I do trust that this discussion is helpful to you and will be of service to you as you work your way through the counseling exam questions. Tonight, we're looking at Counseling Exam Number 9, which is an exam topic asking you to evaluate secular methods for counseling and life change.

We're asking you to evaluate some of the secular methods that are being used in the world today, and you will find that many of these methods have been brought into the church. As we emphasize an approach to counseling ministry that centralizes the truth of scripture, which emphasizes the authority and sufficiency of God's word, we also want to be discerning as to the other counseling methods that are being practiced today.

I always say that we want our counselors to be known for what we are for, not for what we are against. We want to be for Christ, we want to be for the scriptures, we want to be for the church, we want to be for our counselees. Yet at the same time, there is this balance that we want to be able to graciously and fairly evaluate some of the secular methods that are being practiced today, so that we may be able to minister with biblical discernment.

Paul tells Timothy in 2 Timothy 2 verse 15, "Do your best to present yourself to God as one approved, a worker who has no need to be ashamed, rightly handling the word of truth." That's why many of you are writing these counseling exams. You want to be a workman who does not need to be ashamed, you want to be diligent in the scriptures, you want to be approved unto God as one who handles the word of God accurately.

But if you go to the next verse, Paul tells Timothy in verse 16, "But avoid irreverent babble, for it will lead people into more and more ungodliness, and their talk will spread like gangrene. Among them are Hymenaeus and Philetus, who have swerved from the truth, saying that the resurrection has already happened.

They are upsetting the faith of some." The balance is the servant of Jesus Christ must be devoted to God's word. The servant of Jesus Christ must be diligent to study and to handle the word of God accurately. Then on the flip side, the servant of Jesus Christ must be discerning as to those things which would contradict the teaching of God's word.

Hebrews 5 verse 14 gives this definition for spiritual maturity. It says, "But solid food is for the mature, for those who have their powers of discernment trained by constant practice to distinguish good from evil." We want you to hold fast to the sufficiency of scripture, and we also want you to be able to discern truth from error, and to evaluate secular methods for counseling.

By the way, on the ACBC podcast this last week, I would encourage you to listen to that. The ACBC podcast is in the midst of a three-part series on evaluating the Enneagram personality assessment. This is a very interesting discussion between Dr. Dale Johnson and Dr. Wren Cherry who did his dissertation on a biblical evaluation of the Enneagram personality theory.

Dr. Cherry actually wanted to do his dissertation on the subject of evaluating the Myers-Briggs personality tests, and their use in the Church of Jesus Christ. He was given the feedback that the Myers-Briggs personality assessment is fading a little bit in popularity in the evangelical world today, and a better use of a study would be to evaluate the Enneagram personality test, which is becoming more popular within Christian circles.

The point of all that is simply this, we want to be discerning. We want to understand what scripture teaches, and we want to understand how secular theories differ from the teaching of God's word. We also want to be aware of where our people are living, and the things that they are dealing with in their everyday lives.

As you evaluate these four secular approaches to counseling, I hope you will think of not just theories, but I hope you will think of people. I know that in our own counseling ministry, in our counseling center, we come across counselees who have gone to secular therapy and gone to secular counseling, and they have received counseling that is in accordance with some of these theories.

So I hope that you will approach this with the aim and the goal to love well, those who are in our churches, and just to be aware of the different types of things that they are encountering as they work through the issues of life. So let me read the question for us, and then I'll pray for us and devote our time to the Lord.

Counseling exam number nine is to define, describe, and provide a biblical evaluation of each of the following; 12-step recovery programs, cognitive behavioral therapy, the biogenic theory of mood disorders, and electroconvulsive therapy. Those are four secular approaches to life change, four secular approaches to counseling, and we want to just be discerning as to how these approaches differ from the teaching of God's word.

So let me open our time in a word of prayer, and we'll dive right in. Let's pray. Father, thank you for your word. Thank you for the authority and the sufficiency of your word. Father, we pray that we would be diligent workmen who do not need to be ashamed, handling accurately the word of truth.

