Book Review

Review: Theological Foundations for Counseling By J. V. Fesko

by on October 29, 2026 | Comment

I was eager to read J. V. Fesko’s new work, Theological Foundations for Counseling. Even though I do not hold certifications in this field, my firsthand experience assisting those with serious mental illness has given me wisdom in the type of informal counseling Christians practice within their immediate circles. I have included the lessons I have learned and the conclusions I have drawn in two of my books.1

I did not know what Fesko’s views on counseling were, but I respected him as a sound teacher, theologian, and pastor. If his views contrasted with mine, I was ready to listen and be challenged.

As it turned out, this book challenged me, but not as I expected. I was not challenged to accept contrasting theological views but rather to examine my heart and my application of those views in my life.

This challenge started early in the book. Applying Augustine’s idea of concentric circles of care, Fesko warns us that before we can counsel others, “we must first counsel ourselves. … Only counselors who personally know Christ and the means by which to grow in their Christian walk can counsel others to do the same. Only one who has personally struggled with sin can both sympathize and empathize with those whom they counsel” (xxi).

This clarification is fitting with the overall purpose of the book, which is to provide a theological foundation for counseling. As Fesko explains, “Basing counseling on Scripture does not mean simply pointing people to relevant passages of Scripture, as helpful as this might be. Rather, it means being familiar with principal doctrinal truths contained in Scripture” (xxii).

I have noticed the need for this theological foundation in my own long reflection on mental disturbances and struggles. When speaking in churches, I have often been asked, “What can we do?” Pastors, as well as regular church members, relatives, and friends of people who live with a mental illness, are often at a loss and eager to receive a to-do list or a set of Scripture verses that can miraculously work in their situations. Eventually, I have come to the same conclusion drawn by Fesko: Counselors—both formal and informal—need a solid theological foundation and a clear understanding of how this foundation applies to counseling.

The relation between general and special revelation, faith and reason, common and special grace, and body and soul is familiar to most Heidelblog readers. So are the doctrines of the sufficiency of Scripture, union with Christ, and God’s covenants with mankind. These are invaluable riches we have inherited in our Reformed tradition. Yet they still need clarification, especially in their practical applications to our daily interactions with ourselves and others.

The book’s logical structure and clear explanations are typical of Fesko’s writings. After a concise introductory chapter on our present context and how philosophers such as Francis Bacon, René Descartes, Immanuel Kant, Friedrich Nietzsche, Sigmund Freud, and Ludwig Feuerbach have influenced our thinking, each of the following twelve chapters focuses on a specific Christian doctrine, highlighting its biblical foundation and history of interpretation and ending with practical applications to counseling, a useful “conclusion” (with numbered points), and a list of books for further reading. Overall, it is meant to help the readers grow in their theology and mature in wisdom rather than providing examples of counseling. (These examples are present but not in the quantity one would expect from a counseling manual.)

Like most authors, Fesko was motivated to write this book by a recognition of a need—in this case, the discovery that “historic Reformed theology did not appear very often” in general discussions over counseling. While “much of the debate has taken place over Scripture and the various domains of counseling and its related disciplines,” Fesko realized that “mining the riches of the church’s past” would bring “new voices to the discussion” (xi). These riches include doctrines that are rarely associated with counseling—such as covenant theology and union with Christ.

Although the general tone of the book is academic, Fesko’s clear explanation of key words and concepts makes the text accessible to anyone who is interested in a serious study of this subject. And as Fesko correctly points out, counseling is not limited to professionals. We all practice counseling in our daily lives.

Controversial Claims

While Fesko’s inclusion of many aspects of Reformed theology widens the theological discussion on counseling, his chapters on common and special grace and the sufficiency of the Scriptures have attracted strong reactions from adherents of what is generally known as biblical counseling.

This is not surprising. On his first page, Fesko describes his early, youthful impressions of a 1970 book he had been required to read, Jay Adams’s Competent to Counsel, which is largely recognized as the spark that ignited the debate between what have been described as biblical and integrationist approaches. At that time, Fesko found Adams’s book “interesting but at the same time somewhat strident against anyone who wanted to employ the insights of psychology in counseling” (ix). In its practical applications, he found it falling short. Later in his book, Fesko levels similar criticism against counseling organizations such as the Association of Certified Biblical Counselors (ACBC) and the Christian Counseling and Educational Foundation (CCEF).

Given the divisiveness of current debates on biblical counseling, Fesko is reluctant to use the terms biblical and integrationist. “I suspect most will want to categorize this work as integrationist, rather than biblical, counseling,” he says in his preface, rejecting this categorization on his conviction that his position is aimed at recovering a biblical harmony rather than an attempt “to integrate two things that do not otherwise belong together” (xii).

