The counselor has completed the first session. Now what? This chapter, together with Chapter 4, will give step-by-step instructions to the beginning counselor for organizing the data collected in session one and proceeding forward with planning for subsequent sessions. Together, both chapters provide the basis for what a counselor is to do between sessions. There is a checklist provided at the end of Chapter 4 (fig 4.1) in order to ensure thorough preparations for the steps explained in both Chapters 3 and 4. Both chapters provide forms for keeping the crucial data at the counselor’s fingertips.
This chapter includes instruction for the following steps:
- Post-Session Prayer
- The Session Notes
- The Session Log
- Analyzing the Data to Build an Agenda
- The Case Report
- Post-Session Prayer
As with anything we do in God’s Kingdom work, prayer is the first step. This cannot be overstated. The counselor needs the Holy Spirit’s guidance in thinking through what has just taken place in the first session as well as insight and wisdom for upcoming sessions. Prayer helps the counselor to remember he is completely dependent on the Lord for any success that takes place in counseling. And the counselee needs God’s power to begin the change process that is just barely underway. Prayer is the privilege opened up to the follower of Christ when the veil was torn (Matt. 27:51; Luke 23:45). The privilege of prayer was provided at a costly price—the blood of our precious Savior, Jesus Christ. This may be one of the most commonly neglected steps, yet is a most vital step.
- The Session Notes
The notes taken in each session will be essential for maintaining the direction for the entire case. After prayer, then, the first step is to review the session notes and to fill in any notes that are incomplete or were not written during the session. It is important to do this as soon as possible, while the session is fresh in the counselor’s memory. After taking a few minutes to read through and complete the notes, a “Session Log,” an “Agenda,” a list of “Questions to Ask in Future Sessions” and a “Case Report” should be completed. These are discussed in detail below.
- The Session Log
A “Session Log” is a simple chart that will assist the counselor in maintaining an easily accessible record of what has been covered and what has been assigned. Figure 3.1 provides an example of a completed “Session Log” chart and a blank reproducible form is available as Figure 3.4. After the first session with a counselor’s first counselee, this may seem like “busy work.” But by the time the counselor gets to session twelve and has multiple counselees at varying phases of counseling, this log can be a life-saver. With just one glance, the counselor can see what Scriptures have been taught and memorized. He can see what verses of hope have been given and what diagrams have been drawn. He can see if there is a pattern of not completing homework. He can reflect back to the first session to see when counseling began and he can peruse the dates to confirm a start date and to check attendance.
At the top of the “Session Log” is a space for the “case.” This is where the case is identified apart from the counselee’s first and last name, for privacy reasons. Counseling offices often have a system of case numbering that may include the counselee’s and the counselor’s initials and a number that is assigned according to the system. Or it may be advantageous to simply use the counselee’s initials or first name and last initial or some similar means to identify the case.
Figure 3.1 is provided as a mere example of how the information from each session can be organized. There are many varying formats that might be used, including an electronic form. If paper charts are preferred, it is recommended that the form be reproduced two-sided onto cardstock and placed in each counselee’s file at the time of the in-take process. Figure 3.2 provides a blank reproducible “Session Log” form.
Case: CW 1-18-13 L N Year: 2013 Page 1 of 3
|Scripture Reading Assigned||Eph||Eph||James||James||Col|
|Scripture Memory Assigned||1 Cor
10 : 31
|Eph 4 : 29||Phil 4 : 8||Phil 2 :
3 – 5
|Review of all so far|
|2 – 8||2 – 15||2 – 22||2 – 29||3 – 7|
|Collateral Reading Assigned||1st ½ Pride Humility (Scott)||2nd ½ Pride
Into His Likeness
|Ch 1 When Sinners Say I Do|
|Additional HW Assigned||Bring 3-ring binder||View Feb 5
|Make 1st Transform
|Scripture of Hope Given||Rom 8 : 28 – 29||Eph 2 :
11 – 13
|Heb 4 : 16||Titus 3 :
4 – 7
|2 Cor 12 : 9 – 10|
|Topics & Scriptures Taught
|Purpose for life: Col 1:16
Eph 4 :
|Putting others first before self
Lk 9 :
23 – 24
Phil 2 :
3 – 5
|Role of wife &
Eph 5 :
22 – 27,
1 Pet 2 :
18 – 3 : 6
|Eager to learn & change||Ready to start 1st transforma- tion plan
|Likes change she is sees in herself||Husband
|HW complete?||yes||yes||Most; had questions||yes||Most;
- Analyzing the Data to Build the Agenda
Once the notes and the “Session Log” are complete, it is time to begin building an agenda that will direct the course of counseling. The agenda is a customized list of topics that will need to be covered with the counselee in order for her to realize genuine biblical change and to grow in maturity, becoming more fruitful for God’s glory. In other words, the agenda is the counselor’s set of goals for future sessions. Although the agenda may change or grow from one session to the next, the counselor must begin building an agenda from the data gathered from the first session.
