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Training and Education of North American Master's of Divinity Students in Relation to Serious Mental Illness

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Abstract and Figures

Individuals in psychological distress often seek out assistance and support from pastors. To determine the extent of mental health training students preparing for the pastorate receive, Master's of Divinity (MDiv) programs at accredited seminaries in the North America were surveyed after contact by telephone. Of the 70 seminaries assessed, 88% offered courses in which the topic of mental illness was addressed in some form (although this point may not have been in a counseling course). Of those seminaries, 43% offered a counseling course or courses specifically dedicated to mental illness. All church traditions reported a minority of seminaries that provided courses dealing with mental illness. These findings emphasize the need for increased mental health awareness and education in seminaries.
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Training and Education of North
American Master's of Divinity Students in
Relation to Serious Mental Illness
Halle E. Ross a & Matthew S. Stanford a
a Department of Psychology and Neuroscience , Baylor University ,
Waco , Texas , USA
Published online: 08 Aug 2014.
To cite this article: Halle E. Ross & Matthew S. Stanford (2014) Training and Education of North
American Master's of Divinity Students in Relation to Serious Mental Illness, Journal of Research on
Christian Education, 23:2, 176-186, DOI: 10.1080/10656219.2014.899480
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Training and Education of North American
Master’s of Divinity Students in Relation
to Serious Mental Illness
Department of Psychology and Neuroscience, Baylor University,
Waco, Texas, USA
Individuals in psychological distress often seek out assistance and
support from pastors. To determine the extent of mental health
training students preparing for the pastorate receive, Master’s of
Divinity (MDiv) programs at accredited seminaries in the North
America were surveyed after contact by telephone. Of the 70
seminaries assessed, 88%offered courses in which the topic of
mental illness was addressed in some form (although this point
may not have been in a counseling course). Of those seminaries,
43%offered a counseling course or courses specifically dedicated
to mental illness. All church traditions reported a minority of
seminaries that provided courses dealing with mental illness.
These findings emphasize the need for increased mental health
awareness and education in seminaries.
Mental illness is a very real concern in the lives of millions of Americans.
Recent data suggest that almost 50%of all Americans will meet diagnostic
criteria for at least one mental disorder in their lifetime (Kessler et al.,
2005; Pierre, 2012). Within a given 12-month period, more than 25%of
Americans (26%) meet criteria for a psychiatric disorder (Pierre, 2012).
Research within faith communities has shown that these numbers are the
same among Christian congregants (Rogers et al., 2013).
Address correspondence to Matthew S. Stanford, Department of Psychology and
Neuroscience, Baylor University, One Bear Place #97334, Waco, TX 76798, USA. E-mail:
Journal of Research on Christian Education, 23:176–186, 2014
Copyright #Taylor & Francis Group, LLC and Andrews University
ISSN: 1065-6219 print=1934-4945 online
DOI: 10.1080/10656219.2014.899480
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Clergy and Counseling
Many individuals struggling with mental illness seek out the services of
a pastor, priest, or chaplain, which make clergy front-line mental health
workers (McMinn et al., 2005; Stanford & Philpott, 2011; Weaver et al.,
2003b). Weaver et al. (2003b) found that clergy are most commonly sought
by congregants in times of crisis, grief, trauma reactions, depression, signi-
ficant changes in family structure (e.g., divorce), changes in health=injury
to self or a loved one, and death of a loved one. Data from a study by Schindler
et al. (1987) indicate that clergy members are perceived to be superior to psy-
chiatrists and psychologists in personal qualities (e.g., warmth, caring, stability).
This characterization may make clergy appear more approachable and comfort-
ing than mental health professionals. Additionally, an overwhelming majority of
Americans identify themselves as religious, with up to 95%claiming to believe
in God and 42%reporting attendance at church in the past week (Farrell &
Goebert, 2008). Perhaps for these reasons clergy are pursued more often
in times of emotional distress than other professions (Farrell & Goebert, 2008;
Stanford & Philpott, 2011), and perhaps more commonly than psychologists
and psychiatrists combined (Farrell & Goebert, 2008; Weaver et al., 2003a).
As a result, the clergy’s role in the mentally ill parishioner’s recovery
process is extremely important. Pastors spend more time counseling parishi-
oners now than in previous decades (Virkler, 1979). Giblin and Barz (1993)
conducted a study to assess the competencies of pastoral counselors. Results
from their study indicated that pastoral counselors were more apt to focus
on the interpersonal, intrapersonal, and spiritual issues of their counselees
and less likely to focus on recognizing and treating serious mental illness.
