Cognitive Biblical
Therapy Certification Program
Counseling Through God’s
Transformative Word
Welcome to Course 1
Chapter 1 Topics:
a. Introduction to CBT Courses
b. Setting the tone in the Initial Session
c. Types for Christian Counseling
d. Explaining Cognitive Biblical Therapy
e. Connecting to the Client’s Issues
f. Observing the Client’s Body Language
g. Assessing the Client’s Spiritual Knowledge
h. Ending the Initial Session
i. Defining Doctrinal Concepts
j. Drawing the Client into Counseling
Important Note: Answering the section questions is a great way to prepare for the end of the chapter quiz.
Quiz Requirement: A score of 75% is necessary to continue to the next chapter.
Be ready: You may find the chapter questions and quizzes difficult to get a perfect or passing grade. Do not fret, grace abounds to review and learn from Dr. Wilkinson’s answers!
Account Access: You must be signed into the coursework page (which is separate from the main CBT website) to take the quiz and advance.
Course 1 Chapter 1
Introduction to the Methodology
of Cognitive Biblical Therapy (CBT)
Introduction to CBT Courses
This is an introduction to Cognitive Biblical Therapy. This is the very first course. In this course the basic attempt is to help you go through an initial session. For some of you who take this course, this is going to be very elementary, because you are either in counseling or you are in some practicum at a university or college. But the basic idea here is simply to start you from an initial session: how do you seat them, how do you greet people, what kind of things do you talk about, how do you make them comfortable in understanding the basics of Cognitive Biblical Therapy. I’ll discuss with you the questionnaire, how it’s scored, what the Word Studies of the Biblical Norms are about, how you present this basic thought or idea to the client, so that he or she can understand your counseling process and have peace with that. Also, how to present yourself in such a way, both as a person and spiritually, that you provide a sense of credibility, compassion, tenderness, and empathy. So, it will be a broad brush at this point.
Now a quick overview of the other courses: the second course will go more deeply into the methodology itself; the third course will be an analysis and an application of the actual methodology both in understanding the questions and the Biblical concepts behind them. I want you to think about the fourth course as a library: a catalog of “How to Use It” for various presenting issues such as marital counseling, sexual or physical abuse, anorexia or bulimia. It’s going to be just a listing of the types of cases that you would deal with normally, and ways to analyze the results of the questionnaire. Also included are the application of the method to the presenting issue, types of things to look for, ways people typically react, and how to work with them in treatment. That’s the fourth course.
The fifth course will be a practicum. That’s going to vary by your individual circumstance. The idea of the practicum is to make sure that you get supervised actual client experience. When possible, someone will actually observe counseling, will be observed, and some of you are dealing with state licensure so that will be part of the two-year supervision. It is the attempt to give you that hands-on experience of using CBT with clients. The sixth course is optional and is useful to those who need directions for setting up a counseling practice in a church, private practice or in a clinic. It will explain practical basic things like working with church leadership, elected officials, or clinic managers. Details such as setting up a contract, deciding about buying furniture or decorating office space, access to phone use, secretarial support, making copies, hours for using the space, privacy for clients, all the basics. These are the types of things that you need to know in order to negotiate with an organization, a church, or clinic to establish a private practice.
Chapter one is your very first in the five-course certification program, the Introduction to Cognitive Biblical Therapy. This material is presented through these written text and audio files (where possible). In each Course questions are provided in the chapter sections, along with my answers as a response to help you review and prepare for the end of the chapter quiz. The quiz requires you to obtain a 75% passing score in order to move on to the next chapter. A Cognitive Biblical Therapy Certificate will be provided for all who complete their level of training, as a licensed counselor, pastor, graduate level student or lay counselor/ministry leader.
I have outlined the course and written a question for each major section of discussion. Your answers to these questions will help you gauge your learning as you proceed through the course chapters. You may wish to use the Note Taking Pad located on the right side at the top of this page. This first course is not excessively long; each one gets progressively longer. Each course will follow this format of periodic questions as you move through the written text.
