Why I Don’t Do Long-term Counseling


imagesMost people find it easier to call a pastor than a professional counselor when they need someone to talk to.  But just because pastors are easier to get to doesn’t mean we are all equipped for long-term pastoral counseling.  

I know there are a many pastors who are certified pastoral counselors.  I am not among them.  Years ago I decided to limit my serious counseling to one or two visits, then encourage the counselee to seek professional help.

Most people just need someone to listen to them, and most of my counseling ends naturally after one or two meetings.  But for those with persistent problems or serious emotional issues, I steer them to a professional.  Here’s why:

 

  1. I am not a trained pastoral counselor.  I have some training in basic pastoral care, but counseling was not my focus.  Serious problems require professional care.  I think it is pastoral malpractice to fail to refer someone whose problems are clearly beyond the scope of most pastors.
  2. I don’t have time.  I am the single staff member of a small church in small town with many demands on my time.  I try to act more like the triage department of a hospital emergency room — I evaluate and then refer.  That way I have time for the next emergency.
  3. I care enough to refer.  I think this is the most important reason I refer people who need extended counseling.  I care too much about them to take responsibility for their well-being when I know I am under-qualified.  

 

I don’t just drop a person after I refer them, either.  I help them find an affordable counselor, if money is an issue.  I inquire occasionally after referral to see how they are doing.  I do not ask about the specifics of the counseling sessions, I  just express a genuine concern for their well-being.  Almost every situation I have handled like this has turned out well. 

How we handle counseling can have a wide-ranging impact on others.  Rick Warren’s associate, Tom Holladay, has been criticized recently for the counseling advice Saddleback Church gives to abused women and those considering divorce.   What we do in this area does matter. 

How do you handle counseling requests?  If you are a trained counselor, is my approach valid and how could I improve what I do?  Have you ever had a counseling situation deteriorate before you referred the client?  I look forward to hearing your stories about how you handle counseling.

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20 thoughts on “Why I Don’t Do Long-term Counseling”

  1. Hi Chuck,
    I think your strategy is very sound as a Pastor. Most people who go to a Pastor only need a listening ear, some adice or reasurrance that things will be ok as God is in control. They might also need some tips on how to live the Christian life more effectively, which is right up the Pastor’s alley.

    I think you are wise to refer people on to a professional counselor when they need indepth and long term counseling. It is especially good if you can refer to a counselor that has a Christian world view. This way they can see what God is wanting to do in the persons life and work with them to bring that to pass.

    God Bless,
    Dave

  2. Chuck,

    I think your approach is valid. It would be, as you say, pastoral malpractice to try and give someone counsel that you do not have the training for. Most pastors and priests that I have meet are not Carl Jung, nor do they claim to be. They are wise enough and humble enough to know and admit the end of their wisdom on the matter and point the person who can help them further.

    The thing that caught my attention was that you care enough to refer. In a way it surprised me, but it was a pleasant surprise. In the past I knew a pastor of a medium/large church who did pastoral counseling but by the sheer size of the congregation he could not give the amount of time & depth that each person deserved. He did his best, but eventually he had to point them to other help. But he didn’t help refer them to a counselor or check back up with them. That is not to say that he didn’t want to, but time and numbers were against him.

    As you can see, the size of the church does matter. It is a blessing that your members are at a small of enough church to have access to such a dedicated and humble pastor when in need.

  3. Dave, good point about counselors with a Christian worldview. I should have made that clear, but thanks for stating it. Yes, I do refer to Christian counseling services and we have two excellent ones in our area. Thanks for making clear what I was taking for granted. -Chuck

  4. jl,
    Thanks for your comments. Yes, church size does matter, and I understand the pressures of time and attention. It only increases with the size of the congregation, and I relate to the pastor you mentioned. Thanks for your kind comments.

  5. Chuck, my practices are much the same as yours. When I started pastoral ministry at the church I serve, one of the first things I did was to begin to build my network of counselors and professionals to refer to. I’m blessed that there are some really good counselors and clinics in my area.