Referring a Congregant to a Mental Health Professional
Psychologists have more recently begun to realize the importance of
religiosity and spirituality in the lives of those with mental illnesses. The
gatekeeper model recognizes this importance. Within this model, individuals
who provide community services and assist in maintaining moral, social,
or legal order of their community are seen as mental health gatekeepers
because they are the first to be sought out by individuals in psychological
distress (Stanford et al., 2013). Police, social workers, and public health
nurses also serve gatekeeper roles in the community, though they are not
as often sought out during times of psychological distress as clergy (Farrell
& Goebert, 2008). In this model, clergy members counsel parishioners
when qualified and refer parishioners with serious mental illnesses to mental
health professionals. Despite the fact that many clergy feel inadequately
prepared to counsel certain clients, they are also unwilling to refer them
to psychologists (Linebaugh & Devivo, 1981; Lowe, 1986; Mannon &
Crawford, 1996; McMinn et al., 2005; Stanford & Philpott, 2011).
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Reasons for clergy’s refusal to refer to psychologists vary. Virkler (1979)
found that clergy hesitate to refer parishioners to mental health professionals
due to differences in value orientation (real or imagined), being unaware
of available services, stigma associated with seeing a mental health care
professional, and=or financial difficulties. More recent research continues
to support these findings (Linebaugh & Devivo, 1981; Stanford & Philpott,
2011; Weaver et al., 2003a). In fact, a certain level of antagonism exists
between clergy members and psychologists, largely because clergy members
do not fully understand the totality of services psychologists provide, and
psychologists tend to be less religious than the general population (Stanford
& Philpott, 2011). In a study conducted by Farrell and Goebert (2008), 41%of
the responding pastors stated that shared religious beliefs between the client
and the psychologist are ‘‘important’’ (p. 439) and another 15%of responding
pastors stated that those shared beliefs are ‘‘essential’’ (p. 439).
Sin, in particular, plays an important role in clergy-psychologist referrals;
pastors are often concerned about the causative role that sin may play in
psychological distress and how it will be handled in therapy (McMinn et al.,
2005; McRay et al., 2001). Due to this concern, clergy members are more likely
to refer congregants to psychologists who share their religious values
(Stanford & Philpott, 2011). This likelihood may help explain why more
conservative clergy members refer their church members to mental health
care professionals less often than do more liberal clergy (Mannon & Crawford,
1996). It appears that many clergy prefer to refer parishioners to Biblical coun-
selors or Christian counselors who use prayer and Scripture reading in session
than counselors who do not (McMinn et al., 2005). Interestingly, the same
study by McMinn et al. (2005) found that psychologists are more likely to refer
religious clients to clergy members with a doctoral degree to answer religious
questions. While clergy members value religious belief in psychologists,
psychologists value more education in clergy to whom they refer.
According to Virkler (1979), many pastors do not refer parishioners to
psychologists simply because in seminary they lacked the training requisite to
determine when referrals to a medical doctor or psychologist are appropriate.
Of the participants in the study, 68%stated that they had no training in evaluating
the quality of referral resources in their communities, and 56%said they felt
ill prepared to help parishioners transition into the care of the professional to
whom they were referred (Virkler, 1979). More recent research revealed that
45%of pastors stated that they received no training in seminary about the referral
process (Farrel & Goebert, 2008). In their article, McMinn et al. (2005) recom-
mended more communication between clergy and psychologists during training.
Seminary Training and Mental Illness
Not only do pastors feel inadequately trained to refer parishioners to mental
health professionals they also feel largely unprepared to counsel those with
178 H. E. Ross & M. S. Stanford
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serious mental illness. Stanford and Philpott (2011) conducted a study
focused on Baptist senior pastors and found that approximately 71%of pastors
expressed the inability to recognize mental illness, though they refer less
than 10%of the people they counsel to professional psychologists. Farrell
and Goebert (2008) found that the number of individuals with diagnoses
of major depression, bipolar disorder, schizophrenia, obsessive-compulsive
disorder, and antisocial personality disorder that seek counsel from clergy
equals the number of individuals with the same diagnoses who seek help from
mental health professionals. Despite the fact that 95%of clergy believe that
counseling parishioners is important, only 25%feel that seminary training
adequately prepared them to provide such services (Farrell & Goebert, 2008).
