Pastors' counseling practices and perceptions of mental health services: implications for African American mental health.

The purpose of the current study was to investigate pastors' perceptions about and practice of mental health services within their churches. Thirty nine pastors completed an online survey. Results of the survey indicated that pastors who had more positive attitudes toward mental health services reported (1) counseling parishioners more times per month and (2) counseling parishioners on a greater variety of topics. Implications for pastoral care and counseling and future directions in training are discussed.

Mary Wollstonecraft Shelley's Frankenstein, or the modern Prometheus: a psychological study of unrepaired shame.

Mary Wollstonecraft Shelley's modern Prometheus shows us the eternal punishment of unrepaired shame--eternal entrapment within the shame triangle of victim, perpetrator and rescuer. This paper describes how Shelley's insight--that lack of love creates a monster living in shame--is being confirmed by neuroscience and how this is exemplified in two characters--the creature and Victor Frankenstein. Additionally, it delineates how pastoral counselors can help those suffering from unrepaired shame

Christian pastoral care and psychotherapy: a need for theoretical clarity.

Recently, Christian pastoral care and psychotherapy have shown an increasing interest in embracing each other more than ever before. Theoretical clarity is essential both to maintain the individual identities of the two disciplines and to help practitioners select and apply appropriate resources from each other's discipline when necessary. This article aims to contribute to the limited body of literature by discussing some of the exemplary theoretical commonalities of the two disciplines as well as their distinctions. A review of the existing literature, enriched with practical pastoral experiences and academic work of the authors will help to clarify some of the basic philosophical and anthropological assumptions that have impacts on the actual practices of the two disciplines.

Religious counseling in the penal context: strategies of trust and establishment of trusting relationships in a context of distrust.

The paper describes how distrust shapes the network of relationships between the different agents in the penal context, among inmates, between inmates and their family, between inmates and staff, between counselors and staff, and between inmates and counselors, and discusses how counseling strategies need to be adjusted to counter the effects of the institutional and biographical context of distrust. The paper is based on many years of participation and observation in the context of Hong Kong.

Attitudes toward empirically-supported treatments among pastoral mental health care providers: exploratory findings and future directions.

The current study describes the findings of an online survey of pastoral mental health care providers The survey included brief demographic information, and a validated measure of attitudes toward empirically-supported psychological interventions, the Evidence-based Practices Attitude Scale (EBPAS; Aarons, 2004). The responses of 55 pastoral providers' are described and compared to national norms (Aarons et al., 2010). Recommendations for future collaboration between EST developers and pastoral clinicians are provided.

From bedside to graveside: increased stress among healthcare chaplains.

The authors conducted a survey of Baylor Health Care System chaplains in an attempt to understand the stress they experience when leading funeral services of staff, staff family members, and patients. The intensity of stress experienced by these chaplains appears to be related to the cause of death, the deceased's age, and the relationship the deceased had with the chaplain. Further research is needed to corroborate these findings as well as to investigate how chaplains manage their own grief when they are involved in the grief experiences of patients and families.

I stay and I follow: clerical reflections on pastoral care for victims of sexual abuse.

In this focus group study with clerics from the Church of Sweden, the Catholic Church, and the Free Church Movement, experiences of pastoral care for victims of sexual abuse were explored. The material was analyzed using thematic analysis. The participants expressed a wish to offer the best care possible. However, insecurity, a perceived lack of psychological competences, and restrictions imposed by the vow of silence provoked self-protective strategies that may affect both clerics and confidants.

Promoting healthy behavior from the pulpit: clergy share their perspectives on effective health communication in the African American church.

