…even a cursory reading of the leaders in the biblical counseling movement indicates that they have carefully articulated a belief in the importance of the physical body and medical treatment.

Counseling and Medicine

The biblical counseling movement has a persistent reputation for being anti-drug. Because of our annual conference focus on mental illness we have had numerous posts on medicine and mental illness in the last year. Every time I write about counseling and medical issues I make clear that physical care for the body is important, and that counselors should not function as physicians and try to take people off their medications. In spite of those qualifications, people regularly accuse me and others in the biblical counseling world of being against medicine.

Will the Person Hating Medicine Please Stand Up?

It makes me wonder where the accusation is coming from. Who is saying that medicine is unimportant? Someone must be. In fact, I was told during a recent conversation, “Well, you might not be saying that, but other biblical counselors are.” When I asked for the identity of these other biblical counselors no names could be produced.

That got me thinking about leaders in the biblical counseling movement and their statements in this regard.

I think any objective evaluation of the biblical counseling movement would point out four big leaders in the development of our model. I think those four leaders are Jay Adams and Wayne Mack (who had an instrumental role in founding the biblical counseling movement) and David Powlison and Ed Welch (who have significantly developed the movement in recent years.) Every person embracing and practicing biblical counseling today has learned about biblical counseling from at least one of these four men.

So I looked at the statements about counseling and medical issues from the teaching of these four men. Here is an incredibly brief summary of what I found.

Jay Adams

In Competent to Counsel, Jay Adams’s very first book on counseling, he clearly acknowledged the presence of disease and the need for medical doctors, including psychiatrists in caring for people who need help. In a book, What about Nouthetic Counseling?, written a few years afterCompetent, Adams said this:

It is perfectly clear that . . . illnesses can and do affect behavior. In such instances, medical help should be sought and administered prayerfully.

Wayne Mack

Writing in Counseling: How to Counsel Biblically, Dr. Mack has this to say about counseling and medical issues.

Sickness can sometimes be caused by personal sin (Ps. 32:3-4; 38:3; Prov 14:30; 1 Cor 11:30). But sickness that is not caused by personal sin can also be an important factor in the struggles and temptations our counselees face. For instance, viral infection, hepatitis, mononucleosis, diabetes, and hypothyroidism are all associated with depression. In many cases, when Christians suffer from those conditions their depression symptoms may simply be a consequence of the exhaustion and discomfort cause by the malady. So we must not assume that in every case depression is a direct result of personal sin. It may be relieved or eliminated simply by the correct diagnosis and treatment of a medical problem.

He goes on to say that, “It is not our place as biblical counselors to prescribe drugs or remove counselees from drug regimens.”

Ed Welch

Welch’s book Blame it on the Brain is a wonderful effort at reaffirming the Bible’s teaching that human beings are composed of a body and a soul. He walks through chapter after chapter with sophisticated analysis emphasizing the importance of the body, the importance of the soul, and the importance of caring for each one. The point of the entire book is to help Christians know the difference between spiritual issues, physical issues, and combinations of the two in order to help people most effectively.

Welch says,

Since we approach physical and spiritual problems in different ways, we need to be able to distinguish between them. Physical problems are met with understanding, compassion, and creative teaching. Spiritual problems are also met with understanding, compassion, and creative teaching, but the content of the teaching is the law of God and the Gospel of Jesus, and the response is repentance and faith rather than intellectual understanding or simple behavior change.

Throughout his book, Welch assumes and encourages medical care for medical problems.

David Powlison

Powlison penned an Affirmations and Denials document, which many in our movement have used as a standard for faithfulness in biblical counseling belief and practice. Powlison says in that document,

We affirm that God’s providential common grace brings many goods to people, both as individual kindesses and as social blessings: e.g., medical treatment, economic help, political justice, protection for the weak, educational opportunity. Wise counseling will participate in and encourage mercy ministries as part of the call to love.

Where’s the Beef?

Again, this is a brief survey. Each of these men have had much more to say about the importance of medical care for medical problems. Many in the biblical counseling movement besides these men have had plenty to say as well.

My point is that even a cursory reading of the leaders in the biblical counseling movement indicates that they have carefully articulated a belief in the importance of the physical body and medical treatment. I can find no indication that the intellectual leadership of the biblical counseling movement has ever given voice to the dangerous practice of ignoring organic illnesses or encouraging the rejection of medical care.

If this is true then where did the biblical counseling movement get such a reputation?

I think there are several answers to that question. I’ll talk about them in my next post.

Heath Lambert
Share your thoughts


  • frederick Holloway
    December 9, 2018

    I had the opportunity of meeting Jay in his home in South Carolina. We were introduced by Jay’s son-in-law. I was very privileged to sit in the home of the man instrumental in the forward moment of Biblical counseling. Is Jay Adams still among us or gone on to heaven?

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