Pastoral Counseling or Clinical Counseling: What’s the Difference?
By H Bruce Stokes, Ph.D.
Many people are confused about the differences between a Pastoral Counselor and a Clinical Professional Counselor. In some aspects they are very similar. In some, they are very different. This is intended to explain the basic differences so that the Christian can make an informed and effective choice in the matter.
Clinical Counselors such as Clinical Psychologists, Psychiatrists, Social Workers, and Marriage and Family Therapists are licensed and regulated by various governmental boards and professional associations. Pastoral Counselors such as Pastors, Ministerial Counselors, Chaplains and Church Counselors are credentialed and regulated by various ecclesiastical governing structures and may be influenced by professional associations.
One of the most significant differences between clinical and pastoral counselors relates to the basic philosophy of the counseling process. Clinical Counselors have only one contact structure for interacting with their client. This is the professional setting of the office, and they are strongly discouraged from access and interaction beyond that professional counseling relationship. This contrasts with the Pastoral Counselor who may have access and relationship to the person outside of the formal dialog and counseling setting. In other words, the only relationship allowed the Clinical counselor is the formal counseling process while the Pastoral counselor may relate to the client on several levels. A perspective client must determine which context is best for their particular needs.
World View Considerations
Another significant difference relates to shared world views and values. In a clinical setting, the counselor is limited in the degree to which they may discuss and direct the client from the perspective of the counselor’s own values. Counseling theory, as understood in the behavioral sciences, must be the primary determinate of the perspective and advice given. It is acceptable for a Clinical Counselor who is Christian to discuss their values with a client who specifically asks, but giving direct advice or counsel consistent with such values may not always be allowed. In a Pastoral Counseling context, both religious values and behavioral science theories and methodologies are free to be openly explored, but the counselor is expected to counsel and advise from the perspective of the religion he or she represents.
Educational Background and Training
Clinical Counselors are required to meet certain basic educational and training requirements to maintain their license. This training is directly related to the scope and limitations of their practice and may or may not include religious content. Pastoral Counselors may have equal or distinctly different educational and training backgrounds,depending on the requirements of the ecclesiastical authority that they are under. It is possible to find all levels of competency in both Clinical and Pastoral Counselors. Potential clients should examine the educational and experiential background of any counselor they intend to use. Understanding the theoretical orientation and model of religious integration of the counselor is also important.
Both Clinical and Pastoral Counseling involve payment for services. Clinical Counseling may be covered under group medical insurance. Some Clinical Counselors provide sliding scale fees or pro bono services. Pastoral Counselors may work on a fee basis, sliding scale, free-will donation or may provide services free as a ministry. Generally, Pastoral Counseling is not covered by Insurance.
Scope of Practice
Marriage Family Therapists and Social Workers are trained in counseling needs related to individual development, family, marital, and relational issues such as drug addiction or marital adjustment or grief. In addition to this focus, Clinical Psychologists and Psychiatrists may provide services that involve testing and treatment of more serious mental health issues. Pastoral Counselors will tend to have expertise and training that parallels the MFT and Social Worker. Pastoral Counselors will emphasize life adaptation, relationships, discipleship and conflicts related to values and behavior.
Many counselors work in consultation with other professionals. This allows for Pastoral Counselors, Psychiatrists, Physicians and Marriage and Family Therapists to better serve their clients through referral and consultation. Team approaches require the direct permission of the client to allow such consultation. If this approach is valued by the client, they should check to see if their counselor uses such an approach.
Confidentiality in the Counseling Setting
Confidentiality is a part of both Pastoral and Clinical Counseling. The degree to which this is maintained depends onthree factors – the nature of the topics discussed, the character of the counselor, and the legal and theological structures governing the counseling relationship. Some information cannot be kept confidential by any counselor. Certain criminal activity, or threats to harm self or others are subject to legal action if not reported by the counselor. In addition, counselors can be subpoenaed regarding certain court actions. This should be discussed with your counselor.
Making a Choice
Choosing a counselor involves some understanding of the nature of the problem, the type of counseling desired, and the circumstances of the client. The more a person knows about the differences in counselors, the services available through those counselors, and the goals of counseling, the more likely the client will find a counselor who will be helpful. The choice between a Christian Clinical Counselor and a Pastoral Counselor may be simply a matter of appropriateness to the circumstances of the client. But the difference may also be much greater than many realize. This is a serious matter and should be given due consideration before going to a counselor.
About the Author
H Bruce Stokes, Ph.D. is the Dean of the School of Behavioral Sciences at California Baptist University. He is professor of Anthropology and Behavioral Sciences and teaches both undergraduate behavioral science and graduate (Marriage and Family Therapy) courses. In addition, Dr. Stokes is the Pastor/ Teacher of the DiscipleCenter congregation in Anaheim Hills. He has lectured and written related to marriage and family issues and has extensive 35 years of experience in pastoral counseling