Research has been conducted to assess the degree of training clergy
receive as well as the degree to which they feel prepared to recognize serious
mental illness and make the appropriate choice to treat or refer. Linebaugh
and Devivo (1981) found that only 39%of clergy members believed the
training they received in seminary regarding ‘‘the ministry of counseling’’
to be adequate. The researchers conducted a study in which 76 accredited
Protestant seminaries were assessed on the strength of their counseling
curriculum past, present, and future (Linebaugh & Devivo, 1981). Their find-
ings indicated that the concentration on counseling is growing in importance
in Protestant seminaries. The seminaries contacted in the study also expressed
plans to offer more counseling courses and practicums for their students, who
request more exposure to counseling (Linebaugh & Devivo, 1981). However,
the researchers identified one concern: Seminaries fear that too great of an
emphasis on counseling may lessen the pastor’s traditional identity in the
church. Ultimately, approximately forty-seven percent of seminaries were
doing little to no work to prepare their students to counsel as pastors,
a situation which Linebaugh and Devivo (1981) wished to see remedied.
Farrell and Goebert (2008) conducted a study on Protestant ministers in
Hawaii. Of those contacted, 98 responded, the majority of whom were male.
Of the sample 55%stated that their seminary training was not adequate for
counseling those with serious mental illness, and 16%were unsure. The
majority of the sample (37%) claimed that medical factors were the root
cause of mental illness, although many pastors indicated they would still
counsel the individual with such a mental illness. Additionally, 40%of the
pastors who stated that they felt inadequately prepared to counsel the
individuals described in two vignettes also claimed that they would treat
them anyway instead of referring them.
Moran et al. (2005) found that less than 50%of New York City clergy
took at least one clinical pastoral education (CPE) course in seminary.
Mainline Protestant denominations were the most likely participants to have
had exposure to one such course in seminary. Approximately 66%of the
Mainline Protestant group had received at least one CPE during seminary
training. A small significant effect was discovered among denominational
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affiliation, with priests referring less often than rabbis and other clergy. The
level of consultation was low across all religious groups and denominations,
however (Moran et al., 2005).
The present study was conducted in order to assess the state of seminary
training programs in preparing current Master’s of Divinity (MDiv) students
to recognize and counsel serious mental illness. Much of the current research
has sampled practicing clergy to provide retrospective information about the
training they received while in seminary. Research conducted on seminary
programs themselves has not been conducted recently.
Using the 2011 membership list of accredited institutions assembled by
the Commission on Accrediting and listed by the Association of Theological
Schools, directors of MDiv programs at institutions with an accredited
MDiv program (N¼239) in the United States, Canada, and Puerto Rico were
contacted via telephone. When a program did not have a MDiv director, an
assistant dean or a member of the Registrar’s Office with knowledge of the
program’s curriculum and class content was interviewed. These interviews
were conducted between January 2012 and January 2013 during the academic
semesters. Of the 239 institutions with an accredited MDiv program, 219 were
contacted. Of that number, 70 directors agreed to be interviewed, two declined
to be interviewed, and 147 did not respond to the request for an interview,
resulting in a 32%response rate. Institutions that provided MDiv degrees on
more than one campus were assessed one time through the main campus.
Materials and Procedures
The participants first listened to the interviewer read an informed consent
form over the phone. This provided the participants with information regard-
ing the purpose, nature, and duration of the study. It assured each participant
that his or her time and honesty would be appreciated and that his or her
identity and the identity of their program would remain confidential. After
consenting to participate in the study, the participant verbally responded
to a series of questions to obtain demographic information about the
institution as well as items assessing the strength of the institution’s MDiv
program in preparing students to recognize and minister to individuals with
serious mental illnesses. The questions are noted in the Appendix.
Of the 70 seminaries who responded to the survey, 61 (87%) of them were
located within the United States, eight in Canada, and one in Puerto Rico.
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The most common student population size represented in the sample was
300 students (n¼6), with an additional eight seminaries reporting between
300 and 400 students. Overall, the seminaries represented in the sample
tended to have smaller student populations, with all but nine seminaries
having 500 students or less (M¼425.75, SD ¼728.51).
In Table 1, seminary denominations are grouped according to church
tradition in order to demonstrate the representative nature of the sample.
Of the seminaries represented in this study, 64 (91%) offered counseling
courses in their curricula. Programs were also asked to report whether or
not any counseling courses were required or offered as electives and, if so,
how many. The counseling course requirements of seminaries were
relatively low, with 70%of the sample requiring one or no classes in the
concentration of counseling (M¼1.32, SD ¼1.07). Of the total sample, 53%
(n¼35) of the seminaries required one counseling class, while 17%(n¼11)
required no counseling courses. The most commonly required counseling
class among seminaries was Introduction to Pastoral Counseling I.
