Two Sides of the Counseling Coin

Explaining the difference between nouthetic and biblical counseling is a bit like asking whether a coin is heads or tails. A coin is both heads and tails. In talking about the heads side or the tails side of the coin, we are merely emphasizing different surfaces of one thing.

Such is the case with the today’s conservative, Bible-based counseling movement. The language of “nouthetic” or “biblical” serves to emphasize different streams inside one, larger movement. First, I will explain why nouthetic and biblical counseling are two sides of the same coin, and then I will explain the differences that each side emphasizes.

One Coin

Whether you use the term “nouthetic” or “biblical” counseling, Jay Adams was the man who got the whole project started with his first book on counseling, Competent to Counsel: Introduction to Nouthetic Counseling. The word nouthetic in the title comes from a Greek word meaning to confront or admonish. When Adams applied this language to counseling he argued that it included three elements:

  1. confrontation happening in a face-to-face manner;
  2. confrontation done out of loving concern for the counselee; and
  3. confrontation done with the purpose of bringing about change that God desires.

In that book, which introduced evangelicalism to his nouthetic model, the very first time he refers to his project in the early pages, he calls it “biblical counseling.” That was more than 40 years ago, but even today on his own website at the Institute for Nouthetic Studies, Adams says that nouthetic counseling “is biblical counseling.”

In a 1976 book, What About Nouthetic Counseling, Adams said he actually preferred the title “biblical counseling.” He has continued to use the “nouthetic” label to keep his project separate from approaches to counseling that are unfaithful to the Scriptures but increasingly apply the “biblical counseling” label to their work. For Adams, there is nothing sacred about a label. What matters is whether the Bible drives understanding of people as well as the counseling task.

The next big leader in Adams’s counseling movement was David Powlison, who succeeded Adams as the editor of The Journal of Pastoral Practice and immediately renamed it The Journal of Biblical Counseling (a decision Adams himself approved). Powlison is more responsible than anyone else for bringing biblical counseling into the mainstream of evangelicalism. Even Powlison, however, has not been hung up on a “biblical” counseling label, but has at times referred to the movement as biblical-nouthetic counseling and serves on the board of the National Association of Nouthetic Counselors (NANC). For Powlison, like Adams, the defining mark of faithfulness in counseling is whether it conforms to the Scriptures, not what one calls it.

Beyond these two giants in the field, examples could be multiplied. Ed Welch, another key leader, has in the past referred to the movement as biblical-nouthetic counseling. NANC, perhaps the largest organization in the movement, defines their purpose as pursuing excellence in biblical counseling. There are no massive fault lines in the movement between “biblical” and “nouthetic” labels. Regardless of the name a person uses, the people in the movement are committed to using the Scriptures as the source of wisdom that drives the change process in conversational ministry.

Two Sides

Great cohesion does not eliminate distinction between the two strands in the movement. There is one coin, but it has two sides. Today, “biblical counseling” is the popular and default label. When people in the counseling movement, however, intentionally choose to identify themselves in a distinctive way as either “biblical” or “nouthetic,” I think they are referring to two different kinds of distinctions. The first distinction is historical, and the second is dispositional.

Concerning the historical distinction, nouthetic counselors identify with the founding generation of biblical-nouthetic counseling and leaders in the movement like Jay Adams, Ed Bulkley, and Wayne Mack. Biblical counselors identify with second-generation leaders like David Powlison, Ed Welch, and Paul Tripp. But these historical distinctions do not always amount to institutional distinctions. A few smaller organizations like the Christian Counseling and Educational Foundation (CCEF) and the Institute for Nouthetic Studies (INS) are purely one or the other. But large organizations like The Association of Biblical Counselors (ABC), The International Association of Biblical Counselors (IABC), and NANC have diverse memberships that identify with each generation.

An historical identification with one generation of leaders over another leads to dispositional differences as leaders in varied ministry contexts emphasize different things. The “nouthetic” and “biblical” streams within this one movement have four dispositional distinctions on their respective sides of the counseling coin. These distinctions are generalized with exceptions, but they are still helpful in organizing our thinking.

First, there are dispositional differences with regard to doing and believing. In their counseling theory and practice, nouthetic counselors pay particular attention to behavioral change. Biblical counselors focus on the patterns of belief or unbelief that motivate behavior. True change is not merely behavioral but generates from deep within the heart.

