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Is Biblical Counseling Really CBT?

A couple of weeks ago I was in the library at the theological seminary I work at, skimming through a handful of integrationist works on counseling. One volume in particular caught my eye as it contained an evaluation of Jay Adams’ early “Nouthetic Counseling” model. The author concluded that despite Adams’ explicit rejection of dominant psychological systems and principles “the evidence strongly suggests that Adams’s model of nouthetic counseling mirrors many of the precepts of cognitive-behavioral therapy, especially the notions of dysfunctional thoughts and the principles of change.”[1] Essentially the author claims that biblical counselors are really doing psychotherapy whether we think we are or not. While there are many flaws to this assertion, there is one way that I find myself sympathetic to Ross. Biblical counselors haven’t always been thorough in our critiques of secular theories.

Secular theories can be critiqued on two levels. The first is the most familiar – secular therapies ignore the existence of the biblical God, the presence of the soul, humanity’s need for redemption, and a whole host of other cardinal Christian doctrines. These are good and helpful critiques that must be made. Theories that begin with wrong assumptions about the nature of reality and man’s place in the world will not be successful in producing God-honoring heart change. However, when our critiques stop here we have not made any critiques that are differentiated from those offered by other Christian approaches to counseling. Integrationists agree about the moral bankruptcy of secular theories; this is why they do not practice secular therapies as they stand.

The second level of critique differentiates Biblical Counseling from Integrationism. We disagree with the mechanisms for change within secular theories. Where integrationists see therapeutic gold embedded in the mud of an antichristian worldview, biblical counselors see lusterless counterfeits. The problem is not solved by moving the therapeutic system to the context of the Christian worldview as the mechanism of change itself is at odds with biblical teaching on God-honoring human transformation.

Biblical Counseling is often considered to be a nontechnical variant of Cognitive Behavioral Therapy. Similarities do exist between the two. However, Biblical Counseling and CBT offer two different mechanisms for how people change that stem from two different anthropologies. This second level of critique is critical, for understanding CBT allows biblical counselors to articulate what makes Biblical Counseling distinct from other forms of therapy.

Aaron Beck’s “Cognitive Theory” provides the theoretical basis for the interventions of Cognitive Behavioral Therapy.[2] In its simplest form, CT argues that all psychological distress is the result of cognitive distortions (i.e. bad thinking produces bad actions and feelings). Situations or events themselves do not cause suffering but rather difficulties stem from an individual’s cognitive evaluation. For instance, the death of a parent might be grievous to one sibling but a source of joy for another. Therefore, it isn’t the situation (death of parent) but the interpretation (cognitive processing) that leads to distress.

Cognitive Behavioral Therapy is therefore centered on changing an individual’s thoughts, as right thinking will lead to right emotions and actions. Change is accomplished through a variety of interventions aimed at “cognitive restructuring.” A therapist may use a variety of cognitive exercises (homework is often utilized) and behavioral exercises (exposure therapy for example) to accomplish this task. While beliefs may be stubborn and require effort to change, a dedicated individual can accomplish this with the help of his collaborating therapist.[3]

There is biblical support for the idea that interpretations are foundational for much human distress. Paul argues in 1 Thess 4:13 that Christians do not grieve as those without hope. The cognitive content of resurrection in Christ modifies the manner in which Christians perceive the event of death. Similarly, Christians are to interpret potentially frightening situations in light of the sovereign care of God (Phil 4:6-7). Paul urges the believers in Rome to be transformed by the renewing of their minds (Rom 12:2). Thus, the Bible clearly establishes that changing in thinking is essential to human transformation.

At this moment our anthropology is tested. There is textual support for the idea that right thinking leads to right actions and feelings. However, is there a one-to-one correlation between thinking and action? Biblical Counseling diverges from CBT (and Christian variants of CBT) at this point. While the Scriptures clearly draw a connection between thinking and living, it does not then follow that cognition is the most important function of the human heart.