We pray that you would give us discernment as we work through a biblical understanding and evaluation of secular methods. We pray that you would give us a shepherd's heart as we think through these issues, knowing that many of our people and many who come for biblical counseling have been affected by these secular theories.

So just pray that you would help us, help us to be well-equipped, and help us to be instruments in the Redeemer's hands who can bring hope and help to others. We pray, and we ask this all in the name of Christ. Amen. Well, on page 1 of your handout, I've given you a number of resources that I trust will be helpful in your study of these topics.

I generally don't encourage you as you work through these essays to use certain sources such as Wikipedia, but for the purpose of this essay, feel free to use online sources such as Wikipedia and WebMD. Also, the Mayo Clinic has a website that will give you some good information from a secular perspective that summarizes some of the tenets of secular counseling.

So you have four secular theories that we're asking you to evaluate in this essay. Now, in the space of a page and a half, you're only going to be able to do a brief summary and critique of each of these theories. So don't get in too deep as you look at these theories.

The challenge will be in bringing it all of this into a page and a half. But a four-paragraph essay, one paragraph per secular theory would be a good approach to write this essay. So you have the 12-step recovery programs, you have evaluating cognitive behavioral therapy, and there's some good work there from both a secular and a biblical counseling perspective.

I would encourage you to get Scott Mel's article on evaluating CBT. That's on the ACBC website, and Scott has done a tremendous job of just critiquing and evaluating cognitive behavioral therapy from a biblical counseling perspective. You have evaluating the biogenic theory of mood disorders, which is simply stated, the theory that chemical imbalances in the brain are the source of mood disorders.

I do a whole session on that subject in our year one training, and we go into that subject in some detail. But we're asking you to do a one-paragraph summary, evaluating the biogenic theory of mood disorders, the idea that chemical imbalances in the brain are the source of mood disorders.

I hope you have seen, for those of you who have taken year one with me, that I try to approach that subject from a balanced perspective, and that's available in our year one training. Then evaluating electroconvulsive therapy or ECT. There's a good work in the Journal of Biblical Counseling by Richard Hadley, and he writes of his own personal testimony of encountering severe depression and being treated with electroshock therapy.

Just a good perspective, I would encourage you to read that article. I think I put that in the Dropbox folder. Richard Hadley's work on electroshock therapy will be a help to you, and I hope it will help you put faces to the theories that we are evaluating, and realize that people are dealing with severe depression to the point where they are seeking therapies like this to alleviate their symptoms.

Just some helpful resources there to get you started on this subject. As you move to page 2 on your handout, I want to begin with some comments on 12-step recovery programs. As you look at your handout there, this is from Wikipedia. Good summary, 12-step programs are mutual aid organizations for the purpose of recovery from substance addictions, behavioral addictions, and compulsions developed in the 1930s.

The first 12-step program, Alcoholics Anonymous, AA, aided its membership to overcome alcoholism. Since Alcohol Anonymous has been used in our society, the 12-step approach has been applied to many different issues in life. Today, you have not only Alcoholics Anonymous, but you have Debtors Anonymous, Gamblers Anonymous, Narcotics Anonymous, Codependents Anonymous, Overeaters Anonymous, Shoplifters Anonymous, Smokers Anonymous, Spenders Anonymous, and Workaholics Anonymous, and the list goes on and on.

Basically, this 12-step approach was first applied to the issue of drunkenness or alcoholism, as the secular world would call it, and then has since been applied to many different addictions and compulsions in life. Now, many people mistakenly believe that the founders of Alcoholics Anonymous were Christians who established their organization on biblical principles.

Gary Gilley writes a good evaluation of Alcoholics Anonymous from a biblical counseling perspective. I've given you his link in our resources, and he basically writes that Bill Wilson was an alcoholic whose life had become unmanageable, and Wilson ran into an old drinking buddy by the name of Ebbie Thatcher.

