A question can be asked as to whether there is a role for pastoral care. While pastoral care has centuries (millenia) of experience… the last 100 years has seen growth of alternatives for psychoemotional care.

Consider 6 possible (or at least potential) views regarding therapeutic care for those with psychoemotional problems. (These are listed by H. Newton Malony in “The Demise and Rebirth of the Chaplaincy” Journal of Pastoral Care, Vol. 29, 1975)

1. Biophysical. The psychoemotional problems stem from problems with the physical body.

2. Intrapsychic. The problems stem from bad mental processes/conflicts going on within the mind.

3. Behavioral. The problem is bad learned habits that must be unlearned/replaced.

4. Socioeconomic. The problem is the environment the person is in. It is necessary to change the setting.

5. Meaning. The problem is that the individual has failed to gain a sense or purpose or meaning in life.

6. Morality. The problem is conflict between actions and sense of moral obligations and social responsibilities.

Psychiatrists may be generally thought of when it comes to the first of these (mental care tied to medicine). Psychologists of different flavors may work primarily in the 2^nd and 3^rd areas. Perhaps social workers would focus in the 4^th area. But who can handle the 5^th or 6^th areas?

It seems pretty obvious that those specializing in pastoral care (pastoral counseling, pastoral psychotherapy) should be the one’s prepared to work in these areas.

Why?

First, the concerns of meaning and purpose are essentially theological or religious concerns. Religion speaks to the great mysteries… Why am I here? What is my purpose? Is this all there is? Who am I? Theology reflects upon these religious questions. These can also be described as the issues of spirituality. Sadly today, “spirituality” often implies a vague pleasant mysticism, but “spiritus” has more of an idea of “empowered meaning” or “enlivened purpose.” Dealing with issues of meaning and purpose are clearly to be in the skill set of a pastoral care provider since it is the realm of religion, theology, spirituality.

Second, the concerns of morality or social obligation are issues of ethics, of axiology. Dealing with choices as they pertain to what the individual believes his obligations are to God, to society, and to “what is right” is certainly supposed to be the domain of one trained in religious or pastoral care.

But is this true?

Sadly, this often is not very true. Theological training for pastoral care providers is often quite weak. Much of the training of pastoral care is more in the first four areas… particularly in the 2^nd area. Is that wrong? Well, it is not wrong that pastoral care providers be trained in psychological principles. But if the focus is so strong that their theological integration is poor, the result can be that a pastoral care provider is one who essentially practices psychology– but with less skill than a real psychologist. Additionally, there is a strange reticence to give moral guidance in pastoral care. Perhaps this is a reaction to those who are often all too happy to provide quick and easy guidance… often with an ethical base little above Biblical verse dropping.

Pastoral Care Providers need a solid, reflective, nuanced understanding of theology, particularly as it relates to meaning and purpose, and as it relates ot making wise ethical choices. Pastoral Care should follow the wisdom of Psalm 23 in gently leading/guiding. This contrasts the polemic approach of some in ministry. But it also contrasts with the Rogerian “client-centered” approach that fails to give external guidance.

Summarizing, a solid pastoral care provider needs a mature understanding of his or her faith within the context of sound psychoemotional therapeutic principles and methods. If this is the case, such a person is competent to deal with the 5^th and 6^th areas of psychoemotional concern… areas that others have little to no competence in.

One may want to read an old, but good, article.  Has Ministry’s Nerve Been Cut by the Pastoral Counseling Movement? by Gaylord Noyce (1978)