This chapter describes how pastoral counselors draw on religious and theological studies along with psychological studies. Pastoral counselors can be described as bilingual and bicultural. The near history of American pastoral counseling in the 20th century generated several distinct ways of relating psychological studies with religious and theological studies. Pastoral counseling by religious leaders has been going on for centuries. Psychologically informed pastoral counseling and chaplaincy became specialized vocations as religious leaders pursued education and training in psychological counseling. Clinical pastoral education (CPE) within psychiatric hospitals was recognized as a form of clinically based theological education and was required by some seminaries and denominations as preparation for ministry. Pastoral counselors using a theistic worldview will likely retain a more conformist religious identity, especially religiously endorsed pastoral counselors who feel responsible for explicitly representing the cornerstone beliefs of their religious tradition.

The Dictionary of Pastoral Care and Counseling identifies pastoral counseling as a 20th-century phenomenon. E. Brooks Holifield (1983) highlighted how early American pastoral care reflected social and theological issues of the time. Pastoral counseling in liberal congregations began to shift away from cognitive, intellectual answers and toward helping parishioners surrender to a “wider self” that would lead to transformation. For pastoral counselors and theologians, psychoanalysis raised awareness that human emotional, spiritual, and volitional life was more complex and mysterious than supposed by earlier theological anthropologies. The Association for Clinical Pastoral Education standardized clinical pastoral education (CPE) as a professional education program for ministry with a focus on pastoral identity, interpersonal competence, and chaplaincy skills. Pastoral counseling specialization gained credibility partly through academic interest in seminaries and graduate schools. Although racial and multicultural tensions contributed to slow growth in the United States, pastoral counseling gained strength in Asia and Africa.

In many ways, Joretta L. Marshall’s journey in pastoral counseling represents what is often referred to as a more traditional model of formation. Her work as a pastoral assistant, college chaplain, associate pastor, and staff person in a youth crisis center shaped her pastoral identity in church and community. Formed by a doctoral program that was clearly grounded in pastoral theology while working alongside pastoral clinicians who brought sophistication to their theological and clinical integration, Marshall began to see the identity of a pastoral counselor emerging among the multiple identities. Many of pastoral counselors related to the American Association of Pastoral Counselors (AAPC) assume, at their own peril, that there is one traditional model out of which all other pastoral counseling movements arise. Lifelong learning activities emphasized the pressing need for pastoral counselors to increase their clinical competency and effectiveness.