Pastors, Counseling and Mental Health: 6 Guidelines for Pastors to Consider

I write this blog with two things in mind: a) Help those with mental illness to receive proper treatment, and, b) Aid pastors that engage in counseling individuals with mental illness. This is not an end-all be-all formula, but provides basic guidance for pastors. With that said …

The church cannot ignore mental health issues. When approximately 20 percent of the U.S. adult population and 15-20 percent of the U.S. youth population are suffering from mental health issues, there are bound to be members in almost every church that are suffering.

When church members struggle with mental health issues, they often first turn to their pastor for help. The pastor then has to decide what sort of counseling is appropriate for the presenting issue. Questions, such as, “Do I have training in this area?” and “What is my relationship with this individual?” should be circulating in the pastor’s mind. Some issues may warrant counseling solely conducted by the pastor, while other issues may require more expertise in mental health issues. So, how does a pastor know when engaging or continuing in counseling is appropriate or when a referral to a mental health professional should be made?

Here are some basic guiding principles to help pastors recognize when referring a counselee to a mental health professional should be considered:

1. Competence

A lack of training in counseling and mental health issues would indicate that a pastor should refer these issues to a professional in the area. Additionally, when training has been acquired, counseling should occur within the parameters of the training. For example, if a pastor has training only in adult-related issues, then counseling a child would not be recommended. In the field of psychology, we call this “practicing in your area of competency.”

2. Certain Disorders

This point relates to competency, but I believe is important enough to receive its own mark. There are certain mental health issues that are probably best left to specialists in the area. Schizophrenia, severe eating disorders and certain substance abuse, are amongst the few of these disorders. Many of these disorders have medical undertones, require medication or medical intervention, or have symptoms that could result in fatality. For example, an addict that is detoxing from alcohol or benzodiazepines can experience fatal side-effects of withdrawal. The potential for disaster far outweighs the benefits. When in doubt, consult with a mental health professional.

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Sarah Rainer
Dr. Sarah Rainer holds a doctorate in clinical psychology and specializes in working with children, adolescents and families. She desires to increase awareness and psychoeducation regarding mental illness to the Christian community. Sarah is the wife of Art Rainer and has two sons, Nathaniel and Joshua.