Running head: CHRISTIAN COGNITIVE-BEHAVIORAL THERAPY
Christian Cognitive-Behavioral Therapy: A Comprehensive Counseling Approach
Student
Liberty University Online
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CHRISTIAN COGNITIVE-BEHAVIORAL THERAPY
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Abstract
Christian Cognitive-Behavioral Therapy (CCBT) provides a method for identifying false beliefs,
challenging those beliefs, and replacing them with truths of the Bible. CCBT stems from
Cognitive-Behavioral Therapy, which has been shown to be efficacious for a multitude of
problems. The CCBT process accounts for human development and individual differences based
on how different experiences impact beliefs. The experiences come through a variety of sources,
such as parents and media, and give rise to both true and false beliefs. The false beliefs can
negatively affect all aspects of personality from thought-life to actions. CCBT provides a way to
understand and change false beliefs and provides motivation for change through the truths
contained in the Bible and power of the Holy Spirit. In addition, the biblical truths used in
CCBT give a more consistent, non-changing starting point for Cognitive-Behavioral Therapy
from which to challenge false beliefs. Finally, CCBT has Jesus as the ultimate example of health
and can explain illness through the development of belief systems that are counter to Jesus’
healthy lifestyle.
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Christian Cognitive-Behavioral Therapy: A Comprehensive Counseling Approach
Christian Cognitive-Behavioral Therapy (CCBT) is a simple approach that deals with
false beliefs by extending Cognitive-Behavioral Therapy (CBT) to include biblical truths. The
CCBT three-step process involves identifying false beliefs, challenging those false beliefs, and
replacing those false beliefs with biblical truths. The CCBT theory is similar in nature to other
approaches and is strong in its simplicity, its biblical focus, and its integration of theology and
psychology.
What is Important for Understanding Human Personality?
Beliefs are the key to understanding personality. A belief is essentially a statement or
assertion that someone accepts as being true (“Belief,” 2014). Whether beliefs are true or false,
they form the motivation for a person’s actions. Beliefs are developed throughout life and are
the main source, and main determinate of personality differences. The role of CCBT is to
uncover false beliefs and replace those beliefs with truths found in the Bible.
Personality
Personality is “the set of emotional qualities, ways of behaving, etc., that make a person
different from other people” (“Personality,” 2014, para. 1). Beliefs form the basis for a person’s
thoughts, behaviors, and emotions (i.e. personality). These beliefs develop in a variety of ways.
Specifically, the inner-self, the body, and external systems influence beliefs and account
for differences in personality (Hawkins, 2010). First, the inner-self is made up of thoughts,
emotions, and feelings that lead to beliefs as well as stem from beliefs. According to Hawkins
(2010), this inner-self includes the Holy Spirit for Christians, and sin nature, among other things.
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Secondly, the body is comprised of both physiology and biology, and encompasses such
things as genetic make-up, diseases, biochemical processes, physical characteristics, and bodily
functioning. For example, Hart (1999) describes how the biochemistry of the brain affects
anxiety, as well as how certain diseases can mimic anxiety symptoms.
Third, beliefs are affected by external systems. Family, friends, neighborhoods, and
cultures are important in establishing beliefs. Wilson (2001) talks extensively about how parents
teach children false beliefs that extend into and affect their adult lives.
Moreover, external systems include the spiritual world. On one hand, relationship with
God is an effective way to develop healthy beliefs through sanctification (Adams, 1986). On the
other hand, Anderson (2000) describes how Satan can influence personality in a negative manner
and break a person away from the healthy beliefs that the Bible teaches.
In summary, personality is based on the collection of true and false beliefs formed
through mind, body, and environmental influences. CCBT seeks to influence the false beliefs
and replace them with biblical truths.
Motivation
People are motivated to act based on their deeply held beliefs. For instance, if a person’s
underlying beliefs are Christian in nature, she is motivated to love Jesus for all He has done and
to show that love to others. Alternatively, if a person feels she will never amount to anything,
she may not be motivated to act at all, but stay at home in a state of depression.