    I limit my counseling to four sessions at most, but usually begin moving toward referral by the end of the second session. I always include follow-up in my plans, like you, and one of the advantages of building a close network with licensed counselors is that they are cooperative with following up.

    One thing I’ll add: there are times when people don’t need clinical, psychological counseling– they need pastoral counseling. They need someone to address spiritual issues in their lives. This is as much discipleship as it is counseling. We’re doing well if we train others to share in the ministry of discipleship with us; but, as pastors, we not fulfilling our calling if, in these times, we turn them away.

  6. Even with some counseling experience, my first call is as a pastor. My rule of thumb is 7 visits max, then refer. I’ll refer before 7 sessions if it relates to an issue well outside the boundaries of a Pastor.

    1. So what exactly is “outside the boundaries” of a Pastor? Are we not called to shepherd God’s flock in all areas of life? Isn’t God’s Word sufficient for all things, as it claims to be? What exactly am I doing as a pastor if I’m not constantly counselling people to follow Christ and dig deep into His Word, where we find a lamp for the path of our feet? After 25 years of pastoral experience I agree with a former president of the American Psychiatric Association who wrote that if people would just learn to forgive 90% of our problems would go away and our mental health centers would be empty. Isn’t that precisely the realm of pastoral counselling?

  7. I found this a very interesting blog, Chuck. As a christian who over the years found myself needing good counsel, many times I felt forced to seek counsel with the pastor first. The money issue aside, sometimes you are judged by other christians if you go to ‘worldly’ counselors. It is assumed that you are not getting wisdom based on scripture. Many times, I would defend my counselor as someone I knew had christian values. Now that I’ve finally (and thankfully) reached the age that I have a little more wisdom myself. II’ve decided unless it is an issue not dealing with scripture or my spiritual state, I would absolutely not go to a pastor for counsel and I don’t recommend it to my friends either. Let me also say, that I have twice sat in services where the pastor that I respected spoke vehemently against seeking psychological help stating that at the bottom of all issues is ‘sin’. While I might agree with this, there are times we need a trained counselor. Just my little ole’ opinion.

    1. As a pastor I struggle with this all the time. The Bible tells me that God’s Word is sufficient to meet all of our needs, and yet few Christians really believe that. Rather, they are convinced that humanistic principles are superior to biblical ones, and will generally seek help from “professionals”. I think this is a direct result of the fact that few Christians really know God’s Word, or want to know God’s Word, and don’t really believe that the principles within it have much to do with every day postmodern living. Sometimes I just want to scream.

  8. An intelligent and wise approach, Chuck. Worth mentioning here is the close connection between spirituality and sexuality. All effective counseling involves a level of psychological intimacy. That’s why every office I’ve ever had had a large window in the door, and staff present in the building during the counseling session. It is essential to create appropriate boundaries to protect both pastoral counselor and parishioner. Limiting sessions is one boundary, and careful structuring of the physical setting of the counseling is another consideration. Another issue for careful consideration is the careful selection of clinical referrals. While having a particular Christian world-view (that has many meanings!) may be a good selling point and politically wise, I’ve been too often disappointed in the level of competence of “Christian” counselors. Getting to know licensed counselors in the area is an excellent idea. Finding those not antithetical to faith is important too. But finding a good Calvinist who is also a therapist may be challenging! Give me clinical competence first. The first thing I want to know about my doctor and my dentist is if they know what they are doing.

  9. my wife and i had went to our pastor for counseling. i thought this would be best for us as i always felt the bible was a good source for dealing with life issues.
    What i got was … the husband is responsible for 99% of what goes on in his home. i would get a weekly list of things i needed to change so that god could work in my marriage. this went on for a year..

    i thought i was the worst man on earth..

    i went to a christian counselor that my church referred me to. he was a counsler the church recommended. after two sessions, this counsler suggested my family leave this church because it was controlling and not healthy for me or my family.

    my pastor said the cousler was not good, i said but you referred me.

