Mental Illness and Faith-Based Counseling

By: Dr. Garrett Higbee

July 16, 2021



There has been a lot of debate related over the years about faith-based counseling and mental illness. It is not an easy issue to address in a blog or short amount of time. However the more I read, the more I am compelled to share some insights from my journey as a trained psychologist who now practices as a biblical counselor.


Learning from One Another


First of all, I want to say that I have appreciated many of the posts and articles related to this important topic. I think the conversation is helpful and we can learn a great deal from one another. I grieve over those who have lost loved ones, and I am sickened by the trite and hurtful things that many Christians have said in response.


I have gained humility and insight from some challenges to an over-simplistic view of mental health. Even those who we sharply disagree with can help us to form clearer thoughts and deeper convictions.


None of Us Has Arrived


Secondly, that none of us have arrived. The battle is really not about human opinion and proving someone right or wrong. We must guard against our petty tendencies toward self-protection, our preferences, and, worst, our personal prejudices.


The battle is really not about human opinion and proving someone right or wrong.

The battle is for truth and grace. What I love about living under grace is that I have learned that God never compromises truth or grace in the name of love. So, I hope you will catch the spirit of this post as I try to navigate a very sensitive topic with grace and truth.



My History


It is helpful to know who it is who is writing these types of posts. I wish I knew more about others that have had the courage to tackle this tough topic. It might help me to appreciate their view point or understand their passion better.


As for me, I was trained as a psychologist in the 1980’s. I received my doctorate in 1990. I leaned more toward a cognitive-behavior counseling approach and focused a lot on teenagers in my counseling early on. I loved working with teens, and the harder the case the better.


I soon realized that parents were integral in the counseling if a teen was to thrive. So, I started studying family therapy. In graduate school I had the privilege of being trained by some of the best in the field. I find that my background and some of the research and methods had significant results in correcting dysfunctions and conflict in families. My study of the DSM model and psychotropic medication was helpful as well. I grew into a holistic practitioner trying to use best practices to help children and families.


I graduated and moved to Indianapolis where I enjoyed running a private practice and supervised two “day treatment” programs for 12-18-year-olds that were very successful. My goal, like most of those in mental health, was to relieve symptoms, build self-esteem, and teach coping skills for a higher quality of life. I worked closely with psychiatrists who I trusted to be moderate with medications, I was part of an interdisciplinary team of professionals, and I led case conferences that developed very comprehensive treatment plans. Eventually, my practice evolved to include adult clients and a significant focus on marriage counseling.

In 1992 I had a radical conversion experience and a significant crisis in my worldview. I was not looking for Christ to arrest my heart, but I was growing disillusioned with my life and practice. I saw too much recidivism, and I knew people seemed less than satisfied with just a “more functional life.”


After hearing the gospel clearly, and coming to faith, I started to study Scripture and saw the profound way God speaks into the human condition. At first, I thought all my training in psychology had been a waste. It was really interesting how many mature Christians told me my training was invaluable and not to throw the baby out with the bath water. Others told me that psychology was the devil’s playground and that I needed to forsake it completely. It took me a good five years in the faith to reconcile the extremes as both had some truth.

It was helpful when mentors like David Powlison told me that psychology was descriptive, but not prescriptive. I began to see how my study of humanity, psychopathology, and human development before my worldview shift was actually part of God’s journey for me. I was better equipped to understand patterns, to discern root causes, and to help people to consider a biblical equivalent to psychiatric labels. Knowing the efficacy and side effects for most psychiatric drugs was very helpful as well. I was able to help those in my care to be better consumers and, when they seemed conflicted, I was able to help them wrestle through issues of the conscience related to their choice of taking certain medications. To be clear, I never have counseled someone to go off medication and, when appropriate, still refer people to a physician to rule out any biological factors.



After hearing the gospel clearly, and coming to faith, I started to study Scripture and saw the profound way God speaks into the human condition.