Setting the Tone for the Initial Session
The initial session needs to have a foundation of specific elements for the following counseling sessions to build upon. The first element in the initial contact is setting the tone that you have with the client. You need to be relatively relaxed, because the client will have a number of things on his or her mind. He may have just fought with someone or may have been forced by someone to show up. You have to be calm, friendly, and caring. Be human rather than power-exuding, but balance that with confidence that you can help them.
You also need the proper setting for your office; your degrees and license should be on the wall appropriately displayed. Your attire should be business casual to look professional. You establish authority through your office and by your presence. Clients will be assessing your capabilities quickly by your appearance (hair combed and clothes clean). You also want to create a relaxed, comfortable setting such as pointing out the restroom, coat rack, refreshments, etc. The seating should be comfortable, and the wall colors should be soft, muted tones rather than bright or dark.
The proper introductions will establish your credibility and that you are representing God. There needs to be within your own personal life the presence of Jesus so that there is something real and valid that you will show them in your counsel. From reading survey studies on Christian habits, the majority of Christians read their Bible twice a month and pray maybe two or three times a month. They are not sure what this “born again” thing means. They don’t know what a Bible concordance is. Their background of faith is shallow. So, when you introduce yourself, share how you came to know and trust Christ, talk about your schooling, your degrees, how long you have been in practice, and the various presenting problems you have dealt with.
You need to be prepared to introduce yourself to the client. What do you as a counselor want to be like? How do you want to present yourself? How open you want to be, and how vulnerable do you want to be? If some of you have taken courses in secular settings, they talk a lot about setting a boundary between you and your client, such as not socializing with clients or becoming friends. In some cases, clients may know you outside of your practice by belonging to your church. You may share similar interests or hobbies. You have to decide how much you share about yourself, because those types of things make you real, human and approachable.
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Briefly describe four important and foundational elements in setting the tone for the initial session.
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Dr. Dan's Answer:
1. The counselor's demeanor and tone. The counselor should be relaxed, calm, friendly, and caring, because the client may arrive upset, angry, or even forced to come. The counselor should come across as human and approachable rather than power-exuding, balanced with a quiet confidence that he or she can help.
2. A proper, professional, and comfortable setting. Degrees and licenses should be displayed, and attire should be business casual and neat, since clients quickly judge capability by appearance. The office should feel welcoming, with comfortable seating, soft muted wall colors, and small courtesies such as pointing out the restroom, coat rack, and refreshments. Authority is established through both the office and the counselor's presence.
3. Proper introductions that establish credibility and show that the counselor represents God. The counselor shares how he or she came to know and trust Christ, along with schooling, degrees, years in practice, and the kinds of presenting problems he or she has worked with. Because many Christians have a shallow faith background, the counselor's own genuine walk with Jesus must be real and visible so there is something valid to offer in counsel.
4. A deliberate decision about personal openness and boundaries. The counselor should decide ahead of time how open and vulnerable to be and how much personal information to share. Appropriate self-disclosure makes the counselor real, human, and approachable, while boundaries still have to be managed -- especially when the client knows the counselor from church or shared interests.
Methods of Counseling
You have to decide in this introductory course if you want to counsel from scripture or other therapies. Many Christian counselors don’t use scripture, but secular or humanistic therapies such as: Client-centered Therapy, Existentialism, Rational-Emotive or Reality Therapy. Those are all therapies that not only don’t include God, but blatantly ignore Him. The premise underneath these therapies is that power or the ability to heal or change, comes not from an external source but from within yourself. They believe that humans have the power to control life, heal themselves, and make choices that resolve the presenting problems. The second type of Christian counseling is using both therapies and the scriptures, blending them together and is called Integration.