An agenda is simply a plan for accomplishing a goal, a map that shows us our destination (the changes that need to take place) and how to get there (How? Where? When? With whom?). Our goal is more than denouncing sin or solving the problems of the moment. We need to know what specific changes God is calling this person to make in this situation.
This Toolkit provides two different types of forms that help to manage the agenda. The first “Agenda Log” form may be most helpful for the beginning counselor since it is in the form of a checklist (see fig. 3.3). The second form is blank (fig. 3.4) and may be more useful to the experienced counselor.
In the first column of the “Agenda Log” checklist (fig. 3.3), there is an “X” beside eight of the Agenda items. This “X” indicates that teaching on this topic is generally relevant in nearly every case:
- Biblical Counseling: What is it?
- Disciplines of the Faith (Prayer, Bible reading, Church attendance, etc.)
- God’s Glory (Purpose for Living)
- Gospel; Salvation
- The Heart
- Idols of the Heart
- Sanctification and Spiritual Growth
Teaching on the eight topics listed above will help to build a strong doctrinal foundation on which other agenda items will rest. Relevant resources for teaching on these eight agenda items are listed in the third column of the checklist, entitled “Scripture Passages and Resources to Use.”
Figure 3.3. Agenda Log checklist
Agenda Log Checklist for ______________________
|Topic||Scripture Passages & Resources To Use||Date
|X||Biblical Counseling: What is it? *||Appendix B|
|Decision-Making & God’s Leading|
|X||Disciplines of the Faith*
(Prayer, Word, Church, etc)
|Ps 19:7-11, 66:18, 119:11; 2 Tim 3:16-17; Heb 10:25; 1 Thess 5:17|
|Fear of Man|
|Fear of God|
|God Speaks – How?|
|God – Who is He?
|X||God’s Glory (Purpose for living)*||See dialog on pp. 31-33; Rev 4:11; Rom11:36; Col 1:16, 3:17, 23|
|X||Gospel, Salvation*||Col 1-2; Eph 1-3; Rom 1-12; 1 Jn; “The Roman Road” (search online)|
|X||Heart*||Appendix H; Ez 36:26; Prov 4:23; Matt 12:33-37, 15:18-19; Jer 17:9|
|Heresy; False Beliefs|
|Identity in Christ|
|X||Idols of the Heart*||Appendix I; Idols of the Heart by Elyse Fitzpatrick; Matt 6:21|
|X||Pride*||From Pride to Humility by Stuart Scott; 1 Pet 5:5; Prv 8:12-13|
|X||Sanctification, Spiritual Growth*||Chapter 8; Transformed Into His Likeness by Armand Tiffe|
|Sufficiency of Scripture|
* Teaching on this topic is generally relevant in nearly every case and helpful resources for this topic are listed in the second column to aid the new counselor in getting started. Additional resources are available at www.bctoolkit.net.
The second type of form provided in this Toolkit to help manage the agenda is blank and may be more useful to the experienced counselor (see top of page).
In order to build an agenda beyond the initial eight topics relevant to most cases as cited above, the counselor begins by interpreting the data gathered into biblical topics. Paul David Tripp, in his book Instruments in the Redeemer’s Hands, has crafted an excellent resource in helping the new counselor learn to gather and interpret data and construct an agenda that will guide the direction of the case. Tripp’s Chapter 13 “Establishing Agenda and Clarifying Responsibility” as well as his Appendixes 1, 2 and 3 provide foundational principles for effectively creating a thorough agenda.
