Biblical Principles for Counseling Individuals with Medical Issues

Biblical counselors and pastors often have questions when a counselee is struggling with a mixture of physical, emotional, and spiritual difficulties. A new version of a popular resource is now available to equip those who counsel people dealing with a variety of medical and psychiatric diagnoses. In The Christian Counselor’s Medical Desk Reference, 2nd Edition, Dr. Charles D. Hodges Jr. and a team of contributing physicians and health care professionals, all with biblical counseling experience, offer solid biblical principles for counseling individuals with medical issues, addressing a variety of specific problems.

In the following interview, we talk to Dr. Hodges about the new edition.

Q: Can you give us a background of how the first edition of The Christian Counselor’s Medical Desk Reference came to be and what you hope this second edition will also provide to counselors? 

The first edition of The Christian Counselor’s Medical Desk Reference, compiled by Dr. Robert Smith,was published in 2004. It was an invaluable resource that melded both his medical knowledge and biblical counseling experience.  I have heard many say that the first edition encouraged them to believe that the Word of God had much to offer individuals who were struggling in life with both spiritual and medical issues. Doc helped us see that just because a problem is listed in the DSM (Diagnostic and Statistical Manual of Mental Disorders), it does not mean that the Scriptures cannot help. It was his intent to give the reader an understanding of a number of medical issues that would enable them to respond in a helpful way as they counseled. He also intended to dispel the intimidation that biblical counselors often felt when a disease diagnosis was explained as the cause of a counselee’s thoughts, emotions, and behavior.

Twenty years later, Doc asked me to see to it that the book would be revised. What the contributors and I set out to do was offer principles of Scripture and an understanding of medical issues that would enable the counselor to offer real help and hope to individuals who face any of the medical problems addressed in the book. The first two chapters also give a framework to the counselor as they consider counseling any person who is struggling physically and spiritually.

Q: How should counselors use The Christian Counselor’s Medical Desk Reference? How should the book not be used?

The Christian Counselor’s Medical Desk Reference will not make any counselor into a physician or a diagnostician. What we hope it will do is give the reader a resource that can explain the twenty different diagnoses found in the book and give them an understanding of what medicine thinks about these problems today. We also planned each chapter so that a biblical counseling response is outlined by a medical professional who also does counseling.

Q: What are some of the questions a counselor should try to get answers to when determining whether or not a struggle has a physiological factor involved?

Some basic questions would include, What exactly was the diagnosis? It is very important when dealing with problems such as bipolar disorder, which has a spectrum of manifestations. Dealing with BPD1 can be very different from BPD2, so what did the doctor say you had? How was the diagnosis made? Were there lab tests, x-rays, and a physical exam, or was the diagnosis made with a rating scale such as the PHQ9 for depression? What were the thoughts, behaviors, and emotions that resulted in the diagnosis?

I do not engage in debates with patients about whether or not their disease is real or not. It is important to understand what they believe they have, but then to focus on the thoughts, actions, and emotions that constitute their struggle and discuss those from a biblical viewpoint.

The Christian Counselor’s Medical Desk Reference is a valuable asset when a counselor wants to get an understanding of how much any of the selected diagnoses impact the behavior of a counselee.

Q: How did you select the conditions to include in this edition of the book? What are some of the medical and mental conditions that are covered?

As a physician for 48 years and a biblical counselor for the last 30 or so, I tried to pick the problems that I encounter most in counseling and in the office. I also tried to include diagnoses that have been recent the focus of medicine and counseling, even if I was not involved with treating them. As I considered the subjects that we might put in this second edition, I chose subjects that were uniquely medical. The list includes medical problems that are often the reason people came to our counseling center for help.

We have a chapter on generally counseling those with medical illness, and then we cover depression, anxiety, ADHD,  and Autism Spectrum Disorder. There are chapters on alternative medicine, obsessive-compulsive disorder, schizophrenia, bipolar disorder, Post-Traumatic Stress Disorder, premenstrual syndrome, postpartum depression, suicide, the use of marijuana and CBD, dementia, sleep disorders, and autoimmune disorders. There are also two chapters that discuss common psychiatric medications used today, one chapter written by the former chair of pharmacology at Purdue University and another by a former psychiatric nurse.

