Gatekeeping for Faith Leaders, Part 2:
What is my role after I refer someone to counseling?
Hello, friends and faith leaders! If you have somehow stumbled upon this article and wonder what exactly a gatekeeper is, I encourage you to read Part 1 of this series, How do I know when to refer someone to counseling? Further, stay tuned for Part 3 that will more fully cover the topic of Safety assessments.
Maybe since the last time we chatted, you have referred a person in your faith community to mental health services.
Nice! Chances are, a therapist has probably referred a client to a faith leader, as well.
I am certainly hopeful that our revolving-door imagery has helped you imagine how beautiful the symbiotic relationship between faith and mental health communities can be.
And the thing about revolving doors is this: they don’t slam shut. Your role in supporting someone that you have referred to counseling continues.
Here are a few points to remember as you navigate a shifting, yet still supportive, role for someone you have referred to counseling:
1. Help the person continue to develop social supports within their faith community. Remember that you are not working in a vacuum; you have an entire faith community at hand for this person to become connected with. Introduce the person to groups of people in their life stage, or with similar ministry interests.
While the individual may not necessarily want to share all the details of their counseling and healing journey with other members of the congregation, it is highly valuable to help them connect to a sense of social interest. (Read more here about the meaning and impact of social interest on a person’s healing journey).
2. Avoid being a stand-in mental health therapist. Part 1 of this series covers this topic more thoroughly. Remember to practice within your competency as you seek to support this individual in the context of pastoral counseling. Your job, as incredibly important as it is, is not to diagnose or treat mental disorders. Please continue providing wise counsel from a spiritual and religious perspective. However, do not seek to replace the role of a mental health counselor if you have not been trained to do so. Remind the person where your boundaries lie if they refuse to seek mental health support.
3. Honor their confidentiality. In your attempts to connect individuals to other groups within the congregation, honor that what they have told you is theirs alone to share. They will be vulnerable with others in the faith community when they feel it is appropriate.
4. Continue to be available for questions regarding faith, theology, & doctrine. An ethical mental health therapist should be practicing within the scope of their training in the same way that you are! Even Christian counselors trained in using spirituality in the counseling room will not directly answer questions regarding specific doctrines or theology. They will, of course, allow a client to process his or her own spiritual worldviews, but will not insert the counselor’s personal opinions on the topic.
But you, my friends, literally trained for this moment. And we need you to be able to help a client sort through biblical and religious topics in a more direct way with the training that you have been given to discuss these sometimes-difficult topics.
5. Continue to assess for safety as needed. As you continue to have formal and informal interactions with this individual, be aware of any drastic changes in mood, presentation, and/or social interactions. If necessary, assess for suicidal or depressive thoughts or intent and refer to a professional. To do this well, I suggest being trained in mental health first aid. Part 3 of this series will also cover this topic more specifically. Stay tuned!
6. Be available but not pushy. This person does not have to (nor should they be) telling you all the details of their counseling experience. If they never follow up with specifics about how counseling is going, that is okay! You can continue to provide spiritual counsel without knowing exactly what is happening in their counseling sessions.
7. Remember that some spiritual issues are not just spiritual in nature. This probably goes without saying, but oftentimes a person’s concern can present as spiritual but have underlying issues related to mental and emotional health. Likewise, mental and emotional concerns often contain a spiritual element, especially for people with strong faith. It is important for both mental health professionals and faith leaders alike to view a person holistically when identifying root causes of particular struggles. The following passage from the American Psychiatric Association’s Guide for Faith Leaders does a fabulous job of outlining how to manage this topic if it feels somewhat like a chicken-or-the-egg scenario (APA 2016).
Resist prematurely understanding a complex situation as entirely related to religion or spirituality. When mental health issues are not readily apparent, a faith leader may appropriately decide to offer religious counsel and spiritual guidance. If after 4 to 6 sessions, the issues still persist and the congregant exhibits a sense of hopelessness and undiminished distress or additional areas of life dysfunction, referral to a clinical professional
should be made for further diagnosis, assessment, and treatment with ongoing support from you (page 18).
8. Pray for the heart and soul work that this person is doing. Pray for and with the individual you have referred to counseling. Our revolving door of care services has a common thread of being rooted in the cause of Christ and the safekeeping of His people: their bodies, brains, spirits, and souls. We do not take this work lightly, and we refer to you with assurance that you do not, either.
“In abundance of counselors, there is safety.” Proverbs 11:14
“The Lord GOD has given me the tongue of those who are taught, that I may know how to sustain with a word him who is weary. Morning by morning he awakens; he awakens my ear to hear as those who are taught”. Isaiah 50:4
9. Take care of yourself, too. You are a necessary fixture in this community and in this world. We need you to feel healthy and sustained to continue to do the work of sharing burdens with the people that you serve.
Galatians 6 has always made me giggle a little bit. Within just a few verses, Paul encourages the Galatians to both “bear one another’s burdens” (verse 6), but also that “each will have to bear his own load” (verse 5). I encourage you to go back and read the first 10 verses of this chapter in context and consider the full idea of Paul’s instructions here.
In my own prayer and reading of these verses, I have come to understand that these passages are both impelling us to take care of one another while also reminding us that we are ultimately responsible to the Lord for our own actions and decisions as to how we utilize our talents for Him. In a way, this feels freeing to me.
Sometimes we serve a person with great love and that person still chooses to seek unhealthy and/ or unrighteous ways of life for himself.
Yet we have often shared the burden as much as we can. The individual’s response is a personal choice that cannot discourage us in our work to keep serving the people of God in the ways that we do.
So let’s keep working and sharing burdens together, friend. I’ll see you in glimpses through the revolving door, cheering both of us on.
American Psychiatric Association Foundation. (2016). Mental health: A guide for faith leaders.
American Psychiatric Association Foundation. (2018). Quick Reference on Mental Health for Faith Leaders. Washington, DC; American Psychiatric Association Foundation.
Bolger, D., & Prickett, P. J. (2021). Where would you go? race, religion, and the limits of Pastor Mental Health Care in Black and Latino congregations. Religions, 12(12), 1062. https://doi.org/10.3390/rel12121062
Church and Mental Health. (n.d.). Retrieved April 1, 2023, from https://churchandmentalhealth.com/
Home. NAMI Central Texas – Providing education, support and advocacy for those affected by mental illness. (n.d.). Retrieved April 1, 2023, from https://namicentraltx.org/faith-communities/
National Guidelines for Behavioral Health Crisis Care – Samhsa. (2012, October 16). Retrieved March 16, 2023, from https://www.samhsa.gov/sites/default/files/national-guidelines-for-behavioral-health-crisis-care-02242020.pdf
Smith, J. (2019, July 25). A free mental health guide for faith leaders. Key Ministry. Retrieved March 15, 2023, from https://www.keyministry.org/church4everychild/2019/7/2/a-free-mental-health-guide-for-faith-leaders
Training videos on mental health inclusion. Key Ministry. (n.d.). Retrieved March 15, 2023, from https://www.keyministry.org/training-videos-on-mental-health-inclusion