    after being sober for 10 years by the grace of god.. i went out and drank. they (my wife and pastor) tried to baker and marsh act me using things from my past . they also said i committed spiritual adultery and tried to help my wife divorce me.

    in a panic, i called new life ministries and they asked me 5 questions.

    i was in a 12 step program
    i had a sponsor
    i was sober
    i had good christian accountability partners
    i was going to outside counseling.

    they said i was doing all the right things. put up boundaries

    fast froward to today…

    i am attending a different church..\

    my wife has issues she needs to deal with. most probably borderline personality disorder from issues of abuse in her younger years as well as alcoholism from age 12.

    i continue with counseling to deal with my wifes illness and am committed to help her wounds heal.

    she refuses any help from anyone and still insists she is normal.
    (telling your husband i wish you were dead is not normal.)

    from the outside she is functional, but has no friends and gives away more money than we can afford to good mission type ministries.

    bottom line,

    if my ex pastor had referred us immediately, it would have been obvious that my wife was in crisis and get her the help she needed. he was not equipped to notice classic signs of my wife’s illness.

    i still go to counseling to sort stuff through and keep me living for God. In fact i am starting a career as a counselor my self going back to school at close to fifty years of age..

    please pray for me..

    Blessings
    FTG

  10. Thank you all for your comments. Each one offered a different perspective and insight. Dennis raises the issue of appropriate precautions in the counseling relationship, and that applies whether you are counseling in one session or 20. FTG’s experience is both heartbreaking and illustrative of the need for competent counseling services. Several mentioned Christian counseling, which I am assuming would be licensed counselors, not untrained individuals holding themselves out as certified counselors. Good comments from everyone, and thanks for helping sort through all the facets of this difficult situation.

  11. I agree with your approach, Chuck, as well as much of what has been commented here.

    In addition to the reasons shared here, I am often hesitant to enter some areas of counseling because of the effect it has on my relationship with the counselee. I have had people begin to put distance between themselves and me because after “opening up,” they are later embarassed by what I know about them.

    Despite my best efforts to assure them and treat them lovingly, it seems to me there is an awkwardness they can’t overcome. Eventually, they reach a point where there is no relationship at all and ministry to them is essentially impossible.

    Thanks for addressing this important issue.

  12. Nephos, good point and I have experienced the same response in folks who have told me too much, too. Even though I keep their confidence, something changes in our relationship. Good point and thanks.

  13. note…
    ya know, my story may be heartbreaking but i hold no bitterness. it took some time. God is good. Love covers a multitude of sins.

    I continually ask God what he wants me to learn from this..
    I am learning to love unconditionally.
    i am learning to look for God in everything.
    i am learning that good christian people sin. its just sin. i am no different.
    i am learning to look at my wife thru the eyes of Christ, with compassion and empathy. i see her hurt.

    although i would never compare myself to Job, the second part of this verse is what keeps me going..

    Job 13:15-16 (NKJV)
    15 Though He slay me, yet will I trust Him. Even so, I will defend my own ways before Him.
    16 He also shall be my salvation, For a hypocrite could not come before Him.
    thanks guys..

  14. Spankie, thanks for following up to share where you are now. What a great attitude in the midst of a terrific burden! May God continue to lead and bless your life, my friend. You are an example to us all, and I mean that sincerely. -Chuck

  15. As I read your counseling policy I felt like I was reading my own. I follow the same general guidelines. I tell people right off the bat that I am OK in a crisis for a meeting or two, but after that they will need to see someone who can spend more time with them.

    It takes a certain gift mix to be able to sit with people week after week and often times go through the same situation over and over. I realized a long time ago that my compassion level is real high for one or two meetings and then it begins to evaporate very quickly. Somebody sent me a video recently that you might want to check out, it is a little skit that Bob Newhart did on Mad TV. He has an interesting counseling approach that I have often thought in my head but never actually used. Here is a copy of the link
    http://www.youtube.com/watch?v=BYLMTvxOaeE (I am not sure if the link will post so if it doesn’t and you are interested just go to you tube and search for Bob Newhart Stop It).

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