What does the Bible say about the information that has been gathered? This is not simply asking, “Where can I find a verse on _____?” We want to examine things through the lens of the great themes of Scripture, to understand how a distinctively biblical worldview shapes our response to the issues in the person’s life. We are asking, “What has God taught, promised, commanded, warned, encouraged, and done that addresses this situation?
What are God’s goals for change for this person in this situation? This question applies God’s call to “put off” and “put on” (Eph 4:22-24) to the specifics of a person’s thoughts, motives, and behavior. What does God want her to think, desire, and do? Answering these questions marks out our destination.
What are some biblical methods for accomplishing God’s goals of change?
- Help [the counselee] to see herself in the mirror of God’s Word.
- Have [her] keep a focused journal …[to] help her see how the themes of her heart play out in her actions and reactions.
- [Help her to gain] a clear understanding of her God-given “job description.”
- Study Psalm 73 and 1 Peter 1 with [the counselee] to help her escape the discouragement, anger, and fear that result not only from [another person’s] failure but her own self-absorption and now-ism. Teach her how to set her eyes on what is unseen and eternal.
Building the right agenda can make the difference between the counselor feeling as though he is “spinning his wheels” versus one who “gets traction.” Put another way, if we call the first session “Point A” and the last session “Point B,” the agenda will provide the “road map” to reach the destination as efficiently as possible. This does not mean that there will never be “detours.” There will typically be distractions and delays along the way, but the well-constructed agenda will guide the counselor in getting the case back “on track.”
A seasoned counselor can hear a counselee tell about a situation and can often quickly identify misunderstood biblical doctrines, sinful habits and selfish desires. A beginning counselor, however, will need to train himself to interpret what the counselee is saying into biblical themes for change. Interpreting data into biblical categories is also discussed in this Toolkit in chapter 7 “The Transformation Process” under the heading, “Step 1: Define the Problem Biblically.”
By answering the following questions, the counselor can begin to interpret the information into a plan for counseling:
- What happened or is happening in the counselee’s life? (Circumstances, situation, events, treatment by others, rejections, physical problems, etc.)
- How is the counselee responding to what has happened or is happening? Is she commandment-oriented or is she self-oriented in her responses? (Emotionally, behaviorally, reactions, etc.) What sinful responses should be addressed in counseling?
- What are the counselee’s thoughts, beliefs and presuppositions about what has happened or is happening? How is she interpreting what has happened or is happening? What are her thoughts about God, self, others or life in general in relation to what has happened or is happening? Does she have an unbiblical understanding about God, herself and/or her circumstances that must be corrected with Scripture?
- What are the counselee’s main goals, desires, wants, and demands that are being thwarted by what has happened or is happening? What are her idols of the heart?
In addition to the questions above, the following questions can also help the counselor analyze what the counselee has shared:
- What promises of God offer hope and help to the counselee?
- How does the gospel offer help for the counselee?
- What biblical principles will help the counselee?
- What biblical commandments are misunderstood or being disobeyed?
- What sinful habits must be replaced by righteous habits?
- What is the counselee’s attitude toward her circumstances?
- How does the counselee typically respond to pain or adversity?
- What does she run to (instead of God) for her refuge?
In order to find biblical solutions to problems, it is important to apply biblical terminology to what the counselee describes. For example, if the counselee claims to have been diagnosed with “Bulimia Nervosa,” the counselor will find nothing in the Bible concordance under “bulimia” and may thus believe there is no biblical help for such a counselee. However, upon close examination of the “symptoms” the counselee may provide such terms as “cravings,” “anxiety,” “uncontrolled appetite,” “sleeplessness,” or “feeling unhappy.” Biblical themes such as “gluttony,” “deception,” “fear of man,” “greed” or wanting “control” due to failure to “trust God” may be at the root of these “symptoms.” The counselee can provide a list of behaviors, attitudes and “symptoms” via the counselor’s thorough questioning and then it is the counselor’s job to interpret what the counselee has said into relevant biblical categories.
