This chapter explores how pastoral counselors might work with queer-identified persons. It reviews theories of sexual orientation and literature establishing gay/lesbian-affirming approaches to pastoral counseling. The chapter considers emerging theories regarding “queer” identities and how such identities are related to prevailing constructs of gender and sexuality in psychotherapeutic discourses. Pastoral counselors working with queer-identified persons especially in couples and family therapy are challenged to critically reflect on and intentionally deconstruct the ways in which dominant discourses of gender and sexuality have become embedded in operative psychotherapeutic approaches. It is critically important for queer-affirming pastoral counselors to clearly identify the theological, scientific, psychological, anthropological, and sociological conclusions about human sexuality because each of these assumptions shapes the clinical practice. Pastoral counselors are encouraged to seek continuing education and specialized training before working with persons who are transgender, especially those who are actively seeking gender transition.

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 discusses how pastoral counselors are different from other counseling professions. Pastoral counseling exists in a substantial community of related disciplines and professions. The two theoretical bodies of knowledge that combined to create pastoral counseling were the disciplines of psychology and theology. A review of pastoral counseling’s professional heritage sets the stage for the discipline’s contemporary identity dilemma. The formative nature of pastoral counseling training shapes the pastoral counselor’s self and is the rudiment from which the distinctive interventions of pastoral counselors organically emerge. Among the elements of training and formation most salient to shaping pastoral counseling interventions are clinical integration, pastoral formation, and the development of a spiritual orientation. The unique training and formation of pastoral counselors lays the groundwork for the development of interventions. Pastoral counselors share distinctive interventions that are born out of particular ways of being and a particular set of goals and objectives.

This chapter focuses on distinct advances occurred over the past 2 decades that are worthy of greater engagement by the pastoral counseling community. In the past decade, childhood studies have even earned a place in the study of religion, becoming a new program unit in the American Academy of Religion (AAR). When the new program unit of Childhood Studies and Religion sought AAR renewal in 2005-2006, one of the concerns raised by the program committee was the unit’s proximity to what the committee described as normative, Christian, and practical interests. Children have been misperceived as a low-status subject of little theoretical interest except to those in professional or practical areas such as religious education or pastoral care. As childhood studies in religion suggests more generally, fostering respect for religion in all its complexity is an equally important dimension of understanding children.

This chapter focuses on the workings of “Torah therapy” by drawing on what Cheston describes as the three points of focus essential to all counselors: the counselor’s way of understanding clients, the counselor’s way of being with clients, and the counselor’s way of intervening in the therapeutic process. It concludes by comparing and contrasting Torah therapy and pastoral counseling as it is traditionally understood. The wisdom of Judaism, as contained in the reservoir of divine teachings known as the Torah, is intended to guide the Jew’s outlook in all areas in life, including one’s vocation. Torah-based therapist makes a concerted effort to help clients to reconstruct past hurts in a positive light. Torah therapy overlaps with pastoral counseling in large measure but not perfectly, for whereas the government places educational and licensing demands on the pastoral counselor, one may reach the status of Torah therapist less formally and officially.

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.

This chapter proposes a way of understanding pastoral diagnosis as a process of discernment that seeks to bring into dialogue alternative ways of knowing, while at the same time being grounded in a larger interplay between knowing and unknowing, which brings a unique experience to the engagement with human distress. The idea of pastoral diagnosis that developed in the 20th century had its roots in the worldwide pattern of religious interpretive systems in general and more particularly in the centuries-old practice of pastoral care from the Judeo- Christian tradition. Implicit in pastoral diagnosis is not only a way of conceptualizing human distress but also a way of engaging human distress with a particular focus on experience. The pastoral experience implied in the process of pastoral diagnosis with its inclusion of various ways of knowing engages the primary, raw, affective aspects of “core-consciousness” that often underlie human distress.

This chapter presents a type of culturally open pastoral counseling that requires a transformation of self and society beyond an educated mind and a politically sensitive vocabulary. It discusses the current state of multicultural competence and social justice discourses. The chapter offers a few guiding principles intended to foster a more culturally open approach to cross-cultural training for pastoral counselors and other helping professionals. Training cultural competence in pastoral counseling and related fields focuses on meeting the ethical guidelines established by professional organizations. Training and discussions of social justice in pastoral counseling and related fields are aimed at drawing attention to the injustices inflicted on marginalized populations and motivating privileged populations to address and eradicate the resulting disparities. The primary focus of cross-cultural training for pastoral counselors is awareness, knowledge, and self-reflection. Developing cultural competence requires heightened awareness of personal cognitive dissonance when confronted with conflicting beliefs.