As he worked through trying to move towards sobriety, he was alone in his room at the lowest point in his life, and Wilson finally cried out in desperation, "If there is a God, let him show himself. I'm ready to do anything." Gilley writes that the experience had a profound effect on Wilson.

From that point on, he believed in the existence of God, and he stopped drinking alcohol. However, at no time in his life, to our knowledge, did Bill Wilson place his faith in Jesus Christ for the forgiveness of sins. Rather than turning to the Bible to explain more about God, he turned to William James' book, The Varieties of Religious Experience.

James was a philosopher, psychologist, who was intrigued with mystical existential experiences. And so in the literature of Alcoholics Anonymous, you have the quote on your handout that Alcoholics Anonymous is a worldwide fellowship of men and women who help each other to stay sober. They offer the same help to anyone who has a drinking problem and wants to do something about it.

Since they are all alcoholics themselves, they have a special understanding of each other, they know what the illness feels like, and they have learned how to recover from it in AA. Now, for our purposes in this session, what I want to do is just briefly walk through the 12 steps of Alcoholics Anonymous and just do a simple critique of each statement.

I don't think that we have time to get into all of the implications of this, but I hope you will see that a brief application of biblical principles will show some of the shortcomings of Alcoholics Anonymous. And I say this also just making a balancing comment that I am a fan of sobriety versus drunkenness from a common grace perspective, but for our purposes here, I want to do a biblical evaluation of some of these statements.

Number one, the first step says, "We admitted that we were powerless over alcohol, that our lives had become unmanageable." Now, the question with step number one would be simply this, "Could you counsel a believer in Christ to say this and to make this as the believer's confession that I am powerless over alcohol?" Romans 6, verse 14 says that the believer is not a slave to sin, "For sin shall have no dominion over you, since you are not under law, but under grace." And so a believer cannot confess that he or she is powerless over alcohol or over some of the other things that 12 steps are applied to.

We have been freed from sin. We are not slaves to sin. And so we confess that Jesus Christ has delivered us from both the penalty and the power of sin. And so step one would be a problematic statement for a believer in Christ to confess. Number two, "Came to believe that a power greater than ourselves could restore us to sanity." On the surface, that may seem like a good statement, but when evaluated by scripture, we have to say it falls short.

Who is the power greater than ourselves? It is undefined in this 12-step program. Are we speaking of the true and the living God? Are we speaking of the triune God? God the Father, God the Son, God the Holy Spirit, who has revealed himself in the written word of God?

Or is this statement guiding us to confess a belief in a generic higher power? Step number three, "We made a decision to turn our will and our lives over to the care of God as we understood him." That last phrase deserves some careful critique. Do we have the right to come to a God as we have defined him or as we understand him?

Or do we need to accept God on his own terms as he has revealed himself in the scriptures? Psalm 19, verse 7 says, "The law of the Lord is perfect, reviving the soul. The testimony of the Lord is sure, making wise the simple." And so we want to come to God as he has defined and revealed himself in the written word of God.

I'll move a little quicker here, "Made a searching and fearless moral inventory of ourselves." The question here with step number four would be in light of what? What standard is the authoritative standard that measures our evaluation of ourselves? Well, biblically speaking, it's the law of God. Romans 3, verse 20, "For by the works of the law, no human being will be justified in his sight, since through the law comes the knowledge of sin." So making a searching and fearless moral inventory of yourself has to relate to a certain authoritative standard.

And the question would be, what is the standard? And that question is left unanswered in step number four. Number five, we admitted to God and ourselves and to another human being the exact nature of our wrongs. Again, the question would be, which God are we referring to? Are we referring to the triune God as revealed in the holy scriptures?

And you also see here an insufficient understanding of sin. I'll say more about that as we look at number six. We were entirely ready to have God remove all these defects of character. So where is the definition of sin? Psalm 51, verse four, David says, "Against you, you only have I sinned and done what is evil in your sight, so that you may be justified in your words." And so the language of defects of character needs to be evaluated in light of the biblical definition of sin.