Second, there are dispositional differences with regard to sinning and suffering. Nouthetic counselors have a reputation for skillfully engaging patterns of sinfulness. While not ignoring suffering, they believe that effective counseling leads struggling persons to encounter the living God through repentant faith. Biblical counselors tend to emphasize skillful engagement with struggling persons concerning the areas of suffering. They seek to augment a perceived lack in attention to suffering from other biblical-nouthetic counselors.

Third, there are dispositional differences with regard to the counseling relationship. Biblical counselors believe in the importance of befriending those they counsel and adopt an informal approach that focuses on mutuality. They believe an approach that focuses on kindness and compassion is most conducive to the change being pursued in the counseling relationship. Nouthetic counselors focus on an approach that is more formal and focused on engaging issues. They believe that the most kind, compassionate, and effective approach to care is to engage problems as quickly as possible, allowing the counselee to experience progress as rapidly as possible.

Fourth, there are dispositional differences with regard to contending against unbiblical approaches to counseling. As previously mentioned, both biblical and nouthetic counselors believe the Bible is God’s source of wisdom that should inform and direct all counseling. But each side of the counseling coin emphasizes different interests in contending for that truth. Biblical counselors are concerned about an unfortunate reputation for rancor in the counseling debates of the past. Though biblical counselors believe in sufficiency, they tend to devote less time to contending for it out of a desire to be irenic. Nouthetic counselors tend to believe that sufficiency is always at risk from competing counseling philosophies and so are more interested contending for it against unbiblical counseling approaches.

It Takes Two Sides to Make One Coin

Concerning coins, I suppose some people prefer heads, and some prefer tails. People like to pick sides. That is fine so long as we avoid an “I follow Apollos” mentality. It is important to remember that just like a coin needs both sides, so counseling needs its “nouthetic” and “biblical” streams. I am convinced that each side represents a sort of conscience to the other. They each emphasize truth on different ends of a spectrum. The Bible teaches believing and doing; sin and suffering; loving interaction and truthful instruction; the need to contend and the need to care for those with whom we disagree.

Many of us have learned a great deal from both sides. The biblical-nouthetic counseling movement is stronger for its corresponding emphases. Like a coin, the diversity complements rather than conflicts with the fundamental unity.

  • Chris

    Great article, though I think a bit more needs to be said about the dispositional differences. I think Biblical Counseling, for example, sees validity in prescribing medication and does not disagree with its wise use, when necessary. And this stems from more than just a desire to be irenic. Juxtaposed to this, I think Nouthetic Counseling does not find any validity in psychology, including the use of medication. Correct me if I’m wrong, but I do not think that is an exaggeration.

    The dispositional difference concerning Psychology has been, in my mind, the greatest difference between Biblical and Nouthetic Counseling, and I think it should’ve been fleshed out a bit more in the article.

    God bless.

    • kyle

      I am actually pretty confident that your assertion is inaccurate. Both Biblical and Nouthetic streams of counseling are most commonly very critical regarding psychology and medications.

      • Chris

        From what I’ve read in the past 2 years, Biblical Counseling is no longer as hostile/ they are more open (though still cautious) to the wise use of medications. The reason that I bring it up is because I have found the idea that Biblical Counseling disapproves of psychology to be a carried-over caricature from the 1990’s.

        But I think both of us would profit from actually citing the sources of our opinions on this topic.

  • Pingback: 5 Top Christian Blog Posts of the Week: 5 to Live By | RPM Ministries()

  • sam

    Heath’s peacemaking perspective is refreshing. Yes, on each serving as the conscience for the other (AKA, iron sharpening).
    Do agree a bit with Chris above, but think the issues he mentions (meds and psychology) are not totally bifurcated.
    It seems to me that one of the significant differences between the nouthetic and biblical counseling streams is that the former is often phobic about external sources, esp secular psychology whereas the biblical counseling stream is still cautious about secular psych but not so phobic.

  • Mike

    Great Article.

    Another dispositional difference I have found is the nouthetic approach tends to jump into the “put off, put on” a little sooner, where BC has a stronger emphasis on turning to the gospel as the driving force prior to introducing the “put off, put on.” I don’t think any nouthetic counselor would disagree with the gospel being the driving force, I just noticed this area is a little more developed in the BC arena.

