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Dr. Loren TownsendOver the past thirty years I have focused on one expression of ministry—pastoral counseling. If you had asked me in 1979 what pastoral counseling was, I would have had a swift and certain answer. Historically, pastoral counseling was what clergy did with folk in their congregation. By the mid-twentieth century this had expanded to mean the counseling provided by specialized clergy who had extensive training in psychotherapy. These ministers were set aside by their denominations as counseling specialists to provide more intense therapy than parish pastors were prepared to offer. Certification for this specialty required an M.Div., ordination, at least three years of service in a congregation, and several years of clinical training. Sometimes pastoral counselors served as church staff members. Often they worked in pastoral counseling centers funded by a group of churches committed to caring for people suffering from emotional, behavioral, or family problems. This specialty was justified on three grounds: It reflected the image of Jesus the good shepherd who engaged people at the point of their deepest need; it expressed a long-standing Christian tradition that the church should be an active agent of healing and guiding; and it embodied a contemporary Protestant ethic that cultural innovation--like psychotherapy—can be applied critically to religious life. By 1990, this was a near-universal narrative for pastoral counseling.

However, this narrative was filled with tension. From the very beginning of specialization (mid- 1950s) there was intense debate about how close pastoral counseling specialists should be to parish ministry. Presbyterian Seward Hiltner (1964) and Southern Baptist Wayne Oates (1962), for instance, believed that pastoral counseling by definition must be anchored in congregational ministry. To them the idea of “pastoral” counseling outside the walls of the church made no sense--it was a violation of the basic character of ministry, and was probably unethical. On the other hand, United Church of Christ minister Frederick Kuether (1963), one of the founders of AAPC ( the American Association of Pastoral Counselors), argued that pastoral counseling did not belong to the church. Counseling was not about an institution; it was about caring for the inner lives of individuals and families. This reflected a contemporary trend to segregate counseling from congregational life: clients were more likely to be honest outside the walls of the church, client confidentiality was easier to protect, and counseling could be unconstrained by theological, ideological, or practical boundaries usually associated with the church and its clergy. These arguments were extended by Methodist Howard Clinebell (1964), also a founder of AAPC, a distinguished professor of pastoral counseling at Claremont School of Theology, and author of the most highly published and frequently read introductory texts in the field. Clinebell claimed that what made a pastoral counselor was the counselor’s personal identity and not his or her church affiliation. According to Clinebell, pastoral counselors were highly trained therapists who stood on equal footing with psychologists, social workers, and marriage and family therapists. Pastoral counselors, after all, were trained in exactly the same theories and therapy methods as these other professionals. What set pastoral counselors apart was their formation in ministry—the person delivering therapy was shaped by theological education and ordained, and so had access to religious symbols and ritual other professionals did not. As it turned out, this was a compelling argument. It became the driving force behind the remarkable growth of pastoral counseling as a guild, a certified therapeutic specialty, and a privatized ministry. By 1990 there were more than 3000 certified pastoral counselors. In 1988 alone, pastoral counselors in the United States provided one and a half million hours of counseling and collected an estimated fifty one million dollars in fees. Most cities in the United States had a number of private practice pastoral counselors and at least one pastoral counseling center.

Fast forward to 2000. In one short decade pastoral counseling was fragmenting. Nearly half the pastoral counseling centers in the nation had closed. What had been a robust stream of ministers seeking specialized training slowed to a trickle. By the mid 1990s, the simple narrative of pastoral counseling as a privatized ministry of specially-trained, ordained clergy no longer worked, much because the cultural context had changed.

For more than thirty years pastoral counselors held two things in tension. On one hand, ordination gave them a structural connection to the church and authority to practice with little concern for state regulation. On the other hand, pastoral counselors functionally segregated their work from congregational life. There was, of course, a trade-off. Counselors were not usually part of a church staff, so the church did not pay counselors’ salaries or for the parishioner’s therapy. People who saw pastoral counselors paid for therapy like most other counseling clients—with fees for service or health insurance. This worked well until the 1990s when managed care reorganized how insurance companies reimbursed mental health providers. Pastoral counselors were written out of the script because they were clergy and not state-licensed therapists.

Once written out of reimbursement, pastoral counselors had three choices: They could give up counseling and turn to some other form of ministry; they could offer counseling only to clients wealthy enough to pay for services; or they could become state licensed. To stay in practice, most pastoral counselors earned additional degrees to qualify for professional counseling, social work, or marriage and family therapy licenses. Six states (Maine, New Hampshire, North Carolina, Kentucky, Tennessee, Arkansas) passed new laws to regulate pastoral counselors who did not want or were unqualified for other kinds of licenses. This rush to licensing solved one problem. It helped pastoral counselors survive in a rapidly changing climate. However, licensing left a whole host of unanswered questions. Who were pastoral counselors now? How had licenses changed an identity that had supported pastoral counseling for nearly a century? How did state regulation change ministry and pastoral counselors’ relationship to the church? How would licensing affect the future of the field? These kinds of questions went largely unnoticed while people and counseling centers scrambled to survive. As the dust settled several questions were unavoidable.

