Addiction A-Z

Pastoral counseling and psychotherapy

Pastoral counseling is a term that has different meanings depending on the context.  Many people think of it as the spiritual or Biblical guidance offered by the pastor of a church, primarily to members of the congregation but also, at times, to non-church members who may come to the church seeking spiritual help during times of crisis or uncertainty.  In this specific context, pastoral counseling is a typical and very frequent part of the job – i.e., part of “tending the flock” – for any member of the clergy.  As a general rule, however, this type of pastoral “counseling” isn’t to be construed as formal psychotherapy or mental health counseling.

Pastoral counseling also refers to a specialized form of psychotherapy or counseling offered by licensed mental health professionals who have been formally trained in pastoral counseling (which is the primary focus of this article).   In addition to their training in psychology or a related field, these professional counselors have in-depth graduate level training in theology and religion.  This enables them to address the psychospiritual issues, as well as the mental health issues, with which many people struggle.  It also gives them a unique qualification and perspective that most secular counselors and therapists lack.

Although the terms “pastoral counseling” and “pastoral psychotherapy” are often used interchangeably, some prefer to establish a distinction between the two.  This is primarily due to the fact that counseling, as a general rule, is usually a more short-term, solution-focused approach to dealing with a problem. Psychotherapy, on the other hand, usually implies a longer-term, more in-depth therapeutic relationship between therapist and client.  (This distinction is not meant to diminish either term, nor make one seem superior or more important than the other. For the sake of this article, “pastoral counseling” will be used throughout, but with the intent to include psychotherapy in its meaning.)

A Growing Demand

The Washington Post published an article back in 2005 that showcased the growing demand and need for therapy that included a strong spiritual element.  The article, written by Alison Buckholtz, was aptly titled: Help From Above: In Times of Trouble, Growing Numbers of People Take Comfort in Faith-Based Therapy. 

According to a 2014 survey of 35,000 Americans, approximately 80% identify themselves as Christians. [1] Other surveys in recent years have shown percentages as high as 83%.  In addition, a Gallup poll conducted in the early 1990s showed that nearly two-thirds of those surveyed preferred a mental health therapist who represented spiritual beliefs and values, over 80% wanted therapy to include their personal beliefs and values.  Considering these numbers, it shouldn’t be a surprise that a fairly significant number of those seeking professional help for emotional, psychological, or behavioral problems would choose a therapist who not only understands the role of spirituality and faith in the struggles they face, but who is also qualified and prepared to address it in therapy sessions.

The therapy provided by pastoral counselors integrates clinical methods and theories of secular psychology with theology and Biblical (and / or other spiritual) teachings and principles.  Pastoral counselors respect and acknowledge their therapy clients’ spiritual beliefs, needs, and concerns.  Since religious beliefs and spirituality are frequently minimized or excluded in secular psychotherapy, pastoral counseling addresses an important aspect of the human experience.  Some would argue that addressing spiritual issues naturally results in a more holistic approach to therapy.

Some certified pastoral counselors provide counseling services as a paid staff member of a church.  This can be a tremendous help to church pastors, many of whom already have an overwhelming work load week after week.  Many pastoral counselors, however, offer their services in non-church settings, often in a private practice setting or as part of a larger group of pastoral counselors, unaffiliated with a specific church.  Whether or not they are affiliated with a specific denomination or faith (with regards to their counseling work) may depend on the practice (e.g. a group of pastoral counselors in a clinic setting) or the individual counselor.  Many pastoral counselors work with individuals of all faiths, and don’t attempt to impose their personal beliefs upon the clients who seek their services

Bridging the Gap

Pastoral counseling strives to provide a much-needed alternative to purely secular therapy and heavily biased or strict religious or “Christian” counseling.  In the secular setting, many therapists are uncomfortable with religious issues.  This can be due to several factors, including their own discomfort with religion, having a client whose beliefs are vastly different to or in conflict with their own, or feeling that their lack of knowledge makes them inadequate to address specific religious or spiritual issues.