This chapter presents common research methods, both qualitative and quantitative, including how the researcher influences what is being measured, challenges and opportunities in measuring religion and spirituality, and cultural implications of the measurement of religion and spirituality. When reading reports of research on the impact of religion and spirituality on psychological constructs, pastoral counselors must consider what the researcher intended to capture, as this may be different from the pastoral counselor’s personal definitions of religion or spirituality. Pastoral counseling falls in the broad category of the social sciences. There are two general categories of social science research: quantitative research and qualitative research. Research in religion and spirituality must consider the cultures of those who devise the research and the cultures of those who participate. Pastoral counseling research is complex because it crosses multiple disciplines and encompasses concepts that are difficult to define and conceptualize: religion and spirituality.

This chapter explores the diversity of professionals engaged in pastoral counseling, the characteristics of those professionals within the ever-expanding landscape of mental health care, and the settings in which pastoral counseling most often occurs. It describes the plurality present within the discipline, summarizes the discipline’s use of the adjective pastoral, and offers a broad, fluid understanding of pastoral counseling. Pastoral counselors at the center of practice in the 1950s to 1970s may have claimed to speak in a singular tongue and envisioned a monolithic tower representing the theory and practice of the discipline. Pastoral counseling is an approach to mental health care that draws on the wisdom of psychology and the behavioral sciences alongside spirituality/religion/theology. Pastoral counselors are bicultural because they have graduate training in both religious/spiritual/theological education and a mental health discipline. Religiously endorsed pastoral counselors are, like all pastoral counselors, bilingual and bicultural.

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.

This chapter explores the religious differences between counselors and their clients. It explores religious location, including one aspect of religious location that can pose what is arguably the only insurmountable barrier when the counselor and client occupy different religious locations. The chapter focuses on setting out the foundational concept of “language care”. It reflects forms and degrees of religious difference, challenges posed by religious differences in counseling, and the significance in counseling of the counselor’s religious location. Therapeutic relationality is of concern throughout the chapter, but a brief concluding section examines a few practices especially valuable for nurturing therapeutic relationality given differences in clients’ and counselors’ religious locations. The diversity of religious locations is demanding and perhaps daunting. Standards of professional competence and codes of ethics across the mental health professions include at least a mention of religion. The religious location of the counselor matters in the clinical process.

This chapter provides an overview of traditional Native American spiritualities and life ways as systems of faith, then discusses the role and influence of Christianity, and, finally, offers implications for pastoral counseling with Native people from a culturally based perspective. In terms of faith and belief, Christianity has had the greatest influence on Native Americans. Essentially, cultural competence is critical in pastoral counseling with ethnic and spiritually marginalized groups such as Native Americans due to historical struggles, mistreatment, and a resulting potential for mistrust. Pastoral counselors must avoid making assumptions about the cultural identity of Native American clients without gathering information about both the individual’s internal and external experiences. Both verbal and nonverbal cues offer pastoral counselors a sense of a Native American client’s level of acculturation. Pastoral counselors might get involved with working on large social issues that will then indirectly affect the experience of Native American clients.

This chapter examines the relationships between pastoral counseling and spiritual direction with an eye to how the related disciplines can work together to provide holistic care for clients facing the complex problems of modern life. It explores the common ancestor of spiritual direction and psychotherapy in the care for the soul in Western philosophical and religious traditions, tracing their separation in the past century. The chapter considers ideas from an interfaith and contextual perspective and raises questions for the future of pastoral counseling based on cultural differences and emerging social trends. Positive psychology has provided helpful distinctions that are useful in describing how counseling, pastoral counseling, and spiritual direction are both similar and different. Many counselors both pastoral and clinical mental health are interested in promoting cognitive, psychosocial, and faith development, and these concepts also inform spiritual direction; both relationships would cover ideas such as images of God.