There are many other such examples of modern labels being misapplied to “deeds of the flesh.” An “affair” is spoken of as “adultery” in the Bible. “Dysfunctional” is “sinful.” There is no counselee that is not “dysfunctional” since we are all sinful. The term “co-dependency” can be interpreted biblically as “fear of man” or “people-pleasing.” “Addictions” are “enslavement to passions and pleasures.” A counselee who claims “verbal abuse” is referring to the sin of “unwholesome speech.” “Passive/ aggressive” is an example of “stubbornness” and “pride.” A strong desire for something that causes the counselee to put that desire before God’s glory is entertaining an “idol” in her heart.
While reviewing the session notes for the purpose of analyzing or interpreting the data collected, the counselor should take the time to attempt to visualize what the counselee is really saying. Questions will come to the counselor’s mind. Since it is unlikely that these same questions will resurface in a future session, these questions should be logged so they can be asked in subsequent sessions. Figure 3.5 provides a blank form, “Questions to Ask the Counselee.” By maintaining this question log, opportunities to probe deeper into the counselee’s heart and life will not be missed.
Questions to Ask the Counselee
|Questions to Ask and Answers Given||Date of Answer|
Figure 3.5. Questions to ask the counselee
Referring to the dialog of the first session between Bruce and his counselor in Appendix A, we shall begin to interpret the data and consider items that should be checked on the “Agenda Log” as goals for future sessions with Bruce. Before considering the “core data” that the counselee provided verbally, it is wise to think through what the counselee revealed by way of mannerisms or “halo data.” We cannot know by reading the dialog as it is provided, whether Bruce presented himself in the session as confident, arrogant, shy, quiet, self-conscious or something else, but an observant counselor will note Bruce’s demeanor and that observation should be added to the agenda. For example, if Bruce seemed arrogant, then Pride should become an agenda item. If he seemed shy, perhaps Identity in Christ or Fear of Man would become an agenda item.
Continuing on in the dialog, we see that Bruce goes to the gym four times every week. The question that might come to the counselor’s mind is, “What drives Bruce’s faithful work-out schedule?” and this question should be added to the “Questions to Ask the Counselee” form (fig. 3.5). Is Bruce driven by wanting to steward his body well for God’s glory or is his appearance an idol or is going to the gym a time-filler in his boredom or loneliness or is it a place where he sees good-looking women in skimpy clothes? The motive behind Bruce’s work-out priority is a question that the counselor will want to pursue and once the answer is learned, unless Bruce is driven by the desire to maintain his health for God’s glory, his reason will most likely become an agenda item.
When asked why Bruce changed churches, he answered, “There weren’t any singles my age in the church and I just wanted to have more opportunities for Christian fellowship with singles. I thought a bigger church would provide more of an opportunity.” Again, the counselor ought to be asking, “Is this decision driven by his desire to glorify God or self?” Perhaps Church ought to be checked on the “Agenda Log” so that the counselee can be taught God’s purpose and will for Christ’s church.
One area a counselor must seriously explore in every case is the salvation of the counselee. As the counselor in the dialog asked about Bruce’s church history and salvation experience, we saw that Bruce did note some change in himself at salvation as well as the act of obedience for baptism. He also seems to demonstrate some persevering in the faith over the years. Although these are not infallible signs of saving faith, there seems to be enough evidence to proceed in counseling as if Bruce is genuinely saved, expecting that more convincing evidence will be revealed as Bruce is transformed through sanctification. At a later point in the counseling if there would seemingly be no remorse for sin and no power to change but instead signs of rebellion against living for God’s glory, the salvation issue would need to be revisited.
When Bruce is asked how he spends his time, it appears that he spends a lot of his free time alone. There must be some reasons why Bruce is not surrounded by others. Does he repel others in social settings? Does he come across as prideful or arrogant or does he lack conversational skills? Because God created us for community living, the counselor will want to ask more questions in the area of relationships to determine specific patterns that prevent Bruce from close relationships so Relationships ought to be added to the agenda.
As Bruce talks about wanting fellowship, he then begins to reveal his desire for marriage. Both Dating and Marriage are agenda items that ought to be added to goals for future counseling sessions to provide the opportunity to explore God’s design for marriage with Bruce.
In the course of the first session, the counselor makes an observation and asks Bruce a question when he says, “It sounds like you’ve been diligent about your education, your career, your finances your physical health. Let me ask you this: On a scale of one to ten, with ten being the highest, how would you rate your spiritual life?” Bruce answered, “I suppose a five or six.” Bruce goes on to reveal that Bible reading, meditation, memorization and prayer have not been a priority for him. This should tell the counselor that Sanctification and Spiritual Growth as well as Disciplines of the Faith and Priorities ought to be added to the agenda.
