety first in abuse (current ACBC). Practically: know local reporting law, report as required, plan for safety, and do not press for reconciliation. Details are in section 4. [source: ACBC Committed to Care; CT 2019, quoting Moles]

4. Intervention inventory

All example wording below is mine and labelled "(illustrative)", except the short quotes, which are cited. No ACBC or INS handouts or forms are reproduced.

4.1 Personal Data Inventory (PDI) intake

  • Purpose / when. Collect biographical, health, family, religious and presenting-problem data before the first session. Adams printed a PDI form in Competent to Counsel, and ACBC counsellors still use one. [source: Competent to Counsel TOC; Virkler 2023 citing MacArthur and Mack 1994, pp. 387–390; ACBC TIL 555] The form's items are not listed here.
  • Steps.
    1. Send the PDI with the appointment.
    2. Review it before session 1.
    3. Note the presenting problems, medical history and current physicians, who else is involved, church connection and any self-described faith.
    4. Flag anything medical or risk-related for follow-up.
    Steps 3–4 are [synthesis] on how to use it.
  • Example language (illustrative). "Before we meet, please fill in this background form. It helps me use our first hour well."
  • Watch for. Missing medical or medication information, which you should ask about directly; any risk indicators; other parties who may need to be involved. [synthesis]

4.2 Pre-session preparation (current ACBC practice)

  • Purpose / when. To set expectations and make the counselee more teachable before the first session. [source: ACBC TIL 555]
  • Steps. Moorhead's current practice:
    1. Assign a short pre-reading pamphlet on pride and humility (Stuart Scott's From Pride to Humility).
    2. Send an encouraging note expressing hope that God will work as the counselee seeks him.
    [source: ACBC TIL 555]
  • Example language (illustrative). "I'm looking forward to meeting you. I'm hopeful about what God can do as we look at this together."
  • Watch for. A counselee who experiences the pre-reading as an accusation of pride before they have been heard. [synthesis]

4.3 Life story, testimony and gospel check (session 1)

  • Purpose / when. To understand the person and establish their spiritual status, which in this model decides whether to evangelise or to counsel. [source: ACBC TIL 555; Fraser 2012, p. 129]
  • Steps.
    1. Ask for a brief account of the counselee's life, including highs, lows and major struggles. Moorhead allows about ten minutes.
    2. Ask for a spoken account of their faith.
    3. Ask a few diagnostic questions on their understanding of the gospel, especially justification by faith.
    4. If the counselee is not a believer, the model shifts to evangelism.
    [source: ACBC TIL 555; Fraser 2012]
  • Example language (illustrative). "Take about ten minutes and walk me through your life so far: the good, the hard, and what brings you here." Then: "How would you explain what it means to be a Christian?"
  • Watch for. A non-believing or uncertain client. A therapist must not proselytise someone who has not asked for faith-based counsel [synthesis].

4.4 Giving hope

  • Purpose / when. Session 1 and whenever the counselee is discouraged. "Hope" is a heading in Adams's chapter on solving problems nouthetically. ACBC counsellors offer hope from 1 Corinthians 10:13: God is faithful and helps people through trials as they humble themselves under Scripture. [source: Competent to Counsel TOC ch. VIII; ACBC TIL 555] Adams's own procedure for giving hope is not described in the sources used [uncertain].
  • Steps.
    1. Name the problem in terms the model treats as changeable, such as behaviour and habit rather than fixed illness.
    2. Point to a specific promise in Scripture.
    3. Say clearly that change takes work.
    The step order is [synthesis] from the two sources.
  • Example language (illustrative). "What you've described is hard, but it isn't hopeless. Scripture promises God won't leave you without a way through, and we'll work on concrete steps together."
  • Watch for. Hope that a medical or trauma condition will simply go away. Welch (CCEF) cautions that "lightened does not mean depression-free". [source: Fraser 2012, p. 147]

4.5 Data gathering ("hear the whole matter")

  • Purpose / when. Throughout, and above all early on: get all the relevant facts before giving any advice (Proverbs 18:13, 15, 17). [source: nouthetic.org]
  • Steps.
    1. Listen for the facts that bear on the problem.
    2. Actively help counselees who cannot recall or describe events, by asking for specifics.
    3. Gather information from everyone involved, for example by seeing a couple together.
    4. Ask "what" questions about behaviour rather than "why" questions.
    5. Evaluate what you have heard in light of Scripture.
    6. Take notes.
    [source: nouthetic.org; Virkler 2023]
  • Example language (illustrative). "Tell me exactly what happened last Tuesday, from when you got home. What did you say? What did she do next? What did you do then?"
  • Watch for. Accounts from one side only, and gaps the counselee avoids. In abuse cases, do not seek "both sides" in a joint session (see 4.20). [source: nouthetic.org; ACBC Committed to Care]