This chapter focuses on Buddhist approaches to the work of pastoral counseling and the role of the counselor. It explores the topics of Buddhism and pastoral counseling as separate entities, looks at how they can be joined, and presents unique elements of working with Buddhist and non-Buddhist clients. The chapter introduces the notion of the Buddhist pastoral counselor as the kalamitra, or spiritual friend. In Mahayana Buddhism, the teacher is often termed kalamitra, Sanskrit for spiritual friend. The kalamitra as counselor is one who has worked with his or her own mind and therefore knows the workings of the mind and how the mind creates suffering. Similar to all counseling, the Buddhist pastoral counselor will rely on the relationship with the client as the main process and intervention of counseling. Buddhism and mindfulness will continue to influence psychology, and therefore Buddhist pastoral counseling as a discipline will continue to grow.

This chapter provides some thoughts on exploring the possibility of developing a model of pastoral counseling in Muslim communities. As a concept, pastoral counseling does not translate entirely or accurately in the Muslim community. Religious leaders in most Muslim communities are well-meaning, well-intentioned individuals who want to provide help to members of the faith, but often they have no background or expertise to do so. The notion of pastoral care as it exists in the Muslim context bears little semblance to the way that it is understood in its broader professional context. Muslims are required to live in their own historical time and seek contemporary solutions to practical problems of human existence drawn from the knowledge base of society in their own time. Viewing Muslims through the exclusive lens of their religion can become very problematic when attempting to provide care in the context of mental health and mental well-being.

This chapter addresses the importance of understanding the dignity of human nature. The human condition is a complex theological, philosophical, and psychological term that refers to the nature of our human experience. Significant pastoral concerns arise directly from the givens of human existence, as well as the contexts in which those experiences occur. The organization and method of discourse cover six key contexts for understanding the human condition:human dignity and depravity, story, relational style, family, gender, and view of God. The essential unity of the human family with God is part of the dignity inherent to the human condition and is often described by the mystics. One’s view of God has direct implications on one’s understanding of the human condition and thus one’s counseling practice. One cannot truly understand the human condition without first examining how humanity views the divine.

This chapter provides the pastoral counselor with a “working hypothesis” about Hinduism and the culture of South Asian Hindus, it is no substitute for the recognition of the uniqueness of each individual who seeks counseling. Hindu subgroup is a growing population in the United States, and those in pastoral counseling and other helping professions will benefit from understanding the Hindu worldview. Hinduism is a philosophical approach to life and its problems, in which the “concepts of community, interdependence, divinity” and interconnections are implicit. Both cultural and religious concerns affect Hindu clients, teasing apart distinct cultural and religious interactions may be challenging. Although it is unlikely that a Hindu client will seek out a pastoral counselor to specifically address religious or spiritual issues, pastoral counselors are likely to encounter clients who identify as Hindu in a variety of settings such as hospitals and community agencies.

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.

This chapter explores the interventions employed within pastoral counseling that resonate with other mental health professions. Although interventions differ by definition and discipline, the chapter intends to elucidate the common ground shared across professions that serve to promote mental well-being. The actual interventions employed by different allied health professions similarly share a common ground. Most of the interventions used by pastoral counselors stem from a psychotherapeutic perspective informed by psychological theories and the historical, collective experience of the mental health disciplines. Pastoral counselors and other allied professionals are equally likely to draw from the shared pool of therapeutic interventions. The allied professions find common ground in psychodynamic interventions given the historical roots and cultural breadth of that paradigm. The humanistic and existential paradigms of psychotherapeutic intervention serve as another common ground for pastoral counselors and the allied professions.

This chapter explores pastoral counselors as mental health professionals, in terms of their professional identities, training, and licenses. Among the most significant transformations in the field of pastoral counseling over the past half-century have been the entrance of laypersons into the profession and the increasing numbers of pastoral counselors who identify as both religious leaders and licensed mental health professionals. Some of the largest growth in the profession has occurred among laypersons seeking training in pastoral counseling and licensure as mental health professionals. The curricula of mental health training programs are most often designed to meet national standards outlined by professional organizations and state/provincial licensing board requirements. In addition to training models and licensure requirements, pastoral counselors who work as mental health professionals are also exposed to and often endorse the prevailing paradigms, ethical codes, and standard practices of their mental health disciplines.

