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From the Publisher
From the Preface (pre-publication version): Context shapes action. It is a potent ingredient in our thoughts, beliefs, feelings, and behaviors. The times and places in which you do things influence how you do them, and circumstances shape your response to the words and actions of others. Services, products, professions, even avocations need to fit the context in which they are performed or consumed. I would not recommend sushi for a toddler’s birthday party menu—nor would I dare serve hot dogs and red Jell-O brand gelatin to my wife for an anniversary dinner (but she would be happy with the sushi). A rural general practitioner would require a new set of skills to practice medicine in a large urban emergency ward. A university English professor would need retraining to teach writing for primary school children. Anglers, of course, are accustomed to adapting to their context: jigging for walleye in a Minnesota lake requires different tackle, technique, and mystique from fly-fishing for Atlantic salmon in a Scottish stream or setting out trot lines for monster catfish in a south Texas river. Pastoral counseling is no exception. Its usual context is not a professional office in a medical arts building or psychiatric hospital. The primary context of pastoral counseling—indeed, its heart—is the congregation. In the course of pastoral conversation with those they serve, parish pastors, rabbis, and priests daily offer counsel in some form: a late night visit with a worried parishioner in the waiting room of an intensive care unit, guidance given to parents troubled by their son’s drug use, help for a married couple at the brink of divorce who have decided to give counseling a try for a session or two, spiritual direction with a widower experiencing an arid prayer life since his wife’s death, and an infinite variety of other pastoral moments. Due to their context—the many people they serve and multitude of functions they fulfill, as well as the wishes of their parishioners—ministers rarely see people in counseling for more than a few sessions and often only for one (see chapter 1).
In the congregational context, therefore, counseling inevitably is brief (“brief” in this volume designates a counseling duration of no more than ten sessions, but typically many fewer). Parish pastors have little choice in the matter; it is their reality. Like the doctors, teachers, and anglers in the illustrations above, if they are to minister effectively, they need to adopt strategies to suit that reality. As early as 1949, Seward Hiltner wrote that the time limitations of the parish suggest that most pastors’ counseling be brief. According to him, the principal benefit of brief counseling is to help a parishioner “turn the corner,“ or change direction: “Even brief counseling can often do just enough to bring a slightly new perspective, hence altering the approach to the situation and giving a chance for spontaneous successful handling of it by the parishioner.“ Generally Hiltner and his contemporaries favored an insight-oriented, long-term counseling approach. Brief pastoral counseling methods are much more finely tuned now than when he wrote these lines, and they are better designed to help people change direction in a few sessions. Turning the corner, in fact, is a primary goal of brief pastoral counseling, under the assumption that the other ministries of the church will continue to support people as they grow and move into the future. Strategies for Brief Pastoral Counseling is an attempt to synthesize the thinking of established and up-and-coming thinkers in the area of brief pastoral counseling. It follows up the work I began in Brief Pastoral Counseling and, much earlier, in Crisis Counseling. The book summarizes the literature in the brief pastoral counseling field and offers a new way, one that addresses the real, day-to-day context of pastoral counseling as it is practiced in local congregations among living, breathing, unique persons. The eleven authors of Strategies for Brief Pastoral Counseling propose an orientation toward pastoral counseling based upon short-term counseling theory and methodology, with the underlying assumption that the vast majority of counselees wish to deal expeditiously with their problems and are unable or unwilling to devote more than a few visits to the task. People seek help from religious professionals because they quickly want to address whatever is troubling them, and not necessarily to achieve insight or delve into their distant pasts. While the primary context of pastoral counseling is the congregation, the authors do not intend to exclude pastoral care and counseling specialists; indeed, it is my hope that many of them will read these chapters. Some may find themselves working once again in the parish setting as changes in insurance benefits and health care delivery cause a shift away from long-term therapy for troubled people. Indeed, a majority of the work of specialists, whether they are hospital chaplains, private practitioners in pastoral counseling, or military chaplains, is already brief in nature. Experiences and ideas of these professionals are needed in the conversation. It is my hope that the ministries of parish pastors and pastoral counseling specialists will inform and enrich each other.
About the Author
Howard W. Stone is Professor of Psychology and Pastoral Counseling at Brite Divinity School, Texas Christian University. Among his many influential books are Brief Pastoral Counseling; Crisis Counseling; Depression and Hope; and (with James O. Duke) How to Think Theologically.
Excerpt. © Reprinted by permission. All rights reserved.