Fesko elaborates on this characterization of the biblical and integrationist camps most thoroughly in chapter 5, which is about common grace. In Fesko’s view, Jay Adams’s criticism of psychiatry as giving way to “humanistic philosophy and gross speculation”2 has led to the discrediting of this area of science, reflecting a tendency to minimize or limit the recognition of common grace.

These claims have been contested by some biblical counselors who believe that Fesko’s description of Adams is a mischaracterization. Some have written lengthy rebuttals, accusing Fesko of lacking familiarity with biblical counseling and inaccurately treating its authors. In their view, this disqualifies him from addressing the subject.

I understand how a reader who is deeply familiar with the writings of Jay Adams and other principal authors of the biblical counseling movement might want to bring clarifications. Some of their rebuttals, however, might be ignoring the practical consequences of these authors’ teachings. If it is true, for example, that Adams did not disregard science,3 his conclusion that “in the area of psychiatry, science largely has given way to humanistic philosophy and gross speculation” is one of many statements (whether correctly interpreted or not) that have contributed to a strong suspicion of psychiatry and psychology in some Christian circles—a suspicion that, in some cases, has had disastrous consequences.

My suggestion is to take this book at face value. Fesko is well versed in historical theology, and his treatment of the doctrines included in this book is worth reading. Some might want to do a deeper study and examine Fesko’s quotations of biblical counseling authors in their context. Most readers, however, would do best to take a charitable approach to both Fesko and the authors he quotes and focus on the content of his criticism. In other words, “If the shoe fits, wear it.” If you notice in yourself or others any of the problems he attributes to the writings of Adams or ACBC, focus on the remedies he provides and honestly assess their value.

Beyond Controversy

Fesko’s intent was never to write a manual for counseling. Possibly much of the controversy has stemmed from an attempt to categorize this book as such. Yet Fesko is clear about his intentions: “If people want to place this book in a category, I believe it is merely classic, Reformed, confessional theology” (xiii). The question he seems to raise is, How can a firm grasp of this theology inform our relationship with others as formal or informal counselors?

Likewise, this is not meant to be a comprehensive work on systematic theology. Fesko has chosen doctrines he found particularly relevant to the work of counseling. For example, after reminding us throughout the book that “counseling is a game of inches, not miles” (108) and “sanctification is a crockpot, not a microwave” (125), Fesko aptly ends with a chapter on suffering, an inevitable reality that must be faced with empathy and true, biblical hope rather than fake optimism.

I particularly appreciated Fesko’s distinction between proximate and ultimate goals. Although “all Christians should pray and look for opportunities to share the gospel of Christ and thus share the ultimate goal of pointing people to Jesus,” he says, “sometimes we must first give a cup of cold water before we address ultimate goals. We first enter a house of mourning with mourning and only afterward seek to answer why suffering has occurred” (xx, 152; emphasis original).

I also appreciated Fesko’s inclusion of both formal and informal counseling. Much counseling occurs over time—often informally and through ordinary people. Fesko learned this in his early pastoral ministry when an older pastor advised him, “Sanctification doesn’t happen on Sundays. It happens in the days, weeks, months, and years that you labor with your families to help them grow in their sanctification” (125). This slow, steady process applies both to our efforts to counsel others and to our personal growth.

In fact, by constantly focusing our attention on our own theology, Fesko removes the sharp distinction of counselor and counselee and reminds us of our mutual growth in Christ. This is well expressed in Fesko’s prayer for this book: “I pray, O Lord, that you would use these words to teach others how to know you better so they can give a cup of cold water to those who thirst” (xvii; emphasis added).

I recommend this book to all Christians who are willing to do the patient work of examining their theology in the light of many relevant yet often neglected doctrines and carefully apply them to their daily work of counseling themselves and others.

Notes

  1. See Simonetta Carr, Broken Pieces and the God Who Mends Them: Schizophrenia Through a Mother’s Eyes (P&R, 2019; and the upcoming Simonetta Carr, Together in Brokenness and Wholeness (Christian Focus, 2027).
  2. Quoting Jay E. Adams, Competent to Counsel: Introduction to Nouthetic Counseling (Zondervan, 1970), xxi.
  3. Adams’s full quote in this respect is “I do not wish to disregard science, but rather I welcome it as a useful adjunct for the purposes of illustrating, filling in generalizations with specifics, and challenging wrong human interpretations of Scripture, thereby forcing the student to restudy the Scriptures. However, in the area of psychiatry, science largely has given way to humanistic philosophy and gross speculation.”

©Simonetta Carr. All Rights Reserved.

J. V. Fesko, Theological Foundations for Counseling (Baker Academic, 2026).

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  • Simonetta Carr
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    Award-winning author Simonetta Carr was born in Italy and has lived and worked in different cultures. A former elementary school teacher, she has been a homeschooling mother for many years. As a writer, she has contributed to newspapers and magazines around the world and has translated the works of several Christian authors into Italian.

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