Number seven, humbly asked him to remove our shortcomings. Are we speaking of a biblical confession of sin? What is the shortcomings that we are speaking of here in this statement? Are we talking about rebellion against God, transgression of his law? Are we talking about biblical confession that leads to repentance?

And so just looking at that statement from a biblical perspective, I believe shows some of the inadequacies of step number seven. Made a list of persons we had harmed and became willing to make amends to them all. That's good if it's evidence of true repentance, but there's little said about true repentance in the 12 steps.

May direct amends to such people wherever possible, except when to do so would injure them or others. Once again, that's good if evidence of true repentance. Continue to take personal inventory, and when we were wrong, promptly admitted it. Number 11, sought through prayer and meditation to improve our conscious contact with God as we understood him.

Praying only for knowledge of his will for us and the power to carry that out. So evaluate that in light of 1 Timothy 2, verse 5, which says, "There is one God and there is one mediator between God and men, the man Christ Jesus, who gave himself as a ransom for all, which is the testimony given at the proper time." So we're coming to God the Father through the work of God the Son, as we are empowered by the ministry of God the Spirit.

It appears in the 12-step program that you can improve your conscious contact with God apart from a mediator, apart from a savior. And then number 12, having had a spiritual awakening as to the result of these steps, we try to carry this message to alcoholics and to practice these principles in all our affairs.

So as we speak of spiritual awakening, are we talking about true conversion? Are we talking about being born again by the power of the Spirit? Jesus said in John 3, verse 5, "Truly I say to you, unless one is born of water and the Spirit, he cannot enter the kingdom of God." And so just evaluating the 12-step program, that was a brief run-through of the 12 steps.

You see that there really is a different view of God in the 12 steps. God is referred to as a higher power that you can understand on your own terms. There's a different view of sin. There is a different view of Christ. That's really important because Christ is necessary in order to come into the presence of God.

We cannot come into God's presence apart from a mediator who is the Son. Different view of salvation, a different view of change. I would say as a footnote, there's a different identity that is being proclaimed by the 12-step programs where in AA, you are called to confess, "I am an alcoholic.

I am one who is powerless over alcohol," where in Christ, the New Testament Christian needs to proclaim, "I am in Christ. My identity is defined by Christ. Christ is in me. The Spirit lives in me. And yes, I may have even very intense temptations to abuse substances, but my identity is not defined by the sins that I am tempted by.

My identity is defined by my relationship with Christ." So, there is a different identity system being proclaimed by Alcoholics Anonymous and then a view of hope. If you're an alcoholic, then you need to be in therapy and participate in AA meetings the rest of your life. The Bible says that the Christian is freed from the power of sin and will still deal with temptations to sin, but is no longer a slave to sin.

And so, our goal in biblical counseling and in biblical sanctification is different than the goal of the 12-step program. Our goal is not sobriety as the end point of our counseling. Our goal is Christlikeness. And if a person is becoming more like Christ, they will be more self-controlled in their relationship with substances.

We can do some more work on this. I would encourage you to grab some more material from the ACBC website on the subject of addictions. Ed Welch has a good book called Addictions. Just speaking of addictions from a biblical perspective, we see that addictions are really evidence of a worship disorder that is in the heart.

And so, a more biblical term for what we would call addictions from a secular perspective would be idolatry. And so, there's much more work that we could do on that. But just evaluate biblically the 12-step programs. I'll write a good paragraph on that just walking through some of the 12 steps.

You don't have to walk through all 12 of them, but do evaluate and biblically critique some of these statements in light of scripture. Let's move to cognitive behavioral therapy. Jonathan Goldberg is a secular therapist who defines CBT or cognitive behavioral therapy in this way. He writes, "With CBT, a clinician works with an individual to understand how automatic negative thoughts can contribute to emotional feelings, as well as physical feelings, and how the individual can engage in positive behaviors that help to manage these feelings.