The first obvious question was about ordination and ecclesial connection. Pastoral counselors had to be professionally licensed to maintain a practice. But, when a pastoral counselor was licensed, authority and accountability shifted away from the church and to the state board that issued the license. This made one defining element of pastoral counseling—ordination--structurally and functionally irrelevant. Licensing shifted pastoral counselors’ priority away from ecclesial anchors and toward practice as state-regulated mental health professionals. Most justified this shift by arguing that state law should provide religious consumers access to faith-based services. In this equation, ecclesial connection and ordination were reduced to a counselor’s preferred identity and an “add on” value that benefitted religious clients to whom church connection and ordination mattered.

Ordination, subtly decentralized in licensing struggles, was also directly challenged as a social justice issue within the pastoral counseling guild itself. To claim ordination as a central defining value meant that many women and most gay, lesbian, bisexual, and transsexual people were excluded from the field because their denomination would not ordain them. Furthermore, ordination assumed a largely male, heterosexual, and Protestant identity that grounded pastoral counseling within a specific and exclusive ecclesiology. After several years of study and conflict, the American Association of Pastoral Counselors broadened its definitions to decentralize ordination and embrace more individually-defined forms of religious connection.

Together these shifts changed the shape of pastoral counseling and brought a central question into bold relief: What is pastoral about pastoral counseling when “ordained clergy” is removed as a structural support? This is no small question. It has befuddled several denominations that can’t quite figure out how state regulated practices relate to Word and Sacrament, or what to do with non-ordained people who identify themselves as pastoral counselors. This question also turned the pastoral counselor certification process on end and caused seminaries to wonder whether training counselors was part of their basic mission. This question motivated my own four-year study funded by a Lilly Foundation Grant and a grant from the American Association of Pastoral Counselors. In the study, I interviewed and reviewed theological statements from nearly 100 pastoral counselors across the United States selected to represent maximum variation. What I found was a seismic shift that seems to have broken a grand, unified narrative of pastoral counseling into several smaller, more discrete narratives. Here are three examples that illustrate the many ways pastoral counselors now talk about themselves and their work.

David is a traditionally trained pastoral counselor. He is Presbyterian, has a Doctor of Ministry degree, and completed a three-year residency in a historic AAPC training program. Additional classes from a local university qualified him for a state license. He is part of a group private practice that rents space in a church-owned building. Most of his referrals come from pastors he has known for years. His clients know he is an ordained minister and his office is decorated with religious pictures and symbols. When I asked what makes his counseling pastoral as opposed to some other kind, he spoke of his theological education, ordination, and counselor training. These, he believed, had been forged into an integrated identity as a minister who lives out word and sacrament in counseling. He uses the same theories and techniques as other kinds of counselors, but believes his relationship with clients is different. Because of his ministerial identity, therapy becomes a form of worship as he embodies God’s presence and invites grace and transformation into the sacred space of the counseling room.

Carrie belongs to a denomination that will not ordain her or recognize her as a minister. She is a licensed psychologist and earned a degree in a program that taught “spiritually-integrated psychology.” She was hired by a Samaritan Center and worked with a local pastoral counseling center to meet requirements for certification as a pastoral counselor. When I asked what made her counseling pastoral, she spoke of herself as an incarnation of God’s love in session. This is expressed by her empathic pastoral presence with clients and her willingness to help clients work with spiritual issues in therapy. She believes this is very different from Christian counselors who, in her opinion, focus on evangelism and guiding clients toward a parochial vision of “Christ-like living.” Carrie is a certified pastoral counselor but she most often refers to herself as a “theologically-integrated” or “spiritually-integrated” therapist. She thinks the public mistakenly interprets “pastoral counseling” as the counseling offered by clergy. Though she cannot be ordained, Carrie believes that her education, supervision, and spiritual work with clients has “graced” her into “an alternative priesthood” that is not exactly sacramental, but is transformational.

Angela completed a master’s degree in counseling in a seminary. She identifies herself as a marriage and family therapist and a pastoral counselor. She is not ordained, cannot qualify for ordination, and does not desire ordination. She describes her work as a “ministry of counseling.” Angela credits her seminary education with helping her define counseling as a ministry even though she is not ordained, is not formally endorsed by any church, and works in a public agency. She believes that seminary helped her define counseling as part of a broader ministry of healing. This happened as she gained a deeper sense of her Christian heritage, worked alongside M.Div. students, learned to think theologically about counseling theory and practice, and learned to identify issues of social justice that affected her clients. This background helped her form a bridge between her licensed work as a marriage and family therapist and ministry in a broad, non-ecclesial frame. Though she works in a public agency where she is not allowed to refer to herself as a pastoral counselor or highlight her theological training, she believes her voice is valued because of its theological depth. She is known for raising theological and social issues with her colleagues as they discuss treatment and policy decisions. Therapists in her agency often refer clients to her who want to work with religious or spiritual issues.

On one hand, these three examples show a common thread. Pastoral counselors I interviewed almost universally stated that “pastoral counselor is who I am, not what I do.” Theological commitments, personal spirituality, and counseling theory are integrated into a sense of self that guides professional practice. On the other hand, these stories represent increasing variation in what pastoral counselors mean when they say “it’s who I am.” Clearly, the traditional narrative of specially-trained clergy who counsel church-related people is quickly being eclipsed by new and diverse stories.