On the other side of the coin, some religious counselors are unable to honor the beliefs of anyone whose faith or views differ from their own.  Even if they’re able to hide their bias (and judgement) from those they’re trying to help, it will inevitably have a negative influence on their interactions.  Unfortunately, this can cause harm to vulnerable clients, particularly if the message they receive, directly or indirectly, is that their problem (e.g. their depression, anxiety, relationship issues, marital problems, etc.) is the direct result of sin in their life, a lack of faith, or because they’re not “walking with the Lord”.   There are many people who want absolutely nothing to do with any type of religious / spiritual / pastoral counseling because they don’t want to relive painful past experiences in which they felt harshly judged or “preached at” by someone with strong religious beliefs.

Today, many people are seeking professional help – not just for difficult issues or circumstances in their life, but also for serious mental health issues – that specifically includes a strong spiritual component.  Even non-religious individuals find comfort in the possibility that there may be a loving God, higher power, or “Source”.  The possibility of something bigger can help ease the pain, especially for someone who feels all alone, who’s struggling to find meaning or purpose in life, or who is desperately trying to come to turns with or make sense of the harsh unfairness of life.  Pastoral counselors are trained to address sensitive spiritual issues in a way that isn’t preachy, on the one hand, or overly intellectualized or completely lacking on the other.

Pastoral counselors, like all mental health professionals, are trained to recognize the warning signs of potential homicidal or suicidal tendencies in their clients and obligated to alert the proper authorities when warranted.  They are also trained to identify symptoms of psychosis, such as hallucinations or delusions.  They are qualified to handle these types of clients and situations, and obligated to provide appropriate referrals for individuals who need a higher level or different type of treatment (e.g. alcohol or drug rehab or residential treatment for an eating disorder).

Certified pastoral counselors are trained in mental health assessment and are educated regarding safety concerns, including warning signs of suicidal or homicidal tendencies and symptoms of psychosis, such as delusions. Pastoral counselors who work in mental health agencies may be best able to respond to these psychiatric emergencies appropriately and expeditiously.

Services Provided by Pastoral Counselors

Pastoral counselors can provide a wide range of services, including:

  • Individual counseling
  • Family counseling
  • Group counseling
  • Couples and marriage counseling
  • Pre-marital counseling
  • Community education
  • Clergy assessment
  • Supervision (e.g. of pastoral counseling students and interns)

Like many mental health professionals, some pastoral counselors specialize in treating certain populations (e.g. couples, elderly individuals, or adolescents) or disorders (e.g. trauma and PTSD).  Areas of specialty or focus may include (but aren’t limited to):

  • Children
  • Adolescents
  • Adults
  • Couples
  • Families
  • Elderly individuals
  • Veterans / Active military personnel
  • LGBT individuals
  • Trauma survivors
  • First responders
  • Terminally ill / hospice patients
  • Grief and loss
  • Caregivers

Disorders, Conditions, and Issues that may Benefit from Pastoral Counseling

As a general rule, pastoral counselors are qualified to treat individuals with the same disorders and problems as any other type of mental health counselor, including:

  • Depression
  • Anxiety disorders
  • Substance abuse and addiction
  • Stress
  • Relationship problems
  • Anger issues
  • PTSD and unresolved trauma
  • Spiritual issues / crisis of faith
  • Parenting
  • Behavioral problems
  • Domestic violence (victims and offenders)

Spirituality, religious beliefs, and / or existential issues often play a prominent role in problems that many people struggle with, such as:

  • Feelings of hopelessness
  • Feelings of worthlessness
  • Addiction recovery (e.g. traditional 12-step programs have a strong faith element)
  • Difficulties with forgiveness (of others, self, and even God)
  • Suicidal ideation and behavior
  • Divorce (those considering divorce or recovering from divorce)
  • Finding love / coping with being single
  • Aging
  • Death and dying
  • Terminal illness
  • Coping with the death of a loved one
  • Coping with chronic illness or disability
  • Major life transitions
  • Excessive guilt
  • Shame
  • Letting go of the past
  • Finding purpose or meaning in life
  • Self-esteem
  • Struggles or concerns related to sexual orientation
  • Coping in the aftermath of tragedy
  • Difficulties choosing a career or path in life
  • Conflicts with regards to one’s family or one’s own faith or religious beliefs
  • Individuals who believe something bad in their life (including a mental illness) is punishment for sin or a lack of faith

While many types of psychotherapy can help individuals work through any of these, pastoral counseling may be especially helpful for those who grapple with the spiritual, theological, and existential questions and issues they often trigger.

