Pastoral Counseling

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Pastoral Counseling

Pastoral counseling is the practice of talking with individuals, couples, and families to increase their understanding of emotional and religious conflicts and to help resolve problems using religious and other resources. Pastor is a biblical word for shepherd, one who cares for the health and salvation of believers, as in the sentence, "The pastor is a shepherd of the congregation." Pastoral counselors are called and entrusted by religious communities to help people strengthen their faith in God. They are trained to listen, respond empathetically, make assessments, and provide resources for people who seek their help. "Christian modes of healing have always distinguished themselves by achieving a spiritual advance in connection with the healing process" (Hunter 1990, p. 497).

History of Pastoral Counseling

Pastoral counseling has been one of the tasks of religious leaders since the early Christian Church elected deacons and elders to organize visitation and distribution of food for widows and orphans (Acts 7). Pastors and other leaders have talked with people about their concerns, illnesses, and fears for many centuries, and guidelines for pastoral care and counseling have been available since Tertullian wrote about repentance and confession in the second century b.c.e.

Modern pastoral counseling in the United States began in about 1920, when Anton Boisen started the first clinical training program in a Boston hospital. He was influenced by the psychologies of Sigmund Freud and William James and followed the models of professional education of medicine and social work. The first book-length descriptions were published in 1936, and since that time the literature has focused on bringing the best insights of the new psychologies to ministry, especially the psychoanalytic traditions of Freud and Erik Erikson and the humanistic traditions of Carl Rogers. Pastoral Psychology, a journal edited by Seward Hiltner, was a primary forum for the new discipline beginning in 1950. Freud's insights into the human condition had dramatic impact on theology and pastoral counseling because they helped to explain pervasive forms of human sin and unhappiness and provided ways of helping people through changes in personality and faith. Carl Rogers put a more positive face on counseling by emphasizing empathy, acceptance, and positive regard. From dialogue with Freud and Rogers pastoral counseling developed coherent theories and practices and a movement that has had significant impact on religious communities and their ministries.

Contemporary Issues of Pastoral Counseling

Since 1965, pastoral counseling has experienced significant changes as religion and society have been challenged on many fronts. Several issues have dominated these debates:

What psychological theories should pastoral counselors utilize?
What makes pastoral counseling religious?
Should women be counseled differently than men?
What differences do culture and class make in pastoral counseling?
Who pays for pastoral counseling?

What Psychological Theories Should Pastoral Counselors Utilize?

Pastoral counseling in the early twentieth century adopted psychoanalytically oriented theories that focused on exploration of aggressive and sexual impulses in individuals for improved mental health. Most pastoral counselors met in one-on-one weekly sessions for many weeks to help individuals gain insight into their unconscious conflicts. Adapting this method for congregations has been challenging, since most people would not engage in such intensive, long-term counseling. In 1966 Howard Clinebell's Basic Types of Pastoral Counseling transformed the common understanding of pastoral counseling when he recommended new forms of pastoral counseling, including short-term family counseling. Dozens of schools of psychotherapy introduced new understandings of the best way to help people, and Clinebell argued that these new approaches had merit. During the last four decades of the twentieth century, many forms of pastoral counseling have became acceptable, including behavioral, cognitive, family systems, self-help, and other therapies. The result is a transformed landscape for practicing pastoral counseling and pluralistic understandings of the psychological foundations for pastoral counseling.

What Makes Pastoral Counseling Religious?

In 1966 Don Browning's The Moral Context of Pastoral Care reminded pastoral counselors that the religious and ethical dimensions of pastoral counseling were equally as important as the psychological. Browning argued that the various theories of psychology often functioned like religions—that is, they had ethical and philosophical assumptions that needed to be critically examined. For example, the assumption that the unconscious fears of individuals determine mental health may not be compatible with some theologies of prayer and inspiration by the Holy Spirit. This opened up whole new avenues of exploration often fueled by the question "What is pastoral about pastoral counseling?" Implied in this question is the concern that pastoral counselors often functioned as psychologists rather than religious leaders guided by Holy Scripture and religious traditions.