4.6 Interpreting the problem: three levels and "dodges"

  • Purpose / when. After the initial data. Adams separated three levels:
    • Presentation: the symptom or feeling that brings the person in.
    • Performance: the present behaviour.
    • Preconditioning: the underlying habit pattern.
    Virkler's illustration is Adams's case of Ginny: passive-aggressive habits led to marital conflict, which presented as depression. Adams also identified "dodges", meaning blame-shifting and avoidance. [source: Virkler 2023]
  • Steps.
    1. Write down the presenting complaint.
    2. Identify the current behaviour linked to it.
    3. Look for the long-standing pattern behind it.
    4. Note how the counselee explains the problem away.
    5. Check for organic causes (4.7).
    [source: Virkler 2023; step 5 per Adams's organic/sin distinction]
  • Example language (illustrative). "You came in because you've felt low for months. As we've talked, the pattern I hear is that when you're hurt you go quiet and withdraw. Let's look at that pattern."
  • Watch for. Reading a depressive, psychotic or trauma condition as nothing more than a sin pattern. Virkler criticises Adams's handling of cases such as Steve and Mary on exactly this point. [source: Virkler 2023]

4.7 Organic causes and coordination with physicians

  • Purpose / when. Whenever there is a medical history, medication, or symptoms that may be organic. Adams's taxonomy was organic, demonic (rare) or sin-caused. He held that the pastor works side-by-side with a physician, while criticising psychiatrists who mainly prescribe. ACBC (Lambert 2013) states:
    • Starting or stopping medication is outside counsellors' purview.
    • Counsellors are trained to send medication questions back to the prescribing physician.
    • Stopping can be dangerous, in some cases life-threatening.
    [source: Virkler 2023; Fraser 2012, p. 131; Lambert 2013]
  • Steps.
    1. Record current medical care and medication from the PDI.
    2. With consent, liaise with the physician.
    3. Never advise starting, stopping or changing medication.
    4. Refer medication questions back to the prescriber.
    5. Refer for medical evaluation when symptoms suggest a physical cause.
    Steps 2 and 5 are [synthesis].
  • Example language (illustrative). "Questions about your medication are for your doctor. I'd encourage you to raise them with her, and with your permission I'm glad to talk with her too."
  • Watch for. The counselee or church community pushing to stop medication. ACBC acknowledges this has happened (section 5). [source: Gospel Herald; Lambert 2013]

4.8 Directive biblical instruction (teaching segment)

  • Purpose / when. In every session, to teach the biblical standard that applies to the problem. In Adams's model the counsellor is directive and says what Scripture requires. Current ACBC practice (Moorhead):
    • One priority theme per session, after reviewing homework.
    • Teaching lasts about 5–15 minutes and is a dialogue, not a lecture.
    • Counsellor and counselee read and interpret the text together.
    • Recurring themes include the glory of God, the heart, God's sovereignty, the gospel, humble love, and confession and forgiveness.
    • The counsellor sometimes sets the agenda instead of following the counselee.
    [source: Virkler 2023; ACBC TIL 555]
  • Steps.
    1. Pick one theme that fits the problem as interpreted.
    2. Read the text aloud together.
    3. Ask the counselee what it says and what it means.
    4. Connect it to the specific behaviour.
    5. Turn it into an assignment.
    [source: ACBC TIL 555]
  • Example language (illustrative). "Let's read this passage together. What do you see it asking of you? Where does that touch what happened with your wife this week?"
  • Watch for. Teaching that turns into a monologue. Signs it is working are the counselee applying the text unprompted and homework being done. [source: ACBC TIL 555; signs are synthesis]

4.9 Nouthetic confrontation

  • Purpose / when. When a specific pattern contrary to Scripture has been identified. The aim is to correct it out of concern, combining Adams's three elements: confrontation, concern and change. [source: Kellemen 2023]
  • Steps.
    1. State the behaviour concretely.
    2. Name the text it falls short of.
    3. Say that the counsellor's motive is the counselee's good.
    4. Ask the counselee to own the behaviour.
    5. Move straight to what change looks like.
    [synthesis] from the three elements.
  • Example language (illustrative). "I care about you and your marriage, so I want to be straight with you. The way you described speaking to him on Tuesday is what Scripture calls harsh words. What would it look like to take responsibility for that?"
  • Watch for. Shame without a path to change, and confronting a victim over their reactions to abuse (section 5). [synthesis; CT 2019]

