Sometimes people call our office and want to talk to a pastor, and other times they call wanting counseling. However, people often don’t realize there is a difference or are not used to attending a church where a formal counseling ministry is an option.

The result is that some people request counseling and feel awkward when they’re given intake forms to fill out in order to make an appointment. Others start a conversation with a pastor wanting a more extended, in-depth helping relationship than that individual pastor has the capacity (by training or schedule) to offer.

So what is counseling? Counseling exists on a spectrum.

• On one end of the spectrum, counseling is every helpful conversation. Any time we hear someone’s struggle, express compassion, offer perspective, and make suggestions, we are counseling.
• On the other end of the spectrum, counseling is an artificially paired helping relationship based upon experience or expertise. In this scenario, one person—the helpee—identifies a need in their life and seeks out someone else—the helper—because they believe the helper is uniquely qualified to help them.

That defines counseling but begs a second question: What does a pastor do? A pastor definitely offers every-helpful-conversation counseling. A pastor may be an excellent fit for problem-focused, expertise-based counseling.

And now a third question: How do I know if I want my pastor to be my formal counselor? For that we will look at six contrasts between the broad role of a pastor and the narrow role of a counselor. As you read these, you can ask yourself, “Do I want a pastor to be my formal counselor? How would that impact my week-in-week-out relationship with the church? Am I OK if my pastor indicates that he does not believe he is the best fit to serve me in the area I’m seeking guidance?”

1. Pastoral interactions are not exclusively problem-focused. Counseling interactions are problem-focused. You talk to your pastor about more than your struggles. A pastor is part of the community you do life with. Formal counseling is an intentional relationship predicated upon overcoming a challenge or navigating a life transition.
2. Pastors offer ongoing relationships. Counselors offer short-term relationship. A pastor doesn’t cease being your pastor when a particular goal is met. However, a counselor does cease being your counselor when your counseling objectives are met.
3. Pastoral relationships are mutually beneficial relationships. Counseling relationships are singularly beneficial relationships. A pastor is a member of the church who benefits from the body life of the church as much as any other member. It is as much the responsibility of church members to encourage and support their pastors as it is for their pastors to encourage and support them. A counselor does not ask for support from the counselee. The relationship exists to benefit the counselee.
4. Pastors speak out of personal experience and biblical principles. Counselors speak out of biblical principles and advanced training. Pastors are not expected to know the best practices for various life struggles. Their criteria for ministry qualification is based upon character and doctrine more than counseling competence (1 Timothy 3:1–7). Members of our counseling team hold at least a master’s degree in counseling and receive supervision to ensure a quality of care while they serve you.
5. Pastors adhere to informal relational protocols. Counselors adhere to formal relational protocols. Conversations with a pastor may be had on the sidewalk at church, over the phone, or in a small group setting. The constraints of conversation are guided by basic moral principles—avoiding gossip, being edifying, situational appropriateness, etc. By contrast, conversations with a member of our counseling team are by appointment, adhere to confidentiality principles as defined by the informed consent on our intake forms, do not occur in casual social settings, etc.
6. Pastors shepherd an entire congregation as a team of elders. Counselors offer private ministry and have a limited caseload while receiving supervision. Your pastoral care may be handled by multiple pastors at your campus. You don’t have one pastor who is in charge of all your pastoral care needs. By contrast, a member of our counseling team sees particular individuals/families and has a limited case capacity based on the times they are available for appointments. Members of our counseling team receive supervision, but you would not receive counsel from a team of counselors.

Hopefully, it is clear that the content (biblical substance) of the interaction with a member of our pastoral team and a member of our counseling team should be very similar. In this sense both forms of care are ministry; they are Bible-based forms of care intended to help navigate the challenges of life with the hope of the gospel in order to experience the full life God intended.

However, the nature of the relationship (duration, focus, formality, etc.) is different between our campus-based pastoral team and counseling ministry. One is informal; the other is formal. One is based upon life experience; the other is based on having particular training. One is an open-ended relationship; the other is a short-term, goal-focused relationship.

As you seek to identify who is the best person for you to reach out to at this season of life—a pastor at your campus or a member of our counseling team—we hope these distinctions help you identify what type of care is the best fit for your current need.

Bridgehaven Counseling Associates is a distinct, 501(c)(3) parachurch ministry that is a subsidiary of The Summit Church. Bridgehaven is one part of a holistic pastoral counseling strategy at the Summit, which we also want to be blessing to our sister churches in RDU.

