Meeting the Needs of the Wounded: The Importance of Pastoral Counselors

Photo by Nik Shuliahin on Unsplash

Not far from where I’m sitting, an old gnarly giant oak tree once towered over the landscape. A few weeks ago, much like Job, it struggled to stay upright as each round of frozen torment pounded down. Its branches bowed more and more, sometimes cracking and breaking, and I could almost hear it crying out, “For my sighing comes like my bread, and my groanings are poured out like water. Truly the thing that I fear comes upon me, and what I dread befalls me. I am not at ease, nor am I quiet; I have no rest; but trouble comes (Job 3:24-26).” 

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Like the Great Oak, many of us have found ourselves beaten down by life’s storms. Yet, when we reached out for help, we found only “quick fix” advice reminiscent of Job’s friends: “Pray more,” “Take every thought captive,” “Confess your sins,” and “Have more faith.” These hopefully well-intended words fell far short in empathy and effectiveness, particularly when spoken by our pastors. While each holds some truth, these rote Christian responses too often invalidate our painful lived realities—first, by not sitting with us in our suffering, and second, by forgetting that perhaps the most pernicious effects of sin and brokenness happen in our minds, making it difficult or even impossible for us to change our thoughts and emotions on our own. 

Just as the brokenness of this world has generated viruses, bacteria, injuries, and all sorts of medical issues that prevent the body from healing on its own, it has done likewise—through loss, trauma, problematic neurochemistry, relationship difficulties, and a host of other malefactors—to obstruct our thoughts, emotions, and will from correcting themselves without assistance. We sometimes need intervention to heal, and when we don’t get it, other things begin to fester, like doubt in a loving and good God.

The Need for Pastoral Counseling

John Wesley was committed to a holistic form of pastoral ministry in which pastors cared for all the needs of their people, including the spiritual and the physical (Randy Maddox, “John Wesley on Holistic Health and Healing,” 2007, 8). Wesley even seemed to understand that the psychological, given its indivisible connection with the soul and the body, is essential to ministry, acknowledging both its physical contributors as well as its spiritual components (Maddox, 16). In fact, both physical and psychological suffering most often raise existential and spiritual questions for people. Having well-trained pastors and leaders who not only understand mental illness but also have learned skills of pastoral counseling—such as being present in suffering, listening deeply, challenging distorted views of God and others, administering grace, engaging the spiritual disciplines, and speaking life to the hurting—is crucial to whole-person ministry. 

Consider the mission field of mental health: One out of four US adults will have a diagnosable mental health condition this year (Substance Abuse and Mental Health Services Administration, Key Substance Use and Mental Health Indicators, 2023, 40). In fact, half of us, that is, every other person reading this article, will have experienced a diagnosable mental illness at some point (Ronald Kessler, “Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders,” 2005). The rest of us most likely will have some mental health struggles too, even if we don’t fully meet the diagnostic criteria, just like the “almost sickness” we’ve experienced in our physical bodies from time to time. 

Being a Christian—even a pastor—does not reduce these likelihoods (Lifeway Research, “Study of Acute Mental Illness and Christian Faith,” 2014, 5). 

Abdication of the Ministry of Counseling

The people in our pews are hurting, both with mental health concerns and the corresponding spiritual questions. Most will not seek out a professional counselor, and the majority believe pastors should offer counseling and soul care; however, most pastors tend to disagree and are woefully underprepared to provide care (Barna Group, “How Pastors & Non-Christians See the Church’s Role,” 2023). In a 2014 study by Baylor University, only a third of seminaries required more than one pastoral counseling course, and one out of five required none (Halle Ross-Young & Matthew Stanford, “Training and Education of North American Master’s of Divinity Students in Relation to Serious Mental Illness,” 2014, 181-182). While most offered pastoral counseling courses as electives, students typically did not have space in their program requirements to add them. This material was most often not even found in extracurricular activities or fieldwork experiences (Ross-Young & Stanford, 183). Not surprisingly then, we are seeing a growing number of seminaries lessening academic requirements in pastoral counseling, sometimes even canceling their pastoral counseling degrees altogether. 

As a result, two-thirds of pastors rarely, if ever, speak to mental health issues in sermons or other messages (Lifeway Research, “1 in 4 Pastors Have Mental Illness,” 2014), and the majority of evangelical and fundamentalist Christians believe that prayer and Bible study alone can “fix” even the most serious forms of mental illness (Lifeway Research, “Half of Evangelicals Believe,” 2013). Because of the lack of pastoral counseling training for those entering ministry, mental health care in the Church too often over-spiritualizes psychological struggles and provides overly simplified solutions, like the utterance of trite Christian epithets that bring shame rather than healing. Too many pastors are neither prepared for nor interested in this kind of real-life suffering.

In fact, the Church has relegated this area of ministry to mental health professionals. 

As a licensed mental health professional myself, I appreciate the acknowledgment of our specialized training and skills in treating mental illness, but this relegation of care by the Church is a failure fully to carry out the mission of Christ. An increasing number of people in the Church seem to have written it off as unimportant to the work that we do, as more and more often this task is handed it over to professionals who cannot do what pastors and pastoral counselors do – that is, help people find healing, transformation, and sustenance in Christ.