African Americans continue to suffer disproportionately from health disparities when compared to other ethnicities (ACS 2010; CDC 2007). Research indicates that the church and the pastor in the African American community could be enlisted to increase effectiveness of health programs (Campbell et al. in Health Edu Behav 34(6):864-880, 2007; DeHaven et al. in Am J Public Health 94(6):1030-1036, 2004). The objective of this study was to investigate African American pastors' perceptions about health promotion in the church and how these perceptions could serve as a guide for improving health communication targeting African Americans. Semi-structured interviews with African American clergy revealed that pastors feel strongly about the intersection of health, religion and spirituality; they also believe that discussing health screening and other health issues more frequently from the pulpit and their own personal experiences will ultimately impact health behavior among congregants. This study suggests that African American clergy see themselves as health promoters in the church and believe this communication (i.e., pastor-endorsed health information materials) will impact health behavior among underserved and minority populations.

Empowering Latino church leaders to deal with the HIV-AIDS crisis: a strengths-oriented service model.

Ideology and attitudes of Latino church leaders in the United States toward HIV/AIDS are explored. A qualitative approach utilized with emergent categories including: a desire within the Latino church for greater acceptance of HIV/AIDS sufferers, the supposed contaminating influence of HIV/AIDS individuals over other church members, and the feelings of helplessness many church members experience in relation to the HIV/AIDS crisis. Understanding ideological resistance that prevents engagement is here identified and a strategy of empowerment of church leaders is recommended to overcome it including: adopting a strengths-oriented service model that focuses on resources religious denominations already have, as opposed to a financially driven, medically oriented service model that highlights what churches often do not have; church leaders educating health care agencies on how to use religious beliefs to motivate church members to work on behalf of HIV/AIDS patients; the power of doctrinal ideology in affecting church and civil society's response to HIV/AIDS.

Reinterpreting funerals and pastoral care: a pastoral theology response to Tom Long's Accompany Them with Singing.

This article addresses Tom Long's (2009) criticism that a traditional pastoral care approach to funerals is responsible for significant distortions in contemporary Christian funeral practices in the United States. The article will show that his criticism should be affirmed but that his solution for a contemporary understanding of pastoral care and funerals is not adequate. A critique and reinterpretation of pastoral care and funerals will show that Long's reform of Christian funerals needs to incorporate a contemporary understanding of caring for the bereaved in funerals.

The 'methodic' exploration of the ethical and pastoral dimension in interaction: the cycle of encounter.

Social competence can be understood as the capacity to interact with each other. As such, it is the acquisition and optimization of an interior attitude that transcends technique; it is a way of loving and doing justice to one another. A scheme is presented to explore the ethical and spiritual dimensions of the pastoral counseling process. Ethics is both an objective discipline and a relationship. Relationships are built during qualitative encounters that build respect and construct religious meanings. All encounters share this process. This article explores the logic of ethical dynamics with particular focus on pastoral counseling encounters.

Using prayer and scripture in a Christian-based stress-coping support group for church attendances: implications for professionals.

This study explored the participants' perceptions of using prayer and scripture in a Christian-based stress-coping support group (CSCSG). Twenty-eight church attendances were recruited from a Presbyterian Church in Taiwan. Based on the finding from qualitative analyses using a modified grounded theory approach, four themes related to the participants' learning experiences emerged. The four themes identified were stressful life events, stress-coping experiences, integration of Christian faith with life, and spiritual connection. A follow-up survey indicated that the participants perceived the experiences gained from the CSCSG as appropriate, important, functional, and constructive in coping with stress. Research questions and implications for church professionals are discussed.

A psychospiritual, family-centered theory of care for mothers in the NICU.

Weighing less than three pounds four ounces, very low birthweight infants account for 1.4% of births and 46% of infant deaths in the U.S. Mothers of these infants often endure significant suffering while witnessing their children struggle for life. By examining their psychological and theological needs, and drawing on a mother's lived experience, this article develops a psychospiritual, family-centered theory of care to aid chaplains in providing spiritual care to mothers in the NICU.

Pastoral identity constructed in care-giving relationships.