The Summit saw the need for a counseling center that provided the highest quality, gospel-centered, pastoral counseling for our members and community who desire to receive care in a formal and confidential setting. We wanted to be able to make this high quality pastoral counseling available on a scale that a church with a weekend attendance of 10,000+ would require.

Four phrases capture the relationship between Bridgehaven and the Summit.

1. Functionally controlled: A ruling majority of Bridgehaven’s board of directors is comprised of elders or officers from the Summit. We do this to ensure that the ministry of Bridgehaven remains true to the mission and values that we intended when we launched the ministry. The board of directors oversees the adding and removing of counselors for the ministry and ministry budget and accounting, and approves new ministry initiatives.
2. Fully accountable: The Summit's pastor of counseling serves as the ministry strategist and supervisor for the staff at Bridgehaven. The board of directors serves as the first point of appeal for complaints those receiving care at Bridgehaven might have.
3. Financially independent: Bridgehaven and its staff are supported through the counseling donations and teaching registrations from the ministry provided by its staff. The compensation for Bridgehaven counselors is not underwritten by the Summit.
4. Formal confidentiality: Information discussed in counseling is considered privileged unless there is a signed release of information or relevant mandated reporting laws. While counselors at Bridgehaven greatly value the support or involvement of pastors or small group leaders in counseling, the involvement of these individuals would only occur with the written consent of a counselee.

The launch of the downtown Raleigh office of Bridgehaven was an excellent example of how we want Bridgehaven to be seen and utilized by area churches. Several churches, led by Christ the King Presbyterian Church, expressed their desire for us to help them start a counseling center.

As we learned what they wanted in a counseling center and they learned more of what Bridgehaven was, we realized we were like-minded and that launching a second office of Bridgehaven close to them met both our needs. This allowed the Summit to have a center closer to our Blue Ridge, Cary, and Capital Hills campuses and for these churches to have a quality pastoral counseling resource near them.

Our goal for the Summit-Bridgehaven relationship is to continue to do three things:

• Provide high quality, gospel-centered, pastoral counseling on the scale our members need.
• Be a blessing to our sister churches in RDU by helping them meet the same need for their congregations.
• Provide this pastoral counseling in a context of privacy and confidentiality when that is what best serves an individual or family.

Let’s start with the question, “What does a Summit small group look like?”

A small group usually consists of seven to 15 Summit members who meet on a regular basis in someone’s home to study and discuss the Bible, pray for one another, care for one another, and do ministry together. These groups meet all across the Triangle on various nights of the week.

We can use this description to begin to draw some distinctions.

• G4 groups meet for a more narrow purpose: to address a particular life-dominating struggle or major life transition.
• G4 groups are a place to get one's life back in order more than “do ministry together.”

This is because a Summit small group focuses on general discipleship—the overall spiritual maturity of a group of believers who are facing a variety of challenges and opportunities—while G4 focuses on particular discipleship—setting aside a season of life to overcome a particular life-dominating challenge with people facing a similar challenge.

G4 is a ministry that provides a peer-support setting for individuals to invest several months overcoming a life-dominating struggle for the purpose of fruitfully enjoying life and ministry as part of a general small group.

"G" is for gospel-centered groups. Often recovery or support groups are criticized for centering an individual’s identity in their struggle. We want to provide the benefits of peer support, subject-specific groups while emphasizing that our identity is not found in an issue but in an individual: the person of Christ.

"4" designates that four types of groups are provided:

• Recovery: Groups helping individuals recover from addictions or other life-dominating struggles. Examples: addiction, anger
• Support: Groups for those needing encouragement and support during a period of suffering or major life transition. Examples: grief, divorce recovery
• Therapeutic educational: Groups providing education to navigate specific life issues. Examples: blended family principles, parenting an addict
• Process: Groups for those needing help processing problematic emotions or traumatic experiences. Examples: depression, trauma

See the list of the current group topics.

So, which one is for you?

If you are looking for a group of people to do life with as you grow in general discipleship and find ways to reach your community, a Summit small group is the place for you.

If you feel like a life challenge is preventing you from engaging relationships authentically or are part of a Summit small group and need more intensive care in a particular area, then a G4 group would be an excellent fit.

Let’s begin by making sure you understand what each option shares in common. Both Bridgehaven and the graduate intern program offer high quality, pastoral counseling for individuals and marriages. With that in mind, we should also ask, “What is the difference between the two?”