4.10 Confession, forgiveness and reconciliation (with role-play)

  • Purpose / when. Once the counselee owns a wrong. The sequence is repentance, then confession, then reconciliation. Confession may be made to God, to church elders, or to the person wronged. Counsellors use role-play to rehearse it. Competent to Counsel has a chapter titled "Confess Your Sins", which covers James 5 and the relation of sickness to sin. [source: Virkler 2023; Competent to Counsel TOC ch. VII]
  • Steps.
    1. Help the counselee name the specific wrong without excuses.
    2. Identify who was wronged.
    3. Draft and role-play a short confession that does not shift blame.
    4. Plan when and how to make it.
    5. Debrief at the next session.
    [source: Virkler 2023; detail synthesis]
  • Example language (illustrative). "Let's practise. I'll be your brother. Tell me what you did, without 'but', and ask for his forgiveness."
  • Watch for. Never use this to push a victim toward forgiving or reconciling with an abuser. ACBC's guidance requires evidenced repentance and safety first, and accepts that some cases will not be reconciled. [source: ACBC Committed to Care]

4.11 Dehabituation and rehabituation (habit change programme)

  • Purpose / when. This is the core change work, after confession. Adams treats sanctification as replacing habits through repetition. [source: Virkler 2023 citing Christian Counselor's Manual pp. 191–216; Fraser 2012, p. 133]
  • Steps (as Virkler summarises Adams).
    1. Own it. The counselee keeps a log list of each occurrence of the target behaviour.
    2. Disown it. The counselee names the biblical alternative and seeks forgiveness.
    3. Restructure daily life to make the change possible.
    4. Break the links in the chain that leads to the sin, by removing cues and opportunities.
    5. Enlist accountability partners.
    6. Practise the new pattern repeatedly.
    7. Report back each session.
  • Example language (illustrative). "This week, every time you snap at the kids, jot down the time, what led up to it and what you said. Next to each one, write what a gentle answer would have been. We'll go through the list together."
  • Watch for. Check whether logs are being kept. A falling frequency of the target behaviour, and the new behaviour appearing unprompted, are the model's markers of progress. [source: Competent to Counsel TOC ch. IX "Recording Progress"; marker wording synthesis]

4.12 Put off / put on pairing

  • Purpose / when. Whenever a goal is set. Stopping a behaviour is "not sufficient". Each sin to put off is paired with a biblical alternative to put on. [source: Fraser 2012, p. 133; Virkler 2023]
  • Steps.
    1. Name the behaviour to put off.
    2. Find the corresponding positive biblical behaviour, for example replacing lying with speaking truth.
    3. Define the replacement concretely: who, when and what words or actions.
    4. Assign practice of the replacement.
    The detail is [synthesis].
  • Example language (illustrative). "It isn't enough to stop the silent treatment. What will you put in its place? Let's write the actual sentence you'll say when you're upset."
  • Watch for. Goals written only as prohibitions.

4.13 Homework every session; the "cliff-hanger"

  • Purpose / when. To carry change into the week. Concrete homework is assigned every session and reviewed first at the next. With the "cliff-hanger" technique, the counsellor leaves part of the problem for the counselee to solve between sessions. [source: Virkler 2023; nouthetic.org; ACBC TIL 555]
  • Steps.
    1. Write the assignment out and hand it over.
    2. Make it specific and achievable.
    3. Link it to the session's text.
    4. Open the next session with a review.
    5. Where useful, end on an unsolved piece for the counselee to work out.
    [source: nouthetic.org; Virkler 2023]
  • Typical assignments in sources. Bible reading and memory work, journaling, log lists, the two-path chart (4.17), planned confession or conversation, schedule changes, and pamphlets. [source: ACBC TIL 555; Virkler 2023]
  • Example language (illustrative). "Here's your assignment, written out. Read the passage each morning, keep the log, and come back with one idea of your own for how to handle Thursday evenings."
  • Watch for. Non-completion (section 5). Completion and specific reports are the main progress signals.

4.14 Scheduling and total structuring

  • Purpose / when. When disorder, avoidance or neglected responsibilities sustain the problem. Counsellors help counselees draw up a schedule that honours God. Competent to Counsel includes sections on "total structuring" and "discipline". [source: Virkler 2023; Competent to Counsel TOC ch. VIII]
  • Steps.
    1. Review a typical week.
    2. List responsibilities owed to God, family, work and church.
    3. Build a written schedule that includes devotions, work and duties.
    4. Check adherence at the next session.
    The detail is [synthesis].
  • Example language (illustrative). "Let's put your week on paper: when you get up, when you read, when the bills get paid. Then we'll see where it's breaking down."
  • Watch for. Schedules so rigid they collapse. Start small.