According to Crabb (1977), all actions are logically based on a person’s beliefs about
what makes her matter globally and personally. Unfortunately, if a person does not understand
how to properly meet her needs because of false beliefs, she is motivated toward the wrong goal,
which can lead to neuroses (Crabb, 1977).
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Furthermore, these wrong goals are motivated by beliefs developed through sin nature,
but positive change toward Jesus is motivated by the Holy Spirit (Adams, 1986). Crabb (1977)
echoes this thought when he says that only Christians can reach self-actualization in Maslow’s
hierarchy of needs because they are the only ones who can truly satisfy their lower level needs
by putting their faith in Jesus.
Similarly, sinful, immature motivation to meet a person’s own needs can work to
sabotage relationships (Cloud & Townsend, 1999). Cloud and Townsend (1999) make the point
that people “must be free to say no before [they] can wholeheartedly say yes” (p. 49). When
people are motivated to love others through knowing Christ, they are no longer doing things
because they feel they have to, but because they want to (Cloud & Townsend, 1999).
Human Development
Although people may have a predisposition for certain personality traits from birth,
personality is also fashioned through experiences. CCBT looks at the false beliefs developed
throughout life from the influence of parents, other adults, environment, and media.
Most importantly, parents are a major influence on a child’s beliefs. Unfortunately,
children tend to believe everything their parents tell them because their brains have not fully
developed. If parents are not careful, they can teach their children false beliefs that extend into
adulthood (Wilson, 2001). Through parental influences and other life experiences, children learn
to sin and need to turn away from those sinful behaviors later in life to be healthy (Adams,
1986). However, Wilson (2001) notes that people sometimes maintain the childhood beliefs,
because they do not realize that, as adults, they have a choice in what they believe.
If parents provide sufficient care and guidance, then children often develop into healthy
individuals (Wilson, 2001). However, if children are raised in an unhealthy environment, they
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learn maladaptive ways to deal with life (Wilson, 2001). One place where this is particularly
devastating is how the adult’s image of God relates to the image of his/her own father (Wilson,
2001). In this case, a person with an abusive or absent father can have a difficult time accepting
God as loving and available (Wilson, 2001). This is an unfortunate side-effect of unhealthy
beliefs learned in childhood.
Individual Differences
CCBT looks at the core false beliefs in an individual developed through her internal and
external environment. Different experiences, whether related to gender, culture, economic
factors, abuse, or something else, result in the formation of different beliefs. For example,
Wilson (2001) describes how neglected children learn that they are responsible for meeting their
own needs. This false belief can hinder their ability to learn to rely on God (Wilson, 2001).
CCBT focuses on understanding false beliefs such as the example above. Since CCBT
does not focus on a specific belief, but beliefs in general, it can be applied across cultures, to
different genders, and to people with different belief systems. The important part in CCBT is to
understand which beliefs are causing the problem and work toward changing them.
The other factor that makes CCBT different and applicable to all, despite differences in
personality, is that it has a personality-independent standard: the Bible. This is important
because it is not the counselor’s truth or the truth of today, but divine truth (Adams, 1986).
Therefore, this Bible-focus reduces the chance that personality preferences will steer the client in
the wrong direction.
Where Are Problems Developed?
In CCBT, problems are traced to lies that a client believes. These false beliefs can stem
from lies taught by parents or other authority figures, as well as, through television and other
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media. These beliefs can be conditioned into the client during childhood or caused by a
traumatic experience (Hart, 1999; Wilson, 2001).
False beliefs can be re-lived through experiences in adulthood and perpetuated by a
negative thought-life (Backus & Chapian, 2000; Wilson, 2001). Backus and Chapian (2000)
describe this perpetuation as a “tar baby” that a person makes larger and larger with more
negative self-talk (p. 30).
Alternatively, Adams (1986) describes the false beliefs as the result of the fallen world
and a sinful nature, and Wilson (2001) notes how these false beliefs originated with Adam and
Eve. Problems develop when people lack obedience to Christ and do not listen to Him or rely on
Him (Crabb, 1977; Hart, 1999).