The third type of Christian counseling that exists is pure Biblical counseling. One of the leaders in this field of Biblical counseling is Jay Adams. He calls his type of counseling Nouthetic Counseling and asserts that the presenting problem results from sin. Therefore, the remedy is the confrontation of the person with the problem (sin), so that they can repent to the Lord, find scripture for understanding, and pray for forgiveness and healing. Often people have tried this on their own and have not been successful, because healing requires a timely process rather than an instantaneous change.
Cognitive Biblical Therapy (CBT) provides a five-step process that provides guided change over time (sanctification). Through CBT more facets of the problem are investigated beyond just the sin, such as one’s belief system, concepts of God, coping mechanisms, and personality type. So those are the three types of counseling: totally secular, the combination or blended, and purely Biblical.
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Name and briefly describe how CBT differs from each of the other types of counseling.
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Dr. Dan's Answer:
Secular (humanistic) therapies -- such as Client-centered Therapy, Existentialism, Rational-Emotive Therapy, and Reality Therapy -- do not include God, ignoring divine creation, sinful nature, and the need for a Savior. Their premise is that the power to heal and change comes from within the person. CBT differs because it rests entirely on Scripture and teaches that healing and change come from God through a relationship with Him by the Holy Spirit, not from human self-sufficiency.
Integration blends secular therapies with Scripture, where the counselor picks which humanistic principles to use alongside Scripture. CBT differs because it is not a blend. Its process is drawn from Scripture (Proverbs, Corinthians, Timothy, James, John, and Thessalonians) and from diagnostic Word Studies of Agape love, with no secular therapy mixed in.
Pure Biblical (Nouthetic) counseling, led by Jay Adams, treats the presenting problem as the result of sin. Its remedy is to confront the person with the sin so they repent, find Scripture for understanding, and pray for forgiveness and healing. Yet many Biblical counselors do not use a Biblical assessment, treatment method, or transformative process that can lead into behavior modification. CBT shares the Biblical foundation but differs in two ways: it provides a five-step process of guided change over time (sanctification), and it looks at more facets of the problem than sin alone -- including the person's belief system, concept of God, coping mechanisms, and personality type.
Explaining Cognitive Biblical Therapy
There are four basic elements of CBT: 1) CBT provides a process for Biblical Counseling, 2) CBT process is based on scripture from Proverbs, Corinthians, Timothy, James, John, and Thessalonians, 3) The elements do not come from any secular therapy, and 4) Word Studies were used to develop the concepts of Agape Love. I developed CBT during my doctoral studies in Christian Counseling and have applied it in my counseling practice over the last five years before developing these courses.
When you have an initial session, you will explain CBT in a brief time frame so that the client understands how this differs from other types of counseling. You want to assure them that they don’t need to learn it all at once, but will develop understanding over time. Share how others have been helped through problems in the past. Some people have been to a lot of counselors, and others have never experienced counseling. Assessing the client’s background will help understand their current relationship with God. Don’t be afraid, or hesitant. You’ll be amazed at how open people are to share about God. Some people think that a CBT won’t work with non-Christians. That’s the furthest thing from the truth. It will work with anybody, because everybody you see has an eternal soul, has a spiritual sensitivity to God, and can be reached by God.
There are times when I have made referrals to other health professionals for such things as physical illness. In one case, a client had Alzheimer’s Disease and Lou Gehrig’s Disease rather than a spiritual or relational issue. In some cases, there will be psychiatric referrals for chemical imbalances. If there is a medical problem, the client needs medication, so that their ability to think and reason is either restored or enhanced. Sometimes clients have been in an extremely stressful situation for numbers of years, and they have lost the ability to reason or understand. Once that is corrected, people may need relationship counseling.
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Why is it important that the client understand CBT as a different type of counseling in the initial session of the counseling process?
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Dr. Dan's Answer:
Many clients have already been to other counselors, and others have never been to counseling at all. Explaining briefly how CBT is different helps the client understand what will happen and have peace with the process from the start. It sets expectations: this counseling is based on Scripture rather than secular theory, it is a structured process rather than a single confrontation, and the client does not have to understand everything at once but will grow in understanding over time.
