Whether the counselor believes the counselee is made in the image of God determines which model counselors use.
Psychology is “the study of the soul” and Psychotherapy is “soul healing” (psyche=soul and therapeuo=to heal) and yet one study reported statistics showing academic psychologists to be among the least religious group of scholars, with 50% reporting no religious preference. Secular Psychology denies the soul in its view of human nature and therefore handicaps its ability to help biblically.
Let us fast forward to the emergence of the modern discipline called psychology in the late 1800s. In the light of the Enlightenment and emboldened by Darwin's explaining life independent of a Creator, science embraced an empirical approach that allowed only what could be seen and measured, excluding the divine altogether. Whereas the early philosophers generally held to some supernatural beliefs, the new psychologists embraced a methodology that barred the supernatural from the table. Over time, most who practiced psychology abandoned the “soul” of their discipline and embraced a godless worldview to match their methodology. Jones (1994) reported statistics showing academic psychologists to be among the least religious group of scholars, with 50% reporting no religious preference compared to only 10% of the general population. Clinical psychologists were little different, with only 33% claiming religious faith to be the most important influence in their lives in contrast to 72% of the general population. At a time when 90% of the population claimed to hold belief in a personal God, less than one third of counseling and clinical psychologists could endorse a similar claim (Shafranske, 2001). A chasm has developed between the scientific study of persons and faith (Counseling And Christianity: Five Approaches, edited by Stephen Geeggo and Timothy A. Sisemore, Downers Grove: IVP Academic, 2022, 21).
One of the debated areas of counseling is the use of medicine
John MacArthur, who is Biblical in his counseling model, referred to D. Martyn Lloyd-Jones .... who was actually trained as a physician. He pointed out that depression and certain mental illnesses often have causes that are physical rather than spiritual. Pernicious anemia, arteriosclerosis, porphyria, and even gout are all examples Lloyd-Jones suggested of physical diseases that can cause dementia or produce depression (Healing and Medicine. Eastbourne: Kingsway, 1987, 144-45).
MacArthur then added: It is also sensible for someone who is alcoholic, drug-addicted, learning disabled, traumatized by rape, incest, or severely battered, to seek help in trying to cope with the trauma. Some kinds of therapy or medical treatment can serve to lessen trauma or dependency (John MacArthur. Counseling: How to Counsel Biblically, 8).
Another area of debate is the difference between Biblical and Integrated Counseling
Just as there are differences between Biblical counselors (Nouthetic versus Biblical) there are differences between Integrative counselors. In Counseling And Christianity: Five Approaches (edited by Stephen Geeggo and Timothy A. Sisemore, Downers Grove: IVP Academic, 2022) five different approaches to integrated counseling are discussed. They range from the most integrated with secular psychology to the least:
1) A Levels-of-explanation approach (The most integrative with secular psychology) 2) An integration approach 3) A Christian psychology approach 4) The transformational approach 5) A Biblical Counseling Approach (the least integration with psychology)
Larry Crabb who is more Integrative than MacArthur in his counseling model, however, similarly agrees with him on the use of therapy and medicine.
Crabb stated that he must make a vital distinction between two categories of problems, each generating its own list of questions:
(1) Problems resulting from physical/natural causes which sometimes require medicine and therapy
• depression and other affective disorders
• Behavioral or emotional problems stemming from a chemical imbalance
• degenerative disease (e.g., menopause-related anxiety symptoms)
• Learning disabilities caused by perceptual malfunction, early learning deficits, or the like
(2) Problems resulting fundamentally from moral causes
I want to argue for the intended sufficiency of the Bible to provide a clear and adequate structure for understanding and dealing with problems in the second category (Larry Crabb. Understanding People, Zondervan, 46-47).
If we fallen sinners are made in God’s image (Gen 1 and 3), then God can help and heal through His Word
Some extreme Integrative Counseling models are very much different from Biblical Counseling.
A. Non-biblical Approach
A Levels-of-explanation approach is the most extreme Christian integrative model listed in Counseling and Christianity: Five Approaches by Stephen P. Greggo and Timothy A. Sisemore.
• Almost totally based on secular psychology.
• Based almost exclusively on a Secular Worldview
• Uses secular testing models (DSM) The Diagnostic and Statistic Manual of Mental Disorders (DSM) the catalog of mental illnesses created by the American Psychiatric Association. Heath Lambert at The Gospel Coalition gives a critique of (DSM) (click DSM to read the article) in Christian Reflections on Mental Illness (May 7, 2014, Heath Lambert).
B. A Biblical Approach
• Is totally based on God’s Word (Again, acknowledging, as does both MacArthur and Crabb, that medicine or therapy are sometimes necessary).
• Is based on the Christian worldview
• Uses Christian testing models such as the Personal Data Inventory by Jay Adams and The Spiritual-Convictions-Questionnaire (click to view) by Stuart W. Scott.