The counselors at Bridgehaven:

• Have completed a masters or doctoral degree in pastoral counseling.
• Are well-experienced in the areas in which they offer counseling.
• Offer counseling as their ministry vocation, meaning they offer appointments throughout the week.

The counselors in the graduate intern program:

• Are completing a masters or doctoral degree in pastoral counseling.
• Are well-supervised for the counseling they offer to ensure a quality of care is provided.
• Offer counseling one night per week.

Based on these similarities and distinctions, there are five questions to consider in determining which is the better fit for you.

First, is a pastoral counselor the best fit for your area of need?

If your counseling need involves the possibility of medication, then you would need to know our team does not carry the qualifications to prescribe or oversee a medical regimen. We would be happy to serve as a supplemental care to a physician or psychiatrist.

If your counseling need involves court proceedings, you need to know that a pastoral counselor is viewed differently than a licensed mental health professional. In these instances, we believe it is the best investment of your time to meet with a licensed counselor who can serve both your counseling and legal needs (e.g., providing expert testimony or evaluations the court would recognize).

Second, does a weekly session format serve your area of need well?

If you need counseling that requires meeting more frequently than weekly (i.e., intensive outpatient counselor) or desire casual social interaction (i.e., mentoring), then neither Bridgehaven nor the graduate intern program would be a good fit.

Third, what is the depth of your struggle?

The more crisis-oriented your struggle is, the more experience you will want your counselor to have. Based on this criterion, the more crisis-oriented your struggle, the more likely Bridgehaven would serve you better than our graduate intern program.

There is one helpful point of clarification in this area. Many people hear the title “intern” and think “early kid in his/her 20s, just out of college.” For a frame of reference, the average age of graduate interns is 35; this number will vary from year to year.

Fourth, what are your financial constraints?

For a variety of reasons, life struggles often coincide with financial struggles. If you are not in a position to be able to make a donation for counseling, then in order to ensure the frequency and duration of care necessary to serve you well, we recommend selecting the graduate intern program.

Fifth, what is your scheduling flexibility?

Formal counseling is rarely a single meeting. Your counselor needs to get to know you, your struggle, and build trust with you. The two of you will need to establish goals and develop biblical strategies to reach those goals. That takes time.

One of the advantages of the graduate intern program is that this counseling is offered in the evenings between 6 and 9 p.m., a time when most people are off of work. Bridgehaven does offer some evening appointments, but the majority of their appointments are during the normal work-week hours.

As you walk through these five questions, hopefully becomes clear which option would serve your needs best.

There are two questions that can guide this discussion:

• What is the difference between formal and informal pastoral counseling?
• What is the difference between pastoral and clinical counseling (i.e., LPC, LMFT, LCSW)?

The first question was largely addressed in another FAQ about the difference between the role of a campus-based Summit pastoral staff and a member of the Summit counseling team. But to summarize, informal pastoral counseling is a “doing life together” relationship of mutual care that occurs in natural community, while formal counseling is a private relationship forged on the basis of a particular need where there are clear role differences between the helper and helpee.

The second question can be answered from several angles. We will consider seven differences between formal pastoral and clinical counseling.

1. Authority and accountability: A pastoral counselor is accountable to the local church or ministry board under which he or she serves. A clinical counselor is accountable to the state licensing board (e.g., LPC, LMFT, LCSW) whose credential he or she holds. The entity to which a counselor is accountable sets the standards by which that individual can practice and serves as the point of appeal if a counselee believes the counselor behaved unethically.

 

2. Diagnostic system: A clinical counselor defines the counselee’s struggle according to the criteria of the latest edition of the Diagnostic and Statistical Manual for Mental Disorders in order to operate in compliance with the managed care system, which allows the financial advantage for the counselee of paying for counseling through their insurance (see compensation point below). In this sense, clinical counselors work predominantly from a perspective that counselees struggle with “mental illness” because their practice is part of the healthcare system.

Pastoral counselors work predominantly from a perspective that the source of the counselee’s struggles are “problems in living” (i.e., beliefs and values enacted in choices and relationships) or “meaning of life” issues where temporal struggles are interpreted in light of their eternal significance. A pastoral counselor operates from a worldview that utilizes the categories of Scripture to advise a counselee as they navigate life struggles of sin, suffering, or identity.