It also builds trust and hope. When the counselor explains that CBT is built on Scripture, developed through doctoral study, and applied in practice -- and shares how others have been helped -- the client has reason to believe that this approach can work where other attempts may have failed. Being clear from the beginning that God and the Bible are central keeps the client from being surprised later and lets the counselor gauge the client's current relationship with God.
Finally, the counselor is honest about what CBT is and is not. When the problem is medical -- such as a chemical imbalance or a physical illness -- the counselor refers the client to other professionals. Once that is treated and the client's ability to think and reason is restored, relational and spiritual counseling can be effective.
Steps in the CBT Process
The CBT method begins with a questionnaire that measures their understanding of God’s love based on the attributes listed in I Corinthians 13:4-8. Their answers to the 75 questions are analyzed through a specific scoring pattern. That analysis provides information that guides your counseling path. The goal is that the person will have a deepened relationship with God so that they can function practically, and solve emotional issues with God’s help and the skills they learn. Some have no relationship with God and will need to learn and understand the plan of salvation which is part of the counseling. But the key element you should remember is that CBT is God’s plan from the Scripture by which people come into a practical, functional, rational, thinking relationship with God through the Holy Spirit.
For example, in John 14 Jesus said he wouldn’t leave us alone as orphans, because the Father would send another. What this means is that through the Holy Spirit each person can have a personal, ongoing, viable, daily, relationship that enables you to function, think, find answers, face problems, deal with your boss, raise your kids, and have a good marriage. That’s the major difference here. I know of no other therapies that are focused on a process and Scripture in this practically applied way through assessment and diagnostic norms for Agape love. The restorative nature of God’s love that provides spiritual truth as the replacement for their conditional love distortions and transformation of the heart goes miles beyond behavioral and cognitive modification. The unique style of applying Scripture and its principles to daily problems at work, with family and tenuous situation draws the client to a deeper understanding and reliance on God and His Word. These are important elements to explain to the client in the initial session that helps the client make an informed decision to step into the Cognitive Biblical Therapy (CBT) process.
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Briefly explain how the CBT process moves the client to the end goal of restoration.
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Dr. Dan's Answer:
CBT begins with a 75-question questionnaire that measures the client's understanding of God's love based on the attributes of love in 1 Corinthians 13:4-8. The answers are analyzed with a specific scoring pattern, and that analysis guides the counseling path. It shows where the client's understanding of love and of God is distorted.
For all clients, the aim is a deepened, practical, functional, rational, thinking relationship with God through the Holy Spirit. As Jesus promised in John 14, He does not leave us as orphans. The Holy Spirit gives each person an ongoing, daily relationship that enables them to think clearly, find answers, face problems, work with a boss, raise children, and have a good marriage.
Restoration comes as the client replaces false beliefs with God's truth, learns new skills, and depends on God's help to solve emotional and relational problems. The client can understand and make an informed decision about committing to the CBT process.
Connecting to the Client’s Issue
Providing your background will help the client feel more comfortable with you. This is a great time to give them a brief statement of your relationship to God. I caution you here: there have been times when I said too much. The people were gracious to me; they listened to me talk about my background, about my involvement in drugs and alcohol and all these kinds of things, but they really had more on their minds! What they really wanted to tell me was why they were there. Learn from me and talk about your salvation, a major turning point, your commitment to God, and your submission of your will. Share examples of how God has been faithful to you, restored you, protected you. Your personal story, examples related to your relationship with Jesus, including your dependence upon the leading of the Holy Spirit lends a spiritual authenticity. Be sensitive to watch their faces and look for their emotional state so that you can regulate your talk using the feedback from them.