Working Definition of Health
From a Christian perspective, health is based on the truth of the Bible. The most
important truth is that Jesus is “the way and the truth and the life” (John 14:6, New International
Version). Jesus is the best example of health, and relationship with Him provides the path to
health (Adams, 1986; Backus & Chapian, 2000).
In addition, health means following the Holy Spirit and is demonstrated by the “fruit of
the Spirit” (Galatians 5:16, 22). The most important of which is to love God and others. Wilson
(2001) describes knowing and loving God as providing the “highest joy” (p. 189).
Moreover, loving God provides a path to loving yourself. A person learns self-love
through understanding her place as a child of God and learning about His acceptance and love
for her (Anderson, 2000; Backus & Chapian, 2000).
Finally, when a person is truly healthy, or faithful to God, she is no longer trying to meet
her own needs in Maslow’s hierarchy of needs, but is able to live for a higher purpose (Crabb,
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1977). In this way, she can also love others instead of trying to use them to meet her needs
(Cloud & Townsend, 1999).
Working Definition of Illness
False beliefs contribute to many psychological problems. False beliefs can stem from
experiences, sinful nature, biology, the brain, and the devil. As described earlier, these false
beliefs affect thoughts, behaviors, and emotions, as well as cause separation from God.
There seems to be a consensus that false beliefs are the cause of illness (Backus &
Chapian, 2000; Crabb, 1977; Wilson, 2001). Even Anderson (2000) and Adams (1986), the
authors furthest from mainstream thinking, target thought-life as important in defining illness.
For example, Adams (1986) describes how problems stem from habitual sins and sinful desires,
and Anderson (2000) talks about sinful thoughts placed in Christian minds by the devil.
Finally, Cloud and Townsend (1999) talk about setting boundaries and maturing as ways
to improve illness. This maturing essentially boils down to responsibility for behavior and
moving that behavior toward Christ-likeness (Cloud & Townsend, 1999).
Psychological and Spiritual Illness
Illness has both psychological and spiritual components. False beliefs contribute to
psychological problems such as errors in thinking, maladaptive emotions, and unhealthy
behaviors. In addition, these false beliefs cause the spiritual problem of separation from God.
Wilson (2001) believes that “the primary wound affecting all of us is spiritual. And it is
self-inflicted” (p. 28). This illness has existed since Adam and Eve committed the first sins. Sin
has been perpetuated as people sin in their own lives and teach that sin nature to their children
(Wilson, 2001). Spiritual illness is only eased by putting faith in Jesus and growing in
relationship with God (Adams, 1986).
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Further, Adams (1986) agrees that sin is a significant problem. He goes so far as to make
salvation the first issue in counseling (Adams, 1986). Although this may not be the best
approach, Adams (1986) does drive home the point that God should be involved in the
counseling process, and that the ultimate goal is to help people come to know Christ.
At a minimum, CCBT can teach the client more truthful statements founded in the Bible,
even if only implicitly. This will help relieve clients of their psychological illness and hopefully
help them down the path to spiritual health as well.
Role of Integration and Multitasking
CCBT was brought about by infusing cognitive-behavioral therapy with biblical truths.
Therefore, it is straightforward to claim that CCBT integrates psychology and theology.
However, counselors should go one step further by ensuring psychology is subservient to
Scripture (Crabb, 1977).
Regarding the integration of psychology and theology, Hart (1999) and Wilson (2001)
offer similar views to CCBT. Whereas, other approaches (Adams, 1986; Backus & Chapian,
2000) are at the extremes. Adams’ (1986) theory involves very little, if any, integration of
psychology, and Backus and Chapian (2000) offer minimal integration of theology.
Furthermore, multitasking is also important to CCBT. CCBT looks at all aspects of a
person to understand the underlying source of problems. Within this multitasking approach, a
variety of questionnaires, tests, and interviews may be used to obtain client history. Next, the
counselor uses this history to determine the source of the problem. Then, the counselor can
propose appropriate techniques to help solve the problem the client is having. Of particular note,
Hart (1999) seems to pay close attention to multitasking, especially related to medical conditions
that may contribute to problems.