    Another area is the distinction between “the flesh,” you can read more here…

  • Kevin Carson

    Heath, I appreciate your spirit and balance. I wish more biblical counselors and nouthetic counselors would do good self-counsel as to their own spirit before using broad brushes with a poor spirit to pigeon hole others. As an insider from both groups myself, I believe your distinctions are interesting to read. Your final paragraph though is what is essential. You write, “The Bible teaches believing and doing; sin and suffering; loving interaction and truthful instruction; the need to contend and the need to care for those with whom we disagree.” Yes. It is both/and. May God be pleased with all biblical-nouthetic counselors as we consider our own heart as we reflect on considering helping others and how to help others.

  • John S

    Thanks this was helpful, including the comments. I am grateful for both ‘dispositions’ and since I don’t have to take sides I plan to have the best of both worlds.

    Hopefully, as led by the Spirit, choosing the tact that best fits the occasion, that it may give grace to those who hear. To borrow a phrase.

  • Bob Kellemen

    Thanks, Heath, for a robust, relational, nuanced answer to an intricate question. For those who would enjoy an even more detailed description, three resources from Heath come to mind. 1.) The introduction Heath wrote to “Counseling the Hard Cases.” 2.) Heath’s book, “The Biblical Counseling Movement After Adams.” 3.) Heath’s plenary message at this year’s NANC Biblical Counseling Conference on “What Biblical Counselors Can Learn from the Epistles.” All three, like this blog post, are excellent resources.

  • Jon Davis

    Thanks, Heath. I too appreciate your balanced and careful approach.

    I also agree with Chris’ comment above. Would’ve liked to have heard more about each side’s approach to mental illness, medication, and psychological methods, tools and resources. Perhaps another follow-up post? I’d appreciate your thoughts on this.

  • Pingback: Lambert explains Christian counseling strategies()

  • Barry

    Heath, a thoughtful summary. For those that are interested in a more exhaustive treatment on the topic I suggest reading David Powlison’s doctoral dissertation entitled,”The Biblical Counseling Movement: History and Context” and Welch’s article in the Journal of Biblical Counseling, “How Theology Shapes Ministry.” Adams was no doubt was a trailblazer and renegade very much needed for his time, but very few people know that he left a year later after founding CCEF with John Bettler. Actually, there has been many differences that developed since that time, some of which Heath enumerates in the article e.g. theology of suffering, heart, grace.

    Although it is hard to enumerate everything in one article, the most significant development that the article glosses over is that Biblical Counseling Movement as developed by Powlison, Welch, Tripp, Lane etc is gospel-centered. In my opinion, this is what makes the two approaches completely separate coins. To borrow a phrase from Welch’s article your theology shapes your methodology. A gospel-centred approach recognizes that change comes only by grace instead of mere putting off and putting on or habitation and rehabilitation. Further, as Heath alludes the stereotype, which has quite a bit of traction, is that nouthetic with it’s confrontation of sin tends to be a one trick pony and can come across as very legalistic, whereas a gospel oriented approach is much more nuanced in treating the person. Incidentally, noutheto in 1 Thessalonians 5:14 refers to everything from encouragement to confrontation. Adams latched onto Hobert Mower’s behavioral psychology and adapted it with biblical confrontation model.

    I guess what I am highlighting is that Adams was the “founder” of the modern biblical counseling movement for which I am grateful, but there has been so much development and balance since that time and to merely say they are two sides of the same coin is a being a little over simplistic.

  • David Murray

    Thanks Heath. This was helpful and constructive.

  • Pingback: What I Read Online – 10/10/2012 (a.m.) | Emeth Aletheia()

  • Sandra Garman

    Great article on the differences in counseling methods. You made this very clear and concise. Thank you

  • Matt Smethurst

    Very helpful, Heath. Thanks!

  • Joe

    Barry’s comments above are helpful. I deeply appreciate Heath’s irenic (Greek word like nouthetic!) tone and while there is much good being done by a diverse group within the broader biblical counseling movement, there still remain differences. Thankfully there is a growing center aided in many ways by CCEF and its writings. Also, David Powlison is a faculty member at CCEF since 1981. While he has served on the NANC board, from which he is stepping down, his place of employment is CCEF. I wish Heath had made that more obvious. Also, while CCEF values both a sophisticated model that can winsomely engage modern psychology and psychiatry without compromise, it also values a model that is accessible enough for a lay-person to understand without becoming simplistic.

