Ministry views all persons as related to one another as creatures of God’s creation. In this fellowship, it is believed that individuals can find meaning, wholeness, and the ability to transcend the pain of life’s experience.
Contrary to James’ view of individual consciousness as finite and Freud’s limited focus on relationships within the immediate family, ministry asserts that all persons are connected, and this connection can be a route to healing. Responsibility to other human beings and to the world is seen as a component of these healing connections. As such, pastoral counseling includes an ethical dimension in the psychotherapy process.
A goal of pastoral counseling is to guide individuals towards greater wholeness within themselves and in their relationships with others. Six dimensions of this growth have been described:
- enlivening the mind
- revitalizing the body
- renewing and enriching intimate relationships
- deepening one’s relationship with nature and the biosphere
- growth in relation to significant institutions
- deepening and vitalizing one’s relationship with God.2
Credentialing of pastoral counselors
Pastors of any religious congregation can function as pastoral counselors. Clergy generally do not counsel outside their parishes, although they may do so even if they lack training beyond seminary. Some clergy have developed excellent skills in counseling and psychotherapy through mentorship, self-directed study, and their own psychotherapy and are competent pastoral counselors. However, certification by the American Association of Pastoral Counselors (AAPC) provides assurance that a counselor has met certain minimum training requirements.
Most pastoral counselors who practice in mental health agencies have obtained AAPC certification. The AAPC accredits pastoral counseling centers, approves training programs, determines credentialing criteria, and ascertains whether an individual has met educational and experiential requirements. It also offers a referral service for persons seeking a pastoral counselor (Box 2).8
HOW TO LOCATE A PASTORAL COUNSELOR
- American Association of Pastoral Counselors (AAPC) referral service
- Pastoral counseling centers can be found in the Yellow Pages or on the Internet. Many centers are accredited by the AAPC.
To be certified, a pastoral counselor must have a theology-based master’s or doctoral degree or a comparable degree in pastoral counseling. An AAPC member supervises one-third of the required hours of pastoral counseling experience. A supervised, self-reflective pastoral experience is also required, usually through clinical pastoral education (CPE). This training promotes the integration of theology and behavioral science that is central to pastoral counseling.
CPE generally involves closely supervised work as a hospital chaplain, with classroom instruction and small-group discussion of cases that students encounter on their rounds. These discussions help students:
- identify clinical and theological issues in patients with physical and mental illness
- become aware of their own issues when dealing with patients (i.e., sources of potential counter-transference)
- work toward a mature personal theology.
To receive AAPC credentials, a pastoral counselor must be recognized by a religious organization. Although ordination is not required, the individual must work within a local religious community and be endorsed by its leaders. This requirement helps ensure that the candidate conforms to a generally accepted interpretation of religious experience and not some idiosyncratic personal theology.
Interviews. After the candidate’s training documents have been received and approved, the candidate meets with a three- to four-person certification committee. This 90-minute interview is intended to educate the candidate and promote clarity of purpose within the profession, as credentialing is based solely on the written documents. The committee:
- reviews an audio- or videotape of a therapy session that reflects the candidate’s work
- talks with the candidate about integrating basic theologic concepts and theories of psychology and behavioral science, both professionally and in therapy
- attempts to determine the sophistication and maturity of the candidate’s personal theology
- explores the candidate’s awareness of his or her own psychodynamic characteristics and tendencies.
WHEN IS PASTORAL COUNSELING APPROPRIATE FOR YOUR PATIENT?
Appropriate
- To obtain a standard spiritual assessment
- Loss or bereavement
- Chronic or terminal illness
- Guilt, vocational confusion, or lack of direction
- Conflicts regarding patients’ own religious beliefs or those of their families
- Conflicts related to patients’ interpretation of the Bible or other religious texts
- To help patients re-enter the community after institutionalization
- For patients who believe their mental illness is a punishment for having insufficient faith
- As a segue into the mental health system
Not appropriate
- Patient rejects religion or spirituality
- Patient views pastoral counseling as a means to deny the need for psychiatric treatment
- Treatment by another clinician might “dilute” therapy
- Patient uses religion to obtain special privileges or to feign health and functioning
- Role confusion exists because the counselor is the patient’s seminary teacher or pastor
Source: Adapted from Oates WE. The religious care of the psychiatric patient. Philadelphia: The Westminster Press, 1978.