I Referred My Saint to Therapy:
A Pastor’s Guide to What Comes Next
Introduction: When Pastoral Meets Clinical
As a pastor, you are often the first person people turn to in times of crisis. Your calling is to shepherd God’s people, offering spiritual counsel, prayer, and biblical encouragement. But there are times when you may notice that a saint is struggling with mental health or relational challenges and needs additional support. Making a referral for professional mental health counseling is a great first step, but it leaves some pastors wondering, What happens now? What is my role once they start therapy?
This guide explores what to expect, how to maintain your spiritual role, and practical ways you and your church can support your congregants while they are participating in professional counseling.
1. What to Expect After a Referral
The Focus May Be Different from Pastoral Counseling
Therapists use evidence-based tools, such as cognitive-behavioral techniques, trauma-informed care, or grounding techniques. This approach can feel different from Bible studies or prayer meetings, but the two can complement each other. The therapist addresses emotional, cognitive, and behavioral aspects of their clients’ functioning, which can, in turn, help them become more open to your spiritual leadership and the work of Christ in their lives.
Pastor Scenario: Pastor Daniel had been counseling Marcus and Alisha, a young couple in his congregation. They came to him after repeated conflicts in their marriage, asking for prayer and guidance. For several weeks, Pastor Daniel walked them through Scriptures on love, forgiveness, and humility, even leading them in couple’s devotions. While they appreciated his care, their arguments didn’t stop. Instead, they actually seemed to escalate.
Sensing that something deeper was going on, Pastor Daniel referred them to a licensed marriage and family therapist. In therapy, the couple began learning cognitive-behavioral strategies to identify distorted thinking during arguments and practice healthier communication patterns. The therapist also helped Alisha process unresolved trauma that was fueling her reactivity in conflict.
At first, Pastor Daniel wondered why the couple wasn’t simply praying more together, as he believed their problems would be solved if they just followed the Word. But over time, he saw the fruit. Marcus and Alisha were learning how to calm their nervous systems, communicate without defensiveness, and take ownership of their actions.
When Pastor Daniel met with them later for pastoral care, he noticed something remarkable. Their spiritual practices were actually becoming richer because they weren’t being hijacked by constant conflict. Bible studies felt more productive, prayer wasn’t interrupted by shame or anger, and they felt freer to worship together.
Therapy Takes Time and Isn’t Linear
Although we want healing to happen quickly, it rarely occurs in an instant. Therapy often involves unearthing painful memories or unlearning harmful patterns, which can cause people to become more in touch with uncomfortable emotions that they would have previously avoided. Progress looks like ups and downs, not a straight line, and this reality can often feel discouraging for both the client and the people around them. However, as new patterns are formed and healing occurs, change tends to become more apparent.
Pastor Scenario: Deacon James referred a young man, Kyle, who had been struggling with panic attacks. After a few sessions, Kyle seemed more withdrawn. The therapist explained (with Kyle’s consent) that confronting anxious thoughts can be draining at first. Within months, Kyle was steadily improving. It was helpful that Deacon James understood that the therapy process would take time, so that he could better support Kyle’s journey.
Confidentiality Is Non-Negotiable
Therapists operate under strict confidentiality laws (HIPAA in the U.S.). Unless your congregant signs a written “release of information,” you will not receive details about what is discussed in therapy. This lack of communication can feel uncomfortable at times, as it differs from the way many ministry teams function. However, this privacy is an ethical and legal safeguard. It is required of licensed mental health professionals, and it can help clients feel safe enough to be honest in therapy so that they can fully address any challenges they may be having. Expect that most therapy happens behind closed doors, and that is appropriate.
Pastor Scenario: Pastor Johnson referred Maria, a church volunteer, to therapy for postpartum depression. Maria’s therapist could not disclose updates without permission. At first, Pastor Johnson felt disconnected and confused about his lack of inclusion. But after seeing Maria begin to make progress and become more connected to others in the congregation , he learned to respect the process and focused on simply checking in with love and prayer.
2. How Pastors Can Continue Supporting Their Congregants
Maintain Spiritual Care While Respecting Privacy and Individuality
Pray Faithfully: Continue interceding for them privately, and ask if they’d like to pray together.
Offer Scripture as Comfort, Not a Cure-All: Avoid quick fixes like “just have more faith.” Instead, share verses about God’s presence and love (e.g., Psalm 34:18; Matthew 11:28). Recognize that the healing process is nuanced, and the recovery journey can look different for each individual.
Normalize Struggles: Preach and teach that mental illness is not a sign of weak faith. Biblical heroes like Elijah (1 Kings 19) and David (Psalm 13) experienced deep anguish.
Ask open-ended questions like, “Would you like to share how therapy is going?” and be content if they decline. Don’t pry or expect a report. Trust that God is working even if you aren’t privy to every detail.