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How to Source Problems and Structure Effective Interventions
Any good counselor looks at a variety of information to determine from where a problem
stems. Questionnaires, testing, and the interview process provide insight into a person’s past and
present life. In CCBT, these sources help the counselor identify the client’s false beliefs, so
those beliefs can be targeted for change.
Key Elements of My Theory
Under the premise that personality is shaped by beliefs, which essentially begin as
thought-life, it follows that people have the ability to change their personalities. The CCBT
process involves locating false beliefs and attempting to change those beliefs. CCBT offers a
simple, three-step process for change, the key elements of which are to identify irrational beliefs,
challenge those beliefs, and replace those beliefs with biblical truths.
The CCBT process is consistent with many other authors. Adams (1986), Anderson
(2000), Backus and Chapian (2000), Cloud and Townsend (1999), Crabb (1977), and Wilson
(2001) all have thought components in their theories and attempt to help clients change through
targeting their errors in thinking or wrong beliefs. Thought or belief changes, as Adams (1986)
suggests, are most beneficial when they are aimed toward Christ-likeness.
Process and Techniques
Many techniques can be used within the CCBT process to effect change. Each step will
be considered here separately.
The first step is to identify irrational beliefs. This involves getting an in-depth client
history, which includes taking background information, questionnaires, checklists, tests, and
interviewing the client. In addition, a visit to the physician would be necessary to ensure the
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presenting problem was not biologically based (Hart, 1999). In this step, the counselor seeks to
figure out the false beliefs that are behind the client’s presenting problem.
The second step involves challenging irrational beliefs. This step can incorporate a
variety of techniques, but ultimately involves refuting false beliefs with biblical truth.
Questioning (e.g. What is Christ’s view of this belief?) and reviewing Scripture both in-session
and for homework are two techniques for challenging false beliefs. Prayer is also a powerful
tool that can be used by the counselor in different ways depending on the client’s preferences and
beliefs (McMinn, 2011).
In the third step, the counselor helps the client replace irrational beliefs with biblical
truths. This step involves repetition. There are several methods to go about this repetition.
Memorizing scripture can provide the needed truth when irrational thoughts enter a client’s
mind. Meditating on Scripture and learning how to hear the Holy Spirit are other possible
methods to combat irrational beliefs with the truth. Whatever the method, it is important to “take
every thought captive” (Anderson, 2000, p. 5), and replace it with the truth. Then, the truth can
give the client freedom from her problem.
Expectations of Effectiveness
CCBT is an extension of cognitive-behavioral therapy where Christian truths are used to
combat false beliefs. Cognitive-behavioral therapy has been shown to be an effective treatment
for a variety of problems. Hart (1999) showed the effectiveness of cognitive-behavioral therapy
in treating anxiety. In addition, the American Psychological Association Division 12 (n.d.) states
that cognitive-behavioral therapy is effective for a number of problems running the gamut from
marriage problems to mental illness.
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In addition, many studies have shown the effectiveness of CBT. For instance,
McCracken and Turk (2002) showed CBT to be effective for chronic pain. Also, Driessen and
Hollen (2011) showed CBT to be useful in treating depression.
Moreover, several authors use approaches similar to CCBT. The Backus and Chapian
(2000) process essentially mirrors the three-step CCBT process. Adams (1986) and Crabb
(1977) have more complex processes, but both generally contain the elements of CCBT.
Likewise, Wilson’s (2001) theory of change involves changing behaviors and consistent practice,
which again is consistent with CCBT.
Although applied differently, even the Cloud and Townsend (1999) approach of setting
boundaries and working toward maturity has a cognitive-behavioral “feel” to it. Although the
effectiveness of the above approaches is not stated, there is something to be said about the
similarity of these approaches, especially considering the number of years these authors have
been practicing and the number of books they have published.
How Does My Worldview Influence My Theory?
An important assumption in CCBT is that “all truth is God’s truth.” This means that the
Christian can find truth in God’s creation as well as in the Bible. It is not hard for this counselorin-training to see that God can be found everywhere, and findings should not be discounted
simply because they come from nature or science, as long as they are consistent with Scripture.