The Shortcomings of Non-Pastoral Mental Healthcare

Never would I say the work of mental health professionals is unimportant. They serve as a critical and unique role in the healing process for many, but, speaking as someone who is both a psychotherapist and a pastor, they are neither substitutes for, nor interchangeable with, pastors and pastoral counselors. To claim otherwise would be the same as exchanging a landscaper with an arborist who specializes in healing trees. 

Nearly 80% of mental health professionals are not trained to address religiosity and spirituality as anything more than a coping skill despite a growing awareness in the field that faith matters to people’s well-being (for example, Cassandra Vieten et al., “Competencies for Psychologists in the Domains of Religion and Spirituality,” 2016, 100-101). Yet, about half of them believe that they are competent to do so (Cassandra Vieten et al., “Mental Health Professionals’ Perspectives on the Relevance of Religion and Spirituality to Mental Health Care,” 2023, 5), which is a greater percentage than claim to be Christian themselves (Vieten, Additional File 4). 

Without training to recognize spiritual disease, mental health professionals are apt to miss the spiritual searching that often accompanies the psychological struggle. While Wesley did not conflate the two of these, understanding that one may exist with the other, he was concerned that medical professionals do not have the eyes to see the former. He wrote, 

When physicians meet with disorders which they do not understand, they commonly term them nervous; a word that . . . is a good cover for learned ignorance. But these are often no natural disorder of the body, but the hand of God upon the soul, being a dull consciousness of the want of God . . . . It is no wonder that those who are strangers to religion should not know what to make of this; and that, consequently, all their prescriptions should be useless, seeing they quite mistake the case (Wesley, cited in Maddox, 16). 

Those who do seek such training quickly find this training lacking any significant knowledge of Scripture, theology, spiritual disciplines, and the life of faith. Organizations like the Association for Spiritual, Ethical, and Religious Values in Counseling (ASERVIC) strive to improve counselors’ ability to work with clients’ spirituality alongside their mental health concerns, their stated competencies seem to suggest that counselors approach faith as any other worldview that clients might hold… without the specific knowledge of, and experience within, that faith to bring about deep level spiritual formation (ASERVIC, “Spiritual and Religious Competencies,” 2009). Fortunately, ASERVIC does highlight the need for practitioners to bring religious and spiritual leaders into the treatment process.

Seminary-trained mental health counselors not only have more training in these spirituality-focused skills, but also, to some degree, training in biblical studies, theology, and other aspects of faith. We need more of them; there just are not enough Christian counselors to meet the need. Yet, as licensed mental health workers, they remain bound to the laws and ethics of their governments and professional organizations, both of which tend to influence, and limit, the way they perceive and engage faith concerns. There is one other critical deficit in most seminary-trained mental health counselors: they are NOT pastors. 

Soul Care: The Domain of Pastoral Counseling

As a therapist and President of the American Association of Christian Counselors, Tim Clinton claimed, “The Church is needed to provide soul care” (“Presidential Address,” 2013). It is for this very mission, one essential to ministry, that we train our pastoral counseling and ministry students here at Asbury Theological Seminary. 

Christian psychologist David Benner defines pastoral counseling as 

the establishment of a time-limited relationship that is structured to provide comfort for troubled persons by enhancing their awareness of God’s grace and faithful presence and thereby increasing their ability to live their lives more fully in the light of these realizations. The essence of pastoral counseling is helping troubled people bring their woundedness, struggles, doubts, and anxieties into dynamic healing contact with the God who is known by his people as the wonderful Counselor (Benner, Strategic Pastoral Counseling: A Short-Term Structured Model, 2003, 40). 

While pastoral counselors use the same skills and lean on the same scientific research as other mental health professionals, they also draw upon the well-worn practices of the historic Church to provide soul care, guiding and engaging people in their experiences and wrestling with God as they bear the weight of life’s burdens. 

When we engage in the counseling ministry of pastors, we are uniquely attentive to spiritual disease, and its potential cures, embedded within the context of emotional distress. We meet people in the thick of their struggle without severing the spiritual from the psychological. We collaborate with the Holy Spirit to follow His leading in the healing journey of individuals. We help people position their stories within the larger narrative of grace, and we use the spiritual disciplines and sacraments as tools to facilitate healing, sanctification, and relationship with the Divine. Sometimes we wield the spiritual authority we carry to identify sin, to call people to repentance, to pronounce forgiveness and love, to speak prophetic words of life, and to instill hope. 

When I think of how my role as a pastoral counselor differs from my role as a psychologist, the words of Gregory of Nyssa come to mind: “Concepts create idols; only wonder comprehends anything. People kill one another over idols. Wonder makes us fall to our knees” (Life of Moses). We pastoral counselors know that knowing about God—even knowing correctly—is not the same as knowing God, and we walk with people in the midst of their emotional pain and mental illness to help them encounter the Great Physician.

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Wonder overcame me as I drove past that Great Oak and the surrounding fields, still frozen in ice, on the first sunny day after the storms. I was surrounded by a vast crystallized sea, glistening like the purest of diamonds all around me. The sun is always present, as is God’s grace, but there was something about seeing it reflected in the pain of that ice coating that made it even more real and more beautiful. 

Pastoral counselors help people to find an always-present God and the healing, transforming power of Christ amidst their storms.

Janet B. Dean is Professor of Pastoral Counseling Education at Asbury Theological Seminary in Wilmore, Kentucky, a licensed psychologist, and an elder in the Church of the Nazarene.