Behaviors can be adaptive or maladaptive, meaning behaviors can lead to healthier levels of functioning or can lead to poorer levels of functioning." Now, what you see just in that brief statement that cognitive behavioral therapy focuses on three basic things. I think this would be just a summary. It focuses on thoughts and then the relationship of thoughts to emotions, the relationship of thoughts to behaviors.

So the entire presupposition of cognitive behavioral therapy is that the reason you behave the way you do is because you have thoughts about your life and about what is happening to you. Now, this particular secular approach is going to be a little more nuanced. You have to be a little more nuanced in how you critique this.

We would say that there are some similarities between cognitive behavioral therapy and biblical counseling. I'm going to be quick to add that there are also massive differences. But there are some things that you will see that perhaps cognitive behavioral therapy echoes some of the truths that we've been learning in our biblical counseling class.

We teach in biblical counseling that the source of your behavior are the thoughts and the intentions of your heart, that it's out of your heart, the flow, the issues of life. And one of the characteristics of the heart is that the heart is always thinking, the heart is always evaluating, the heart is always having a certain perspective, interpretation on the events of life.

It is what is going on in your heart affects your emotions and ultimately expresses itself in outward behavior. So, you are going to hear some of these themes find their way into cognitive behavioral therapy. And I do believe that this is one of the reasons why many in the church would hold to the idea of cognitive behavioral therapy being a useful approach in the church.

There are some themes there that are echoed from scripture in cognitive behavioral therapy. Now, I'm going to just make a note that there are massive differences, so we want to fairly critique this. But if you look at what the National Alliance on Mental Illness writes and how they summarize CBT, they say that cognitive behavioral therapy focuses on exploring relationships among a person's thoughts, feelings, and behaviors.

During CBT, a therapist will actively work with a person to uncover unhealthy patterns of thought and how they may be causing self-destructive behaviors and beliefs. By addressing these patterns, the person and therapist can work together to develop constructive ways of thinking that will produce healthier behaviors and beliefs. So, again, some similarities to the tenets of biblical counseling.

We teach in Proverbs 20, verse 5, that a purpose in a man's heart is like deep water, but a man of understanding will draw it out. When we're counseling others, we're seeking to draw out the thoughts and the desires of what's going on in their hearts that we may help our counselees replace ungodly thoughts with the truth of scripture and renew their mind according to the truth of God's Word.

David prayed in Psalm 139, verse 23, "Search me, O God, and know my heart; try me, and know my thoughts." And so, there are some similarities. We want to note, as Scott Mel observes, that CBT has become the go-to intervention for most mental disorders in the United States. So, this is a very popular approach to therapy and life change in the secular world.

Some notes here on the history of CBT, and I'll summarize much of this from Scott Mel's excellent article on cognitive behavioral therapy. He notes that CBT was birthed out of two separate forms of therapy—behavioral therapy under B.F. Skinner and cognitive therapy under Albert Ellis and Aaron Beck. Under behavioral therapy, man is a blank slate.

Environment determines a person's behavior. Changing the environment will change a person's behavior. You will remember from secular psychology, the whole experiment with Pavlov's dogs, that the dogs began to salivate when they associated a certain stimulus with feeding, even if they did not receive any food. So, the whole idea here is that man is like a dog in this way that external environment conditions his behavior.

And we did a critique of that in year one training, just showing how behavioral therapy does not account for the thoughts and intentions of the heart, which really drive human behavior. Cognitive therapy saw some of the shortcomings of behavioral therapy and sought to point the finger at the irrational thoughts and beliefs that a person is thinking that are the source of psychological problems.

Under cognitive therapy, the idea went like this, that changing thoughts and beliefs will change behavior. It's not just changing a person's environment that's necessary for life change, but you need to work with a person's thoughts and beliefs. Again, some echoes of biblical truth there. And so, when you put these two sources together, you end up with cognitive behavioral therapy seeking to combine these separate forms of therapy.

And this is a slide from a secular resource summarizing some of the tenets of CBT. There are thoughts, there are emotions, there are behavior, what we think affects how we act and feel, what we feel affects how we think and do, what we do affects how we think and feel.