4.15 "Can't" and choice-language reframes

  • Purpose / when. When a counselee claims inability. Adams challenged "I can't" and coined "You can't say can't" (1970, p. 131). He taught counselees to ask "What does God want?" (1973, p. 122) instead of what they want. [source: Virkler 2023]
  • Steps.
    1. Notice the inability claim.
    2. Restate it as "won't" or "haven't yet".
    3. Ask what God requires in the situation.
    4. Agree one step.
    The detail is [synthesis].
  • Example language (illustrative). "You said you can't talk to him. Is it that you can't, or that it feels too hard and you haven't yet? What do you think God is asking of you here?"
  • Watch for. Genuine incapacity, such as psychosis, severe depression, cognitive impairment or acute trauma. Virkler notes that Adams's model ignores diminished capacity [source: Virkler 2023]. Do not use this reframe there [synthesis].

4.16 One thing at a time, recording progress, generalising

  • Purpose / when. To keep change manageable and lasting. These are chapter-level techniques in Competent to Counsel. The full text is not drawn on here [uncertain on detail]. [source: Competent to Counsel TOC ch. IX]
  • Steps.
    1. Choose one target.
    2. Record its frequency week by week.
    3. Once it is stable, extend the same principle to related areas.
    [synthesis]
  • Example language (illustrative). "Your outbursts are down from six to one this week. Where else does the same pattern show up?"
  • Watch for. Taking on too many targets at once.

4.17 Two-path ("Y") chart (current ACBC practice)

  • Purpose / when. To expose self-centred motives in everyday behaviour. Moorhead draws a Y with a self-centred path and a God-centred path, with "worship" at the centre. He starts with an ordinary question such as why a husband does the dishes. [source: ACBC TIL 555]
  • Steps.
    1. Pick a concrete recent act.
    2. Ask what motivated it.
    3. Draw the two paths.
    4. Place the counselee's motive on one of them.
    5. Assign the chart as homework for a recurring situation.
    [source: ACBC TIL 555; order synthesis]
  • Example language (illustrative). "When you did the dishes last night, what were you hoping to get? Let's put that on the chart. Which road is it on?"
  • Watch for. Use it with someone who is self-blaming or abused only with care, because it can deepen self-blame [synthesis].

4.18 Spiritual disciplines: devotions, Scripture memory, journaling, prayer

  • Purpose / when. As ongoing means of change. Adams's chapter on communication includes daily devotions. Current ACBC sessions spend much of their time on reviewing journaling, Bible memory and other spiritual disciplines. Adams pairs prayer with behaviour change. [source: Competent to Counsel TOC ch. X; ACBC TIL 555; Virkler 2023]
  • Steps.
    1. Assign a specific passage to read and memorise.
    2. Assign a short daily journal entry linked to it.
    3. Agree a prayer focus.
    4. Review all three at the next session.
    [synthesis]
  • Example language (illustrative). "Memorise this one verse this week, and write two lines each evening on where you needed it."
  • Watch for. Disciplines that turn into a score of personal worth.

4.19 Joint counselling and the absent party

  • Purpose / when. In marital and family problems. Couples are seen together whenever both will attend. If only one attends, the counsellor allows no gossip about the absent spouse and takes steps to encourage them to come; INS leaves those steps to its course. [source: nouthetic.org]
  • Steps.
    1. Invite both spouses.
    2. Gather each account in the other's presence.
    3. With one spouse only, keep the focus on that person's own responsibilities.
    4. Invite the other spouse.
    [source: nouthetic.org; step 4 detail not given]
  • Example language (illustrative). "I'd like to hear from both of you together. If he won't come yet, let's spend our time on what's yours to change."
  • Watch for. Do not hold joint sessions if there is any indication of abuse. ACBC makes reunion in the counselling room conditional on criteria including evidenced repentance and the victim's sense of safety, though it does not expressly forbid joint sessions [source: ACBC Committed to Care]. Screening each partner alone first is [synthesis].

4.20 Abuse disclosure protocol (ACBC Committed to Care)

  • Purpose / when. Whenever physical, sexual, verbal or controlling abuse is alleged or suspected. ACBC defines abuse as a pattern of sinful mistreatment of a person made in God's image. It names three categories: physical, verbal (including spiritual manipulation through misused Scripture) and "scheming" (concealment, isolation, financial control, monitoring). [source: ACBC Committed to Care]
  • Steps.
    1. Before any case, know your mandatory-reporting law and put the limits of confidentiality in the consent form.
    2. Take the allegation seriously, listen and document a timeline of facts.
    3. Ask about prior reports, who else knows, any court findings, and whether children or vulnerable adults are involved.
    4. Assess for imminent danger and make a safety plan, including safe places and medical care.
    5. Report to law enforcement or child protective services as the law requires. This does not wait for church adjudication.
    6. Involve church leaders, including a mature woman advocate for a female victim, while coordinating care.
    7. Do not press for reconciliation. Reunion requires evidenced repentance and the victim's safety.
    [source: ACBC Committed to Care] Chris Moles (ACBC) has said "Safety is the first goal". [source: CT 2019]
  • Example language (illustrative). "Thank you for telling me. Your safety comes first. I need to explain what I'm required to report, and then let's work out where you can be safe tonight."
  • Watch for. Pressure on the victim to submit, forgive or reconcile, and attributing the victim's distress to their own sin. These failures are documented in section 5. ACBC's guidance gives church leaders a role in a husband's headship during separation [source: ACBC Committed to Care]. A therapist should apply their own professional and legal duties regardless [synthesis].