When the counselor asked Bruce, “When you talk to God, what do you talk about?” Bruce’s answer should tell the counselor that Prayer as well as God Speaks are doctrines that ought to be included on the agenda.
As the counselor continues to seek answers to questions, Bruce reveals a very short list of areas in which he has been involved in serving. Given the fact that he has been in church his entire life, this is a bit surprising and indicates an area that must be dealt with in counseling. Therefore, Serving and Self-Occupied are areas that will need to be added to the agenda. Because we have already added Church to our agenda, there is an overlap, which is not uncommon. Therefore, as the counselor instructs Bruce in his responsibility as part of Christ’s church, two or three agenda items may be addressed at once. We do not yet know if Bruce tithes or consistently arrives on time for worship. The counselor could have asked him when they were on the topic, but since he did not ask, these are questions that ought to be added to “Questions to Ask the Counselee” (fig. 3.7).
One way that the counselor gathered data about Bruce was saying a series of single words and asking Bruce to indicate either “yes” or “no” as to whether or not that word described him. When the counselor said the word “addicted,” Bruce thought for a moment and then answered, “I don’t think so. I view pornography sometimes but I’m not addicted. I drink a little wine with meals but I’m not addicted. I guess my answer would be ‘no.’” Here we see that Bruce must think “a little” pornography is alright for a Christian to view. Teaching the biblical view of Sex and sexual activity should, therefore, be added to the agenda as well as the doctrine of Sin, since he does not seem to have a clear understanding of what sin is and the seriousness of it. Further questions should be added to the “Questions to Ask the Counselee” (fig. 3.5) about his pornography activity.
Another word that the counselor presented for Bruce’s response was “godly.” Bruce seems to think that godliness is determined by comparing himself to others rather than to God. Therefore Godliness should be added to the agenda and Bruce should be taught that God’s standards are the Christian’s standards. Majority does not rule.
When the counselor began the instruction on living for God’s glory, he asked Bruce, “Why do you exist? Why did God create you?” It seems that Bruce did not know that He was created for God’s glory. Even though the counselor explained his purpose to him from two Bible passages, additional teaching with homework may be beneficial. Because living for God’s glory is foundational for living the Christian life and because it will take some time for Bruce to begin to think in terms of living for God’s glory, God’s Glory should be added to the agenda.
When Bruce was asked, “Describe what comes to your mind when you hear the word ‘counseling,’ clearly he was not familiar with the discipleship process known as biblical counseling.” Depending on the counselee’s history or beliefs about secular counseling and mental health diagnoses, Biblical Counseling: What is it? (Appendix B) might be added to the agenda.
In addition to gleaning agenda items from the counselee’s answers, the counselee’s questions also can create items to be added to the Agenda. For example, while reviewing “What is Biblical Counseling?” Bruce asked the question, “Where in the Bible does it say we are supposed to change?” The counselor saw that the session time was coming to an end and he did not have time to show Bruce the answer in Scripture, so he gave him a biblical answer without showing him the biblical basis but also explained to Bruce that he would write down the question and give a more thorough answer in a subsequent session. Counselees often have good questions but the counselor should not allow the questions to deter the progress of the session. Nor should the question be ignored or cause the counselee to feel that questions are out of place. By maintaining an “Agenda Addendum: The Counselee’s Questions” (fig. 3.6) and addressing the questions at future sessions, the counselor can let the counselee know that questions are an important part of the learning and growing process.
Agenda Addendum: The Counselee’s Questions
|Questions asked by the Counselee||Counselor’s Answers||Date of Question||Date of Answer|
Figure 3.6. Agenda Addendum: The Counselee’s Questions
Most counselees will have occasional questions, but the counselee who interrupts the counselor repeatedly by asking questions, can be encouraged to jot down questions when they arise so as not to interrupt the flow of the session but to ensure that the counselor will, in fact, take the questions seriously.
After reviewing the notes for the session with Bruce, we now have the beginnings of an agenda or “Goals for Future Sessions” for counseling Bruce:
|· Biblical Counseling: What is it?
