Pastoral Counseling: Knowing When to Refer

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The broken and sinful world in which we live produces unthinkable pain for many people. Addressing these wounds often takes a team of committed helpers. It is a delicate and vulnerable decision to ask a therapist to step in, but often a well-trained therapist is what the individual needs. Pastors who enter into counseling relationships should consider several signs when determining the best possible care for a church member. Any threat of harm to themselves or another is an urgent warning sign requiring professional oversight. A threat might include self-mutilation, severe addictions (such as alcohol and drug use), thoughts of suicide or homicide, or an eating disorder. Each of these struggles has the propensity to become lethal without notice. Safety must always come first, and providing it is the highest form of love that can be expressed in those critical moments.

A counseling pastor may also consider referring an individual to a professional when the needs of a client exceed the counselor’s training and ability. Often, personal intuition will let you know it is time to refer. Many pastors express feelings of uncertainty when faced with a need beyond their skill set. These situations may cause anxiety and questions of proficiency. Pastor’s should not ignore these thoughts. Instead, they should seek additional assistance. If a pastor meets with someone several times, but notices minimal improvements, deeper issues may exist unbeknownst to either party. A trained therapist can assist the client in identifying their needs and work with them to overcome these issues. If a person becomes dependent on regular meeting times with a pastor, this may be a sign of an unhealthy relationship, and the individual’s personal growth may be stunted as a result. This is often indicative of a person who lacks a strong support system, and a trained professional may be able to help.

When working with children, couples, or families, a pastor should assess the complexity of their relationships. When family dynamics appear to be causing a level of stress that effects a person’s ability to cope, family therapy may be appropriate. Marriage and family therapists address relational issues and introduce patterns that are edifying to the health and well-being of each family member. Extreme emotional pain can quickly become overwhelming when it is not handled with caution. Those with a history of trauma (such as abuse or tragedy) are very susceptible. Consequently, extreme pain may also present itself as numbness, an inability to articulate or express emotion. If either form of pain is observed, professional therapy may be necessary.

When addressing spiritual matters, a tell-tale sign that deeper troubles are looming is the person’s ability to understand a spiritual truth, but their inability to accept it for themselves. This may be displayed as doubt that God’s love is unconditional or that God’s forgiveness applies to them. These distorted beliefs might be acknowledged, but one’s incapability to overcome them is a sign that the individual is pleading for deeper understanding into their human experience. When pastors find themselves frustrated or wondering what keeps the truth from becoming relevant to such an individual it is a sign that professional help may be needed.

Many pastors are skilled in counseling and may feel confident in their ability to manage the aforementioned signs. However, pastoring is a full-time responsibility requiring a delicate balance. If hours of counseling keep pastors from meeting regular needs within the church, it may be time to seek the assistance of a Christian therapist. The desire to meet church members’ needs speaks to the protective and loving nature of a shepherd. Yet, knowing when to acknowledge that professional help is needed is just as important for the pastor’s well-being as it is to the client and the church.

Misty is a licensed marriage and family therapist associate and licensed professional counselor associate in North Carolina. Before joining Agapé, she completed an MA in Marriage and Family Therapy from Liberty University, and a BA in Bible and Theology from Asbury University. Her therapeutic approach is holistic, considering mind, body, spiritual, and social elements. Originally from Ohio, Misty has lived in Kentucky and Georgia, but is happily calling Charlotte a permanent home with her husband and Yorkie-poo, Ella. In her spare time she enjoys traveling, creating, relaxing, and exploring the great outdoors.