  • J.J. Seid

    I think this post is all well and good, except for the fact that there was a linear progression between the two sides of the coin. Lambert sees the ‘biblical counseling’ strand emphasizing sympathy for suffering and change at the heart level, but of course they emphasized those things not over against confronting sin and seeking behavioral change, but rather *in addition to* confronting sin and seeking behavioral change, precisely because they felt those things had been neglected in the chronologically prior nouthetic wave. This was not an either-or response on their part, but rather a “these things you ought to have done without neglecting the others” response (as Lambert details in his own book, Biblical Counseling After Adams). In other words, a third party is not needed to simultaneously tell the nouthetic strand and the biblical counseling strand, “Hey guys, it’s a both-and,” precisely because that’s what the second-generation biblical counseling strand was saying to the first generation nouthetic strand all along! “Hey guys, it’s a both-and. Let’s confront sin, and expect behavioral change, but let’s also weep with those who weep, and recognize that focusing on behavioral change at the neglect of heart-level change inevitably descends into behavioralism.”

  • Pingback: Check out | HeadHeartHand Blog()

  • Donn R Arms

    Heath, the point I made about your book is well illustrated in these comments. In the early days it was Jay’s foes, secular psychologists and integrationists, who threw stones and misrepresented him. Today, it is his friends who project slings and arrows. Let’s note some of these comments. First there is “Chris” who claims “Nouthetic Counseling does not find any validity in psychology, including the use of medication.” Just not true. Jay has, from the beginning, said truly scientific psychological studies can be of great value. Medicine for objectifiable medical problems is always appropriate.

    Then along comes “Sam” who claims that we nouthetic guys are “phobic about external sources.” I am going to assume Sam understands that “phobic” means “fearful” and that by “external sources” he means the extra-biblical conclusions of the psychologist. In reality, no nouthetic counselor I know fears anything the psychologist has to offer. Secular psychology is largely impotent. What exactly does Sam think we nouthetic types have to fear from it?

    “Mike” should read Competent to Counsel sometime. Jay has an entire chapter on the importance of evangelism, i.e. the gospel, in counseling. It was a fully “developed” issue for Jay from the beginning.

    And then there is “Barry” who begins with a confused timeline. CCEF was founded by Jay in 1968. The reason “very few people know that he left a year later” is that it is not true. Jay continued with CCEF until he physically moved from PA to Georgia in 1976. Still, he remained on the board until the mid 90’s when, rather than fuss with Bettler over the direction Bettler was taking CCEF, he and three other board members quietly resigned.

    Barry should also understand that adding the catch phrase “gospel-centered” to a flawed doctrine of sanctification does not cleanse it from error. Nor does describing Adams’ interactions with Mower as “latching onto” change the fact that Adams’ time with Mower served to demonstrate to Adams how bankrupt and empty Mower’s psychology was. I have letters in my files from Adams to Mower written in subsequent years in which Adams pled with Mower to turn and trust Christ. As though to illustrate how little hope he had Mower eventually committed suicide.

    I am looking forward to talking with you in person about your article. For now, you are exactly correct to say that we nouthetic guys believe nouthetic counseling IS biblical counseling. It is not a separate strand from biblical counseling. We prefer the term nouthetic because it defines what we mean by “biblical” counseling. You see, Larry Crabb, June Hunt, Neil Anderson, Charles Solomon, Ed Smith, David Seamonds, Kevin Lehman, James Dobson, et al all claim to be “biblical.” The term “nouthetic” lets everyone know what exactly we mean by “biblical.”

  • Joe

    Don makes some helpful historical corrections to some of the posts. Thanks, Don. It is true. John Bettler, a great friend of Jay’s, took CCEF in a less “fundamentalist” direction which was not “afraid” to engage with and interact with secular psychology while maintaining Biblical distinctives. This has often been viewed by “nouthetic” counselors as compromise. I don’t think there has been compromise but we all have a lot to learn from our critics. Still, Jay did leave CCEF and disassociate himself from the direction that John Bettler took. To Jay’s credit, he has remained irenic towards CCEF while Don has been more publicly critical. That’s okay, Don!