4.21 Family Conference Table

  • Purpose / when. For family or couple communication problems marked by anger and resentment. Adams's chapter on communication includes "the conference table" and the rule of attacking problems rather than people. Virkler describes it as a Family Conference Table with prayer, confession and a recording secretary. [source: Competent to Counsel TOC ch. X; Virkler 2023]
  • Steps.
    1. Set a regular time when the family sits at a table.
    2. Open with prayer.
    3. Have one member record what is agreed.
    4. Raise one problem at a time and keep the discussion on the problem, not the person.
    5. Allow confession where someone has done wrong.
    6. Read the record at the next meeting.
    Steps 4–6 are partly [synthesis]; the full published instructions are not reproduced in the sources used [uncertain].
  • Example language (illustrative). "At the table, one rule: we attack the problem, not each other. Who will write down what we decide?"
  • Watch for. Use with an intimidating family member can silence others. Do not use it where there is abuse [synthesis].

4.22 Team counselling, multiple counselling, counselees as counsellors

  • Purpose / when. For training new counsellors and for complex cases. Team counselling with up to four counsellors is permitted, and Competent to Counsel covers the pastor's role in a team, multiple counselling, and "clients as counselors". Adams opposed groups that ventilate feelings. [source: Virkler 2023; Competent to Counsel TOC chs. IX–X]
  • Steps.
    1. Explain the team's roles to the counselee and get their consent.
    2. One counsellor leads, and the others observe or add.
    3. Debrief afterwards.
    [synthesis]
  • Example language (illustrative). "Two colleagues will sit in today. One is training. Is that all right with you?"
  • Watch for. The counselee feeling outnumbered, and confidentiality across the team. [synthesis]

4.23 Church involvement and church discipline (risk flagged)

  • Purpose / when. The local church is a means of change: fellowship, accountability, elders. Adams applied the Matthew 18:15–18 "reconciliation/discipline" process, for example to divorce on grounds he regarded as unbiblical. That process can end in excommunication. [source: Fraser 2012, pp. 128, 133; ACBC TIL 555; ACBC Committed to Care]
  • Steps. The model connects the counselee with their church and elders. Discipline is the church leaders' process, not the counsellor's. [source: ACBC Committed to Care]
  • Example language (illustrative). "Would you be willing for your pastor to know what we're working on, so he can support you?"
  • Watch for (risk).
    • Disclosure to church leaders needs explicit consent.
    • Discipline aimed at a victim who leaves an abusive marriage can do serious harm (section 5).
    • A therapist should not take part in church discipline. [synthesis]

4.24 Child training and the home code of conduct (risk flagged)

  • Purpose / when. Adams's model covers parents counselling their children, child training, and a household code of conduct. Virkler reports that Adams endorsed washing out a child's mouth as a consequence for lying. [source: Competent to Counsel TOC chs. VII–VIII; Virkler 2023]
  • Steps. Parents set a short, clear code of conduct with known consequences, model the behaviour, and review it. This outline is [synthesis] from the chapter titles.
  • Watch for (risk). Do not use punitive physical consequences such as washing out the mouth. Current child-welfare standards treat them as harmful, and in some places as reportable [synthesis].

4.25 Heart-level work (CCEF development)

  • Purpose / when. CCEF writers extended Adams's behavioural focus to the heart's motives. Powlison wrote of "idols of the heart", and Welch distinguishes heart issues from brain issues and allows medical treatment for depression. Fraser notes Adams's own emphasis falls on outward behaviour. [source: Fraser 2012, pp. 133, 146–150] CCEF's structured tool for this work, the "Three Trees" diagram, is given as its own entry in 4.25a [source: Roy 2020].
  • Steps (as Fraser outlines Welch on depression).
    1. Gather information.
    2. Separate spiritual from physical symptoms.
    3. Address the heart issues.
    4. Support medical treatment where it is indicated.
    [source: Fraser 2012, pp. 146–147]
  • Example language (illustrative). "Beyond what you did, what were you wanting so badly in that moment that it felt worth the fight?"
  • Watch for. Reducing suffering to sin. Welch calls this "unbiblical and potentially destructive". [source: Fraser 2012, p. 147]