From Chapter One (pre-publication version):
The Changing Times: A Case for Brief Pastoral Counseling
Howard W. Stone
Tony Hillerman, best-selling author of mysteries set in the American southwest, tells the true tale of Black Jack Ketchum, the most successful train robber Folsom, New Mexico, had ever known. Black Jack figured out that, while chugging up the old horseshoe curve southeast of Folsom, the Colorado and Southern train had to slow down so much that a horseman could hop out of the stirrups and onto the train without even having to gallop his horse. It was, apparently, like snatching candy from a baby. The system worked for him over and over again, so brilliantly that he saw no reason to change it.
Eventually the Colorado and Southern Railroad management figured out what he was doing. They packed the train with guards. The next time Black Jack rode up in his usual style, they shot and captured him and quickly brought him to trial—after which, Hillerman adds, “he was consequently and subsequently hanged over at Clayton with such enthusiasm that his head came off.” Ketchum had a method that worked perfectly for a time, but the times changed.
The times are changing for health care and pastoral care just as they changed for Black Jack Ketchum. Long-term therapy was the underpinning of pastoral counseling in the early days of the twentieth century, and remains so for some practitioners in the twenty-first century. It was appropriate then because it was based upon the best information available at the time. Today new information is available. This new data not only favors brief approaches but suggests that, except in a few select cases, long-term counseling is no longer practical. The medical profession has gotten the word. So have mental health researchers, the United States Department of Health and Education, insurance companies, and mental health providers. If the Colorado and Southern Railroad were still operating today, its managed health care organization most likely would mandate some version of brief counseling (in combination with pharmaceuticals, when appropriate) for the treatment of employees’ mental health problems.
The fact is, congregational ministers, priests, and rabbis traditionally have practiced brief counseling for many generations in the parishes they serve. As a variety of other helping professionals “discover” brief counseling with its many advantages—it is effective, enduring, economical, and humane—the time has come for parish pastors to reclaim it as the preferred strategy for helping troubled parishioners who come to them for guidance in resolving their difficulties.
The basic premise of this chapter is that brief pastoral counseling methods should be the primary mode of operation for pastoral caregivers—parish pastors and chaplains as well as pastoral counseling specialists.
Focus on Research
When choosing methods to use in your counseling, what do you take into consideration? Your training? Readings in the field, amply illustrated with individual case studies? Past experience? How we go about counseling parishioners certainly grows out of our own experience, but it also needs to rely on the demonstrable experience of others and the outcomes of their counseling. Well-constructed research documents the work of others in a controlled way and helps to mitigate the unavoidable bias of the helper who is doing the counseling. Pastoral counseling needs to pay more attention to such research, especially to outcome studies, than the field traditionally has done.
My personal physician is a fine family practitioner named Joseph Cappel. When I go to see him, I expect him to have read all of the current journals and bulletins that apply to his area of medicine. If I have a physical ailment, I want him to use state-of-the-art procedures that are based on the best and latest research in the field. Let us say he has two choices of therapy for my condition, and both have been shown in research to be equally effective but one is more invasive, takes longer, and is more expensive than the other. I trust (and my HMO demands) that he will consider those findings when he prescribes my treatment.
Surely clergy have a similar obligation to their parishioners. We have been trained to give heed to revelatory personal experience; however, carefully designed qualitative and quantitative research may be equally revelatory. We need to stay abreast of sound research in our field, and to consider it in choosing how we offer care to those who trust us with their well-being.
Most people who come to us for help are not on a quest for self-discovery. They seek to resolve a specific problem and move on as quickly as possible, not to overhaul their personality. Even though many counselors who are in therapy themselves appreciate and value their personal journey of discovery, for the most part their counselees do not. After the first session, most people do not return for many additional sessions, if they return at all. The pastoral counseling process is—by default if not by design—a short one. People tell us by their actions that, along with alleviation of their troubles, in counseling they want brevity.
There was a time when insurance companies tacitly condoned the long-term therapy bias by at least partially covering its costs. That is no longer the case. Today many health maintenance organizations and insurers reimburse only the more cost-effective brief therapies. The change to short-term modalities has sent ripples throughout the mental health community and set off controversy between proponents of the two approaches.
Is brief counseling a sign of the times? In our fast food, instant coffee, crash diet, microwave age, have people lost their patience to work toward long-term solutions to their problems? Is the desire for a quick fix part of their pathology? Or is it a sign of health, of a willingness to tackle a problem head-on and promptly do what is needed to get on with the business of living?
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