Some people turn to psychologists, psychiatrists, and social workers for help in coping with these crises and transitions. Others look for support and the opportunity to discuss these issues within a spiritual context. But can one find spiritual help and psychotherapy at the same time? Most religious leaders have little time or training to provide in-depth and extensive therapy. And most psychotherapists have little training or desire to discuss in-depth spiritual matters during sessions with patients. The answer may be pastoral counseling.
According to the American Association of Pastoral Counselors (AAPC) pastoral counseling is a form of psychotherapy that uses spiritual resources as well as psychological understanding for healing and growth. The central theme in pastoral counseling is an awareness of the spiritual dimension in human wholeness. Crises and transitions are addressed in terms such as faith, meaning, purpose, and direction, as well as in psychotherapeutic terms.
The foundation of pastoral counseling goes back to the 1930s, when minister Norman Vincent Peale and psychiatrist Smiley Blanton, MD, integrated religion and psychotherapy for psychotherapeutic purposes. Other influential social scientists, such as Carl Jung, Abraham Maslow, William James, and Karl Menninger, also shared this awareness of spirituality and psychotherapy. Over the years, pastoral counseling evolved from religious or spiritual counseling to pastoral psychotherapy, a practice that integrates theology and the behavioral sciences.
Pastoral counselors are certified mental health professionals who have had extensive religious and/or theological training. An AAPC certified pastoral counselor typically has:
- A bachelor's degree from an accredited college or university
- A three-year professional degree from a seminary
- A specialized masters or doctoral degree in the mental health field
Pastoral counselors also have a significant amount of clinical training. This includes at least 1,375 hours of supervised clinical experience (in individual, group, marital, and family therapy) and 250 hours of direct approved supervision in crisis and long-term situations. "As a result of this extensive study, pastoral counselors are among the most educated of mental health professionals," says Roy Woodruff, PhD, executive director of the AAPC.
Like other mental health professionals, pastoral counselors work with a variety of issues, depending on their training and background. They may specialize in marriage and family therapy, addiction, grief, and other issues, including serious mental illnesses. In addition to short- and long-term counseling, they may provide educational programs on preparing for marriage, adjusting to divorce, and coping with loss and grief.
Pastoral counselors may work as clinicians in:
- Health clinics
- State hospitals
- Private and group practices
- Congregation-based centers
- Church or synagogue offices
- Free-standing pastoral counseling centers
Pastoral counselors represent more than 80 different faith groups, but people of any religious faith—or no religious faith—can see a pastoral counselor. "Some people want to see a counselor who reflects their particular spiritual background, but many people see a counselor of a different faith. And for those who are uncertain of their beliefs, pastoral counseling may be part of the searching process," says Reverend Pearson.
So how does one go about finding a pastoral counselor? Reverend Pearson recommends getting a recommendation from someone you trust, such as a friend, religious leader, physical therapist, physician, or other professional. It's important to "shop around" and interview counselors too. Find a counselor with whom you feel compatible and comfortable.
In many states, pastoral counselors are covered by insurance, according to state licensing. Others may offer sliding scale fees or have a certain number of reduced fee hours per week. In some cases, pastoral counseling can be more affordable than other types of counseling, especially if counselors work out of churches and congregations. Sometimes church members even contribute to costs, or they have an assistance fund.
Despite the added benefits of a spiritually based mental health approach, many people do not take advantage of pastoral counseling. One reason is that some people fear that they would be pressed in a certain spiritual direction, particularly if the counselor were of a different faith. According to Reverend Pearson, most pastoral counselors don't give advice or force their religious views, but instead help people to explore and make their own decisions. Those few who do operate from a certain viewpoint are usually up front about it. It's best to inquire about the counselor's views during the initial interview, and if there is a poor match, ask for a referral.
"Another reason some people stay away from pastoral counseling is because they have a negative image of God," says Reverend Pearson. "God may be a projection of an abusive parent. Or they think that God is distant or hasn't answered their prayers. Therefore, it's hard for them to find a spiritual connection."
Lastly, many people don't know about pastoral counseling. Unlike other mental health professions such as psychology and social work, pastoral counseling doesn't get a lot of press. In addition, there is often misunderstanding about what pastoral counselors do. "We don't just work with clergy, but more with everyday folk," says Reverend Pearson.