Where does Pastoral Care End?

Jenna and Mike were married for eight years – eight long years as Jenna described them to her pastor. She couldn’t do it anymore, she told Pastor Logan. She loved Mike, but his constant demeaning and belittling of her had made her anxious, depressed, and overwhelmed with life. As she sat across from Pastor Logan, he could see that she was looking for his blessing, for him to say that it was okay to get a divorce. But Pastor Logan could not bring himself to say that divorce did not grieve the heart of God. He told her that he could see that she was hurting, but he could not condone divorce. Jenna left in tears, deflated by his words, and Pastor Logan was left to decide whether he did the right thing.

While this is a fictional situation, the story rings all too familiar in many churches. As ministers of the Word of God, pastors have ethical demands upon them to steward the Word of God faithfully. Our understandings of what that faithful stewardship of the Word entails will vary, but what should be consistent is how we as pastors recognize when a situation is beyond the scope of our calling or capacities.

Pastors have a critical role to play in pointing people to the life-giving salvation we find in Jesus Christ. But there are multiple situations when counseling is beyond a pastor’s scope or capacity. I would offer the following three “rules of thumb” for pastors seeking to discern when to refer a congregant elsewhere for help.

PASTOR, KNOW THYSELF

Much of the work of being a pastor entails recognizing our limits, whether that is knowing where we end and God begins or recognizing when it is necessary to refer for professional mental health care. As pastors, it is critical that we are cognizant of the scope of our role, the limitations of our training, and even the baggage we carry as sinners saved by grace alone. The pastoral task is to proclaim the Gospel message in word and in deed, to seek to remove the barriers between people and God, and to equip people to follow Christ more closely and love others more deeply. A key component of this role is the art of referral. We need to recognize what we have the power to do and what we do not, refer people to get the help they need – whether from God, a professional, or elsewhere – and ultimately, get out of the way.

CREATE A PROCESS FOR TRIAGE

Wise pastoral leaders advise referring to a mental health professional either when pastoral counseling is needed beyond three meetings, or as soon as a mental health issue that requires the training of a mental health professional comes up. Some of the issues that deem referral to a mental health professional like a trained psychotherapist or social worker include: situations of abuse, someone struggling with an addiction, and mental illnesses including clinical depression or an anxiety disorder.

DEVELOP A REFERRAL LIST

A list of capable professionals can be a key resource for pastors to develop over the course of their ministry. Generating such a list could involve asking licensed professionals who are part of your church community to recommend practitioners they trust who do not go to your church. Many counselors wisely avoid working with people from their own congregation, but I am always surprised by the number of counselors who see people from their church in a professional capacity.

As most of us are not trained to recognize psychosis, it is wise to refer whenever we suspect that someone might be experiencing mental illness, abuse, or an addiction. Once you develop a referral list, a professional that you trust can probably provide you with some key indicators for when it is time to refer. As pastors, it is always appropriate to follow up with a congregant to see if they have gotten the help they need and how they are doing. It is also helpful to know which mental health assistance programs are available in your area. Many congregations participate in programs that offer a limited number of sessions at no cost to people in their congregation.

Referring to a counselor does not mean that Jesus is not sufficient to meet someone’s needs or that prayer doesn’t work to change hearts and minds and lives. It simply means that we, as pastors, cannot meet all their needs. There are a myriad of ways that God meets our needs and mental health care is one of them. But just as I, a pastor, would not attempt to diagnose and treat someone’s cancer, I would not feign to imagine that I can effectively diagnose and treat an addiction.

Getting back to Jenna and Mike. How should Pastor Logan have handled the situation? Even as Pastor Logan was having trouble identifying the situation as abusive, it was clear to him that Jenna was significantly struggling. And Jenna did not need a moral prescription for her situation. I remember hearing from a professor in seminary that divorce is the murder of a marriage. To an extent, I would agree. The end of a marriage is murder. But as I tell the people I counsel, sometimes the marriage has already been stabbed to death by one partner, and filing for divorce is simply the act of pulling the knife out of the wound so that it can heal.

As pastors, we have a profound privilege to speak Christ into the lives of others. It is a privilege we cannot take lightly. With God’s help and the help of trained professionals, we can live fully into our roles and contribute to the flourishing of our church communities.

Shannon Jammal-Hollemans
Adjunct Professor at Cornerstone University (MDiv at Calvin Theological Seminary)