4.25a Three Trees diagram: heat, thorns, cross, fruit (CCEF; Lane and Tripp)

  • Purpose / when. To help a counselee see that their responses come from the heart rather than from circumstances, and to point to the gospel as the means of change. ACBC's reviewer reports that the diagram helps counselees grasp this quickly. Use it when a counselee explains their reactions by circumstances or by other people. [source: Roy 2020]
  • Steps. The four elements and their texts follow the review; the session mechanics are [synthesis].
    • Heat: identify the specific circumstance, painful or pleasant, the counselee was responding to (Jer 17:6, 8).
    • Thorns: name the counselee's own response (for example escape, catastrophising, hypersensitivity, repaying evil, self-righteousness), then look for what the book calls "the sin beneath the sin", the desire that ruled the heart (Jer 17:5–6).
    • Cross: bring the relevant gospel truth to bear and invite repentance (Jer 17:7).
    • Fruit: plan the concrete God-honouring response to the same heat next time (Jer 17:8).
    • Draw the three trees (thorn bush, cross, fruit tree), fill in one recent episode together, and set one episode a week as homework. [synthesis]
    • [source: Roy 2020]
  • Example language (illustrative). "Let's put last Thursday on the diagram. What was the heat? What came out of you? What were you wanting most right then? What does the gospel say to that, and what would fruit have looked like?"
  • Watch for. A counselee who is being abused or is in danger: there the "heat" is a safety issue first, and the diagram must not be used to place responsibility for the abuse on the victim (see 4.20) [synthesis]. Progress shows when the counselee names their own ruling desires without prompting and reports different responses to the same kind of heat [synthesis].

4.26 Termination

  • Purpose / when. Counselling ends when counselees begin solving their problems biblically on their own. [source: Virkler 2023]
  • Steps.
    1. Show that progress is recorded and has generalised.
    2. Space sessions further apart.
    3. Hand over an ongoing plan of disciplines and accountability within the church.
    4. Offer a check-in.
    [synthesis]
  • Example language (illustrative). "You handled the last two blow-ups yourself, using what we've practised. Let's meet once more in a month, and keep your accountability partner in the loop."
  • Watch for. Ending because the counselee has disagreed with the counsellor rather than because they have improved. That happened in a case CT reported. [source: CT 2019]

5. Handling problems

Problems the model itself addresses

  • Non-adherence to homework. The model treats incomplete homework as data and as a responsibility issue. Review homework first, every session, and keep assignments concrete and written [source: Virkler 2023; ACBC TIL 555]. My additions [synthesis]:
    • Find out whether the task was too large, unclear or untimely, and halve it.
    • Add an accountability partner (4.11).
    • Avoid shaming.
  • "I can't" and resistance. Use the reframe in 4.15 [source: Virkler 2023]. First rule out real incapacity, such as depression, psychosis, cognitive limits or trauma. If it is present, refer or coordinate care rather than confront [synthesis].
  • Blame-shifting ("dodges") and a counselee who talks only about an absent spouse. Bring the focus back to the counselee's own part, allow no gossip, and invite the absent party [source: nouthetic.org; Virkler 2023].
  • Stuck counselee. Reassess the data (4.5) and the three levels (4.6). Narrow to one target (4.16), and check for a medical cause (4.7) [source: Virkler 2023; Competent to Counsel TOC]. Also check for unspoken disagreement with the frame or a hidden safety issue [synthesis].
  • Unbeliever or client unsure of faith. Adams held that evangelism comes before nouthetic counselling [source: Fraser 2012, p. 129]. A licensed therapist must not proselytise. If the client has not freely chosen Scripture-based counsel, offer standard therapy or refer [synthesis].

Overwhelm, risk and clinical conditions [synthesis unless cited]