Contraindications for Pastoral Counseling

Pastoral counseling isn’t appropriate for everyone.  In fact, in some cases or situations it would be highly inappropriate to use it.  Contraindications include:

  • Pastoral counseling that creates a dual (and often confusing) role between client and counselor, such as pastoral counseling from one’s own pastor, training supervisor, or seminary (or graduate school) professor
  • Clients who are already in therapy with someone else, and adding or switching to pastoral counseling could potentially confuse, muddy, or weaken what’s already been or is being accomplished in therapy
  • Clients who have no interest in or who clearly denounce any belief in religion or spirituality
  • Clients who are attempting to use pastoral counseling for appearances’ sake (e.g. to look “healthier” or more “open”) or other hidden agendas

Approach to Treatment

Pastoral counselors, like other types of therapists and counselors, vary in terms of their theoretical orientation and the type of therapy or counseling they offer.  In other words, there isn’t one specific therapeutic approach or type of counseling that’s used by all pastoral counselors.  For example, some pastors may have a psychodynamic approach to therapy, while others base their therapy on cognitive behavioral principles or a family systems model.  Others may use an eclectic or integrated approach to therapy, meaning they combine elements of two or more theoretical approaches (eclectic) or tailor their approach (drawing from different theories and methods) to fit the specific needs of each client (integrated).  Also, some pastoral counselors may use specialized therapy methods such as EMDR (eye movement desensitization reprocessing) or sand tray (or sandplay) therapy when warranted.

Pastoral Counseling vs Traditional Counseling / Secular Psychotherapy

In many ways, pastoral counseling is very similar to traditional counseling and secular approaches to psychotherapy.  However, there are several things that set it apart and make it truly distinct in its own right.  These include:

  • The vast majority of pastoral counselors believe in the Biblical God or some other higher / divine power
  • Spiritual issues, faith, and personal beliefs play a prominent role in the counseling process; pastoral counselors help you use your beliefs to resolve and / or cope with the challenges in your life
  • Pastoral counselors have a strong background in theology or a related field, and are well-trained to handle issues related to faith and spirituality

Pastoral counseling differs from other forms of therapy and counseling in other significant ways as well.  For example, it’s not uncommon for pastoral counselors to encourage prayer and use it in the session in a therapeutic way (depending on the client). They may also encourage clients to establish a connection (or strengthen the one they have) with their religious community.

It should be noted that the role of a pastoral counselor does not include preaching, judging, shaming, blaming (e.g. “you’re suffering because of sin in your life” or “God’s punishing you”), or disrespecting their clients’ beliefs.  Like other mental health therapists and counselors, they are expected to create a safe and caring environment for their clients; one that includes genuine support, empathy, compassion, and sensitivity to their clients’ needs and concerns.

Educational and Licensure Requirements for Pastoral Counselors

Pastoral counselors come from a variety of backgrounds in terms of their education, experience, certifications, and licensure, including:

  • Licensed clinical psychologists (Ph.D., Psy.D., Ed.D.)
  • Licensed professional counselors (LPC)
  • Licensed clinical social workers (LCSW)
  • Licensed clinical professional counselors (LCPC)
  • Licensed marriage and family therapists (LMFT)
  • Licensed mental health counselors (LMHC)
  • Licensed marriage and family counselors (LMFC)
  • Licensed pastoral counselors (LPC)
  • Licensed clinical pastoral therapists (LCPT)
  • Licensed pastoral psychotherapists (LPP)

In addition to the above, many pastoral counselors are also ordained ministers.