Of the 70 institutions represented, 55 offered counseling courses as
electives, though MDiv directors stated that students were not often able to
find time in their program requirements to take these classes. Furthermore,
there was a distinct lack of counseling elective options for the MDiv student
who wants to become a pastor. Of the institutions surveys, 70%offered 6 or
less counseling courses as electives, while the majority of students only had
time for 0–4 electives in their tenure as an MDiv student.
Most counseling classes offered by seminaries focused on interpersonal
relationship problems such as premarital counseling, couples counseling,
family counseling, grief counseling, or some variation thereof. Of the semin-
aries assessed, 88%(n¼59) offered courses in which the topic of mental
illness was addressed in some form (although this may not have been
TABLE 1 Church Tradition of Respondent Seminaries
Church Tradition Seminaries, n(N¼70) Total Sample, %
Reformed 12 17.1
Inter=Multidenominational 10 14.3
Baptist 8 11.4
Evangelical 7 10.0
Methodist 7 10.0
Roman Catholic 7 10.0
Restorationist 5 7.1
Nondenominational 4 5.7
Charismatic 2 2.9
Lutheran 2 2.9
Presbyterian 2 2.9
Unitarian 2 2.9
Episcopalian 1 1.4
Orthodox 1 1.4
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a counseling course). Of those seminaries, 43%(n¼30) offered a counseling
course or courses in which the topic of mental illness was addressed, and 31%
(n¼21) offered a course or courses specifically dedicated to mental illness.
In addition, the seminaries were assessed on the number of seminars or
guest speakers outside of class that spoke about the topic of mental illness.
The overwhelming majority, 79%(n¼55), stated that such seminars were
hosted only occasionally or never. By contrast, 11%(n¼8) of the seminaries
reported hosting such seminars regularly. In addition, when seminaries did
offer such seminars, the students were generally not required to attend them
unless an individual faculty member chose to make attendance at such an
event part of the requirements for the course he or she was teaching.
Furthermore, when assessing the MDiv students’ exposure to members of
the church or community with mental illness, the results revealed that provid-
ing future pastors with first-hand experience assisting the mentally ill is not
emphasized. Almost every seminary provided some form of internship, clinical
pastoral education, chaplaincy, or fieldwork experience; however, none of
them were in organizations where interacting with an individual with a mental
illness would be a regular occurrence. Generally, students were only placed in
such positions if they expressed an interest in the area of psychology or were
students in a MDiv program with a concentration in counseling.
Of the seminaries represented in the current study, many stated
that their programs trained MDiv students to refer individuals with mental
illnesses to trained professionals. Not much detail about the ‘‘training’’ for
referral was provided, nor did the MDiv directors state to which types of
mental healthcare professionals (e.g., Christian, non-Christian) their students
were encouraged to refer their congregants.
Of the 70 seminaries represented in the sample, there appeared to be no
significant differences between them in counseling=mental illness course
requirements when assessed by church tradition. All of the church traditions
reported a minority of seminaries that provided courses dealing with mental
illness. Additionally, one seminary of the Reformed tradition was the only
respondent who reported that clinical methods of treatment for mental illness
(e.g., medication) would not be deemed acceptable by the church.
The results of this study indicate that the majority of accredited MDiv
programs do not provide future pastors with sufficient training to effectively
recognize and respond to congregants struggling with serious mental illness.
While most seminaries assessed in this study offered at least one required
pastoral care course, mental health issues, if discussed at all, were not the
main focus of the course. At best, serious mental illness was discussed within
one module of the class or at the discretion of the professor. As a result, the
training future pastors receive in the field of mental health varies by
182 H. E. Ross & M. S. Stanford
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individual seminaries. For this reason and others, Lincoln (2010) has called
for a more standardized MDiv educational experience.
Additionally, seminaries were asked to provide their official stance on the
subject of mental illness. Overwhelmingly, the seminaries responded that no
official stance about mental illness and the Christian faith existed, which suggests
the lack of interdenominational and intra-denominational unity in Christianity
with regards to mental illness. Some MDiv directors responded that this lack
of official stance reflected the desire to allow students to formulate their own
opinions on different matters in addition to preventing denominational conflicts
over official statements about mental illness. This practice, however, does not
appear to be working well for seminary MDiv students, some of whom receive
no training or extremely minimal training in recognizing serious mental illness.