Pastor Scenario: Pastor Mark regularly checked in with a congregant in counseling. Instead of asking, “Are you better yet?” he asked, “How can I walk alongside you in this season?” The congregant said this made them feel safe without pressure.
Collaborate When Appropriate
If your congregant signs a release form, you and the therapist can collaborate. That might look like a phone call or a joint care plan, especially when spiritual issues overlap with mental health struggles. Your insight about the church context can be valuable.
Pastor Scenario: With consent, First Lady Nina spoke with a therapist about a congregant battling religious scrupulosity (religious OCD). Her insights on their faith tradition helped the therapist avoid unhelpful language, and the therapist helped the pastor understand compulsive cycles versus genuine conviction. This collaboration was mutually beneficial, and the congregant felt supported and more confident in her healing journey.
3. Ways the Church Can Support Holistically
Reduce Mental Health Stigma
Mental health stigma is lessened when ministry leaders talk openly about mental health in sermons and small groups. You can share biblical examples of suffering and healing or invite testimonies from members who have benefited from counseling. These public discussions open the doors for people to feel safe talking with you about their mental health struggles and make congregants more likely to follow your recommendations to seek professional help.
Provide Tangible Help
Access to transportation, childcare, or financial aid can make the difference between whether or not a person is able to participate in therapy. Your saint may feel incredibly supported if you offer to use the benevolence fund to pay for a few therapy sessions or assist with arranging transportation or childcare. This gesture will also show them how much you believe in the value of professional mental health assistance.
Train Leaders
Depending on the size and structure of your church, small group leaders, deacons, and other ministry leaders may be the first to interact with saints who are struggling with their mental health or relationships. These individuals must be able to recognize signs of depression, anxiety, and other mental health disorders and know how to respond. Trusted mental health professionals can be invaluable resources for providing training, whether in-person or via Zoom.
Create Safe Spaces
Make your church a place where people feel safe admitting, “I’m not okay.” Few things break down barriers more than when leaders are transparent about their own struggles and their journeys towards healing and restoration. You could also consider offering resource tables with counseling referrals or trusted books and resources on mental health from a biblical perspective.
4. Addressing Common Pastoral Concerns
“What if therapy contradicts our faith?”
Therapists are trained to respect the religious beliefs of the people they work with, but not all mental health professionals understand the nuances of each Christian denomination or have competency with integrating biblical principles into therapy. It can be beneficial to build relationships with a few therapists so that you can ask them questions about how they would navigate different types of situations (before referring congregants to them). This networking will enable you to refer your saints to professional counseling with greater confidence. Your saints may also feel more comfortable with seeking professional help if they are aware that you know and trust the therapist they will be working with. If concerns arise, discuss them with the therapist respectfully, while honoring client confidentiality.“What if they step back from church?”
Sometimes, part of the healing journey includes a season of rest and reevaluation. This may mean a congregant temporarily steps back from certain ministry roles. As pastors and leaders, it’s natural for us to feel concern when this happens, because we deeply care about their spiritual well-being. But stepping back does not necessarily mean drifting away. Instead, it can actually be a sign of wisdom and renewal. By providing opportunities for them to stay relationally and spiritually connected without the weight of performance, we create a safe space for true healing. Even Jesus modeled rhythms of rest and solitude. In the long run, permitting saints to pause helps them return stronger, and it builds a healthier, more resilient church family.“What if they talk about me in therapy?”
Therapy often explores relational dynamics, and it can feel vulnerable to know that your congregants may be discussing their perception of you in therapy. Therapy is a safe space for people to work through the challenges they are having so that they can communicate needs and concerns in a healthier, more productive manner. This dynamic may mean that your saint will discuss their concerns related to the church or individuals in the congregation. However, the goal of therapy is not to bash anyone or place blame. Instead, the goal is that therapy will help the saints in your church work through their stuck points so that they can better reflect Jesus and live out His purpose for their lives.
Conclusion: Pastors and Therapists Can Work Together
You do not have to choose between pastoral care and professional counseling when caring for the members of your congregation. Therapy and pastoral care can work hand in hand. Sometimes, clients grant permission for pastors and therapists to collaborate to support their recovery. At other times, clients prefer privacy as they work through their challenges in therapy. Your role as a pastor is still vital in both scenarios, as you continue to love, support, and guide spiritually. When pastors encourage professional counseling, respect boundaries, and embrace collaboration, they help foster deeper, more sustainable healing.
We’re Here to Support You
Our agency is available as a resource should you need information, training, or consultation. If you have questions about navigating difficult conversations or connecting someone with help, please don’t hesitate to reach out at 757-895-7953 or info@integritycollective.org. You do not have to handle these situations alone.
With gratitude for your service,
Integrity Counseling Collective PLLC
This resource was created by Integrity Counseling Collective PLLC, dedicated to supporting faith communities in addressing mental health with compassion and care.
