Nouthetic Counseling: A Critical Evaluation

So I made the mistake of asking my Facebook friends what nouthetic counseling (Greek: noutheteo, to admonish) is yesterday. I received a flood of responses. However, most of the responses were very much pro- nouthetic counseling. And they spoke glowingly about self-styled BIBLICAL COUNSELOR Jay Adams.

In this post I will give a critical (yet fair) evaluation of Adams’ work from the viewpoint of a Reformed believer who has suffered from severe mental illness for 22 years. I know I’m emotionally invested in this discussion, but I will let the data and the soundness of my arguments speak for themselves.

Nouthetic counselors are found under the ACDC (Association of Certified Biblical Counselors).

It seems to be this ignorant, pre-scientific system of beliefs invented by someone called Jay Adams who has no expertise in psychiatry, nor even in psychology, he isn’t a scientist, or even an MD. He decided that “nouthetic counseling” == BIBLICAL COUNSELING! And tragically, many Christians agree with him. Even many pastors with seminary degrees. So someone with virtually no knowledge of modern psychiatry and psychology writes a bestseller and is lauded soon after as a paragon of wisdom and expertise in Christian counseling. How sad! In some Reformed circles, this man is lionized and even idolized.

It seems that virtually nothing is taught in most seminaries to equip pastors to deal with the profoundly mentally ill. It is like 99% his fallible opinion and 1% Scripture. His exegesis and Biblical reasoning is so so superficial and flawed that I marvel he’s been able to take the Reformed world by storm. It’s really sad when this is the state of mental health understanding in the Church. God created us with minds to learn and comprehend. Capable of making make advances in knowledge, and how we understand the brain, to help people.

Jay dismisses all of that and reduces a complex set of emotional, behavioral, neurological, and biochemical processes to a simple mantra that our mental illness, even severe mental illness, is caused in ALL CASES or 99% CASES by hidden sin in the person’s life. Jay’s teaching is not only NOT biblical, but it’s very dangerous and has the potential to cause greater pain, harm, and misery for believers who are mentally ill.

Yes, nouthetic counseling may help a limited number of people who have mild forms of mental illness, such as excessive worrying, and some types of mild anxiety. But it cannot do much for severe mental illnesses such as bipolar disorder, schizophrenia, schizoaffective disorder, borderline personality disorder, dissociative identity disorder, and others. These people are not suffering from hidden sin, their fundamental brain chemistry is not functioning correctly. Mental illness is a physical disease, just like heart disease, cancer, or diabetes. The amount of harm nouthetic counselors have inflicted on the Church is staggering and makes me so angry! How dare they. They are playing God and ruining people’s lives.

Please educate yourself and talk to some Christian psychiatrists before subjecting someone you love, who suffers from a severe mental illness to nouthetic counseling.

And I’ve read many times nouthetic counselors get their patients to wean off or stop taking their prescribed psychiatric medications completely. They have them take natural supplements! I’ve yet to find a natural supplement that can make the constant voices I hear in my head stop, make me stop having horrible visual hallucinations, or cure my major depressive disorder. It is powerless to help in such cases. Any sane, rational, educated person should be able to see that. However sadly, that is not the case. Millions of believers have been duped by what amounts to snake oil salesmen using biblical lingo.

I’m glad that I asked the question and did my own research on nouthetic counseling. It’s very sad to realize this is the most popular and recommended treatment, for believers suffering from severe mental illness, in the Church. We can do better folks. Much better.

God expects us to engage our full minds (which He created), to use our knowledge to treat severe mental illnesses (whether with cognitive behavioral therapy, psychiatric medications, or other methods of legitimate psychiatry. There should be no shame or stigma, no accusation of hidden sin, and no dismissal of brain chemistry and other hard scientific knowledge, associated with our treatment of believers suffering from severe mental illness.

My hope is that seminaries will do much better in treating the severely mentally ill and that pastors will be equipped to provide spiritual support while at the same time not discounting the help of modern psychiatry. I also hope that more regular members of churches will become educated on these issues, and no longer remain in ignorance. I pray that severely mentally ill believers will find the love and assistance they need to become well, and able to function in society.

If you care to learn what causes my schizophrenia (no, it isn’t due to hidden sin), you can read this excellent article on Johns Hopkins Medicine’s website.

Nouthetic counseling seems to be one level up from the common view of the severely mentally ill throughout history, namely that they were demon possessed. Now they are informed that their complex, deep seated, harmful, and negative affectations are all illusory, and that the true problem is hidden sin in their life. This is cruel, condescending, patronizing, ignorant, anachronistic, unscientific, and frankly very unbiblical. As I admonished earlier, we can do better.

By the way, this article is an excellent review of Adam’s book “Competent to Counsel” which sold millions of copies, and launched the nouthetic counseling movement. Here is another useful article which critiques Adams’ work. And here is an excellent article which goes more into the background of psychology and Adams’ work and argues that nouthetic counseling is unbiblical.

If you’d like some more in-depth critical analysis I highly recommend the following PhD doctoral dissertation on Adams’ work.

A critique of the nouthetic counseling technique of Jay E. Adams
Roger Clayton White, Wilfrid Laurier University
Click here to download the PDF.

3 responses to “Nouthetic Counseling: A Critical Evaluation”

  1. Thanks for your post and the article, brother. I’ll be interested to see what others say in response to it. I have to “speak the truth in love” (Eph. 4:15) to you and say that I disagree that your review is fair. While it’s true that we all have a bias, I find myself often reminded of my father’s saying…”A man convinced against his WILL (my emphasis) is of the same opinion still.” Interpreted, that means that we all choose to believe what we want until or unless we’re convinced otherwise. I’m confident that describes your position regarding Jay Adams and the Biblical Counseling movement. It likewise describes the writers of the other critical works you cited and linked to. My wife and I (and numerous other biblical counseling friends) have had many who’ve tried every other form of counseling (including much “Christian” counseling) and have been psychologized and medicated for years for the “labels” popularly used and overused and described in the DSM’s for decades. It’s been only the Lord’s transformation – the Spirit using His Word – to address their inorganic “issues” and teaching them what He wants each of us to know and apply. I apologize for the length of this but I thought it necessary to give my critique of biblical counseling from a different perspective than yours. I pray the Lord’s blessing on you. Feel free to ask me for some excellent biblical resources that address the needs you find prominent in your life. God bless. – In Christ’s love, Steve Cranston


    • Hi brother Steve. Thanks for reaching out. I admit I may well have some internal biases that color my understanding of nouthetic counseling. I will try to read more, study this issue and pray about it. I know for a fact that my mental illness is so severe that I could not function without my psychiatric medications and would be permanently institutionalized if I didn’t take my medications. Also due to my aggressive psychosis I would be a danger to both myself and others. My quality of life of before I took medication, compared with after I took medication is night and day. My medication has been a true grace of God in my life. I know some people can function without medication and do well, but I’m not one of them. Nothing I read or hear could convince me otherwise on this specific point. Like I said I’ve had severe mental illness for 22 years, so this isn’t a new rodeo for me. I know what my I can and can’t handle. And what’s best for me individually. I am open to learning more about other ways nouthetic counseling could help me. But any suggestion that I should not take psychiatric medications will be a no go for me. Blessings!


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