Thomas (2012) found that educational variables accounted for twenty
percent of the variance in interprofessional collaborative practice and this
was statistically significant. Without a more cohesive theological position
on mental illness, members of the Christian congregation throughout the
nation do not receive a similar standard of referrals, respect, and support
from their pastors and other congregation members. In order for the church
to move past the belief that all mental illness is the result of spiritual warfare
or a personal failing, the church must come together to discuss the views
of mental illness and establish a systematic stance on the topic, taking into
consideration both the biological and spiritual aspects of sin (Stanford,
2011). As a result, MDiv students will be better educated and prepared
to assist congregants experiencing serious mental health issues.
Linebaugh and Devivo (1981) found that a majority of the Protestant
seminaries surveyed intended to expand counseling programs and mental
illness training for future pastors. Of the seminaries in their sample, 47%
did not prioritize the improvement of mental illness training for MDiv
students. Results of the current study indicate that such program changes
do not appear to have occurred during the past three decades. The majority
of seminaries in this study reported minimal counseling requirements for
pastoral MDiv students and even less exposure to mental illness training
specifically. Of the seminaries in the current study, only 27%reported that
they were currently working to improve mental illness training in the MDiv
program—an even lower percentage than that of the seminaries working
towards improvement in the 1981 study by Linebaugh and Devivo.
Limitations of the present study include the small sample size resulting
from the low response rate of the participants. Additionally, reliance on
self-report data from the institutions can introduce bias into the study;
however, some of the data can and was verified and cross-checked via the
schools’ websites. While attempting to make the study more attractive to
participants by limiting the duration of participation time, the researcher also
eliminated the possibility of expanding the line of questioning and gaining
more knowledge about the programs.
Training & Education of MDiv Students 183
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The current study contributes to the existing research in the field by
assessing the education and preparation of MDiv students to recognize, refer,
and provide assistance to those with mental illnesses. Weaknesses in the
majority of MDiv programs represented in the study include: lack of required
courses that are strictly dedicated to mental illness; lack of an official stance
on the topic of mental illness; lack of seminars or lectures outside of class that
discuss different aspects of mental illness, religion, and referral patterns; lack
of exposure of MDiv students to individuals with mental illnesses; and an
overall lack of desire to expand or improve the MDiv requirements in these
areas. As a result, individuals in the congregation continue to suffer under
well-meaning pastors who primarily tell people to pray harder or confess
sin in relation to mental health problems. Due to their gatekeeper roles, pas-
tors have a responsibility to provide aid for individuals with mental illnesses,
either by conducting interventions for which they are qualified in their own
offices or referring to an appropriate professional. Because the MDiv degree
is one of, if not the most common degree for a pastor to have, steps must
be taken to improve the training MDiv students receive in seminary and
the continuing education they receive throughout their careers.
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recognizing and treating serious mental illness. Psychiatric Services,59, 437–440.
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(2005). Lifetime prevalence and age–of–onset distributions of DSM–IV disorders
in the National Comorbidity Survey replication. Archive of General Psychiatry,
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Lowe, D. W. (1986). Counseling activities and referral practices of ministers.
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1. Name of Seminary:
2. Affiliation:
3. Number of students:
4. Do you offer the Master’s of Divinity (MDiv) degree to women?
5. Location:
6. Does the MDiv program at your seminary offer counseling courses?
a. How many are required?
b. How many are available to be taken voluntarily?
c. How many of these counseling classes deal specifically with issues
such as premarital counseling, couples therapy, or family therapy?
d. Can your counseling program be defined as Biblical counseling,
pastoral counseling, or Christian counseling? Please provide the best
possible description of your program’s goals.
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7. Are any courses offered specifically to educate students on mental illness
and how to assist=counsel someone dealing with mental illness?
a. Is the course or are the courses dedicated specifically to this topic?
If so, what are the names of the courses?
b. Are these topics discussed within another course or courses that is=are
offered? If so, what are the names of the courses?
c. How many of these courses are required, if any?
d. How many are available to be taken voluntarily, if any?
e. If these classes are offered on a voluntary basis, are students
encouraged to take them?
8. If classes dealing with mental illness are offered, when were they first
introduced into the curriculum? If the topic is part of another class, when
was the information added to the curriculum of that class?
9. What is the seminary’s official stance on mental illness? Are clinical
methods of treatment considered acceptable (e.g., medication, therapy)?
10. Are seminars dealing with the topic of mental illness and its treatment
offered regularly, semi-regularly, occasionally or never? If offered, are
students required or encouraged to attend?
11. Is your seminary making a conscious effort to increase the number
of courses focusing on mental illness, recognizing it, and treating it?
How so?
12. Do your students have experience with mentally ill individuals through
some type of internship or program with a church or in the community?
What type of program?
13. Do you believe the training the MDiv students receive is adequate to
meet the needs of the local church?