While the educational and licensure requirements may vary somewhat from state to state (within the U.S.), pastoral counselors are generally required to:

  • Have a bachelor’s degree, usually in psychology, sociology, theology, religious studies, or a related field
  • Have a master’s and / or doctorate  in a related field, such as a Master of Divinity, (M.Div.), Doctor of Divinity (D.D.) in pastoral counseling, Doctor of Ministry (D.Min.) in Pastoral Counseling, Master of Art’s (M.A.) in Pastoral Counseling, Doctor of Philosophy in Pastoral Counseling (Ph.D.) or Doctor of Theology (Th.D.) in Pastoral Counseling
  • Have a required number of supervised clinical hours (this usually involves providing therapy or counseling services, including crisis as well as long-term situations)
  • Personal psychotherapy (required by some programs, but no longer required for AAPC certification)

Pastoral counselors are required to have a license to practice in most states in the U.S.  Only 6 states, however, currently offer the LPC (Licensed Pastoral Counselor) license.  Pastoral counselors in the other 44 states will often get additional training (if needed, depending on the states) to obtain licensure as a professional counselor, marriage and family therapist, or other licensed mental health professional so they can practice in the state.

In addition to professional licensure, many pastoral counselors obtain their certification in pastoral counseling from the American Association of Pastoral Counselors (AAPC).  The two certifications offered are for Certified Pastoral Counselor (CpastC) and Certified Clinical Pastoral Therapist (CCPT).  In order to be certified, the AAPC requires pastoral counselors to have a minimum of 375 pastoral counseling hours under their belt and 125 supervised hours in a training program that’s been approved by the AAPC.  They must also be actively involved in their church or religious community, be endorsed by the religious community’s leaders, and have at least three years of ministry experience.  It should be noted that the AAPC holds its members to a very high code of ethics, which is outlined on their website.

The AAPC was established in 1963.  In addition to setting the standards for professional conduct for its members, the AAPC also approves pastoral counseling training programs, sets the criteria for credentialing, accredits pastoral counseling centers, and determines whether or not pastoral counselors have met all the requirements for certification.

Settings for Pastoral Counselors

With the growing demand for therapists who are both attuned to and qualified to address the spiritual needs of their clients, pastoral counselors can be found in many different settings.  Besides churches and group or individual private practice offices, pastoral counselors can be found offering their services in the following settings:

  • Military bases
  • Nursing homes
  • Hospice care facilities
  • Correctional institutions
  • Drug and alcohol treatment facilities
  • Community centers
  • Hospitals, including Veterans’ Hospitals

Finding a Certified Pastoral Counselor

If you’re interested in working with a certified pastoral counselor there are several ways you can go about finding one in your area.  You can search online for pastoral counseling followed by [your city].  The listings that appear should give you a good starting point.  You can contact a local church or seminary (if there’s one in your area) if they can recommend any certified pastoral counselors in the area.  You may also consider contacting the American Association of Pastoral Counselors to see if they can give you a few names of pastoral counselors in your city.

Before starting counseling with any pastoral counselor (or any therapist or counselor), be sure to do your due diligence.  It’s important to find someone who has the proper training, certification, and licensure to offer the type of counseling you’re seeking.  It’s also a good idea to ask about the person’s counseling experience in general, as well as his or her experience working with individuals with a similar issue or disorder (e.g. PTSD, an addiction, or sexual orientation issues) as yours.

If you ascribe to a particular faith (e.g. Christianity, Catholicism, or Judaism) you may feel more comfortable working with a pastoral counselor who shares your faith.  This isn’t mandatory or necessary; it’s based on your personal preference and comfort level and something to keep in mind when selecting a counselor.  As a general rule, certified pastoral counselors are trained to respect the faith and beliefs of each individual client, whether they’re the same or completely different than their own.   Their goal isn’t to convert you to their faith or religious viewpoint; rather, it’s to help you within the context of your faith, belief system, and spiritual values.

Pastoral counselors have helped millions of people over the years work through difficult life circumstances, emotional pain, challenging psychological issues, and spiritual struggles.  If you prefer a holistic approach to mental health treatment that integrates psychology, theology, and spirituality, then pastoral counseling is definitely worth considering.

References:

[1] http://www.pewforum.org/2015/05/12/americas-changing-religious-landscape/

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