Note: There are many clinical counselors who hold a high view of Scripture and many pastoral counselors who are clinically-informed. This distinction is not mean to portray that pastoral and clinical counseling are mutually exclusive. The same could be said for “therapeutic strategies” point below.

3. Values: A clinical counselor seeks to work within the value structures of each counselee and not impose their values on their client. A pastoral counselor believes that Scripture provides the values that contribute to human flourishing because the Bible reveals God’s intent for how people and relationships were designed to function.

4. Compensation: With a clinical counselor, counselees are usually able to process their counseling expense through their insurance. With a pastoral counselor in a parachurch setting like Bridgehaven, a donation is made to the ministry at which the counselor serves to support the ministry and counselor in their service to the community.

5. Treatment strategies: A clinical counselor works with the counselee to identify goals and selects best-practice therapeutic strategies to reach those goals based upon the leading diagnosis in the counselee’s life. A pastoral counselor seeks to make practical application of Scripture to the problems in living the counselee has identified and encourages these to be lived out in the context of Christian community to reach the counselee’s desired goals.

6. Training: A clinical counselor has standardized educational and supervised experience criteria which are set by the state in which he or she practices. A pastoral counselor’s education and experience may vary. It is important for the counselee to understand the education and experience level of their pastoral counselor.

7. Professional cooperation: When other professionals are involved in the counselee’s life—physicians, social workers, psychiatrists, attorneys, etc.—these professionals are more accustomed to working with a clinical counselor and there may be advantages that make meeting with a clinical counselor decidedly advantageous for the counselee. When these professionals consult with a pastoral counselor, they do so more as a clergy member providing life history or a character witness than as someone providing a mental health assessment.

It is important to note that the Summit believes both pastoral and clinical counseling are good professions/ministries that God uses to restore people to the full functioning he desires for them. We affirm Christians serving God and receiving care in both settings.

However, the Summit counseling ministries have chosen to offer pastoral counseling options in our ministries because these allow for the most free expression of a Christian worldview.

We would encourage you to use these criteria to help you assess whether a member of the Summit counseling team—that is, Bridgehaven and the graduate intern program—or a clinical counselor with a Christian worldview would be the best fit to serve your counseling needs.

This is a question that many people aren’t sure how to frame. We know we shouldn’t wait until things are “that bad,” but we want things to be “bad enough” to merit the time and energy of counseling. If only it were as clear-cut as holding your kids out of school—if they have vomited or had fever in the last 24 hours, they stay home.

We will offer nine points of reflection to help you identify whether making the time and energy investment in counseling is wise for your life struggle. The more of these you identify with, the more likely counseling would be a wise step for you.

1. “I don’t have anyone I feel like I can talk to” (isolation). Being alone with your struggle may be the strongest indicator that it’s going to get worse. Counseling provides an outlet for you to get comfortable talking about your struggle. The counseling ministries at the Summit will encourage you to begin connecting with a small group so that this isolation relief can begin to occur in more natural, day-to-day relationships.

2. “I don’t know what to do next” or “What I’m doing isn’t working” (confusion). Another major factor that causes a struggle to get worse is a sense of powerlessness that emerges from confusion or ineffectiveness. Counseling can provide additional strategies and recommend new resources to offset the sense of powerlessness when we’ve done everything we’ve known to do and it hasn’t provided relief.

3. “You are trying to hide your struggle” (shame). Hiding is isolation on steroids. When we are tempted to hide our struggle, the confidentiality of counseling can provide a safe context to begin breaking that habit.

4. “My struggle is getting progressively worse” (depth). Whether it is intensity of unpleasant emotions, level of dishonor in conflict, or sense of desperation about circumstances, when you can tell that your struggle is trending in a bad direction in spite of your efforts to change, then counseling is a wise step to prevent allowing the struggle from becoming more rooted in your life.

5. “My struggle is dominating my thoughts or emotions” (frequency). Do you notice that the struggle is beginning to consume a larger percentage of your waking hours and/or disrupting your ability to sleep? Even if the intensity is remaining relatively constant, an increase in the frequency of your struggle can make counseling a wise step toward reclaiming this part of your life.

6. “I am withdrawing from or losing interest in things I enjoy” (adhedonia). Adhedonia means the loss of pleasure. When we lose interest in things we normally enjoy, that is an indicator that we are experiencing a level of time or emotional pressure that is unsustainable. Counseling can provide a context to think about what can and needs to be done.