Halle E. Ross is a doctoral candidate in clinical psychology at Baylor Univer-
sity, Waco, Texas, USA. Her research interests include the interactions
between religion and mental health.
Matthew S. Stanford is professor of psychology, neuroscience and biome-
dical studies at Baylor University, Waco, Texas, USA. As a Fellow of the
Association for Psychological Science, his research focuses on the interplay
between psychology and issues of faith.
186 H. E. Ross & M. S. Stanford
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... Clergy provide informal counseling for a range of mental health conditions, including depression and substance use disorders (17,18). However, seminary education provides limited formal mental health training (19,20). Thus, access to evidence-based care through direct engagement with Black churches remains limited. ...
... More research examining the direct clinical outcomes of providing evidence-based therapeutic modalities such as CBT or IPT in this and any future church-affiliated clinical settings is needed. There are also opportunities to develop new therapeutic modalities within these settings that are tailored to the population being served (20). In traditional mental health care settings, Black Americans are more likely than White Americans to terminate care or find care less satisfactory (25). ...
Black Americans face substantial barriers to mental health services that are due, in part, to historical and contemporary issues of anti-Black racism. Identifying novel models of care that increase access and engagement in mental health services is important. One such model was developed by a predominantly Black church in Harlem, New York City, which built a free mental health clinic to serve the surrounding community. However, treatment barriers and facilitators of this care model have not been reported. Therefore, the authors conducted a qualitative study to identify Black Americans' (N=15) perspectives of their experiences seeking and receiving care from this church-affiliated mental health clinic and the role of the church in promoting mental health service utilization. Treatment facilitators included health care that was free of charge, services affiliated with a trusted institution, and access to culturally competent care that integrated their faith perspectives. Participants perceived the churches as having the potential to provide psychoeducation, destigmatization, and connection to mental health services. The perspectives shared suggest that this novel model of care may address several barriers to mental health care faced by some Black American populations.
... Clergy's referral practices can depend on their secular education (Payne, 2014) or their theological education. In a survey of master of divinity programs, only 34% provided a course on counseling or mental health, suggesting that clergy may need further training and support on mental health awareness and appropriate interventions (Ross & Stanford, 2014). Yet, clergy feel strongly that they have a role to play in responding to mental health concerns and that mental health should not be relegated entirely to the professional sphere (Payne & Hays, 2016). ...
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Mental illness is a prevalent concern that affects Christian churches in North America in significant ways. Previous studies on the relationship between mental illness and the church have found that beliefs and practices within the church can contribute to stigma towards people with mental illness. Yet, the typical experience of people with mental illness who attend church has been found to be positive, suggesting that there are considerable resources within the church for supporting those who experience mental health problems. One such resource is the concept of hospitality, which promotes a sense of belonging for those with mental illness in the church. This qualitative study advances the construct of hospitality as a helpful paradigm for addressing mental health needs within the church, capturing perspectives and practices that are currently in place or seen as necessary by church attendees. The study methodology also emphasized the need to incorporate cultural considerations that are appropriate for the racial and ethnic make-up of particular churches. Semistructured focus group interviews were conducted with participants from eight churches that were either predominantly African American, Asian American, Latinx, or multi-ethnic. Findings resulting from content analysis of transcripts indicated that hospitality was a broadly helpful construct for addressing mental health concerns in the church, though some cultural differences existed in the understanding and application of hospitality. Both the interface of the findings with the existing scholarly literature and the relevance of findings for church leaders are discussed.
Obsessive-compulsive disorder (OCD) is a debilitating psychiatric condition with high rates of misdiagnoses and extended treatment gaps. These may derive in part from poor mental health literacy (MHL) among clergy, who are frequently consulted by those with mental health problems. Therefore, the current study examined the MHL of OCD among clergy on Guam. Clergy (N = 110) provided diagnostic impressions, treatment recommendations, and referral recommendations in response to one of six randomized vignettes describing a common manifestation of OCD: contamination, symmetry, religion, homosexuality, pedophilia, or aggression. Clergy typically misidentified OCD (64.5%), especially in vignettes describing taboo thoughts. They more often recommended that the cases described in the vignettes receive pastoral/biblical counseling and a referral to a clergyperson for professional help rather than professional medical or mental health services. Overall, results reveal needs among clergy for increased MHL, especially concerning OCD's heterogeneous symptomology and evidence-based treatments.