  • Suicidal ideation or self-harm. What ACBC publishes: in its podcast "Is Someone You Love Suicidal?" (Truth in Love 96), Heath Lambert advises making sure the person is not left alone, getting rid of dangerous objects they might use, calling emergency professionals or 911 when the situation is urgent, and getting ongoing counselling help; he says that crisis response in detail is a topic for another episode [source: ACBC TIL 96]. In "Suicide" (Truth in Love 176), Keith Palmer advises going to the person, listening well rather than giving quick answers, involving law enforcement while the person is still actively threatening suicide, removing weapons and other means after an attempt, looking at the family situation, and building a care team (a lead counsellor, a same-gender mentor and a home group) [source: ACBC TIL 176]. Neither episode mentions crisis lines, hospital assessment or medical referral. CCEF's Journal of Biblical Counseling carries a toolbox article, "Evaluating a Person with Suicidal Desires" (Sironi and Emlet), which CCEF describes as giving probing questions to gauge risk and to establish a safety plan; its content is not reflected here [source: CCEF product page; uncertain]. Powlison's minibook I Just Want to Die is short spiritual encouragement; its publisher page mentions no crisis line, emergency or medical step [source: New Growth Press page]. ACBC's Standards of Conduct do not address suicide directly. They allow use of secular institutions when hospitalisation is needed "for extreme and urgent care" (I.B), recognise professional medical care for medical problems (V.C), require honesty about the limits of competence (VII.B) and obedience to local law (IX.D), and allow confidentiality to be broken to protect people from harm (X.B) [source: ACBC Standards of Conduct]. No step-by-step ACBC or CCEF suicide protocol is published in the sources used [uncertain]. What a licensed therapist does [synthesis, consistent with the ACBC steps above]: ask directly and calmly about suicidal thoughts; carry out a standard structured risk assessment (ideation, intent, plan, past attempts, access to means, protective factors); write a safety plan with the client, including people and places to contact; limit lethal-means counselling to secure storage or removal by a trusted person; arrange same-day emergency assessment when risk is high, and do not leave a person at imminent risk alone; with consent, involve the client's physician or psychiatrist. Give the client crisis numbers: 988 Suicide and Crisis Lifeline (call or text 988, US) and Samaritans 116 123 (UK and Ireland), or local emergency services. State the limits of confidentiality for risk to life in the consent form. Talk about suicide without judgement, and do not frame suicidal thoughts as primarily sin or confront them as such; present them as something people get through with help. See Nally v. Grace Community Church below for the leading case on pastoral counselling and suicide.
  • Psychosis, bipolar disorder, severe depression, eating disorders, substance dependence.
    • Refer for psychiatric and medical assessment.
    • Never discourage medication. ACBC's stated position is that medication decisions belong to the prescriber [source: Lambert 2013].
    • Virkler holds that schizophrenia and bipolar disorder are biological and that Adams's model ignores diminished capacity [source: Virkler 2023].
  • Trauma and abuse survivors.
    • Do not use confrontation, "dodges" analysis, or forgiveness and reconciliation assignments on reactions to trauma.
    • Prioritise safety and stabilisation.
    • Offer trauma-focused care or refer.
    A survivor in CT's report called for counsellors to refer beyond pastoral care [source: CT 2019].
  • Overwhelm in session. Slow down and drop teaching for that session. Ground the person and reduce homework.

Ruptures

[synthesis] The directive, confronting stance invites ruptures. Name the rupture, take responsibility for your part (the model's own confession principle applies to the counsellor), check whether the frame still fits the client, and offer to change or end the approach. Do not end counselling because the client disagrees (see 4.26; CT 2019).

Modality-specific difficulties and documented concerns (reported neutrally, with attribution)

