NO PLAGIARISM IMMEDIATE COMPLETION NEEDED.

Chapter 1

Introduction

Despite the controversial relationship between religion psychology, and psychiatry, individuals refer to spiritual practices to cope with stressful life events. There is an increasing awareness in the connection of spirituality and religion’s influence in mental health. Prior studies indicate that clients who seek pastoral counseling also address spirituality and religion in their therapeutic conversations, spirituality and religion is essential to many individuals in the United States.[footnoteRef:1] [1: Walker Kathryn Reid, Tammy H. Scheidegger, Laurel End, and Mark Amundsen. "The Misunderstood Pastoral Counselor: Knowledge and Religiosity as Factors Affecting a Client’s Choice." VISTAS, March 23, 2012, 1-16. Accessed February 23, 2019. https://www.counseling.org/knowledge-center/vistas/by-subject2/vistas-spirituality/docs/default-source/vistas/vistas_2012_article_62. ]

The adverse effects that untreated mental health problems have on the society and economy can affect everyday life for individuals causing discomfort to the individual, family members or care takers. Psychological disorders such as severe depression affects the daily life of the individuals, family members, and it could also have influence on their friends. There are many treatment options readily available for individuals suffering from ailments such as anxiety, depression, suicide, and substance abuse, which were recognized to be successful. Typical therapy options include interpersonal psychotherapy, cognitive behavioral therapy, psychodynamic, and existing therapy.[footnoteRef:2] Among most worldwide mental health issues, depression ranks the most common mental health issue in areas such as the UK and is center focus of research that explores the connection between spirituality and mental health.[footnoteRef:3] Prior evidence examines the relationship between populations which demonstrates quantitative measures of the reduced level of anxiety in areas such as anxiety or stress when joined with spiritual techniques.[footnoteRef:4] [2: Abdaleati, Naziha S., Norzarina Mohd Zaharim, and Yasmin Othman Mydin. "Religiousness and Mental Health: Systematic Review Study." Journal of Religion and Health 55, no. 6 (2014): 1929-937. doi:10.1007/s10943-014-9896-1. ] [3: Cornah, Deborah. The Impact of Spirituality on Mental Health A Review of the Literature A Review of the Literature. Mental Health Foundation. 2006. https://www.mentalhealth.org.uk/sites/default/files/impact-spirituality.pdf. ] [4: Cornah, The Impact of Spirituality on Mental Health A Review of the Literature A Review of the Literature. 7. ]

Some research suggest that many pastoral counselors are only trained to accommodate spiritual issues which include particular faith traditions, while individuals believe pastoral counselors have little expertise with psychotherapeutic theories.[footnoteRef:5] Preferably, highly religious clients aim towards counselors who firmly mirror same religious values. Furthermore, increased levels of reported religiosity result in stronger reactions to spiritual mechanisms of counselor descriptions. Additional research is required in the recent years to evaluate the perceptions of individuals, counselors, and the functions that pastoral counseling contributes in cohesively to psychotherapeutic counseling. [footnoteRef:6] Research provides a contrast between pastoral and psychotherapeutic counseling; however, more clarification and investigative studies are essential to further demonstrate the outcomes of pastoral counseling. [5: Walker, Scheidegger, End, and Amundsen, The Misunderstood Pastoral Counselor: Knowledge and Religiosity as Factors Affecting a Client’s Choice, 3. ] [6: Brian K. Jackson, “Licensed Professional Counselors’ Perceptions of Pastoral Counseling in the African American Community,” Journal of Pastoral Care & Counseling: Advancing Theory and Professional Practice through Scholarly and Reflective Publications 69, no. 2 (2015): pp. 85-101, https://doi.org/10.1177/1542305015586773, 85. ]

The church’s role in caring for members of the community with acute mental illness is crucial as statistics prove that individuals with the diagnosis is continuing to rise. Recently, mental health clinicians and psychiatrists recognized the relevance of spirituality and religion as an integrated experience on the delivery of mental health services. [footnoteRef:7] Religious beliefs and counseling affect mental health outcomes and can be used as combined coping mechanisms for individuals with acute mental illnesses. The collaboration efforts of the church such as the resources offered in religious communities’ and the support to loved one’s from family members in the church, provide a robust treatment option for individuals by limiting barriers and aiding victims in many mental ailments such as substance abuse. [footnoteRef:8] While findings propose the possibility of practical collaboration between clinicians, Church, and health care organizations, barriers are formed. [footnoteRef:9] [7: Warren A. Kinghorn, “American Christian Engagement With Mental Health and Mental Illness,” Psychiatric Services 67, no. 1 (2016): pp. 107-110, https://doi.org/10.1176/appi.ps.201400542, p.107)] [8: Kinghorn, American Christian Engagement with Mental Health and Mental Illness, 107.] [9: ]