Exploration of the theological and ethical foundations of pastoral counseling opened up rich areas of creative thought. Within liberal Protestantism, spirited discussion of denominational traditions such as Lutheran, Reformed, Wesleyan, Baptist, Anglican, and Pentecostal became central concerns for pastoral counseling. Within Roman Catholicism, debates about the influence of Vatican II, historical spiritual direction, and pre–Vatican II theologies became important. Within evangelical Christian communities, authority of Scripture, spirit-filled worship and healing, and moral issues such as abortion and sexuality defined the shape of pastoral counseling. Jews of Reform, Conservative, and Orthodox views began to explore the different theological and ethical frames for pastoral counseling. Rediscovering the ethical and religious dimension of pastoral counseling at first fragmented pastoral counseling. But this diversity has developed into a source of creativity as pastoral counselors explore the contributions of their diverse religious traditions.

Should Women Be Counseled Differently Than Men?

Beginning in the 1970s feminist pastoral counselors began to raise questions about pastoral counseling of women. It quickly became obvious that the issues of women had been ignored or minimized during the early decades of male-dominated pastoral counseling. Issues such as childbirth, mothering, sexual abuse, violence against women, discrimination against women in work and income, menopause, aging, and other topics had not been addressed. In addition, some theories and practices of pastoral counseling were unfair to women—namely, blaming mothers for mental illnesses such as schizophrenia, and letting fathers off the hook for their responsibilities of parenting. Developments in the psychology of women and feminist therapies required significant revisions of pastoral counseling. As increasing numbers of women began practicing and writing about pastoral counseling, addressing gender equality and difference became mandatory for the field.

What Differences Do Culture and Class Make in Pastoral Counseling?

In 1968 James Cone's Black Theology suggested that the theologies and practices of religious communities needed to be reworked in the light of white race supremacy. Pastoral counseling during the early twentieth century, for example, did not acknowledge the impact of race and class on many African-American families nor the mental health implications of prejudice and economic vulnerability within white families. At the end of the twentieth century there are too few accredited African-American pastoral counselors. Also in the 1960s, Latin American Liberation theology raised similar questions about pastoral counseling with those who are poor. Roman Catholic priests who lived with the poor revised their practices of pastoral counseling. Many issues that pastoral counselors traditionally diagnosed as conflicts of sexuality and aggression were results of oppression and trauma from race and class violence. If pastoral counseling leads to adjustment to race and class oppression, then the values of justice and love are not served. Discovering how to diagnose the social situations of oppression requires revision of the theories and practices of pastoral counseling. For those who are oppressed by social and economic conditions, empowerment becomes the goal of pastoral counseling rather than insight and adjustment. As pastoral counseling became global, new forms of pastoral counseling informed by African, Asian, Australian, South American, and other cultures became available, disclosing the European and U.S. bias in many theories and practices. For example, honoring ancestors and trusting shamans became religious resources for many Christians who wanted to understand their lives more fully. Communitarian theologies made dramatic contributions to the ideas of relationship and families.

Who Pays for Pastoral Counseling?

Is pastoral counseling paid for by individuals, congregations, health insurance, or government? Because early pastoral counseling often followed a medical model of expensive individual sessions within health care centers, pastoral counseling was profoundly affected when insurance companies, government, and health maintenance organizations drastically changed the economics of health care in the 1980s. Third-party agencies refused to pay for many forms of mental health care, especially outpatient treatment and preventive counseling. Most individuals could not afford expensive pastoral counseling that was not subsidized. As a result, some U.S. pastoral counseling centers and training programs were forced to close. Some congregations provided funding for pastoral counseling centers, especially those organized under the franchise name Samaritan Centers, that provided high-quality, subsidized care in many communities. Other pastoral counselors focused on congregational care through support groups and short-term consultation. State licensing for counselors established secular criteria for care that often made pastoral counseling less available in many communities. Pastoral counseling as a ministry of congregations has historically been the central practice and is receiving added emphasis for the future.

In summary, pastoral counseling has been an important practice of religious communities for many centuries. During the twentieth century, pastoral counseling was dramatically changed by the introduction of modern psychologies. Since 1965 the theories and practices of pastoral counseling have been further transformed by new developments in psychology, theology, gender, culture, and economics. As religious communities revise their understandings of people in relation to God, pastoral counseling will continue to be an important resource in the twenty-first century.