Pastoral Counseling Today

Today the value of attending to a person's spirituality, theology and faith tradition in the context of care,  is a topic of conversation and practice across the health sciences. Christina Puchalski, MD, MS is the Executive Director of the George Washington Institute for Spirituality and Health, Washington, DC, and a Professor of Medicine and Health Sciences at The George Washington University School of Medicine, where she has pioneered novel and effective educational and clinical strategies to address the spiritual concerns common in patients facing illness.

The  Lilly Endowment, Inc., reported that 96% of the population - 242 million Americans - says they believe in God. A 1996USA Todaysurvey found that 79% of Americans acknowledge that faith can help recovery from illness. According to another survey, 77% of patients feel their physician should consider their spiritual needs. In a 1994Newsweekpoll, 58% of respondents said they feel the need to experience spiritual growth.

In 2005,Alison Buckholtz, The Washington Post, wrote an article, Help From Above: In Times of Trouble, Growing Numbers of People Take Comfort in Faith-Based Therapy.Inaddition to writing about this topic she also highlighted the exceptional training andservices which AAPC certified members provide.(http://www.washingtonpost.com/wp-dyn/content/article/2005/12/02/AR2005120202287.html.)

Ms. Buckholtz writes, in Having Faith, Demanding Credentials,"Certified Pastoral Counselors Pastoral Counselors certified by the American Association of Pastoral Counselors, the gold-standard membership group, have postgraduate degrees from accredited universities; experience and training in the ministry; a current relationship with a local religious community; plus significant training and supervised counseling experience. They also have state licenses as social workers, marriage or family counselors or psychologists…. The best-trained and best-prepared certified pastoral counselors are certified by AAPC." (http://www.washingtonpost.com/wp-dyn/content/article/2005/12/02/AR2005120202402.html.

In 2009, Newsweek featured comments from Dr. Harold  Koenig, a psychiatrist, stating that he was "leading the charge for a better understanding of patients' religious and spiritual beliefs in the medical setting. Ken Pargament, PhD., world renowned for his scholarly contributions to the psychology of religion and for providing clinically relevant scientific analyses of religion's role in mental health. Dr. Pargament has also written two books: The Psychology of Religion and Coping: Theory, Research and Practice(1997)and Spiritually Integrated Psychotherapy: Understanding and Addressing the Sacred (2007). Both of these seminal works provide a systematic program of empirical research, guided by theory that is of practical relevance to helping professionals.

Despite increased interest in psychotherapy and increasing numbers of therapists, the advent of managed mental health care and loss of insurance coverage due to unemployment etc. has greatly reduced access to care and counseling services for many individuals and families. AAPC members make every effort to accommodate requests for care for such individuals. While most centers and counselors charge a standard fee for clinical services, adjustments can often be made according to financial need. Others mayprovide a sliding scale.

As a result, many people turn to faith leaders for help with personal, marital and family issues as well as faith issues. Thus, decreased access to care is not only a counseling issue but a broader community concern as well. Larry Graham, PhD, Professor of Pastoral Theology and Care, Iliff School of Theology has identified this challenge in his bookCare of Persons, Care of Worlds: A Psycho-systems Approach to Pastoral Care and Counseling.

In response, AAPC has undertaken a collaborative endeavor, "A National Training Initiative" with Pathways to Promise (www.pathways2promise.org ). This to increase the capacity of faith leaders to respond to such needs of their congregants. Faith leaders play a significant role in caring for those emotional challenges.

One-quarter (25%) of those who ever sought treatment for mental disorders did so from a faith leader. They continue to be contacted by higher proportions than psychiatrists (17%) or general medical doctors (17%). Nearly one-quarter of those seeking help from a faith leader in a given year have serious mental disorders and the majority of them are seen exclusively by the clergy, and not by a physician or mental health professional. (Health Services Research, 2003). Unfortunately, clergy and their congregations rarely feel well-equipped to serve people with mental illnesses.

Over 90% of faith leaders consider substance use as an important problem in their congregations, but only 12.5% of faith leaders have had any training to address this issue. (National Center in Addiction and Substance Abuse at Columbia University, 2001)

A Response: 
In response to these pressing needs, Pathways to Promise and the American Association of Pastoral Counselors have begun to implement a national training and educational initiative. This emerged out of the National Mental Health Summit held in Belleville, IL, sponsored by Pathways to Promise in 2009. Pilot Projects in St. Louis, MO and several communities in Washington state, supported by foundations and by state departments of mental and behavioral health, have just recently completed their first year of implementation.

An NTI site covers a city, county or region. Guiding a local Training Site is a planning group made up of representatives from key and diverse stakeholders-faith groups, consumers and families, community mental health providers and advocates, pastoral counselors, parish nurses, and other community allies. The NTI planning group helps organize neighborhood clusters of congregations and other community partners, who participate in core NTI trainings on mental health and substance use, as well as other trainings identified in the annual curriculum of continuing education. The result is reduced stigma, increased knowledge, and the development of skills in promoting recovery.

An Invitation:
The training resources developed for the St. Louis project are now available online at www.pathways2promise.org. They are available for individuals within a congregation, or as train-the-trainer resources.

An NTI Advisory Task Force will seek national partners among faith groups, agencies, national organizations, state and county behavioral health programs, and foundations.

AAPC is providing a variety of services to a variety of constituents in a variety of locales and communities.

Whether an individual is in crisis, or looking for personal growth, a pastoral counselor can provide the guidance, skill, longer-term relationship and information needed to promote wholeness, with the context and support a person needs to make changes to live life more fully.