I. Mental Disorders and Biblical Counseling

We live in a broken world full of people suffering with profound trouble and intense pain. One manifestation of that brokenness is the problem that our culture recognizes as mental disorder. Increasing numbers of people are diagnosed with these complex difficulties, which require wisdom and multi-faceted care. We confess that, too often, the church of Jesus Christ has not been recognized as a source for profound hope and meaningful help for such difficult problems. We further acknowledge that many Christians have contributed to a negative stigma attached to such diagnoses through simplistic understandings of these problems, and have offered solutions grounded in ignorance.

As an organization committed to pursuing excellence in biblical counseling the Association of Certified Biblical Counselors has, for decades, been calling upon faithful Christians to grow in the twin tasks of understanding complex problems and learning skills to address them in the context of counseling. As an organization committed to the sufficiency of Scripture for counseling we believe that the Bible provides profound wisdom to guide us in caring for people diagnosed with mental disorders.

One example of this wisdom is the biblical teaching on dichotomy. The Bible is clear that God created human beings to consist of both a body and soul. To be a human being is to exist in these two constituent parts, which are separable only at death. Even after death, Christians confess that the bodies and souls of human beings will be restored at the Last Day. This biblical truth points to the high honor and regard that God gives to both the physical and spiritual realities of humanity.[1]

A theological reality like this one requires Christians to honor both body and soul as crucial to human existence. Christians, therefore, should respect medical interventions as a fully legitimate form of care for those struggling in this fallen world. Examinations by medical professionals are crucial adjuncts to a biblical counseling ministry as they discover and treat, or rule out physical problems, which lead many to seek counseling help.

Another example of this biblical wisdom is the teaching in Scripture on the dynamic nature of problems that we experience in a fallen world. Human beings have difficulties, which always carry physical and spiritual implications. Both aspects need to be addressed in an appropriate fashion. Human beings experience problems with spiritual implications for which they are morally culpable and must repent. Human beings experience other physical and spiritual problems, which are not a consequence of their sins, are not their fault, but which are painful realities that attend life in a fallen world.[2]

This theological reality requires Christians to approach problems in a complex way, rather than a simplistic one. Christians understand that some spiritual realities will require a rebuke, but others will require encouragement in the midst of pain. Still others will require help in the midst of weakness.

II. Mental Disorders in Contemporary Culture

Christians today live in a secular and therapeutic culture, which lacks the sophistication of the Scriptures in understanding these matters. This culture attributes physical causation to many problems ignoring their spiritual roots and implications. This practice is confusing and unhelpful since the Bible teaches that not all serious problems are medical problems. The Bible’s teaching on humanity leads us to conclude that many problems are physical in nature, many others are spiritual in nature, and each of these affects the other. God’s Revelation in the Scriptures about the complexity of humanity forbids the secular reductionism that makes all problems merely physical.

The contemporary language of mental illness is one example of this reductionism. The compendium for mental illnesses that our culture recognizes as authoritative is The Diagnostic and Statistical Manual for Mental Disorders (DSM). This manual makes many accurate observations about the manifold problems that afflict people. For biblical counselors, the DSM paints an inadequate and misleading picture. It fails to express, recognize, or understand the spiritual aspect of problems that afflict people. Because of that failing it cannot offer clear help and hope for people diagnosed with its labels. While some of the disorders listed in DSM are medical in nature, many others are not. Even when the problems in DSM have a physical component the spiritual and Godward elements of humanity are not addressed by the DSM, which biblical counseling must take into account. Christians must be committed to a way of understanding and speaking about complex problems that is more likely to lead to real and lasting change than that recorded in the various editions of DSM.

III. Counseling Practice

In light of these realities, ACBC endorses the following standards of belief and practice for its certified counselors and counseling centers that would care for people diagnosed with the complicated problems identified as mental disorders.

1. Biblical Counselors must acknowledge that human beings struggle with physical and spiritual problems.

2. Biblical counselors shall encourage the use of physical examinations and testing by physicians for diagnosis of medical problems, the treatment of these problems, and the relief  of symptoms, which might cause, contribute to, or complicate counseling issues.

3. Biblical counselors shall help their counselees respond biblically to physical problems, but deny that spiritual interventions are the only proper response to problems with a medical element. They reject any teaching, which excludes the importance of the body and the goodness of God, which leads to the blessing of medical care.