So, it's not only work with a person's thoughts, but as you work with their behavior, their behavior will also affect their thought life. There are some similarities here to the tenets of biblical counseling, but what are the differences? As you work through your biblical counseling training and as you look at this approach to counseling and life change, what would you say are the differences between CBT and biblical counseling?

Well, there's one thing that is really missing in this whole approach to life change. Is this not? And what is that? The most important subject of all, where is God in the paradigm here? We not only teach that it is out of the heart, the flow of the issues of life, we not only teach that a person's thought life will show itself in certain emotions and behavior, but we also teach in the tenets of biblical counseling that a person's heart is always relating to the true and the living God, either rightly or wrongly.

And it is because a person's heart is relating to God that a person's thoughts are the way that they are, and that gives rise to either godly or ungodly behavior. So, what's missing in this whole construct is, where is God? And God is the most important subject in the Bible.

God is the most important subject in biblical counseling. And if you do all this work with thoughts, emotions, and behavior, but you leave out how those thoughts, emotions, and behavior are relating to the true and the living God, you have fallen short of helping a person move toward biblical sanctification.

So, a biblical evaluation here, there are some similarities to the concepts of biblical sanctification, the relationship between thoughts and behaviors. There is some similarity to the put-off-put-on concept in sanctification. One major shortfall of CBT is that it does not seek to replace a person's thinking with scripture. It simply seeks a person, to help a person replace negative thoughts with constructive thoughts.

But we are seeking to help people replace ungodly thoughts with true thoughts from scripture. It is scripture that is the source of life change. And then, number three, the goal of sanctification is not merely change behavior, but increasing conformity to the likeness of Christ. I love what David Powelson said here.

And by the way, David Powelson would be, I believe, he would set the gold standard on how to be discerning, how to evaluate secular theories with a spirit of grace and wisdom and compassion and yet biblical insight and holding fast to the sufficiency of scripture. I just think that David Powelson has become an example to me of how to disagree with others with the right perspective and the right tone.

And you always get a sense that he understood the other side's position well enough to articulate it in a way that was fair to them. And then on that basis, was able to critique it from a biblical perspective. And so I just commend his writings to you as an example of how to disagree and how to critique others.

But he does critique CBT in one of his journal articles, and he writes, "Perhaps the biggest difference is this. CBT seeks to change your self-talk. It's essentially self-referential, not relational. It's about changing how you talk to yourself. But I don't want you to spend so much time either talking to or listening to yourself.

My goals are essentially other, referential, and relational. I want to overthrow self-obsession. I want both of us to learn to listen to God and talk with God." So that is the critical piece that is missing in the CBT approach to life change. It's not just replacing negative thoughts with positive thoughts, it is helping a counselee relate to the true and the living God that produces life change.

So do some work on that, and hopefully that's a good primer for cognitive behavioral therapy. Let's move to the third secular approach, and this is the biogenic theory of mood disorders. As Heath Lambert writes, the biogenic theory of mood disorders, more commonly known as the theory of chemical imbalance.

This has to do with the debate about whether our mood disorders are due to imbalances of chemicals in our brain like dopamine and serotonin. So we did some work on this in year one. Elliot Valenstein is a secular therapist who writes of this perspective, and he actually does some critique of this perspective.

He says that the core of the biochemical theories of mental illness is the proposition that biochemical imbalances, excessive or inadequate activity of one or more brain neurotransmitters, cause mental illness, and that drug treatment works because it corrects this underlying imbalance. And as one resource defines, the biogenic amine hypothesis of depression postulates that depression is due to a reduced functional activity of one or more brain amines.

And so you have this theory that there are imbalances in the brain, imbalances in serotonin or norepinephrine. And because these imbalances exist in the brain, that there are mood disorders that our counselees are dealing with. And so a whole host of psychotropic drugs are given in order to correct this imbalance.