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Despite tendencies among some Christians to ostracize people with mental illness, the Christian emphasis on love for one’s neighbor discourages such stigma. This article reviewed the empirical research literature on two components of mental illness stigma, blame and social distancing, and offered commentary in proposing a more nuanced view informed by Christian theology. In regards to blame, Scriptural warnings about the risks of false, harsh, or oppressive blaming indicate considerable agreement with the research literature’s concerns about blaming. At the same time, the importance of moral responsibility in Christian theology suggests that some forms of rebuke, if done gently with concern for the well-being of the person, can promote a sense of responsibility and efforts to change problematic behavior. In regards to social distancing, the practices of hospitality and fellowship, especially toward those who are in need or oppressed, are crucial aspects of Christ’s teaching. Nevertheless, theological perspectives seem to suggest that exclusion, rather than mere distancing, was the primary concern of Scripture, as boundaries are often necessary to protect against harm toward other members of the community. Important lessons for Christians from the psychological literature on stigma toward mental illness are reviewed.
African American clergy provide informal counseling for community members with depression. Through a qualitative case study with two African American clergy and 25 community members in New York City, the authors explored perspectives on training clergy in interpersonal counseling (IPC). Data were analyzed by using thematic analysis. Results were grouped into three themes: mistrust of institutions, depression stigma, and feasibility of training clergy in IPC. Clergy members wanted IPC training but did not want to counsel more people. Thus, training clergy may be insufficient to reduce racial disparities in access to evidence-based depression services.
Though clergy often serve as informal helpers and conduits to the formal mental health care system, few researchers have examined whether such clergy maintain the knowledge necessary to complete this mission. In this study, denominational affiliation, educational variables, and demographic characteristics were examined as potential predictors of mental health literacy (MHL). As a measure of MHL, the Mental Health Literacy Scale was completed by a nationwide sample of 238 Christian clergy. The results provided the first parametric measure of denominationally diverse clergy from across the United States. Results indicated that female gender and higher numbers of clinical mental health training courses significantly predicted higher MHL scores. No significant differences in MHL scores emerged among four main denominational groups: Catholic, evangelical Protestant, historically Black Protestant, and mainline Protestant. Findings may inform mental health counselors on how to increase interprofessional dialog and referral partnerships with local clergy.
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Senior pastors at churches affiliated with the Baptist General Convention of Texas (BGCT) were anonymously surveyed using an online questionnaire to ascertain their knowledge and perceptions of the causes and potential treatments of mental illness. BGCT senior pastors reported a moderate level of contact with the mentally ill and populations known to have higher than average rates of mental illness (e.g., homeless). They also reported that the individuals with whom they counsel are rarely diagnosed with mental illness. While Baptist senior pastors embraced biological causes and treatments for mental illness as most important and effective, they varied greatly across disorders as to the perceived contribution of psychosocial and spiritual factors. Senior pastors in the present study reported being open to referring their congregants to mental health care professionals with whom they shared common values. Overall, the results of the study point to a need for greater mental health education for Baptist clergy as well as opportunities for the development of increased collaboration between the mental health and faith communities.
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The present study examined the experiences and values of families caring for a mentally ill loved one within the context of a Christian faith community. Participants (n = 5899) in 24 churches representing four Protestant denominations completed a survey describing their family's stresses, strengths, faith practices, and desires for assistance from the congregation. Results showed mental illness in 27% of families, with those families reporting twice as many stressors on average. In addition, families with mental illness scored lower on measures of family strength and faith practices. Analysis of desires for assistance found that help with mental illness was a priority for those families affected by it, but ignored by others in the congregation. These results suggest that mental illness is not only prevalent in church communities, but is accompanied by significant distress that often goes unnoticed. Partnerships between mental health providers and congregations may help to raise awareness in the church community and simultaneously offer assistance to struggling families.
Objective: A surprisingly high number of Americans seek clergy support for treatment of mental illness. However, little is known about how the clergy prepare for fulfilling this need or their beliefs regarding mental illness. This study examined the ability to recognize and treat mental illness among Hawaii's Protestant clergy. Methods: Ninety-eight clergy members responded to the survey. Results: Most (71%) reported feeling inadequately trained to recognize mental illness. The most common cause of mental illness that clergy members cited was medical (37%), yet when asked to comment on two case vignettes, many reported that they would provide counseling instead of referral. When referrals were made, 41% considered shared religious beliefs between parishioner and provider important, and 15% considered shared beliefs essential. Conclusions: These findings highlight the need for collaboration between mental health professionals and the clergy. Knowledge of a patient's belief system may help improve crisis interventions and treatment planning for religious patients.