This chapter focuses on the common themes of meaning and the sacred that emerge in pastoral counseling practice. It elucidates explicit and implicit spiritual content that is commonly presented by clients. The chapter explores the explicit spiritual content commonly raised by clients within the Abrahamic traditions. It also explores implicit spiritual content, which is seemingly inherent to the human condition and often occupies the subtext of a client’s presentation. Grounding the exploration of explicit and implicit spiritual content in pastoral counseling is the belief that competent practice requires counselors to be spiritually and theologically flexible. Pastoral counselors employ a diversity of treatment modalities and are not limited to one model or school of psychotherapy. Responding to explicit and implicit spiritual content within mental health practice is a hallmark of pastoral counseling. Whether spiritual content is explicit or implicit, one primary goal of pastoral counseling is to facilitate spiritual growth.

This chapter describes the practice of supervision used across the spectrum of clinical mental health counseling to train pastoral counselors. It advocates the need for pastoral counseling supervisory training and certification at the state licensure level. The chapter highlights practices that can be used to address spiritual and religious issues within the supervisory process. It addresses the practice of clinical supervision in both academic and agency settings with pastoral counselors in training. Clinical supervision is the mechanism that helps to manage the continuous process of both personal and professional formation. Generally, supervision is categorized as a clinical practice that occurs between individuals in a professional setting. Supervisor training and certification is one way to ensure that pastoral counselors in training and all counselors in training receive supervision that attunes the client’s spirituality/religion into biopsychosocial assessment and treatment. Academic supervisors must also address ethical and legal issues while supervising.

This chapter approaches the topics of referral, consultation, and collaboration from the perspective of the pastoral counselor, although religious leaders and allied professionals in other related fields should be able to benefit from the conversation. It addresses why and when a pastoral counselor would choose to work with a client without any additional outside professional resources and why and when a pastoral counselor would choose to obtain consultation, request collaboration, or provide a referral or some variant combination of these. In a pastoral counseling context, consultation is understood as the process of obtaining input from another professional regarding the clinical work that is being done with a client. Collaboration can involve better communication, closer personal contacts, sharing of clinical care, joint education programs and joint program and system planning. Collaboration often happens on an organizational level around topics or events irrespective of any particular client.

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.

An indicator of the growth of research in the field of psychology and spirituality can be seen by examining the increase in the number of citations found over the past several decades in the PsycINFO database, which is the premier resource of the American Psychological Association (APA) that provides abstracts of peer-reviewed literature in the behavioral sciences and mental health. In addition to the field of psychology, data on the relevance of religion and spirituality is being generated by disciplines in the humanities and the physical and other social sciences to which spiritually oriented psychologists and other mental health therapists need to pay attention. One area that blends the psychological and the spiritual and offers an opportunity for collaboration between psychology and pastoral counseling is that of mindfulness-based therapies. The challenges for the world’s religions and spiritual traditions are the challenges for psychology and its allied professions, including pastoral counseling.

Suffering is an ineradicable part of life, even as fate and death. In other words suffering is a highly subjective, complex, universal phenomenon and, thus, an ordinary dynamic of the human condition. It is integrally associated with physical pain and/or emotional distress, mitigated, at times, by the individual’s intrapersonal and interpersonal processes related to resilience or hardiness. History has shown how human beings can adopt attitudes and value systems that devalue differences and establish industries marked by prejudice, racism, judgment, and bias that contribute to an individual’s pain and suffering. Suffering, distress, and pain are ordinary, and yet, some of these experiences happen as a result of the culture’s synthetic pressure and influence. Suffering is a complex, universal, highly subjective phenomenon caused by enduring physical or emotional pain that can be broadly understood through intrapersonal and interpersonal processes and their interaction with constitutional factors.

This chapter explores pastoral counseling assessment through an integrated interdisciplinary framework. Religious and spiritual assessment within pastoral counseling is an interdisciplinary practice insofar as it understands the human being from both theological and psychological traditions. The primary aim of the tacit dimension of assessment is to identify the theological and philosophical lenses through which pastoral counselors understand the sacred narrative of their clients. Context-independent pastoral identities tend to assume that one particular way of being spiritual and religious is sufficient for all people. Pastoral counseling is characterized by the formational experience of developing an identity capable of practicing spiritually sensitive and theologically integrated assessment. Pastoral counselors should engage in explicit, formal assessment of religiousness and spirituality when clinically indicated. The pastoral counselor must develop a sophisticated pastoral identity to offer a sacred space able to encounter the mystery of the client’s world.