The history of the evangelical attitudes to therapy is complex. Several of the historical roots to a general suspicion of psychological perceptive are explored. Freudian psychoanalysis and fundamentalism were not compatible and for decades no attempt at rapprochement developed. The liberal wing of Christianity made early attempts with the religion/psychiatry dialogue of the 1960s. Drastic changes in the youth of the evangelical, especially on the college campus in the 1960s, broke through some of the resistance. A growing disillusionment on the part of the evangelical in the pew concerning the efficacy of the traditional spiritual approach to relational and emotional problems accompanied these changes. The literalism and rigidity of a paranoid stance toward psychological insights has given way to a kind of chaos. The evangelical person seeks outside the church too. There is no consensus theoretically or practically among the many from within the church who are therapists. There are many strengths in the evangelical. These include family and developmental emphases in psychotherapy. The effective therapist will comfortably explore the religious life of the evangelical as it is relevant to the therapeutic task. Acceptance and elimination of countertransferential bias will foster the honesty and mutual respect that are essential for positive outcomes in therapy.