Pastoral counseling, a clinical practice that integrates both psychological and theological concepts into its framework, is not unlike other modes of therapy when it comes to the therapeutic process. What sets it apart is the way faith, spirituality, and theology are incorporated into the model. Pastoral counselors believe this incorporation of spiritual exploration and support can foster wholeness, healing, and growth in those who are seeking help.
Beyond providing psychotherapy, pastoral counselors utilize resources such as prayer, scripture study, and participation in the congregation community to help guide people on their journey toward transcendence, transformation, and greater connection to others.
People have long turned to religious leaders for support, guidance, and solutions related to mental health issues, and ministers of all denominations traditionally provide counseling to members of their religious communities. Pastoral counseling was born from the idea that, although this kind of support is valuable, some issues may require a more professional level of help.
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In the early 1900s, Reverend Anton Boisen, one of the founders of the Pastoral Education Movement, pioneered a unique enrichment program in which he connected theology students with hospital patients who were also experiencing concerns of a psychiatric nature. In the early 1930s, minister Norman Vincent Peale and psychiatrist Smiley Blanton formed the American Foundation of Religion and Psychiatry, known today as the Blanton-Peale Institute. Clinical pastoral education programs like these laid the foundation for the development of the pastoral counseling field, which evolved over the next several decades as more and more members of the clergy sought formal training in psychology.
In 1963, the American Association of Pastoral Counselors (AAPC) was formed to provide certification, accreditation, and training in the field of pastoral counseling. According to the AAPC website, “pastoral counseling evolved from religious counseling to pastoral psychotherapy, which integrates theology and other faith traditions with knowledge, spirituality, the resources of faith communities, the behavioral sciences, and in recent years, systemic theory.”
In 2019, the AAPC united with the Association for Clinical Pastoral Education (ACPE) and the two entities now operate as one under the ACPE name.
According to a 1992 Gallup poll, 66% of survey participants reported a preference for a mental health professional who held spiritual beliefs and values, while 81% of people seeking mental health treatment stated a preference for a counselor with values similar to their own. This data may explain why some people seek help from religious leaders or counselors who share their faith. Pastoral counseling may offer benefit to people of all backgrounds, but it may be best suited to those seeking mental health support or guidance grounded in a theological or spiritual perspective.
People might choose pastoral counseling when they:
- Want to approach mental health issues from a faith-based perspective
- Are not comfortable in a formal counseling setting
- Are facing end-of-life issues
- Have concerns that secular counselors will not validate their religious beliefs
- Have had negative experiences with secular mental health professionals
As pastoral counseling can provide specialized treatment to those seeking such but also meet more general counseling needs, it can be considered a versatile mode of therapy. Pastoral counselors are uniquely positioned to offer a professional level of mental health treatment, thanks to graduate training and education, while also providing spiritual guidance from a faith-based perspective.
Pastoral counseling can offer support to those seeking family, relationship, premarital, or individual counseling. More specifically, it may be helpful to individuals working through or challenged by any of the following situations:
Pastoral counselors are uniquely positioned to offer a professional level of mental health treatment, thanks to graduate training and education, while also providing spiritual guidance from a faith-based perspective.
- Spiritual assessment
- Grief and loss
- Issues related to chronic or terminal illness
- Conflicts around spiritual beliefs
- Mental health issues directly linked to religious beliefs or doctrine
- Crises of faith
- Reintegration into community life after institutionalization or incarceration
- Adjusting to mental health support when wary of the system
Pastoral counselors can range from ordained religious figures like priests, chaplains, and rabbis to practicing psychotherapists who provide what some call pastoral psychotherapy. They might come from any religious background and can be found in multiple settings—congregations, counseling centers, inpatient programs, and private practice, among others.
Training and education is available for those who wish to practice pastoral counseling in various formats. There are pastoral counselors who are not credentialed that actively provide support to people in need. There are also pastoral counselors who are more affiliated with the religious aspect of their role and have less training in mental health treatment. But a vast majority of pastoral counselors seek certification.