· Disciplines of the Faith
· God Speaks
· God’s Glory
· Gospel, salvation.
· Sanctification; Spiritual Growth
Figure 3.7. Agenda for counseling Bruce. This might also be referred to as “Goals for Future Sessions.” Resources and Scriptures to be used have not yet been added to the Agenda.
The list for “Goals for Future Sessions” for counseling Bruce may appear to be very long and it will most likely grow even longer as the counselor learns more about the counselee. This is not a concern and will be discussed further in Chapter 4, “Planning for the Next Session.” Some of the items in the list above overlap with other items. Others are more foundational, meaning once growth begins in that area, growth will extend into other areas as well. For example, once Bruce’s neglect of God’s Word and other disciplines of the faith are addressed, he may begin to be convicted of his own sins and the seriousness of them and so extensive teaching on every specific area listed will most likely not be required. Also, the counselor must bear in mind that the Holy Spirit will do much of the teaching between sessions through the Word and the homework assignments (Eph. 6:17; John 14:25-26, 16:13).
There are two resources recommended here that can help the counselor draw out additional agenda items from the counselee as well as assisting in defining the problems biblically. First, From Pride to Humility by Stuart Scott can be assigned as homework. This small booklet of only thirty-two pages explains pride and humility from a biblical basis and lists thirty manifestations of pride. If the counselee is asked to mark the manifestations that she identifies in herself, highlighting the top two or three that are most dominant in her daily life, some core issues will be brought to light and can be added to the agenda. Additionally, in Chapter 7 of this Toolkit, a resource entitled Transformed Into His Likeness by Armand P. Tiffe is highly recommended for counselors to use as a tool for the counselee’s transformation. In Transformed Into His Likeness, the author has listed one hundred and fourteen put-offs with respective put-ons and relevant Scriptures. By using this resource when introducing the counselee to the sanctification process, many more agenda items may be identified and defined biblically as the counselee is asked to mark every put-off that she sees in herself.
In the following chapter, “Planning for the Next Session,” the counselor will be instructed in what to do with the agenda that has been compiled but before moving on to planning for the next session, a Case Report for Session One ought to be prepared.
- The Case Report:
Now that the agenda is started, the next step is to prepare a Case Report. A Case Report is a series of written questions that the counselor answers after every session. This report provides excellent opportunity for supervising counselors as well as providing accountability, organizing data and maintaining detailed records of sessions. The official ACBC Case Report contains twelve questions:
- Significant background information
- Summary of reasons they came for counseling (presentation problem).
- What changes were made by the counselee since last session (as a result of applying last session’s counsel and performing last session’s homework)?
- What main problems were discussed in this session?
- What unbiblical habits of thinking and/or behaving are you seeing in the counselee (pre-conditioning)?
- What idols and/or heart issues are emerging? (“I must ___________.”)
- What Biblical solutions were presented in this session (tie in with #4)?
- What homework was given and how did it specifically apply to the problems (tie in with #4)?
- If someone asked the counselee right after the session, “What did you learn that you needed to change,” what would you want him to say?
- How was hope or encouragement given in this session?
- How is the overall counseling process progressing? What issues have been sufficiently addressed by you and changed by the counselee?
- What are your goals for future sessions?
Note that questions 7 and 8 in the list above are to be “tied in with #4”:
Question 4: What main problems were discussed during the session?
Question 7: What biblical solutions were presented during the session (tie in with #4).
Question 8: What homework was given and how did it specifically apply to the problems (tie in with #4)?
Together, Questions 4, 7 and 8 provide a complete picture of problems addressed in the session, but Questions 5 and 6 interrupt flow of thought both for the counselor composing the report and for the reader. For this reason, some counseling ministries have re-formatted the order of the questions in order to allow for Questions 4, 5 and 6 to work together in providing an uninterrupted picture of the counsel given in the session:
Question 4: What main problems were discussed in this session?
Question 5: What biblical solutions were presented in this session (tie in with #4)?
Question 6: What homework was given and how did it specifically apply to the problem (tie in with #4).
Another change that some counseling ministries have implemented is the re-wording of Questions 9 and 10 in order to provide for the counselee’s input rather than the counselor assuming what the counselee might be thinking:
ACBC Question 9: If someone asked the counselee right after the session, “What did you learn that you needed to change,” what would you want him to say?