Emerging narratives tend to locate pastoral counseling as a specialized mental health profession that requires specific spiritual and theological training, but not ordination or direct ecclesial connection. Most pastoral counselors entering the field today work in public agencies, private practice, or counseling centers that are not related to the institutional church. This complicates things. In 1963 the primary question confronting Wayne Oates and Howard Clinebell was, “Should pastoral counseling be confined to what clergy do in their parishes, or can it be expressed in private settings outside the church?” In 2009 the dominant question seems to be: “How do we make theological sense of a wide range of counselors from diverse religious backgrounds who now call themselves pastoral and who practice in contexts that were unimaginable to Howard Clinebell and Wayne Oates in 1963?” This question presses us in several ways.

First, it presses us to examine the role of ordination and ecclesial connection for pastoral counselors. Ordination has become irrelevant for certification and is superfluous to many places where pastoral counselors practice. But, in several narratives pastoral counseling continues to be an extension of the church’s ministry and not a mental health subspecialty. In these stories, ordination remains highly valued by counselors, clients, and churches. This difference pushes both the church and pastoral counselors to re-evaluate their theologies of ordination and ministry. For example, how does ordination relate to pastoral counseling? To whom is it important, why, and under what circumstances? Should third-party insurance payers be the ones who determine if ordination is valuable or not? If pastoral counseling is valued as an extension of the church’s ordained ministry, how is it to be supported financially? If it cannot be supported, what is lost when a public market trades substantive guidance within a religious community for an individualistic approach to therapeutic spirituality? Changes in pastoral counseling press us to construct contemporary theologies of ministry wide enough to support diverse narratives and practices.

Pastoral counselors increasingly find their vocational home in public agencies rather than churches or church-related centers. This new narrative presses us to examine the place of public ministry and the role of pastoral counselors in expressing a public theological voice. For example, how can a pastoral counselor who works in a state-supported mental health agency raise her theological voice? Can she insist that a client’s religious questions be part of a treatment plan? Does she have a responsibility to advocate for a theologically-informed vision of human life as she helps design new programs of service? How does she balance competition between pastoral values and those of the public market? Where does she find conversation partners to help her negotiate this rocky ground? Again, we are pressed. Our theologies of ministry must be thick enough to support ministry in the public arena. They must also be accessible enough to help pastoral counseling students learn to organize their work in vastly different and public contexts.

Finally, as the grand narrative of a unified field of professional pastoral counseling has broken into multiple new expressions, the role of parish pastors in counseling becomes clearer. The 1980s' vision of a muscular profession of pastoral counseling required teaching pastors to defer nearly all counseling to highly trained experts. New narratives tell us that there is a place for many kinds of pastoral counselors, which includes parish pastors. Polls over the past fifty years show that most Americans turn to their pastors first when they have a problem in living. They expect pastors to help. Often this means referring to a counselor because many problems are complex, enduring, and require a specialist. However, sometimes, as in some rural parishes, services are not available. Sometimes parishioners are too poor to pay for counseling, and if they are helped at all, it will be by their pastor. And, in some cases, it will be best practice for a problem to be managed in parish-based counseling. Increased counseling by parish ministers appears to be one way pastoral counseling is diversifying. This renewed narrative calls for conversations to define how pastors can manage complex dual roles, how counseling fits among countless other obligations, and what kinds of problems need specialized care. It also calls for specialists to demystify what happens behind closed therapy doors and teach pastors the nuts and bolts of effective treatment. Seminaries must provide basic counseling education for those called to parish ministry and encourage strong cooperation between counseling students and future congregational ministers.

In closing, “What is pastoral about pastoral counseling?” The answer in 2009 seems to be, it depends—for instance, it depends on when, where and how a pastoral counselor was trained, the specific contexts of their practice, and the interpretive traditions that guide their individual spiritual and religious commitments. We live in a world where grand narratives are dethroned and replaced. Pastoral counseling’s grand narrative has been shattered and we are actively constructing alternate stories of what pastoral counseling will be. We have a responsibility to articulate theologies of ministry that are rich enough to organize the boundaries and practices of diverse new narratives.

 

Dr. Loren Townsend is the Henry Morris Edmonds Professor of Pastoral Ministry and Professor of Pastoral Care and Counseling at Louisville Presbyterian Theological Seminary in Louisville, Kentucky.

This article was initially delivered as a Convocation address at Louisville Presbyterian Theological Seminary, February 5, 2009.  Based on forthcoming book: Loren L. Townsend, Introduction to Pastoral Counseling (Abingdon, 2009).

References:

Clinebell, Howard. (1964). The challenge of the specialty of pastoral counseling, Pastoral Psychology 15.

Hiltner, Seward. (April 1964). The American Association of Pastoral Counselors: A critique, Pastoral Psychology 15. 

Kuether, Frederick. (1963). Pastoral counseling: Community or chaos, The Pastoral Counselor 1.

Oates, Wayne . (1963). Protestant pastoral counseling. Philadelphia: Westminster Press.