Unchained: A Bivo’s Guide to Handling Mental Health Counseling

Recently, on a list meant for pastors of small churches, a pastor asked for encouragement concerning a situation they were facing. A person had come into the church and immediately started becoming involved in the church. So far, so good. Then the pastor received a phone call about a crisis in this person’s life and they wanted to meet one-on-one. The pastor gave counsel over the phone and agreed to meet. After that meeting the layperson asked that the pastor meet weekly in a one-on-one counseling and Bible study context. It was at this point that the pastor reached out to this group for confirmation of their feelings that they should not be doing this kind of counseling. The group indeed did encourage the pastor in the decision made. Such circumstance are not uncommon in ministry. It become especially hard to accommodate request like this when you also hold an outside job as time tends to be limited.

The very first course I took in my quest to enter ministry was called “Pastoral Care and Counseling”. It was conducted as a series of lectures by people with specialties or experience in various areas of ministry. We had a section on premarital counseling, marital counseling, hospital and chaplaincy ministries and various other subjects. The very last lecture was given by someone with legal expertise and his advice was this…”most of what you have heard is good, but don’t do any counseling outside of spiritual counseling”. There was quite of bit more to that lecture, but the essence of it was that unless you are educated in counseling, have a license, have legally separated yourself from the church entity and have adequate liability insurance, don’t do it. Refer these individuals to someone who meets these requirements.

The fact is that you do not have to be in ministry for long to encounter people who need mental health counseling. Some of these are more obvious than others. In my context I find that there is at least one person at any one time who might meet these criteria in my church. It may manifest itself in many ways. The key to freedom here is that you have to know that you are to spiritually counsel people, but are not called to mental health counseling (unless of course you meet those previous requirements). If someone came to you and told you that they are short of breath, had chest pains and are feeling faint, you would not then attempt to give them medical advice. You would call 9-1-1 and get them some qualified help.

This brings me to my second point. Do not wait until the need arise before you find qualified Christian mental health professionals. Find them BEFORE the need arise. And when it does, refer the needy person to them.

Is there a realistic method of assessing who needs spiritual counseling and who needs mental health counseling? The rule of thumb is generally to meet with someone no more than three times. By the third visit you should have a good sense of what kind of help this person needs. Oftentimes it will take even less than three visits. I had one couple several years ago who wanted to get married and I started premarital counseling with them. By the end of the first session I knew that these people needed more than I could give and really required some serious couples counseling. Praise the Lord, these two individuals never did marry as I am quite sure there would have been a divorce in their future!

So remember, a) three visits max, b) assessment is crucial, and c) if need be refer to a qualified professional (whom you have located prior to the need!).

“For my iniquities have gone over my head; like a heavy burden, they are too heavy for me.” Psalm 38:4-7

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