They may think you’re insane because you’re talking about this God stuff. Be careful not to take advantage of them, be insensitive, or say too much. Encourage them to ask you questions. They may want to share their own faith walk. Establish that you are a Christian, and also that you are real. That counseling is an important, critical part of your life that you are committed to fully. Explain how long you have counseled, how you have helped people before counseling. What types of presenting problems you have worked with. Describing your professional experiences gives them a sense of confidence in you, can begin to build relational trust and enables them to relax and be more comfortable.
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What element of credibility does sharing your personal story establish within the minds of the client in regard to the counselor and the method of CBT?
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Dr. Dan's Answer:
Sharing the counselor's background establishes a twofold credibility: that the counselor is both a genuine Christian and a real, competent professional.
Spiritual authenticity. When the counselor briefly shares his or her salvation, a major turning point, commitment and submission to God, and examples of God's faithfulness, restoration, and protection, the client sees that the counselor has personally experienced what he or she is offering. The method is not just theory -- it has worked in the counselor's own life.
Professional confidence. Explaining how long he or she has counseled, the kinds of presenting problems worked with, and a real commitment to counseling gives the client confidence that the counselor is capable and experienced. This lets the client relax and feel more comfortable.
Together, this builds trust in both the counselor and CBT: the client can believe that God has worked through this person and this method before and can do so again. The counselor must stay sensitive to the client's face and emotional state so that the sharing builds credibility without becoming too much or pulling attention away from the client.
There needs to be a shift from the explanation of CBT and the background of the counselor to learning the reasons the clients are seeking counseling. The best way to find the issues is just say, “I need to understand you, so would one or both of you begin and tell me what your concerns are.” Don’t use words like problems, difficulties, or trouble, because you are trying to be as soft, gentle, and tender as possible. They are already traumatized. In other words, things are already difficult, so laying a label on their difficulty at the front end can create more emotion than they need. Explain that you may break into their comments, at times for clarity and insight.
Ask them if you can take notes so that you don’t miss anything. Some of the things you’ll need clarity about will be things like how many times you have been married, or what they mean by fighting. Be straightforward: do you mean that you hit each other, do you throw objects at each other, do you curse each other, do you do this in front of the children? If they say, we don’t get along, ask them what not getting along means to them: does it mean you fight every day, does it mean you sleep on the couch all the time, does it mean you haven’t been sexual for six months? People use vague generalities and that won’t help you a bit. As the counselor, you have to get definite, concrete actions and attitudes and situations and problems or else you’ll be lost. Make sure that you get into the clarity and depths of this.
Help them to understand that there’s a domino effect, sort of a rock and ripple situation. If they have a basic problem, there is a pretty sure thing that it will be affecting others: a number of things are happening that are causing the problems. Since these are all tied together, and if there is a spiritual problem in your life, things you’ve described are actually symptoms or ripples, like those that result from a rock thrown in a pond. Through the counseling process, we will work together to find out what the “rock” is that causes the ripples.
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Explain the three main reasons for the conversation to shift from the foundational elements of CBT and the counselor's background to listening to the client's explanation of the presenting problem.
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Dr. Dan's Answer:
1. The client came to be heard. Clients have much on their minds, and what they really want is to tell the counselor why they are there. When the counselor says too much about his or her own background, clients listen graciously but they are waiting to share their own concerns. The shift keeps the focus on the client and shows care and sensitivity.
2. The counselor must gain a clear, concrete understanding of the problem. People speak in vague generalities such as "we fight" or "we don't get along," which will not help the counselor. By inviting the client to share ("I need to understand you...") and then asking direct, clarifying questions and taking notes with permission, the counselor gets definite actions, attitudes, and situations.
3. The counselor must begin to find the root cause behind the symptoms. The issues the client describes are usually connected in a domino, or "rock and ripple," effect. What the client describes are often ripples caused by an underlying "rock" -- frequently a spiritual problem. Listening carefully lets the counselor help the client see that the symptoms are tied together, and that together they will work to find the rock that is causing the ripples.