To become certified, prospective counselors must meet the requirements of their religious group, usually ordination, and receive graduate-level training in both theology and psychology, as defined by the American Association of Pastoral Counselors (AAPC).
Requirements set forth by the American Association of Pastoral Counselors stipulate candidates must earn one of the following graduate degrees:
- Masters in Divinity
- Graduate or Doctoral degree in Biblical Studies, Theological studies, or Spiritual Studies
- Graduate or Doctoral Degree in Pastoral Counseling
Candidates must also complete 375 hours of supervised counseling experience and a self-reflective clinical pastoral education (CPE) experience. The supervised CPE experience is coupled with classroom instruction and discussion to ensure candidates fully integrate their learning in theology and behavioral science. Once the training requirements and practical experience are completed and approved, candidates take part in a 90-minute interview conducted by a certification committee to finalize the process.
Currently, only a handful of states in the USA have license options for people in this field, including Tennessee (Clinical Pastoral Therapists) and North Carolina (Pastoral Counselors). In most states without this type of license, pastoral counselors must obtain and maintain one of the other types of licenses that permit the practice of psychotherapy: LCSW, MFT, LPC, LMHC, or similar. The majority of insurance companies do not reimburse pastoral counselors for services rendered, yet another reason is common practice for certified pastoral counselors to also pursue licensure in fields such as professional counseling, social work, or marriage and family therapy.
While some pastoral counselors have not had extensive training in the diagnosis of mental health concerns, many pastoral counselors are licensed mental health practitioners who are able to diagnose and treat any number of issues. Additionally, certified pastoral counselors are trained in mental health assessment and suicide/homicide assessment, and they are typically able to diagnose the warning signs and symptoms of other serious psychiatric concerns.
Although pastoral counseling is a well-established and viable mode of therapy, there are some possible areas for concern that mental health professionals and people seeking treatment may want to keep in mind. Some pastoral counselors view the therapeutic relationship as one that is multi-faceted and stretching across various settings and roles. Even for those who foster a private counseling environment, outside encounters may be inevitable when working with someone who is a member of the same congregation. The AAPC Code of Ethics explains that certified pastoral counselors are to take every precaution to avoid confusing dual/multiple relationships, as the balance of power can put counselors at an unfair advantage. However, in the cases of those who are not certified or believe that dual relationships enhance treatment, the people they treat may experience an increased risk.
Another possible concern has to do with the role of confidentiality for clergy and where it differs from confidentiality requirements for other mental health professionals. Pastoral counselors may encounter ethical dilemmas if the two bodies that govern them do not agree when it comes to keeping information confidential. Some states have differing laws when it comes to pastoral duties to their parishioners as compared to the duties of mental health professionals and protected health information. Counselors may wish to educate themselves in the particular laws and regulations that speak to their role as an ordained religious leader and to those meant to guide their role as a mental health professional.
- American Association of Pastoral Counselors. (2020, July 23). Retrieved April 19, 2021, from https://en.wikipedia.org/wiki/American_Association_of_Pastoral_Counselors
- Ashton, A. (2015, October 2). Can pastor counselors be prosecuted for malpractice? The Christian Post. Retrieved from http://www.christianpost.com/news/can-pastor-counselors-be-prosecuted-for-malpractice-146559
- Brief history on pastoral counseling. (n.d.). American Association of Pastoral Counselors. Retrieved from http://www.aapc.org/Default.aspx?ssid=74&NavPTypeId=1158
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- Becoming a pastoral counselor. (n.d.). Retrieved from http://www.pastoralcounseling.org/how-to-become
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- Walker, K. R., Scheidegger, T. H., End, L., & Amundsen, M. (2012). The misunderstood pastoral counselor: knowledge and religiosity as factors affecting a client's choice. Retrieved from http://www.counseling.org/docs/vistas/vistas_2012_article_62.pdf?sfvrsn=4