This is a follow-up to my most recent post about Christian care-giving that focused especially on hospital chaplains (although much of what I said could apply to any form of Christian care-giving).
It seems serendipitous if not more that today’s (Sunday, September 14) newspaper carries a front-page story entitled “Seminary grads lack psych training.” As often happens, the headline doesn’t exactly fit the story. To get the “whole story” you have to read the whole article.
The article reports on a study conducted of 70 seminaries by a university psychology and neuroscience professor. (The article containing the results of the study was published in the August issue of The Journal of Research on Christian Education.) The study found that many seminaries do not train students going into ministry “in the skills they need to counsel church members who may deal with mental health crises or psychological distress.”
In my opinion, pastors have no business counseling people who are in the midst of mental health crises or suffering psychological distress. At least not if “counseling” means offering them psychological therapy. Of course, the exception would be a pastor who has a graduate degree in psychology or counseling and a license to practice such.
I once attended a church where the pastor fancied himself a professional psychological counselor. He asked the church for financial support to obtain training in administering and interpreting the MMPI (Minnesota Multiphasic Personality Inventory). I was opposed to that. He had no graduate study in psychology or counseling. In my opinion (then and now) diagnosis of mental illness should be done by a person with more than training in administering and interpreting the MMPI.
These days, anyway, psychology and counseling are extremely specialized fields and counseling the mentally ill is a practice fraught with pitfalls of many kinds–including legal ones.
In my opinion, seminary students should be taught enough about mental health and illness to be able to identify mental illness in a parishioner and refer him or her to a professional, licensed therapist. Beyond that the pastor’s role should be limited to praying with the suffering person and advising him or her spiritually and theologically. But prayer and spiritual-theological advice should not substitute for professional medical-psychological treatment in cases of real mental illness (as defined in the DSM-V). (Note: I am not limiting my understanding of mental and emotional pathology to the DSM-V but I am saying every pastor should know enough about the pathologies described there to recognize them. He or she should not attempt to treat them.)
Many, if not most, seminaries do this in courses on spiritual formation and pastoral care–even if they do not have a formal course on pastoral psychology or counseling.
I strongly believe that the normal pastor (one without graduate training in psychology and a license to counsel personals suffering mental illness) should restrict himself or herself to three practices with regard to the mentally ill. First, such a pastor should detect whether the parishioner presenting for pastoral care is possibly suffering mental illness or is simply anxious spiritually. Second, insofar as the presenting parishioner is suffering mental illness (even if that’s only suspected), the pastor should refer him or her to a licensed therapist. Third, the pastor should offer the person spiritual-theological care that does not infringe on the mental health care a licensed professional can offer.
A good pastor should have a list of licensed mental health professionals for referral and should walk the suffering parishioner through the maze of finding one he or she can afford and making the necessary initial appointment. This should be done even if the pastor only suspects mental illness is the problem. He or she should not make that final determination.
If, however, the presenting parishioner is suffering only spiritual anxiety with no indicators of mental illness (e.g., “I don’t understand why God is doing this to me” or “My prayers don’t seem to be working,” etc.) the pastor should offer pastoral care and theological insight.
There is one problem area in all this, one possible exception. If the presenting parishioner is exhibiting clear signs of demon possession (or oppression although the line between them is unclear) I believe the pastor should be prepared to deal with that in spiritual warfare that does not replace professional counseling but complements it. That requires, of course, that the pastor’s list of professional, licensed mental health care professionals include ones who believe in demon possession and oppression. Indicators of demonic involvement would normally be supernatural ones and/or evidence of true evil that goes beyond anything found in the DSM-V.