This chapter provides brief introduction to key issues in distance counseling, with particular emphasis on the implications of pastoral counseling practices for pastoral counselors. Distance counseling technologies include both asynchronous and synchronous formats. An increasing number of counseling professionals now offer distance counseling as one part of their traditional, face-to-face, counseling practices, and a smaller number of counselors practice primarily in a distance format. It is important to emphasize that distance counseling is not intended to replace entirely conventional modes of pastoral counseling; rather, it may serve as an essential adjunct to traditional methods. Like other forms of spiritual and mental health care, pastoral counseling is most often offered to clients as a face-to-face activity. Distance pastoral counseling may limit some forms of assessment and understanding of the client and his or her experience and concerns. As an emerging practice, distance counseling presents both opportunities and challenges for pastoral counselors.

This chapter examines the development and organization of pastoral care within the context of managed care. It illustrates an approach that has been effective at engaging a medical system while providing quality care to patients. The chapter provides a potential plan on how to further establish a training program in the context of educational systems and licensing boards. Pastoral psychotherapists have historically been well educated and trained in diverse counseling and psychotherapy clinical theories and methodologies. The term pastoral in pastoral psychotherapy typically connotes a specificity of education, training, supervision, and experience. The Integrative Psychotherapy Training Program (IPTP) offers a useful model for how pastoral counseling and psychotherapy is self-differentiating while extending its influence into the complexities of a very large health care delivery system. When developing an integrative psychotherapy service center and training program, the program must discern the service needs of the health care system.