Q: Tell us more about the team of writers who contributed to the book.  

As the list of topics came together, one thing became obvious: it would take more than one medical writer with a biblical counseling background to cover all the subjects. Thankfully, there were a number of medical professionals who agreed to help with this project. The group consists of ten physicians, two nurses, a pharmacist, and a social worker. All of them have a part in the biblical counseling movement.

Q: Individuals are often identified by their labels or diagnoses. Can you share a few good reminders for making sure we see counselees as individuals who are struggling and suffering with their thoughts, emotions, and behaviors?

When I set out to write and edit this book and recruit others to write, I set down the pattern that I hoped would govern the way the chapters would be written. I borrowed the pattern from a friend, Amy Baker, who was the editor of the excellent book, Caring for the Souls of Children. She told us that as you write, see the individual as a sufferer first and a sinner second. I gave the same instruction to contributors to The Christian Counselor’s Medical Desk Reference. I think of James 2:12–13 (NIV): “Speak and act as those who have been judged by the law that gives freedom, because judgment without mercy will be shown to anyone who has not been merciful. Mercy triumphs over judgment.” Keep in mind where you came from as you see where others are. I think that softens the tone of counseling and writing.

Of all the things I tell students as I teach counseling, one of the more important is to not counsel labels. When individuals come to counseling with a label such as obsessive-compulsive, bipolar, or post-traumatic stress disorder, make a note of it, get to work looking at the thoughts, behavior, and emotional fallout that come from it, and then apply Scripture to the problems.

Q: Anxiety and depression are common conditions that people seek medical treatment, counseling, or both to address. Are both counseling and medical treatment necessary in all cases? Is medication always effective?

The key to answering this question lies in getting a good definition for anxiety and depression. Both are blurred by our current societal definition.

It is likely that 90% of individuals diagnosed with depression in the US today are struggling with normal sadness over loss, grieving the loss of important things. That leaves 10% who may have medical diseases that come with a sad mood and those who struggle with sadness for no discernable reason.

Biblical counseling applies to all of it.

Medicine has limited benefit for those who are sad over loss, but it may have some benefit for those with medical ailments and those with disordered sadness. Current thinking in both secular and biblical counseling is that the significant majority of individuals will do just as well in counseling as those who take medication in the short run, and in the long run, they most often do better in counseling.

Q: How can biblical counseling be helpful for children with diagnoses such as ADHD or even Autism Spectrum Disorder (ASD)?

Recently there was an article published that described a process by which individuals with ADHD could learn to drive in a way that reduced accidents. Indeed, they could learn to pay attention.

Biblical counseling offers the parent a framework for training their child and educating them. It is most important that we adapt the educational setting to the child’s unique learning abilities and challenges. Helping that child learn to pay attention in settings that are not as stimulating as Minecraft is a gift that will serve him or her for a lifetime.

The chapter written on Autism Spectrum Disorder is excellent. I think biblical counseling is useful for parents as they seek the child’s best interest. It is important for them to see that their child may have important gifts in a narrow range. It is important to help the parent find the ability range of the child and then work within it.

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The Christian counselor’s Medical Desk reference

The Christian Counselor’s Medical Desk Reference 2nd Edition helps counselors understand how some medical conditions impact counseling needs. Dr. Charles Hodges Jr. and a team of contributing physicians, health care professionals, and biblical counselors answer questions and offer solid biblical principles about counseling individuals with medical issues and address a variety of specific problems.


About the author

Charles Hodges

Charles Hodges, MD, is a family physician. He is a graduate of Indiana School of Medicine and also received an MA in Counseling and MA in Religion from Liberty University. He is the executive director of Vision of Hope, a counselor and instructor at Faith Biblical Counseling Ministry, and a fellow for the Association of Certified Biblical Counselors (ACBC). He is the author of Good Mood, Bad Mood: Hope for Depression and Bipolar Disorder, a contributing author of Caring for the Souls of Children, and editor of The Christian Counselor’s Medical Desk Reference, 2nd Edition.

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