  • Medication.
    • Lambert (ACBC executive director, 2013) called it a myth that ACBC trains counsellors to take people off psychiatric medication.
    • Lambert also said he was "relatively confident" that some NANC counsellor has told someone to stop medication, which he described as contrary to training.
    • Ed Stetzer has linked the perception partly to people who "have actually experienced anti-medication and anti-science counseling approaches in the biblical counseling realm" [source: Gospel Herald]. In a 2013 Lifeway Research telephone survey of 1,001 US adults, 48% of self-identified evangelical, fundamentalist or born-again Christians (27% of other Americans) agreed that with Bible study and prayer alone people with serious mental illness could overcome it [source: Lifeway Research 2013].
    [source: Lambert 2013; Gospel Herald] Response: ask every client from this background about medication changes made on non-medical advice, and refer back to the prescriber [synthesis].
  • Abuse handling.
    • Christianity Today ("When Restoration Hurts", 2019) reported survivors' accounts of ACBC-linked counsel. The accounts include blaming the victim, being told that talking about the abuse was "dwelling on bitterness", pressure to reconcile and submit, a sexually abusive father being encouraged to return home, and an investigation that did not proceed. Some of these involved counsellors linked to ACBC. ACBC and centre representatives responded, and the article includes Moles's "Safety is the first goal". [source: CT 2019]
    • In 2023 ACBC issued abuse guidance (Committed to Care) and a statement acknowledging "past failures" by its counsellors. [source: ACBC Committed to Care; Roys Report 2026]
    • In April 2026 ACBC removed Grace Community Church (Sun Valley, California) from its approved training centres without public explanation. This followed years of criticism of the church's handling of abuse and a 2023 complaint against an elder who oversaw its counselling ministry. [source: Roys Report 2026]
    Response: follow 4.20 and your own legal duties. Never conduct joint sessions with an alleged abuser before an independent safety assessment [synthesis].
  • Attributing distress to sin. Critics such as Virkler (2023) and some within the movement (Welch, as reported by Fraser 2012) warn against reducing non-organic suffering to sin. [source: Virkler 2023; Fraser 2012, p. 147] Response: do a full biopsychosocial assessment before any moral framing [synthesis].
  • Clients harmed by previous nouthetic or biblical counselling. [synthesis]
    • Assess for spiritual abuse, shame, unreported abuse and medication changes.
    • Respect the client's own faith choices and avoid attacking their beliefs.
    • Offer evidence-based treatment, or faith-sensitive practitioners if the client wants them.
    • Consider whether there are reporting duties, for example about child abuse.
  • Scope and ethics for a licensed therapist. [synthesis] Get written informed consent stating that the counsel is religious and directive. Keep within your licence's rules on imposing values. Keep clinical records and confidentiality to professional standards, not church norms. Do not share material with church leaders without consent.
  • Pastoral counselling and suicide: Nally v. Grace Community Church (California Supreme Court, 1988). Kenneth Nally, 24, a member of Grace Community Church of the Valley (Sun Valley, California) who had received pastoral counselling there, died by suicide on 1 April 1979, weeks after an overdose and hospitalisation. His parents sued the church and four pastors, including John MacArthur, for clergy malpractice and negligent failure to refer him for psychiatric care, and alleged that the pastors discouraged further professional care. The record also showed that the pastors arranged or encouraged several medical visits, that one pastor suggested a psychologist, and that the family declined hospitalisation recommended by two doctors; the plaintiffs argued the pastors should have told hospital staff that Nally said he regretted surviving the overdose. The court (Lucas CJ for five justices) held that non-therapist pastoral counsellors had no legal duty to refer a suicidal counselee to professionals, called the causal link "tenuous at best", and did not reach the First Amendment questions. A concurrence (Kaufman J, joined by Broussard J) would have recognised a minimal duty for counsellors who hold themselves out as able to help suicidal people to advise professional care, but found no breach proven, so all seven agreed on the result. Whether these pastors used Adams's method specifically is not established in the sources [uncertain]. [source: Nally 1988] Practical point: whatever the legal position of clergy, a licensed clinician carries full professional duties of suicide-risk assessment and referral [synthesis].
  • ACBC's own standards on referral and confidentiality. ACBC's Standards of Conduct say counsellors should not use, or refer to counsellors who use, interventions that conflict with Scripture (I.B), while recognising professional medical care for medical problems (V.C) and allowing secular institutions where hospitalisation is needed for extreme and urgent care (I.B). Confidentiality is kept as far as possible but may be broken to protect from harm or to honour the authority of the home, church or state (X.B). Women are not to counsel men formally, and men are to avoid ongoing one-to-one counsel with women (V.D). [source: ACBC Standards of Conduct] Practical meaning for a client coming from this setting: referral to secular psychotherapy may have been discouraged as a matter of policy even where medical and hospital care were accepted, and personal material may have been shared with church leaders; ask about both [synthesis].
  • ACBC's 2023 statement on abuse. In "ACBC's Continued Commitment to Care" (20 February 2023, signed by executive director T. Dale Johnson Jr.), ACBC responded to criticism of its approach to abuse cases, stated that its counsellors "must follow mandatory reporting requirements to civil authorities", and pointed readers to its full Statement on Abuse and Biblical Counseling [source: ACBC 2023].

Sources

Pages consulted

Books cited, known via the sources above [uncertain on content beyond what those sources report]

  • Adams, J. E. (1970). Competent to Counsel: Introduction to Nouthetic Counseling. (Zondervan Academic edition 1986, ISBN 9780310511403.)
  • Adams, J. E. (1973). The Christian Counselor's Manual: The Practice of Nouthetic Counseling. (Zondervan Academic edition 1986, ISBN 9780310511502.)
  • Adams, J. E. (1976). What About Nouthetic Counseling?
  • MacArthur, J., and Mack, W. A. (Eds.) (1994). Introduction to Biblical Counseling. This is the "1994" work Virkler cites for the Personal Data Inventory (pp. 387–390, recommended there by Mack) and for the line on guilt (p. 104); it was previously mislabelled here as an Adams title.
  • Lane, T. S., and Tripp, P. D. How People Change. New Growth Press (edition and year not stated on the publisher page).
  • Powlison, D. (1988). Article cited by Virkler (pp. 65–66) on the long-term friendship model; title not given by Virkler [uncertain].

[uncertain] The sources used give no session count or session length, no step-by-step ACBC or CCEF suicide protocol, and no text of CCEF's Dynamics of Biblical Change course. The California Supreme Court case on Grace Community Church's pastoral counselling is Nally v. Grace Community Church (1988).

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