ROUGHLY EDITED COPY LUTHERAN PASTORAL THEOLOGY & PRACTICE LPTP-31 Captioning Provided By: Caption First, Inc. P.O. Box 1924 Lombard, IL 60148 800-825-5234 www.captionfirst.com *** This text is being provided in a rough draft format. Communication Access Realtime Translation (CART) is provided in order to facilitate communication accessibility and may not be a totally verbatim record of the proceedings. *** >> DAVID: I run into a lot of deeply troubled people asking for my help nearly every week. How do I know when to refer them to counselors and when to meet with them myself? I'm currently attempting to decide whether a congregation member who seems deeply depressed needs psychiatric help in addition to the spiritual counseling I'm trying to offer. How shall I discern this? What about marriage counseling? How much should I feel comfortable handling? Are there resources for such decisions that I could be using? >> PROF. SENKBEIL: Okay. Great, David. It's important that you remember who you are when addressing questions like this. In fact, there's a short answer to your question and then there's a longer answer. And guess what? You're going to get both. The short answer is you do what you're trained to do. And I know of very, very few pastors who have the kind of specialized training that's necessary to deal with deeply disturbed people in whatever area. If they're dealing with mental illness of one variety or another or if they're dealing with deeply troubled relationships, that entails a level of specialty that really is not part of pastoral training. Now, that said, pastors are equipped and they are prepared to address people at their innermost being level. And this is true for all the kinds of individuals that you described. In other words, while people seek additional help, they're not to be derived of pastoral help. That lies at the very core of things very frequently with a lot of these issues and problems that people wrestle with, namely, questions of guilt and shame. And there, of course, the Gospel, which is preached in the church, which is given to the pastors to proclaim, the sacraments of baptism and the Lord's Supper have at their core the forgiveness of sins for Jesus' sake in his very name instead to be fully absolved and free of guilt and also to be cleansed of the shame that often happens as kind of a -- of a carryover from sins that were committed against an individual. So, in other words, as a pastor, you are equipped to address people's needs on a very fundamental level but in a specialized area, namely, in the area of the soul. Now, of course, no pastor worth his salt would ever attempt to resolve a person's physical illness solely on the basis of spiritual care. Unfortunately, however, some pastors venture out to address emotional or mental problems on the basis of spiritual care alone. And that's not healthy. Just as we are in partnership with physicians of the body when it comes to caring for people's souls, so I think it's also important that we form alliances with counselors in the area where we live. Identify those individuals who are trained in terms -- in areas of counseling who can help those needs that you address, that you mentioned, such as marital counseling needs or psychological help. And, by identifying those professionals, you can then refer as necessary. Now, what are some signs and indications that it might be necessary to refer an individual? Well, certainly, every human being has their ups and downs emotionally. And it's quite natural for a person sometimes to be in a time in their life or a period in their life when they are generally quite content and quite happy, so to speak. And then sometimes it goes in a cyclical fashion. And for a number of days or maybe even weeks they're not quite so happy. They're in a little bit of a depressed mode. But, when that becomes an overwhelming burden, when it's very hard for a person, for example, to get out of bed in the morning consistently, when it really affects their appetite and some of their sleep cycles, when it affects their personal lives in a number of ways, that may be an indication that it's time to seek additional help of a spiritual�-- rather of a mental nature or perhaps of a physical nature. One of the good ways is to refer a person to their physician to get a physical checkup and then to be referred from there to various counselors and therapists that could be of assistance addressing these kind of depressed modes. Sometimes we find people who come to us in a kind of a really exuberant mode that's really out of sync with reality. If a person is not really in sync with things as they are actually happening, for example, if they're hearing voices or if they're seeing things that are not there, this is an indication that there might be something seriously wrong with them mentally. And, of course, they need some interventions. So the longer answer to your question is find those resources in your community, both physical and mental, that might be of assistance to your people. And then refer them as necessary. I would add also, importantly, don't neglect those people then having referred them. Remember they still need the ministration of the word of God and the sacraments. In other words, they need their pastor even when they're in the hospital for bodily needs or under the care of a therapist for their emotional or mental needs or perhaps hospitalized as well. We continue to provide this ongoing care. And also it's possible to actually engage in a partnership with these professional therapists. And they would always require the individual who's coming to them for help to sign a release so that they could confer with you. But I found again in my own ministry this is of great value when it comes to providing the kind of spiritual help that's needed in the motion of their particular crisis that they're facing so that I am in tune with what's developing with them in terms of their psychotherapy. So this consulting relationship can be very, very helpful provided the person is willing to sign that release that's needed. So these are some ideas on how to refer and when to refer. *** This text is being provided in a rough draft format. Communication Access Realtime Translation (CART) is provided in order to facilitate communication accessibility and may not be a totally verbatim record of the proceedings. ***