You have antidepressants, mood stabilizers, anti-obsessionals, psychostimulants, antipsychotics, anti-anxiety medications. We did a critique of this in year one, which basically says that when you go to a therapist, they will not do a lab test of the chemical imbalances in your brain. There is no lab test to measure those chemical imbalances, but they will ask what is going on in your life and what are your behaviors and what are your symptoms?

And then measure those symptoms up against some of the standards in the DSM-5. And on the basis of that, a diagnosis will be made of a mood disorder. And then it's theorized that the cause of the mood disorder is a chemical imbalance in the brain. And medication is then prescribed in order to correct this seeming imbalance.

Now, I think I've tried to strike a balanced perspective on medications in year one. We are not anti-medications in the biblical counseling movement. We don't believe it's a sin to take medications, psychotropic drugs. There is no Bible verse that says in scripture, "Thou shalt not take psychotropic drugs." We have the perspective that medication may be a common grace measure that helps a counselee temporarily achieve some kind of stability.

But we do have concerns about the way medication is prescribed and the overuse of medications in addressing people's mood disorders. We're not doctors. We don't put people on medication. We don't take people off medication. But we do have a biblical perspective that man is both material and immaterial. The chemical imbalance theory remains just that, a theory.

Science has not proven that these imbalances can be measured by a verifiable lab test. And so it's a theory. I take the kind of moderate position that I'm sort of a skeptical agnostic on the issue of chemical imbalances. I don't really take a hard stance one way or the other, but I would just say that it's a theory.

And that until these chemicals are measured by verifiable lab tests, then it will remain just that. As a biblical counselor, I don't feel like I need to argue the point. My job is to minister the scripture to a person's heart. I'm not a physician who treats the body. I am a counselor who treats the soul.

And yet it is helpful to look at this theory of chemical imbalances with some discernment. Levels of neurotransmitters cannot be measured in neural synapses. Therefore, imbalanced chemicals in the brain remains a theory. We have no blood tests or scans to show us that a specific brain chemical is out of balance.

And that the imbalance of this specific brain chemical is then connected to psychological symptoms. In contrast to a medical diagnosis, a psychological diagnosis will be made on the basis of a person's thinking, feeling, and behavior, not on physical tests such as blood work, x-rays, bone scans, CT scans, or MRI scans.

We believe that man is both material and immaterial. So even if the theory of chemical imbalances were one day to be proven by a verifiable scientific test, our task in biblical counseling would remain unchanged. Our goal would still be to minister the word of God to a person's heart so that their soul would grow in relationship with God, and then to deal with the physical limitation of a chemical imbalance as a physical weakness that is the context for God doing a work of sanctification in a person's life.

And so as my professor Robert Jones has written, if research consensus does emerge, that chemical imbalances would be proven one day. The task of the Christian and the pastors and counselors who help the Christian will involve learning to follow Jesus in the midst of their now demonstrable medical problem.

At that point, however, a physician would not label the problem as a chemical imbalance or depression, but as an actual demonstrable disease name such as hypothyroidism. A good place to start as you evaluate this secular approach to life change is the ACBC Statement on Mental Illness and Medicine, which is found at the ACBC website, biblicalcounseling.com.

It says on that statement, "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." The difference between the medical model of life change and the biblical counseling approach to life change is we believe that man is not merely physical.

Man is physical and he is spiritual. Man has a body and a soul. And so it is theorized that these chemical imbalances cause mood disorders. We are interested in applying the Word of God to the immaterial part of man, the heart or the soul, and we believe that even if the chemical imbalance theory were to be proven, it would not eliminate the need for biblical counseling.

Jones writes this, "I encourage my counselees to be educated and seek the facts. They or their spouses or family members should ask direct questions since many patients act timidly around their doctors. I plead with physicians to be honest and forthcoming . . . answering no, none, and I don't know from physicians are acceptable and to be expected in these situations.

Such answers do not indicate incompetence or mean that one should not proceed with discussing medication. Along the same lines, my task as a pastor or counselor is not to play doctor by recommending that a person begin, taper down, or discontinue his use of medications. To even suggest that a counselee should consider, start, increase, reduce, or stop a medication oversteps his bounds.