Increasing attention has been given to psychologist-clergy collaboration in mainstream psychology journals, yet much remains to be considered regarding how these collaborative relationships will benefit the work of pastors and Christian congregations. The purpose of this research was to evaluate clergy perspectives regarding what psychologists can offer to facilitate the ministry of the church. Various methods of assessment were used, including a survey of evangelical pastors, responses to an open-ended question via electronic mail and in person, and a focus group of Christian mental health practitioners. Respondents indicated an interest in the relationship of sin and psychological disorder, interventions particularly related to marriage and family counseling, understanding of diverse personalities in dealing with church conflict, understanding of psychological disorders, and methods of caring for their personal needs as pastors. Recommendations are offered for those interested in collaborating with clergy.
Given the frontline role of community clergy in mental health care, this study examined how collaboration with clergy was viewed by mental health and other health professionals outside of the religious community. Searches of health care journals on Medline and PsycINFO yielded 44 articles from non-religious journals from 1980 through 1999 that specifically addressed collaboration between clergy and mental health professionals. Seven themes were identified through content analysis, including the benefits of collaboration to each profession, the need to increase the clergy's knowledge about mental heath, and the importance of referrals. Discussion about interdisciplinary referrals significantly increased over time, rø (1, N = 44) = .31, p < .05).
The purpose of this study is to examine the relationships among variables identified in research literature as obstacles and benefits to interprofessional collaboration-- academic education, interprofessional education, teamwork and communication skills, and trust---as it relates to the participation of clergypersons in interprofessional collaborative practice. The sample consisted of ordained Christian clergypersons in Florida who voluntarily completed a survey questionnaire. Standard and stepwise multiple regression was applied to analyze the data. The model accounts for 25% of the variation of interprofessional collaborative practice. Results also revealed that the education variables explained significantly 20% of the variance of interprofessional collaborative practice.
During the past century, the scope of mental health intervention in North America has gradually expanded from an initial focus on hospitalized patients with psychoses to outpatients with neurotic disorders, including the so-called worried well. The Diagnostic and Statistical Manual of Mental Disorders (DSM), Fifth Edition, is further embracing the concept of a mental illness spectrum, such that increasing attention to the softer end of the continuum can be expected in the future. This anticipated shift rekindles important questions about how mental illness is defined, how to distinguish between mental disorders and normal reactions, whether psychiatry is guilty of prevalence inflation, and when somatic therapies should be used to treat problems of living. Such debates are aptly illustrated by the example of complicated bereavement, which is best characterized as a form of adjustment disorder. Achieving an overarching definition of mental illness is challenging, owing to the many different contexts in which DSM diagnoses are used. Careful analyses of such contextual utility must inform future decisions about what ends up in DSM, as well as how mental illness is defined by public health policy and society at large. A viable vision for the future of psychiatry should include a spectrum model of mental health (as opposed to exclusively mental illness) that incorporates graded, evidence-based interventions delivered by a range of providers at each point along its continuum.
Surveys reveal that religion and spirituality are highly valuable to many people in times of crisis, trauma, and grief. The relationship between coping with trauma and the use of various spiritual beliefs is well established. The importance of clergy in trauma recovery is also well documented. A review of the 469 research and non-research articles published between 1990 and 1999 in the Journal of Traumatic Stress revealed that 8.7% (6/69) of non-research articles, 4.1% (15/366) of quantitative research articles and 2.9% (1/34) of qualitative research articles considered religion or spirituality in their work. Analysis of variance found a significant overall increase in the percentage of articles that mentioned religion/spirituality between the first half (1990–1994) and the second half (1995–1999) of the study period. The results are discussed in the context of the trauma research and in comparison to related disciplines. Recommendations for future research and clinical application are suggested for both traumatologists and religious scholars.
Investigated the status of counseling courses and faculty in the curriculum of 55 accredited Protestant seminaries in the US. Results show that counseling courses and counseling faculty have more than doubled in the past 15 yrs; 53% of the institutions surveyed required a course in pastoral counseling. However, it is concluded that additional academic emphasis is needed. (3 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Surveyed counseling-related activities of 67 male Church of Christ ministers, average age 43.8 yrs, in southern California. Church of Christ ministers are not required to be ordained or to pursue a seminary education, but all Ss had taken some college courses and 71% had taken a graduate course or completed a graduate degree. Data analysis revealed that Ss were consulted for problems similar to those seen by mental health professionals. Counseling techniques were related to the amount of academic training completed in counseling. Ss rarely made referrals to mental health professionals and received referrals even less often. Recommendations are made for greater interaction between clergy and mental health professionals. (PsycINFO Database Record (c) 2012 APA, all rights reserved)