Take for instance Adam and Eve’s decision to rebel against God. Eve knew that for her own good she was not to eat from the Tree of the Knowledge of Good and Evil. The serpent spoke, she saw that the fruit was “delightful” and “desirable,” and she ate. Similarly, Abraham knew that Yahweh had promised the covenant child would come from him, yet he insisted Sarah lie about her relationship to him because he was afraid that wicked men would kill him and take her (Gen 20). James 4:17 perhaps offers the clearest teaching that right thinking doesn’t automatically lead to right action: “Therefore to him who knows to do good and does not do it, to him it is sin.” Indeed, every sin by every believer follows this pattern. We know (cognition) what is right, and yet do not do it (action).

Cognitive Theory therefore errs in its anthropology by establishing a hierarchy in the functions of the heart where thinking leads to actions that then produces emotions/feelings. Eve knew what was right but desired what was wrong. Abraham knew he would have a child and yet did evil because he was afraid. James 4:17 implies that something else lies in the equation between thinking and doing because simply knowing right does not guarantee doing right. While CT offers a minimalistic approach to humanity, the Scriptures present a picture of man thinking, desiring, and doing.

Central to changing a man’s life is changing his desires (Jas 1:14-15). Jonathan Edwards wrote in Religious Affections,

And as in worldly things worldly affections are very much the spring of men’s motion and action; so in religious matters the spring of their actions is very much religious affection: he that has doctrinal knowledge and speculation only, without affection, never is engaged in the business of religion.[4]

It is not particularly difficult to change people’s actions. Put a gun to someone’s head and they will suddenly be willing to do all kinds of things they never thought possible. But the affections are much more complex. That same gun to the head may compel a man from Boston to say that he loves the Yankees, but it won’t actually change his affections. Love cannot be changed by external force alone.

Here Jonathan Edwards is helpful once again. Drawing on years of witnessing revival and transformation he extends an observation, “I am bold to assert that there never was any considerable change wrought in the mind or conversation of any person, by anything of a religious nature that ever he read, heard or saw, that had not his affections moved.”[5] In order for people to change, every function of the heart must change (Prov 4:23, Luke 6:43-45). In his aptly titled book You Are What You Love James K.A. Smith offers a more modern take on the same theme: “[O]ur most fundamental mode of orientation to the world is love. We are oriented by our longings, directed by our desires.”[6]

CBT aims to change people by changing their thoughts. But changing thoughts doesn’t instill virtue according to the Scriptures. Biblical Counseling aims at a deeper target. The goal of our instruction is love, after all (1 Tim 1:5). CBT and Biblical Counseling are not siblings or cousins. Rather they are strangers that resemble one another only at a passing glance. Each is oriented around a different center for human change, and both cannot be right.


[1] George R. Ross, Evaluating Models of Christian Counseling (Eugene: Wipf and Stock, 2011), 91.

[2] This article focuses on Beck for the sake of brevity. Beck’s “Cognitive Therapy,” Ellis’ “Rational-Emotive Therapy,” and Meichenbaum’s “Cognitive Behavioral Modification” are often lumped together under the category “Cognitive Behavioral Therapy.” While each theory and therapy contains variations, all agree at their core that cognitive distortions produce psychological distress.

[3] For a helpful summary of Cognitive Behavioral Therapy, see Judith Beck, Cognitive Behavioral Therapy: Basics and Beyond (New York: Gulliford Press, 1995).

[4] Jonathan Edwards, “A Treatise on Religious Affections,” in The Works of Jonathan Edwards, 6th printing, (Peabody: Hendrickson, 2007), 238.

[5] Ibid.

[6] James K.A. Smith, You Are What You Love, (Grand Rapids: Brazos Press, 2016), 11

 

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Nate Brooks
Nate Brooks serves as Coordinator of the Christian Counseling Program at Reformed Theological Seminary — Charlotte and is a Ph.D. student in Biblical Counseling at Southwestern Baptist Theological Seminary. He counsels and teaches at Oakhurst Baptist Church in Charlotte, NC where he lives with his wife Kate and two sons.