As I grew both in my faith and as a biblical counselor, I saw God work in amazing ways. I worked in several churches and ended up starting Twelve Stones to help the most severe cases of “mental illness.” Most of those who came were Christians, but not everyone. I really believed that a biblically-focused treatment would be superior to anything I had seen or been involved with before.


In the five years I worked at Twelve Stones we saw folks who struggled with bi-polar, schizophrenia, suicidal thinking, and borderline personality traits. We met with victims of rape, incest, and physical abuse. We worked with men addicted to pornography, drugs, and alcohol.


I really believed that a biblically-focused treatment would be superior to anything I had seen or been involved with before.

At the same time, we worked with marriage conflict, parenting issues, significant anxiety, and depression. The intensity kept us on our knees and we did not have the luxury to dismiss “mental illness” or what I would call “deep and profound soul sickness” as just a lack of faith.


In most cases, people were hurting deeply, trying to understand suffering and faith, and sought to get right with or closer to God. There were physical, mental, emotional, and relational issues that all had to be addressed. Many who came for help were disillusioned with counseling, the church, and most Christians.


My question was not how did you get so disillusioned with people or people of the faith, but what do you think about God and what is your problem with Jesus? I was not ignoring their complex symptoms or pretending that a Bible verse would fix everything. For most, nothing they had tried including years of psychotherapy and even Christian counseling had worked. At the same time, I knew from both personal experience and numerous breakthroughs with very severely troubled people that the power of Jesus Christ and His Word was the only real and transformative answer for lasting hope and help. I knew that there had to be a change of mind and heart that had not yet come about.


My question was not how did you get so disillusioned with people or people of the faith, but what do you think about God and what is your problem with Jesus?

I found that common themes of pride and unbelief plagued those who struggle the most. Pride often morphed into anger or foolish actions, and unbelief descended into extreme fear or despair. At the core, all the DSM diagnoses no matter what the cause had a profound spiritual component. Over the years of being involved with Twelve Stones leading, counseling, and now as a board member, we have seen hundreds break free of life-long patterns of sin and others rise up out of a victim mentality to embrace new hope and life in Christ.



Dr. Garrett Higbee presenting Soul Care training for a Local Church.


The Role of the Church


I now work in the local church again. I have always had the goal to return soul care back to the church. However, in the last thirty years of counseling as a Christian, I have come to believe we are not doing a great job as a church as a whole in helping those who are severely mentally ill.


Not only that, but we are poorly equipping those who love them as well. We would benefit greatly by teaching our people to be grounded in a biblical worldview, but at the same time training our counselors and pastoral staff to understand psychology and psychiatry at a fundamental level.


I have come to believe we are not doing a great job as a church as a whole in helping those who are severely mentally ill.

I am not a big fan of the word “integration.” I don’t think you want to mix the fallibility of a “soft science” with the inerrant Word of God. I do think, however, there are methods, research findings, and medical interventions that can be very helpful for those we serve and love.


I don’t think we want to rearrange symptoms like fruit on a tree, but get down to root issues and motivations that drive our speech and behavior. Our target is radical heart change, not symptom reduction. Our esteem will fail us, but God’s esteem through our new life in Christ is a love that never fails. We are not interested in coping skills, but helping people appropriate their identity in Christ and teaching them to live an abundant life.


We would benefit greatly by teaching our people to be grounded in a biblical worldview, but at the same time training our counselors and pastoral staff to understand psychology and psychiatry at a fundamental level.

We can only do this because we are the church. We can only do this because we have divine weapons and tools given to us by our creator. After all, we have the Word of God, the Spirit of God, and we are the community of God, making the church God’s best place for discipleship and care.


Questions for Reflection


1. What are your convictions about faith-based counseling and mental illness?


2. How can you be involved in helping the most hurting in your community?


3. How well are you doing at remaining humble and learning from those with whom you may disagree?


This article, with small modifications, first appeared on the Biblical Counseling Coalition website on October 13, 2014.