    What concerns me about Heath’s post is his comments about CCEF being one-sided and NANC being more broadly accepting. Strange that this comes on the heals of his being made Executive Director of NANC. CCEF remains commited to wise engagement of culture with a pastoral approach to counseling that is richly grounded in the Bible. I think that all of the organizations within the broader biblical counseling movement have strengths and weaknesses but you have to admit that CCEF has been the leader in challenging the movement to grow in intellectual and practical wisdom. And CCEF is not a “small” organization. We have been in existence since 1968 and have trained thousands of pastors and lay-people. Many of the current leaders in other biblical counseling organizations rightly refer to CCEF as a major influence in their thinking about counseling/discipleship. Also, it was Johh Bettler who started NANC to be an accrediting body of CCEF trained counselors. While that never played out the way John had planned, the fact remains.

    While I understand the nature of the “blog”, Heath’s post is far to general and simplistic for this topic. I wish his generalizations were as easy as he states.

    • Heath Lambert


      I am so thankful for all the comments that you’ve made. I have many thoughts about the comments that have been posted particularly the comments about differences concerning the use of psychotropic medication. There is a very good reason why I didn’t address this as a dividing line in the movement which I believe most who are familiar with biblical counseling literature will be aware of. I won’t address that here, but will save it for another time.

      I wanted to address your concerns in particular in order to share some facts that may help you understand my perspective.

      First, I’m not sure what you mean by saying I believe CCEF is “one-sided” and NANC is more “broadly accepting.” I didn’t say this. What I stated is that CCEF identifies purely as “biblical counseling” whereas there are some members of NANC who would call themselves “nouthetic” and plenty of others who would say they are committed to “biblical counseling.” I was talking about who affiliates with whom not who is more accepting of different positions. No faculty member at CCEF would say they are “nouthetic.” There are, however, plenty of NANC members who would say they are nouthetic, and many others who would rather not use that label (like me!). I don’t mean to be controversial in this observation. I think I’m stating an obvious fact.

      I am also trying to state what seems an obvious fact when I say CCEF is small and NANC is big. I promise I don’t mean this as a slam against anyone. I am making an observation about the size of the organizations. CCEF has a handful of gifted faculty members. NANC has thousands of members all across the world. Your comments seem to focus on something I didn’t mention which is influence. I’ll bet we would agree that CCEF has been vastly more influential in biblical counseling over the last two decades than NANC has been even though CCEF is smaller. I am not in a bad mood about this, but rejoice over the many advances brought to biblical counseling by the leaders of CCEF. In fact, I wrote a book–available from Crossway–praising this good development.

      Another comment. I was asked to write this blog post back at the very beginning of 2012 and finished it shortly after I received the request. That was months before NANC even formed a search committee and even longer before they began interviewing me. I did not write this post with the bias of being the next Executive Director of NANC.

      One final word. Before I submitted this post to TGC I circulated it to various leaders in the biblical counseling movement. Some were more affiliated with the “nouthetic” side of the coin others were more affiliated with the “biblical counseling” side. All of them are well-known and established leaders. One of those leaders was David Powlison. All of them, including David, said they believed my analysis of the movement in the post is exactly correct.

      That doesn’t make me right so I remain eager to hear criticism of my viewpoint. But I hope it helps you see that I wrote this post trying to build bridges between members of a big family and desperate to avoid having this be a hit piece on either side of the counseling coin.

      Warm blessings to you in Christ dear brother,

    • Donn R Arms

      Thanks for the affirmation, Joe. It is assuring to know my gentle criticisms are “okay.” Your statement that “we all have a lot to learn from our critics” raises two categories of questions in my mind. First, what exactly have you learned from your psychologically oriented critics? Have they helped you minister more effectively to counselees? Have you gained any insight into the Word, learned more about Christ, or come to understand better the work of the Holy Spirit in a counselee’s life?

      Second, which critics are you referring to? Are you as open to and anxious to learn from your nouthetic critics as you are your psychologically oriented critics? When is the last time you sought to open a dialog with them? I don’t mean the Martin Bobgan type of critic but rather men like Adams himself, who even though he remains “irenic” has deep and profound criticisms of what is taught at CCEF these days.

  • Pingback: SBTS Southern Blogs » Lambert explains Christian counseling strategies()

  • Pingback: Friday’s 5 to Live By | Biblical Counseling Coalition Blogs()

  • Pingback: Explaining the Difference Between Nouthetic and Biblical Counseling: Two Sides of the Counseling Coin | Biblical Counseling Coalition Blogs()

  • Pingback: Because You Are Loved | Hope Fully Known()