7. “My ability to function at home or work is being affected” (productivity). When your life struggle impacts your ability to fulfill your basic life roles, then it is likely to begin deteriorating your sense of value as a person. That is a very emotionally dangerous way to think about life. Counseling can be helpful in assisting you to navigate the sense of failure you feel and the ways you can address the struggles that made it hard for you to fulfill these life roles.

8. “I think everyone around me is wrong, lazy, or an idiot” (blame-shifting or cynicism). When our attitude toward life means either everyone else is wrong or we’re wrong, we should assume that’s a big red flag. It also likely means we’ve burned many of our relational bridges. Counseling can be a context to see things more clearly while we take steps to mend the bridges we’ve burned.

9. “I am beginning to escape or numb myself through substances or mindless activities” (addiction). When we are satisfied to escape or numb our struggles in a manner that does nothing to resolve them, we are surrendering. The likely result is that our numbing or escaping activity will become addictive because, as the struggle inevitably grows, so will the duration of time given to our numbing or escaping activity. When you see yourself entering this pattern, counseling is highly recommended.

Counseling is a verb more than a noun; it is something you participate in more than something you receive. With this in mind, it is important to ask the question, “What do I need to do to set counseling up to succeed?” We’ll consider this question for three phases of the counseling relationship.

Phase 1: Before Your First Appointment

1. Be committed. Some people come to counseling wondering “if it will work for them.” This reveals a mindset that is passive toward what will happen in the counseling relationship. Coming to counseling is like joining a gym; it is a great context for change but can’t produce the desired results without your participation.
   • When you think of expectations for counseling, think about what you’ll be doing between sessions.

2. Paperwork. Intake forms are more than an administrative necessity; they serve a vital function for you and your counselor. Intake forms are designed to help you intentionally overview your life in light of your struggle to begin solidifying the goals you have for counseling. Intake forms also allow your counselor to get to know you efficiently. Counseling often jumps into the “deep waters of life” quickly, and intake forms are one way your counselor can be sure to have an overview of your life so that your struggles do not over-define who you are.
   • Spend a solid 30-45 minutes thoughtfully completing the counseling intake forms.

3. Be humbly self-aware. Your counselor won’t get to know you better than you know you, and your counselor will only get to know you as you reveal yourself. This means the courage of transparency is required for counseling to be effective. Don’t be ashamed of the areas in which you need to grow. Prepare yourself to describe them clearly, humbly, and from the perspective of as many people as are affected by them.
   • Use more first-person pronouns (I, me, my) than third-person pronouns (he, she, them) in the first session.

Phase 2: During Your Counseling Relationship

1. Be honest. Don’t make your counselor ask the “right questions” to get the “needed information.” That is like taking your car to the mechanic but being coy about what needs to be fixed. If you are not honest with your counselor, your counselor is not really counseling you but a figment of your imagination. The advice you receive may be sound, but it will not be well-suited to you or your situation.
   • Before each session and whenever counsel may not feel well-suited to your situation, ask yourself, “What would my counselor need to know to advise me well?”

2. Be consistent. This means (a) making your appointments, (b) being on time for your appointments, and (c) completing any homework between sessions. When the continuity of counseling is disrupted because of missed appointments, it is difficult for the counseling relationship to catch traction. The most profitable time in a counseling session is usually the last 10 minutes, and if you’re late, you cut that time out of your session in the beginning. It is completing the homework between sessions or reflecting on the counseling conversation that ensures each session builds on the momentum of the previous one.
   • For as long as you are in counseling, make counseling a high priority.

3. Be patient. Being proactive is not a synonym for being impatient or a perfectionist. Counseling involves prioritizing important goals; that is frustrating. Counseling also involves engaging change in a way that allows the changes to endure; that is often less efficient than we would like. This means the “how” of counseling (process/verb) is more important than the “what” of the counsel (content/noun). You are learning how to approach life when it’s messy more than a set of skills to address something in a tidy way.
   • Realize this honors you. If there were a quick solution to the struggle that brought you to counseling, that would be demeaning to the time you invested in resolving the matter before counseling began.

Phase 3: As Counseling Concludes

1. Be known. The long-term effectiveness of counseling is largely predicated upon the quality of relationships you have outside of counseling. You want to pass the baton of trust and transparency from a counselor to trusted friends who can provide ongoing accountability and support.
   • Be a part of a small group, and seek opportunities to be more open about what you’re learning and how you’re growing through counseling in the small group setting.