Referring the counselee to his prescribing physician is always the wisest course." So we do a much fuller treatment of this in an entire hour of study in our year one training, and also there's a lot of good material on the ACBC website dealing with the issue of psychotropic drugs.

And I just encourage you to think through this in a balanced way. And we read Charles Hodge's book, Good Mood, Bad Mood, and just some of the concerns that we would have as biblical counselors that people are too quickly maybe placed on medications and then a second and third medication to counteract the side effects of the first medication.

There are concerns about that approach, and we believe that we are able to help the counselee using the word of God, addressing the issues of life, and bring that soul into greater fellowship with God. So just an overview of the biogenic theory of mood disorder. Lastly, fourth secular approach is electroconvulsive therapy or ECT.

With ECT, this is from the WebMD resource, "Electrodes are placed on the patient's scalp and a finely controlled electric current is applied while the patient is under general anesthesia. The current causes a brief seizure in the brain. ECT is one of the fastest ways to relieve symptoms in severely depressed or suicidal patients.

Conditions that are treated by ECT is severe depression, particularly when accompanied by detachment from reality, a desire to commit suicide, refusal to eat, treatment-resistant depression or severe depression that doesn't improve with medications or other treatments, severe mania, a state of intense euphoria, agitation, or hyperactivity that occurs as a part of bipolar disorder.

Other signs of mania include impaired decision-making, impulsive or risky behavior, substance abuse, and psychosis. Catatonia, characterized by lack of movement, fast or strange movements, lack of speech, or other symptoms, it's associated with schizophrenia and certain other psychiatric disorders. In some cases, catatonia is caused by medical illness and agitation and aggression in people with dementia, which can be difficult to treat and negatively affect quality of life." Just some biblical considerations here.

"The body is a temple of the Holy Spirit. Therefore, great care should be taken when considering this treatment." 1 Corinthians 6 verse 19, "Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own, for you were bought with a price." Number two, "The exact mechanism of ECT's effects on the brain is not understood.

The treatment should be handled with a great deal of prudence." And we do want to note that biblical counseling can help with depression. One of the things that the use of ECT will remind reminds me, and I would encourage you to read Richard Hadley's journal article on how, as a new believer, he struggled with intense depression and actually received electroconvulsive therapy.

And it just reminds me that there are people who are experiencing such severe depression that they are willing to go to great lengths in order to relieve that depression, even in a therapy like this, when the exact mechanism is not fully understood. And so allow the study of this treatment to motivate you to help people with depression, and may your church be a hospital for the weak and for those who are struggling.

Well, those are four secular therapies, approaches to life change that we want to biblically evaluate and think through. I know that this has been a lot of material packed into an hour, but I do hope you will do your own study on this subject and be discerning as to how to evaluate these theories.

And also be aware that there's a lot of good material coming out on the ACBC website, the ACBC podcast, just biblically evaluating some of the theories that are out there. I think one of the dangers is that we uncritically import these secular theories into the church and then add some Bible verses to them in order to make them look Christian.

But at the core, there really is a secular approach to life change. And I hope this essay topic will equip you to be discerning and both hold to what is good and to reject what is false. So thank you so much for joining us tonight. It's been a joy to walk through some of these material with you.

I do want to let you know that next Sunday I will be speaking at a retreat next week. And so you can pray for me as I minister God's word next week. So there will be no class next Sunday evening, but we will resume class on Sunday, May 2nd at five o'clock Pacific time.

And I hope to see you there. Let me pray for us and we'll close our time together. Father, thank you for the truth that you have given us your word. And we just pray that you would help us to be faithful and help us to minister to souls, clinging to the sufficiency of your word.

Help us to think through these issues in a biblical and a balanced way and give us much wisdom that we may be approved unto you as workmen who do not need to be ashamed, handling accurately the word of truth. And we commit this time to you in Jesus name, amen.