Observing the Client’s Body Language
You can learn a great deal about the person just by watching his face, how he sits in the chair, listening to his tone of voice, and looking at the condition of his clothing. Five basic elements that are involved within observing the client's body language are: 1) facial expression, 2) body posture, 3) condition of the clothing, 4) the tone of the voice, and 5) his body positioning used toward you or toward the person with him. And by body positioning I mean things like turning a shoulder away from the person, or being very rigid, straight and upright in his chair or being very relaxed and perhaps laid back, and eye contact.
Things about facial expression will be simple things like are they crying, a lot of people cry as they talk about troubles. There are also phony criers. You hear the sobs, but you don’t see the tears. You can pretty much spot things that are genuine or false. You can learn a lot from watching their eyes: shooting daggers, fear, anger, hopelessness, avoidance, shame, guilt, hate. Sometimes it’s a manipulative tactic. Sometimes cowering demonstrates submission to another person.
Sometimes you will notice skin tone, either that a person will appear to be very healthy, or illness that affects pallor, drained or washed out. That will help you determine if medical help is needed. There may be substance abuse, and need to see if they wear long sleeve shirts in the heat of the summer, that may be covering up needle tracks. Or you may need to look at his eyes to see if they are always dilated. Sometimes you’ll see bruises and it’s not uncommon if a woman is being abused to see places where her husband has grabbed her, perhaps shook her or restrained her or pushed her into a wall. If the person is being beaten, you may see bruises about the face, around the shoulders or the back. It’s not always men that abuse women either. I had one case, where a man would be chased to the couch where he would curl up to be beaten by his wife for at least one-half hour on his back, arms, and face, often with knuckle sized bruise marks on his arms. I’ve had people come in with black eyes. As you observe people, make notes in your initial session, because all this is used to form a diagnosis at some point. Your treatment plan will address these issues.
A second element of observational client body language is body posture. You will see women dressed seductively or walk, talk, act or sit in a seductive manner. And, this might sound odd, it can be men or women. A woman will tend to do things that will let you see parts of her body like dropping and picking up things to expose skin to you. Sometimes men may keep his shirt open more than usual. Men and women may make seductive comments or look inappropriately at the counselor. Other seductive actions can be hand motions, tone of voice, and eye movements.
Sometimes people go the opposite way. They will be overly off-putting such as wear austere clothing, sloppy clothing, or dirty clothing or have body odor. Clothing provides information about background, financial condition, self-image, social status, personal hygiene and self-care, clothing they may wear may be mismatched, out of date, or worn. So, you want to observe that.
The next characteristic to observe is the voice: is it sarcastic, cutting, demeaning to another, or measured and precise, almost clipped in his speech? Does their speech portray a mood, or change moods often from one type, like changing from complaining to anger or sarcasm?
The last area is the body language towards another person, spouse or yourself. Observe how they interact with another person, eye contact, how they touch, posture, nervous body movement like tapping, foot bouncing, etc.
Those are the five areas to observe: 1) facial expression that involves crying, eye contact, 2) skin tone and body posture; 3) condition of the person’s clothing; 4) voice; and 5) body language towards his spouse or towards yourself. My thought is that the body language provides information about the internal, spiritual condition of the client. Body language most often changes over the course of the counseling process. Explain if you agree with the body language importance or you don’t agree with its importance and support your reasons on either side.
Hello, World!
You have almost completed Chapter 1. By now, you have read an overview of the Cognitive Biblical Therapy methodology, the phases and processes. Courses 2, 3 and 4 will provide you with a much deeper knowledge and skill to use the CBT method to help people. If for some reason you are not able to start or take Course 2, 3 and 4, please keep in mind, all of the CBT materials are copyrighted and you will need permission by the Biblical Christian Counseling Ministry, Inc. to use any of the materials. Further, note the description levels of certification to use the copyrighted materials. See the copyright under this chapter’s text for the copyright description. For further information, feel free to reach out to: cbtcoursework@gmail.com.
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