4. Biblical counselors reject the notion that medical interventions solve spiritual problems. They embrace the use of medicine for cure and symptom relief, but deny that medical care is sufficient for spiritual problems, which require Christ and his gospel for ultimate relief and lasting change.

5. Biblical counselors shall be committed to counseling those with medical problems, but should not attempt to practice medicine without the formal qualifications and licensing to do so. When they have questions or concerns of a medical nature they should refer their counselee to a competent medical professional for diagnosis and treatment.

6. Biblical counselors shall nurture a spirit of humility, understanding many issues at the nexus of body and soul defy simplicity. They recognize that many problems are combinations of physical and spiritual issues. Others are problems, which are not easily identified as one, the other, or both.

7. Biblical counselors do not reject the true observations found in The Diagnostic and Statistical Manual of Mental Disorders, but do reject that DSM is an authoritative guide for understanding the cause and treatment of complex problems of human behavior, thinking, and emotions. They affirm that God’s Word in Scripture serves as this authoritative guide. Biblical counselors move toward using biblical language to refer to the counseling problems that people face. They are committed to applying the Bible to an understanding of the causes of and treatments for these problems.

8. Biblical counselors are committed to biblical discernment in understanding the nature of spiritual issues, and to dealing with sin through gentle, Christ-centered correction.

9. Biblical counselors are committed to biblical discernment in understanding the nature of spiritual issues, and to dealing with suffering through Christ-centered encouragement.

10. Biblical counselors are committed to biblical discernment in understanding the nature of spiritual issues, and to dealing with weakness through loving care in the context of the body of Christ.


[1]Genesis 2:7; Matthew 10:28; 1 Corinthians 7:34; 2 Corinthians 5:1; 1 Timothy 4:8    [2]Matthew 5:8; 26:38; 2 Corinthians 7:9-11; 1 Thessalonians 5:14
Share your thoughts


  • Rebecca Piquard
    May 13, 2016

    I appreciate the people who took the time to study, learn, and teach these things. Having a mental health disorder of my own I really appreciated having a more clear understanding of how to view it in a medical/spiritual light with Biblical truth. Thanks!

  • Tsholo
    September 1, 2016

    Nice article. Please write article 2, solely devoted to issues in DSM that are unbiblical. Beaides the Bible, is there a manual that Biblical counsellors can use (that you recomment) to understand sme of the cmplex issues that people think only psycho analysis/therapy can handle?

  • Aaron T. Stewart, Jr.
    April 25, 2017

    I cannot write a two or three sentence response to the statement regarding mental disorders, medicine, and biblical counseling. The writer seems to be saying that the medical and the mental are one and the same. For instance, the brain, being a physical organ of the body can malfunction and cause many physical problems. How can the mind being non-physical be ill? As a counselor, I agree that spiritual problems can cause physical problems or that physical difficulties can lead to spiritual problems. I choose to believe that mental disorders are not the same.
    The Church has become so involved with Psychology and Psychiatry that many counselees are coming solely because of their so called mental illness. Of course, the basic treatment for these counselees is a variety of anti-depressants which often becomes a cause rather than a cure. When a psychiatrist cannot get the medicine right, the result is a counselee who is suffering from panic attacks that make it almost impossible to counsel spiritual things. The counselee has become a slave to the treatment of the Psychiatrist and yet because they are a Christian, they feel compelled to seek out biblical counseling to see if they can be helped with their mental illness. Somehow the Church must convince the believer that the first step cannot be to go to the Psychiatrist. I can help an individual if they will first come to me. I am not sure this is a problem right across the board, but it is becoming more common place with me. I believe this a dilemma that is not being addressed because we have gotten away from where the rubber meets the road.
    Thanks for listening and a response would let me know if this happening with other counselors.

