The Law and Church Counseling: Part Four—Quality of Care
Note: You’re reading Part Four in a blog mini-series on The Law and Church Counseling. Read Part One Caring Carefully, Part Two The Legal History and Climate, and Part Three Scope of Care. I’m summarizing these posts from material in chapter twelve of Equipping Counselors for Your Church. To learn more about the book, which is now available for pre-order, visit Equipping Counselors.
Building Safeguards in Your Ministry
We can compare scope of care and quality of care in a non-technical, non-legal sense:
• Scope of Care: Claim to Do Only What You Are Trained to Do
• Quality of Care: Do with Integrity and Propriety What You Claim to Do
While these matters can seem technical and even intimidating, they involve practical and necessary safeguards. Seven pertinent issues summarize the quality of care matters that every biblical counseling ministry should address: propriety, humility, referral, confidentiality, church discipline, documentation, and supervision.
Propriety in Biblical Counseling
We have all heard the horror stories of sexual temptation and sexual involvement between a counselor and a counselee. Obviously, the motivation for safeguarding this area must be much greater than simply avoiding a lawsuit. Propriety should be motivated by our desire to honor God and to minister in healthy, helpful ways to hurting, vulnerable people. Safeguards include:
• Perform Background Checks on All Trainees: This is increasingly a common, necessary, and expected practice in all church ministries. It should be standard as part of the enlistment process for a biblical counseling trainee.
• Do No Allow Counseling Sessions Off Premises
• Require All Counseling Sessions to Meet in a Building When Others Are Around
• Require That Counseling Sessions Meet in Rooms that Have Doors with Windows: While this can be problematic in some buildings, it is worth the cost.
• Discourage Mixed Gender Sessions without a Third Person Present: Have a trainee or staff member present.
These safeguards protect everyone. Of course, we want to protect the hurting person in need of trustworthy care. We also want to protect the care-giver. All it takes is one false accusation or one moment of succumbing to temptation to destroy a person’s reputation, family, and ministry.
Humility in Biblical Counseling
God’s Word commands us not to think more highly of ourselves than we ought, but rather to think of ourselves with sober judgment according to our gifting and training (Romans 12:3; 15:14). We all have limits and limitations. Thus, we should never allow any of our church counselors to counsel beyond their competence, ability, or training. A detailed intake policy and procedure (see Appendix 11.1 of Equipping Counselors for Your Church) provides a safeguard so that the person needing care is assigned to a person qualified to care for that individual with that specific issue.
We should never give cross-disciplinary advice (advice related to any profession for which we are not trained such as law, medicine, and psychiatry). Regarding medications or physical issues, defer and refer to qualified medical personal. It is a wise best practice to maintain a consulting relationship with trusted medical professionals. Those who lead the biblical counseling ministry need to have access to other pastors, counselors, and educators with whom they can confer and consult.
Seeking certification from national biblical counseling ministries for your counselors and/or for your counseling ministry can be another sign of humility. It communicates that you are part of a group larger than yourself, it typically provides opportunities for outside continuing education, and it often offers collegial relationships and supervisory connections.
Referral and Biblical Counseling
Referral is one specific way that we demonstrate humility in biblical counseling. No one is equipped to minister to everyone. No training program has the time to equip trainees for every possible issue. Your informed consent form should list the areas where your ministry will focus. Counseling issues outside those areas should be referred to others with pertinent expertise. It is imperative that your ministry identifies professional resources to refer people to when issues arise beyond the competency of your team.
Related to referral are the issues of wrongful termination, abandonment, and follow-up care. The duty of care operates continually until the counseling relationship is validly terminated. If the counselee desires continued counseling but the counselor believes that ongoing counseling would no longer be effective, then the counselor is responsible to recommend an appropriate referral.
Ideally, the decision to end counseling should be made mutually. If the decision is made because the initial issues that brought the person to counseling have been satisfactorily addressed, then the counselor should complete a Commencement Summary (see Appendix 11.1 in Equipping Counselors for Your Church). The final counseling session should address a summary of the initial goals, a summary of the growth resulting from the meetings, insight concerning any unresolved areas, suggestions for further growth (including appropriate follow-up care), and the reasons for commencement.
The counselee should complete a Biblical Counseling Evaluation Form (see Appendix 11.1 in Equipping Counselors for Your Church). Counselees should know that if an issue returns or new issues develop, they are invited to contact your ministry again. Often it is helpful at commencement to schedule another appointment three months (or a mutually-determined time) later for a “check-in/check-up.”
The Rest of the Story
Join us for Part Five Building Safeguards into Your Ministry as we learn four additional principles of scope of care in church counseling: confidentiality, church discipline, documentation, and supervision.
Join the Conversation
What are your thoughts on propriety, humility, and referral as they related to church-based biblical counseling ministries?
Generally, this is sound advice, perhaps with the exception of issues related to Psychiatry. In Rev. 21:8 and 25:15 we have what the KJV calls Sourcers. In the original Greek, this word is pharmkeia, which, within the study of the Greek language and culture, described individuals whom administered and used mind-altering substances, especially within a spiritual connotation. (see Strong’s #5331, #5332 and #5333.) The point of these scriptures is that although drugs may be used to heal, they are not to be used for matters of convenience, to avoid dealing with root problems of spiritual nature. Since we know often times what people refer to as “mental illness” are deep spiritual problems (depression is an example- antidepressants NEVER “heal” depression, they just mask it, and the government actually concedes this fact, just read the FDA drug inserts for a change!, and this fact is evidenced in itself by the return of the depression following one stopping the use of the drug.) how then as Christians, is it ethical not to speak against what the Bible clearly cautions against?