2. Grow independently. As counseling concludes, you should begin growing more outside of counseling in areas that are distinct from your counseling agenda than you are inside of counseling in the areas of your counseling goals. Counseling begins because struggles were interfering with life. Counseling concludes when life can be meaningfully engaged despite the remaining struggles.
   • Don’t put life on hold because you are in counseling. Especially in the latter stages of counseling, set goals for things you want to pursue, not just overcome. Let your small group be the context in which you share about and seek guidance on these matters.

3. Be joyously imperfect. Sanctification is a life-long journey; “graduating” counseling doesn’t mean we’re a finished product. Unless we are at peace with this reality, we will never feel like life is “good enough” to free us from counseling. However, when we are honest about our struggles in natural community and these struggles no longer impair our ability to engage our primary life roles, then the artificially-paired relationship of counseling is no longer needed.
   • Enjoy being “in process.” Allow it to bring a sense of adventure and purpose to life as you continue to discover areas that God wants to grow and shape your life.

When you decide that you would benefit from counseling (and that sometimes takes us a while to acknowledge), there is still another hurdle to navigate: How do you find a counselor who is a good fit for your needs? Counseling is not as objective as medicine, so finding a good match with a counselor is more important than most helping relationships.

In the Summit counseling ministries, it is important to understand the difference between how counseling pairings occur at Bridgehaven as compared to the graduate intern program. In the graduate intern program, you would complete the intake forms, submit them to the church office, and our pastor of counseling will assign you to the best-fit counselor from our team.

At Bridgehaven, the process of matching with a counselor is more self-selecting. The steps below are meant to help you in this process and are also applicable to identifying a good match for counselors outside of Bridgehaven. When seeking outside counselors, we recommend the guidance provided by CCEF in the post “Choosing a Christian Counselor.”

Here are seven steps to identifying a counselor who is a good match for your needs.

1. Determine what your goals are for counseling. Unless you can articulate what you want to accomplish, it will be difficult to identify the best person to help you accomplish these goals. No counselor does everything. The better you can articulate your goals, the more helpful the guidance you receive in step 6 will be.

2. Know what is important to you in a counselor. Chances are you won’t find a perfect match. Gender, age, training, experience, personality, etc.—any of these factors and more may be legitimately important to you, but the question in step 2 is: Which is most important?

3. Factor in the level of specialization required for your counseling needs. Are you struggling with a life transition, a general problem in living, a physical condition with emotional-relational ramifications, a counseling issue with legal implications, etc.? These may require particular credentials or specialization for a counselor to effectively help.

4. Factor in the logistics of travel and expense. Counseling is rarely a one-time meeting. Gaining history, building rapport, identifying goals, examining relevant principles from Scripture or science, and developing strategies take time. For these reasons, selecting a counseling option that allows for an appropriate frequency and duration of meeting is important for counseling to be effective.

5. Read the biographies of each counselor on the center’s website. Once you know your goals and priorities, you can identify the center(s) that are a good fit and review the staff biographies with intentionality rather than curiosity. This will allow you to make an initial phone call with the information you need to ask informed questions.

6. Call, explain your need, and ask questions. The better you can explain your need and understand the basic services of the counselor/center you are calling, the more effective you will be at identifying a good match. A good potential scheduling call to a counselor would sound like, “My name is [blank], and I am wanting counseling for [describe]. I have looked at your site and think [name] might be a good fit. Does that seem reasonable, or would someone else be a good fit? If so, I would like to understand what makes them a better fit.”

7. Realize there still may be trial and error. Counseling is as much art as it is science. You may take wise steps and still not be satisfied with the counselor you begin meeting with. This is unfortunate, but not failure. You will have learned things to help you navigate this process more effectively in identifying someone who is a good match.

We hope this guidance helps you in identifying a counselor who is a good fit to helping you reach the health, wholeness, and holiness that God desires for you.

The National Alliance on Mental Illness (NAMI) recognizes six areas of independent professional practice for the diagnosis and treatment of mental health issues. While NAMI’s recognition of professional mental health practitioners may not be exhaustive, it is perhaps the most concise and descriptive of mental health services provided by different disciplines.

We believe it is helpful for churches to be aware of the education and primary purposes of each type of mental health professional in order to effectively care for the people within the body of Christ.