Another important part of this counselor-in-training’s worldview is that the Bible
provides the ultimate truth. Adams (1986) speaks of the Bible as a book that can be applied
across cultures and generations. The Bible is so special because it is written by the only allknowing, all-powerful, and ever-present God; a God who is just and loving and cares for all.
Therefore, the truths provided in the Bible can be trusted today as well as in the future. The
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Bible provides the Christian counselor the one source that will not change, and therefore, can be
used as a consistent source of knowledge (Adams, 1986).
Finally, the ability to contact God through prayer and by listening to the Holy Spirit is
also a power that is not provided through any other source in counseling. Christian counselors
have the authority of the Bible to aid them in counseling and the power of the Holy Spirit to
guide them to help clients when even the counselor cannot fully understand the hurt of the client
(Adams, 1986). This is a great comfort for a counselor-in-training to know that she does not
have to have all the answers, yet can still have hope she can be a useful tool for God’s work.
Theoretical Considerations and Worldview Dimensions
The CCBT three-step approach provides a simple, easily implementable approach for a
client to follow. Step three, in particular, provides simple methods to help the client ward off
negative thoughts and behaviors.
Several other approaches also seemed to provide helpful ways to deal with problems.
Backus and Chapian (2000) and Wilson (2001) provided two other simple alternatives to the
three-step CCBT approach that could be easily applied by a client. In addition, Hart (1999)
provided a plethora of techniques for dealing with stress and anxiety, including meditation and
breathing exercises.
Finally, the least useful of the approaches seemed to be the ones proposed by Adams
(1986) and Anderson (2000). Adams’ (1986) approach to evangelize first may cause clients to
shy away from help, and Anderson’s (2000) approach amounted to exorcism, and did not provide
any help beyond renouncing evil practices.
All of the approaches incorporated biblical principles, although some to a lesser extent
than others. At one end, Backus and Chapian (2000) provided more of a self-help book. At the
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other end, Anderson (2000) and Adams (1986) stuck more strictly to biblical principles. The
approaches in between these two extremes seemed to have a good mix of biblical principles and
psychology, such as Crabb’s (1977) approach to Christian maturity and Cloud and Townsend’s
(1999) approach to relationships.
Approach to Integration
There are several approaches to integrating psychology and theology. The CCBT
approach attempts to take a proven method of psychology and adapt it to incorporate Christian
principles. This approach is consistent with Crabb’s (1977) “Spoiling the Egyptians” concept in
which a counselor takes from psychology, while making sure it is consistent with Scripture (p.
49). Cloud and Townsend (1999), Crabb (1977), Wilson (2001), and Hart (1999) also seem to
take this approach in their theories.
On the other hand, Anderson (2000) and Adams (1986) both take Crabb’s (1977, p. 42)
“Nothing Buttery” approach of primarily using the Bible as their source. Moreover, Backus and
Chapian (2000) seem to take a “Tossed Salad” approach where they take a little bit of
Christianity and combine it with psychology but do not fully consider psychology through the
lens of theology (Crabb, 1977, p. 37).
The “Spoiling the Egyptians” approach seems most consistent with this counselor-intraining’s worldview, given that it allows the counselor to find truth in the world as well as in
God’s word. However, the caution is that the counselor must always be sure that the findings in
psychology are consistent with God’s written word (Crabb, 1977).
Conclusion
Beliefs are the basis for thoughts, emotions, and behaviors. Unhealthy beliefs lead to
unhealthy behaviors just as healthy beliefs lead to healthy behaviors. Unhealthy beliefs can lead
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to physical, psychological, and spiritual “illnesses.” CCBT seeks to treat these illnesses by
uncovering the false, unhealthy beliefs behind them and combating them with biblical truths.
“Put me on trial, Lord, and cross-examine me. Test my motives and my heart. For I am always
aware of your unfailing love, and I have lived according to your truth” (Psalm 26:2-3, New
Living Translation).
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