From developmental and training perspectives, previous studies have defined pastoral identity as an individual property of pastoral practitioners. Grounded on an empirical study of interviewing 20 pastoral counselors and chaplains, this paper presents pastoral identity as a social construction between pastoral caregivers and seekers (and God in the midst). Informed by a recent social-psychological approach to identity, the paper explores one possibility for an interactional, intersubjective, and constructive paradigm of pastoral identity.

Clergy referral of suicidal individuals: a qualitative study.

In a national study, 25% of help-seekers contacted clergy; suicidal behavior was one of the significant predictors for making contact. Clergy have been found to refer 10% of help-seekers to mental health providers. This qualitative study explored the referral practices of 15 northeastern Mainline and Evangelical Protestant clergy when contacted by suicidal individuals; all referred to mental health providers. Participants reported low confidence with risk identification and provided moving examples of pastoral care.

Research report: a grounded theory description of pastoral counseling.

Historically, clerical paradigms of ordained ministry have defined pastoral counseling. However, these fail to describe pastoral counselors in the complex social, theological and medical contexts in which they now work. This study asks the question: How do pastoral counselors in clinical practice describe what is uniquely "pastoral" about the counseling they offer clients? Grounded theory was used to propose a preliminary description and an intermediate theory of how pastoral counselors interpret "pastoral." Eighty-five pastoral counselors were selected for the study over a four year period using criteria to assure maximum variation. Interviews and pastoral identity statements were collected and coded, and theoretical models were organized using NVIVO, a computer assisted qualitative design and analysis software (CAQDAS) package. Results suggest that pastoral counselors share some common ideas regarding "pastoral identity" and clinical practice. How pastoral counselors interpret "pastoral" is highly context sensitive and varies widely.

A survey of clergy practices associated with premarital financial counseling.

The purpose of this exploratory study was to gain an understanding of the state of clergy-led premarital financial counseling. Clergy respondents (n = 223) indicated that they often include a financial component in their formal premarital counseling. The most frequently discussed financial topics are budgeting, managing debt and credit, and saving. The most frequently cited obstacles to providing premarital financial counseling are lack of time and lack of subject matter expertise.

Allergy and spirituality.

This article considers the relationships of allergic reactions to substances and emotions. It deals with spiritual sensitivity as well. Resistance is a key to allergic reactions: Allergic reactions involve the body's resistance to substances, emotions, and their energies. A major problem in spiritual formation is resistance to giving up the prideful and self-centered position and moving into loving relationships. It is sometimes possible from an alternative approach to promote spirituality by treating allergy. In spiritual formation, one may sometimes decrease allergic tendencies by giving up pride and other negative emotions. I propose that the alternative method I advocate not only reduces symptoms but deals with causes on an energetic level. It works with physical, emotional and spiritual factors. It provides new ways for counselors and spiritual directors to quickly get to basic issues and clear negative emotions and beliefs. This may be accomplished within or in connection with the therapists' or directors' particular religions, practices and/or therapeutic approaches.

Practicing discernment: pastoral care in crisis situations.

This article correlates a particular experience of providing pastoral care for a person in a crisis situation with a particular understanding of the practice of pastoral care. Through engaging in correlative practical theology, it highlights the need for practicing discernment when providing pastoral care for persons utilizing narratives to work through crisis situations.

Defining and advocating for spiritual care in the hospital.

A definition of spiritual care and attention to the scientific literature can strengthen the advocacy efforts of hospital funded chaplaincy programs. Adapting Pargament's work, spiritual care is defined here as giving professional attention to the subjective spiritual and religious worlds of patients, worlds comprised of perceptions, assumptions, feelings, and beliefs concerning the relationship of the sacred to their illness, hospitalization, and recovery or possible death. Results from the scientific literature are then presented in response to four advocacy related questions: 1) How do hospital decision makers and chaplains perceive the experience of hospitalization, 2) Does a need for spiritual care exists; is it relevant, 3) Who can best provide spiritual care, and 4) Are chaplain visits helpful? This definition and advocacy material can be useful when decision makers review the funding of spiritual care.