Psychiatrist: Psychiatrists are physicians with either a doctor of medicine (M.D.) degree or doctor of osteopathy (D.O.) degree who also have at least four additional years of specialized study and training in psychiatry. Psychiatrists are licensed as physicians to practice medicine by individual states. "Board certified" psychiatrists have passed the national examination administered by the American Board of Psychiatry and Neurology. Psychiatrists provide medical and psychiatric evaluations, treat psychiatric disorders, provide psychotherapy (in some cases), and prescribe and monitor medications. There are several subspecialty boards in psychiatry, including child and adolescent, forensic, and addictions.

Psychologist: Psychologists have a doctoral degree (Ph.D., Psy.D.) in clinical, counseling, or health psychology/behavioral medicine. Psychologists are also licensed by individual states to practice psychology and, in many states, are licensed as health service providers. They can provide psychological testing and diagnostic evaluations, treat emotional and behavioral problems and mental disorders, and provide a variety of psychotherapeutic techniques. Psychologists usually attend a four or five-year graduate program, with a year of internship followed by a one year postdoctoral period of supervision prior to licensure. There is also a National Board/Council of Health Service Providers in Psychology that requires psychologists to provide two years of documented supervision post-licensure in particular areas of specialty.

Social worker: Social workers have either a bachelor's degree (B.A., B.S., or B.S.W.), a master's degree (M.A., M.S., M.S.W., or M.S.S.W), or doctoral degree (D.S.W. or Ph.D.). In most states, social workers take an examination to be licensed to practice social work (L.C.S.W. or L.I.C.S.W.), and the type of license depends on their level of education and practice experience. Social workers provide a range of services based on their level of training and certification. Typically a bachelor’s level social worker provides case management, inpatient discharge planning services, placement services, and a variety of other daily living needs services for individuals. Master’s level social workers can provide this level of services but are also able to provide assessment and treatment of psychiatric illnesses, including psychotherapy.

Licensed professional counselor: Licensed professional counselors have a master's degree (M.A. or M.S.) in psychology, counseling, or other mental health-related fields (some may hold doctorates) and typically have two years of supervised post-graduate experience. They may provide services that include assessment and diagnosis of mental health conditions as well as providing individual, family, or group therapy. They are licensed by individual states and may also be certified by the National Board of Certified Counselors.

Licensed marriage and family therapist (LMFT): The American Association for Marriage and Family Therapy is a professional association of therapists who conduct marriage and family therapy. A graduate degree (M.A. or M.S.) plus post graduate supervision by an approved supervisor is required for licensure (some may hold doctorates). LMFTs are licensed by individual states.

Many individuals choose to seek pastoral counseling from the local church or a parachurch ministry. Individuals in these ministry settings may or may not carry the credentials listed above. It is important for you to know the credentials your counselor does or does not carry and the implications this may have for the care you receive.

For a better understanding of the difference between pastoral and clinical counseling, please see the relevant post above.

We often get asked the question, “Do you know a good counselor in [name of city]?” This is the guidance we give when the answer to their question is, “I’m sorry. I don’t know someone I can personally recommend there.”

• Step 1: Make a list of trusted churches you know in that area. This choice may be denominationally-based for you. Or, perhaps there is a network of churches that aligns with your beliefs. Maybe there are several pastors in that area you’ve heard preach, and you appreciate how they teach the Bible.
• Step 2: Call these churches and ask, “Who do you recommend for counseling?” At this point, you do not have to provide a significant amount of personal history. You might clarify by saying that you are seeking “marriage counseling” or “personal counseling” or “addiction counseling.” As you call multiple churches, take note of any counselor(s)/center(s) that are repeated among your trusted churches.
• Step 3: Call the counselor/center that was most repeated among your trusted churches. This is the phone call where greater personal disclosure is advised: “I am seeking counseling for [describe in a concise two to three-minute summary]. I have contacted several churches I trust, and they recommended you. I want to know if you have training in my area of need. If not, is there another Christian counselor you would recommend for this type of life struggle?”
• Step 4: Schedule an appointment. At the end of this process, you will have identified a trusted counselor who is recommended by the Christian community in this area, and/or allowed that counselor to direct you to someone who is well-trained in your area of need.
• Note: If you are calling for a friend or family member, you will not be able to schedule an appointment for them. But you will have identified a best-fit counselor for needs that you can recommend to them.

Additional guidance on how to interview a prospective counselor is provided by the Christian Counseling & Education Foundation (CCEF).