Published on August 23, 2021 by Eugene Ho

B&H Academic, 2015 | 366 pages

A Book Review from Books At a Glance

by Caleb Martin


The idea that the Bible is written to address the troubles and trials that comprise the issues at play in counseling marks biblical counseling off from other approaches to soul care. Many have seen the Bible be sufficient to transform the hearts of those struggling with commonplace issues – depression, anxiety, lust, anger, and a litany of other troubles. But, if we’re honest, doubt often creeps in when it comes to people who have “serious” problems. We wonder, “What if God’s Word doesn’t speak to this issue? Can the Scriptures really address the core issues any heart-centric problem? With this or that label, shouldn’t a professional meet with this person?” It’s not every day that one gets the opportunity to test the sufficiency of Scripture against some of the most difficult issues of life.

Counseling the Hard Cases is a multi-author volume written by counselors who have counseled those hard cases that provide the strongest challenge to the sufficiency of Scripture. Each chapter is a window into how the Scriptures speak to complex, befuddling, and – at times – bizarre cases of human trouble including sexual abuse, OCD, bipolar disorder, dissociative identity disorder, or anorexia. None of these cases should be viewed as a blueprint. The complexity of human life and struggle means that no two cases are exactly alike. However, seeing ten different counselors address complex situations helps readers gain their footing in navigating similar situations.

A shared theme throughout the book is a biblical conviction that God designed people both body and soul. Each counselor shows respect to the body, illustrating a biblical understanding that the physical body is valuable and that it does have an influence upon the soul. At the same time, there’s a strong conviction that, as influential as the body is, the soul (often referred to as the “heart” in this book) is the control center of the person and the target of a counselor’s focus for true change. Each counselor in his or her respective fashion attempts to unravel the complex issues each counselee is facing and connect the Scriptures to real, particular areas of sin and struggle. Overall, each counselor is identifying the suffering of the counselee but also calling the counselee to repentance, faith, and obedience to Christ.

The remainder of this review will summarize in-depth the first of the ten cases rather than providing microscopic summaries of all ten situations:

Dr. Laura Hendrickson began working with “Mariana” (name changed, as in most counseling-oriented literature) when the latter was about 45 years old. To say Mariana experienced an extremely difficult childhood is an understatement. Mariana’s father first sexually abused her when she was only four; at seven, he forced her to share a bedroom with him to more easily service him sexually. Growing up, she was repeatedly reminded that she was a product of the rape of her mother by Mariana’s paternal grandfather. She was physically and verbally abused by her mother – deprived of food, constantly told she was evil, and was told God hated her and she couldn’t read her Bible or pray. Her last two decades had been spent receiving twenty years of psychotherapy for dissociative identity disorder and bipolar disorder.

The case study shows Dr. Hendrickson lovingly and carefully engaging with Mariana, meeting a total of 58 times for counseling. Dr. Hendrickson speaks of numerous “thorny strands” woven through her story and her heart, wounds driven deep in her soul, caused by others and herself. Unraveling these would take patient, tender care, utilizing God’s Word to cut through these thorns while applying “the balm of his promises” (37).

A few principles of quality, biblical counseling can be observed in this previous statement. Notice first how Hendrickson speaks of dealing with thorny strands – the many experiences, relationships, behaviors, thoughts, desires – and the wounds these represent. She acknowledges the unimaginable, horrific, and complex suffering that Mariana experienced and adjusts her care accordingly. Not only that, but Hendrickson also adds that Mariana contributed to her own problems as well. Confronting a wounded soul with her own sin is a delicate dance, but Hendrickson modeled speaking the truth in love. God’s Word met Mariana as a “balm” in the person of Christ, binding up the wounds of her broken heart (Luke 4:18). God’s Word also cut deep to Mariana’s response to suffering, discerning her desires, and leading her to repentance and faith (Heb. 4:12, James 4:2).

Dr. Hendrickson modeled how compassionately working through this rhythm of suffering and sin helped to tease out themes in her story and work through them, piece by piece. She did not ignore Mariana’s bodily experience, but helped her to identify triggers from her past that would be influential in her story moving forward. The counseling involved Mariana engaging in homework between sessions, which created a sense of ownership for her. And – this is vital – the body of Christ cared lovingly for Mariana outside these counseling sessions.

In multiple case studies throughout this work (as was true with Mariana), counselees came off their medication. One may suppose this is a prescriptive goal for biblical counselors. However, detailed reading shows that this was not a direct goal of any of the counseling scenarios, and in fact, each counselor advised consulting with a physician before altering any routines with taking medicine.

It was evident, in each case study, that the goal was not to remove a psychological label or try to explain all the details of a diagnosis. Some counselors used these descriptions to their advantage, modeling that psychological labels can be helpful at times to understand a counselee’s situation and experience. Each counselor modeled how to lovingly engage the counselee in the uniqueness of his or her story, unpacking their experience as well as applying appropriate Scriptures to real-life situations.

Understanding the categories of body and soul freed the counselors to focus on the soul work while encouraging the counselees to utilize trained physicians to care for their bodily ailments. Through understanding sin arises from the heart (Luke 6:45, Matt. 15:11), the counselors dug deep into patterns of behaviors and desires. This engagement brought about healing and hope, producing repentance and faith in the context of not only the counseling sessions, but the local church as well. While not every counseling case ends well, Counseling the Hard Cases gives encouraging examples of the Holy Spirit’s work through biblical counselors. These examples provide confidence that God is at work and His Word, faithfully applied, produces lasting fruit in the lives of people.


Caleb Martin is a Ruling Elder in the Presbyterian Church in America (PCA) and the Director of Men’s Discipleship at Perimeter Church. Caleb also serves as the Atlanta Clinic Director for Life on Life Ministries. He is a graduate of the University of North Georgia and is currently pursuing a dual Master’s degree program at RTS Atlanta (Biblical Studies) and RTS Charlotte (Christian Counseling). Caleb and his wife Katie have two sons and live in the Atlanta Metro area.

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B&H Academic, 2015 | 366 pages

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