  • Gary Charles Johnson
    October 6, 2017

    As a Christian who has counseled both Christians and non-Christians I have a deep empathy for other counselors that are motivated by love and concern for the welfare of others. Mr. Stewart, I admire your dedication and am sure that you have the best interests in heart for those you counsel. Nevertheless, I am deeply troubled with some of the statements made in your post.
    Of specific concern is your response, “[H]ow can the mind being non-physical be ill?” Although your assertion that the “mind” is non-physical is correct, you fail to realize that the “mind” is only a natural output or product of the brain which is itself physiological and can be ill. Since that is the case, your personal choice that mental disorders are not the same as physical diseases is an opinion not founded in medical fact. Contrary to your assertion that counsellees that have mental problems have a “so called” mental illness, they in fact have a real physiological problem that needs immediate professional medical intervention. Any counselor that is ignorant of that fact puts the counsellee at risk of the consequences, including suicide. So, no, unless you are a medical professional experienced in psychological counseling or psychiatry you cannot help that individual and both you and the Church have a moral obligation to direct that counselee to the professionals. As I have already shown, mental illness is a real physical disease. It is not “sin sickness”, a mind, or a character deficiency that a Biblical Counselor can address. This is not in your level of expertise.
    In respect to your comments concerning psychiatric medications and panic attacks, you have the process backwards. Panic attacks will lead one to a search for professional help unless they are intercepted by well meaning friends, family, or lay counselors. If they overcome this interference and see a psychiatrist, medication may be deemed needed and then the psychiatrist will begin the process of developing a therapeutical plan. This is not a perfect science because people are different and tests don’t exist to pinpoint the exact combination. But, with patience the psychiatrist will get the “medicine right”. This process does not imply that a patient is a slave to the Psychiatrist. Their mental illness may not be completely cured but neither are most chronic illnesses. Most of the complete failures I have seen are due to the failure of the patient to follow the doctor’s instructions. Counselors need to be wary of that and strive to help the counselee “to get back on track”. That is your obligation.
    I speak through experience with my own personal chronic Generalized Anxiety Disorder and Major Depressive Disorder. I am now 61, but was diagnosed at age 48 after a lifelong bout. The first experience I can remember occurred at age 4 (so much for the sin sick or character flaw theory), but medical expertise was almost non-existent then and for years to come. At age 47 I started experiencing panic attacks which led me to seek a solution with a counselor. I was immediately referred to a psychiatrist who began the treatment process with appropriate medication. I was told I was suicidal. I credit this series of events that led to my eventual treatment with God’s protective providence.
    Now, my illness is under control and I volunteer my time to counsel both Christians and non-Christians at the local hospital and church functions. I have used these opportunities to not only empathize with their problems, but encourage them to seek appropriate professional help. But my main emphasis is on teaching the gospel of Christ and that God can help them deal with a mental illness that is not their fault. Now, if a person has damaged their brain through sin and poor lifestyle choices, I exhort them to repent, seek God for forgiveness, and ask Him to help them overcome their illness. In every case, I make sure that obeying Jesus is their answer and offer my assistance to help them in making that decision.
    This post is not founded on criticism, but to correct the ignorance and stigma of mental illness. I do so in love and respect.
    Gary C. Johnson

  • Gregory Alfsen
    October 7, 2017

    Thank you for establishing ACBC’s position in the mist of this controversy of “mental illness”. Just the term “illness” seems to imply a physical component. My understanding is that most, if not all, mental illnesses identified in the DSM have no recognized pathology (e.g. diabetes) and that medical treatment is very subjective and questionable. It appears the above ACBC statement gives too much credibility to the DSM and its definitions of mental illness. It may be helpful to direct the reader to information of what constitutes a medically defined illness or disease. I do understand the intent of the ACBC statement is to establish the counselor’s role as one of humility, compassion, and understanding in all situations when presenting the truths of God’s Word. We are to have the ‘Mind of Christ’. Thank you.

  • Scott Bleeker
    December 5, 2017

    One excellent resource is The Christian’s Guide to Psychological Terms by Marshall and Mary Asher. This resource describes the disorders found in the DSM with biblical terminology and advocates biblical methods of handling those problems.

  • Thom Lolley
    September 11, 2018

    I appreciate the ACBC’s position and desire to address the adverse affects of sin through Biblical interventions. However, I think you’ve made an assumption that was not fully informed. The DSM5 is clearly not the Bible. It was not intended to be. It is a guide that classifies symptoms into diagnostic categories and gives them names so professionals across the world can have conversations about common symptoms.
    Contrary to your assertion in the article, the DSM does not prescribe treatments for any of its diagnoses. Nor does it reject Biblical interventions. Interventions are left to the discretion of the clinician. Of course interventions need to have a basis in evidence for their efficacy. If anything, modern research supports Biblical interventions. Once again, this confirms that God owns all truth. Jesus Christ is Sovereign over His Creation and his truth is available to all, even if they don’t recognize the Source of that truth. When you stop looking down your nose at the Christian professionals God called to clinical counseling, and start focusing on providing us with resources on how to apply the healing balm of Scripture to soul wounds caused by sin, we can do even more to advance the kingdom of Christ.

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