Rephrased Question 9: At the end of the session how did the counselee answer the question, “What did you learn that you need to change?”
ACBC Question 10: How was hope or encouragement given in this session?
Rephrased Question 10: How did the counselee respond when they were asked, “How did you receive hope during the session today?” What verse related to hope did you use during the session?
It is because of the reworking of Questions 9 and 10 that the “Biblical Counseling Record and Lesson Plan” includes Item 9, “Case Report Questions” in order to remind the counselor to seek input on these two questions from the counselee in every session.
When a counselor is seeking ACBC certification, it is necessary to use the ACBC format. For use in local counseling ministries, it is at the counseling pastor’s or director’s discretion how these questions should be ordered or whether or not this form will be used at all. In fact, the counseling pastor or director may devise his own Case Report format.
Below, an explanation of how to complete the individual questions on the Case Report form is provided. The questions are formatted according to the changes discussed above.
Instructions for Completing the Case Report Questions
1. Significant Background Information—This information is predominantly gathered from the PDI and the first session. It should include basic information from all of the following areas: Family life growing up, finances, marriage and children, spiritual life, skills and abilities, free time and social activities and physical health (exercise, diet, sleep and medications). Typically, there is not a lot of data added to this section after the first session or two but where new facts are revealed about the counselee, this question is where the data would be recorded.
2. Summary of reasons they came for counseling (Presenting Problem)—This is what the counselee states as their reason for seeking counsel. This can generally be found on the PDI as the answer to the question, “Describe why you are seeking help.” The answer to this question will typically remain the same throughout the case. Although the counselee often presents only the central problem that is visible from her perspective, the counselor should be observing all facets of life, habits and behavior patterns that may be the root cause or complicating factors of the presenting problem.
3. What changes were made by the counselee since last session (as a result of applying last session’s counsel and performing the homework)?—The answer to this question can either be gleaned by the counselor while reviewing homework with the counselee or by directly asking the counselee the question in the session. Regardless of how the answer is obtained, it can be very helpful to maintain a list of all the weekly answers over the course of counseling, by simply dating the current answer and adding it to the top of the list of former answers. This provides a history of change that can guide the counselor and can greatly encourage the counselee by revisiting the answers in later sessions.
4. What main problems were discussed during the session?—In answer to this question, list all topics discussed during the session.
5. What biblical solutions were presented in this session (tie in with #4)?—In answer to this question, identify Scriptures, stories, examples, diagrams or rebukes used in addressing the problems discussed in Question #4 above.
6. What homework was given and how did it specifically apply to the problems (tie in with #4)?—Chapter 6 of this Toolkit provides specific instruction regarding the assigning of relevant homework. In short, homework should nearly always include assignments from the following five areas:
- Bible reading and study
- Scripture memorization and meditation (mulling over ways to implement the passage into every-day life)
- Collateral reading (a theologically-sound book or pamphlet relevant to the counselee’s problem)
- Church attendance, involvement and/or note-taking
- Projects include anything that the counselee is asked to do, apart from the above
If the homework assignments are listed electronically in the “Biblical Counseling Record and Lesson Plan” for the session, then simply copying and pasting into the Case Report will streamline the answer to this question. However, it should be noted that a supervising counselor will generally require that the purpose for each assignment be included in the answer to this question. See the section entitled “Purposes that Drive Homework Assignments” at the end of Chapter 6
7. What unbiblical habits of thinking and/or behaving are you seeing in the counselee (pre-conditioning)?—The items listed under this question, ought to generate items to be included in the Agenda/Goals for Future Sessions (Question 12 below). Here the counselor identifies unbiblical thoughts, habits and behaviors in which the counselee reacts to the presenting problem (listed in Question #2). For example, the counselee may have presented the problem as “Marriage problems,” but the counselee’s thoughts and actions may be complicating the presenting problem. If a spouse thinks, “I have the right to be loved” or wallows in self-pity or has a pattern of reacting in anger with unkind words, slamming doors, a harsh tone of voice or “the silent treatment,” the initial problem will be compounded. These unbiblical habits, once identified, can be listed in answer to this question. Often patterns of response have years of history and must be identified before a transformation plan can be implemented and growth can begin in the particular area of sin.
8. What idols and/or heart issues are emerging? (“I must_____”)—Here the counselor identifies the counselee’s ruling heart motives, as opposed to behaviors or thought patterns. The answers to this question will generate additional Agenda items or may overlap topics already listed in the Agenda/Goals for Future Sessions (Question 12 below). Even though the counselee may think that the problem is what she stated on the PDI (i.e., marriage or communication problems, for example), by identifying the underlying heart issue early in counseling, the counselor can help the counselee to reap dividends early. To determine idols or underlying heart motives, the question can be asked, “What does the counselee want more than the desire to glorify God?” Also, filling in the blanks to the following statements, can provide answers. The counselor can assign these types of questions as homework for the counselee to answer. For more understanding on heart idols, see Elyse Fitzpatrick’s book Idols of the Heart.
- I have the right to________________________
- I am willing to sin in order to have___________
- I will sin if I don’t get _____________________
- I need__________________________________
- I want__________________________above everything else
9. At the end of the session how did the counselee answer the question, “What did you learn that you need to change?”—This question presents an opportunity for the counselor to learn what made an impact on the counselee in the session. This question should be asked of the counselee at the end of every session and the counselee’s answer stated here. The counselee may need to be reminded of the question at the beginning of the session, so she stays alert to looking for the answer(s). This is not an opportunity for the counselor to relay what he wants the counselee to say. It can also be helpful to leave prior answers to this question recorded here, dating the current answer and adding it to the top of the list. This provides a history that can be helpful to the supervisor, the counselor and the counselee (similar process as in Question #3 above).
10. How did the counselee respond when they were asked, “How did you receive hope during the session today?” What verse related to hope did you use during the session?—Here the counselor relates his attempt at instilling hope by listing the Scripture passage(s) used, but also identifies the counselee’s response to the question. This is not an opportunity for the counselor to relay what he wants the counselee to say. The counselor may think he is instilling hope when turning the counselee toward a particular Scripture passage, but the counselee’s response may be an encouraging word that was spoken in passing. The counselee’s answer can help the counselor to understand how hope is being built for the counselee. Counselees who feel hopeless often hang their hope on that of the counselor’s so an encouraging word from the counselor may be what she identifies as building hope. It is important to note this response. The counselor’s hope may carry her for a season, but the time should come when she begins to place her hope in Christ and in His promises.
11. How is the overall counseling process going? What issues have been sufficiently addressed by you and changed by the counselee?—This question helps the counselor to identify areas that can be removed from the Agenda. This is another question where former answers can be maintained within the Case Report and the current answer dated and added to the top of the list in order to provide a history of areas that have been taught and changed.
12. What are goals for future sessions?—This is where the counselor’s agenda is recorded and maintained (See “Analyzing the Data to Build the Agenda” on page 46). For maintaining an ACBC Agenda for supervised counseling, this section should include not only the areas to be addressed, but also Scripture passages and resources to be used (second column of the “Agenda Log” checklist – See Appendix D). For a local biblical counseling ministry, the counseling pastor or director will determine how much detail the counselor should include in this section.
 Paul D. Tripp, Instruments in the Redeemer’s Hands (Phillipsburg, NJ: P&R Publishing, 2002), 245.
 For helpful resources relating to the remaining agenda items, see “Recommended Resources” online at www.bctoolkit.net as well as resources available at www.faithlafayette.org/store, www.focuspublishing.com, www.biblicalcounseling.com and www.ccef.org/resources.
 Tripp, 246-251.
 Adapted from Robert Somerville’s Sample Counseling Forms for BC592 Counseling Internship, (Santa Clarita, CA: The Master’s College, Revised January 12, 2012), 75.
 Marshall and Mary Asher, The Christian’s Guide to Psychological Terms (Bemidji, MN: Focus Publishing, 2004), 31.
 The official ACBC Case Report form can be found on the ACBC website: http://www.biblicalcounseling.com/uploads/blog/ACBC-Case-Report-Form.pdf.
The Association of Certified Biblical Counselors, “Phase 3 Supervision, Case Report Forms,” (Revised 1-30-06. Louisville, KY), accessed November 13, 2014, http://www.biblicalcounseling.com/uploads/blog/ACBC-Case-Report-Form.pdf.