Ministry Context

While a collaborative approach is necessary, are members of the church and the community actively seeking support to mediate mental health issues? Support given to individual from the clergy, pastor, or religious congregational members is widely considered a key mediator between both spiritual and mental health[footnoteRef:10]. Mental health affects a wide range of demographics extending from the middle east, Australia, to the western civilization. Among these, African American’s mental health is impacted by a wide range of factors, some which consist of social issues, homelessness, physical health issues, and unemployment.[footnoteRef:11] African Americans are less likely to seek mental health counseling from professionals compared to any other majority ethnic group.[footnoteRef:12] According to the U.S. Department of Health and Human Services, only 15.7% of all African Americans diagnosed with a mood impairment actually seek counseling from a professional and 12.6% of African Americans diagnosed with anxiety are seeking treatment.[footnoteRef:13] Barriers to seeking treatment are present in African Americans as they consist of social stigmas, the denial of symptoms, cultural norms, and social norms.[footnoteRef:14] Although African Americans are not proactively seeking professional counseling by an licensed psychotherapist, research is revealing some evidence that African Americans’ are reaching out to church based ministries for treatment for mental health issues.[footnoteRef:15] Spiritual researchers approaching this topic are taking a holistic approach, evaluating the way individuals view their spiritual worldview, while exploring cognitive, emotional , interpersonal, emotional, and behavioral components. The elements of religiosity are increasingly discussed in psychiatry as studies show religious individuals appear to improve coping skills and abilities with severe mental disorders alongside with reducing suicide attempts.[footnoteRef:16] [10: Cornah, The Impact of Spirituality on Mental Health A Review of the Literature A Review of the Literature. 7. ] [11: Avent, Janee R., Craig S. Cashwell, and Shelly Brown-Jeffy. “African American pastors on mental health, coping, and help seeking.’ Counseling and Values 60, no. 1 (2015): 32+. Academic OneFile (accessed April 6, 2019).http://link.galefroup.com.ezprozy.liberty.edu/apps/doc/A411334409/AONE? ] [12: Avent, Janee, Cashwell, and Brown-Jeffy, African American pastors on mental health, coping, and help seeking, 32. ] [13: Avent, Janee, Cashwell, and Brown-Jeffy, African American pastors on mental health, coping, and help seeking, 32. ] [14: Avent, Janee, Cashwell, and Brown-Jeffy, African American pastors on mental health, coping, and help seeking, 32. ] [15: Jackson, Licensed Professional Counselors’ Perceptions of Pastoral Counseling in the African American Community, 86. ] [16: Jones, Simon, Keith Sutton, and Anton Isaacs. "Concepts, Practices and Advantages of Spirituality Among People with a Chronic Mental Illness in Melbourne." Journal of Religion and Health 58, no. 1 (July 28, 2018): 343-55. doi:10.1007/s10943-018-0673-4. 345. ]

Problem Presented

The research performed will examine a representative sample of members from Deliverance Center for all nations church to determine how many members underwent or currently undergoing pastoral counseling as a treatment option of acute mental illnesses and what their outcomes are. The results from this research is not directly beneficial to the subjects but will offer awareness and expertise, bridging the knowledge gap. Statistical analysis will support each hypothesis as stated:

H1: There is a positive correlation between the subjects’ mental health outcome and pastoral counseling session received.

H2: There is no correlation between the subjects’ mental health outcome and pastoral counseling session received.

Purpose Statement

The purpose of this quantitative descriptive research study on the relationship between pastoral counseling on mental health is to gain a better understanding of the relationship between pastoral counseling and mental health. The specific aims of this study are (1) to add to prior findings in order to determine whether majority of the population of individuals are actually seeking pastoral counseling as a treatment option; (2) determine within that population whether pastoral counseling has a positive outcome on individuals with acute mental ailments. Research is aimed at understanding the integration of pastoral counseling and mental health, active practicing pastoral counselors, and whether pastors can serve as educators to mitigate care plans for individuals with acute mental illnesses. [footnoteRef:17] Recent data suggests there is an increasing number of individuals diagnosed with an acute mental illness. [17: Cheney, Gregory J. “Integrating Pastoral and Clinical Identities: A Narrative Inquiry of Pastoral Counselors.” Journal of Pastoral Care & Counseling72, no. 3 (September 2018): 172–79. doi:10.1177/1542305018792357. 172. ]

Basic Assumptions

The subjects included in the study will answer the interview questions in a concise, honest manor limiting bias. The researcher assumes the subjects participating in the survey are Christian, limiting nonfaith-based world views that will present research bias. The inclusion criteria of the sample are substantial, therefore, assures all subjects have experienced similar phenomenon of the study. Subjects have a sincere interest in participating in the research study and do not present altered motives such as using this study to impress their pastor or gain benevolence offering.

Definitions

This section specifies effective definitions for several referenced key terms

Acute Mental Illness Acute mental illness is characterized by significant and distressing symptoms of a mental illness requiring intervention such as treatment. This can be a person’s first experience, repeated episode, or worsening in symptoms. [footnoteRef:18] [18: "Mental Health Definitions." Mental Health Definitions | St. Joseph's Health Care London. January 22, 2019. Accessed February 05, 2019. https://www.sjhc.london.on.ca/mental-health-care/definitions. 1 ]

Anxiety Disorders formerly called neuroses, they are characterized by an excessive level of anxiety, developing in some patients to episodes of panic. [footnoteRef:19] [19: Mental Health Definitions, 1. ]

Bipolar Disorder (Manic-Depressive Illness) A mental state described by intense mood swings, depression alternating with manic behavior. [footnoteRef:20] [20: Mental Health Definitions, 1. ]

Delusions These are false beliefs which are not grounded in reality. [footnoteRef:21] [21: Mental Health Definitions, 1. ]

Depression is a biological illness altering brain chemistry that can progress to a state of morbid and extreme sadness, despair and hopelessness. [footnoteRef:22] [22: Mental Health Definitions, 1. ]

Obsessive-compulsive disorder OCD Individuals with OCD are constantly plagued by fears or thoughts “obsessions” that cause them to perform certain routines or rituals “compulsions”. [footnoteRef:23] Post-traumatic stress disorder PTSD is a condition that develops following a traumatic or terrifying event in which individuals affected are often left having lasting or frightening thoughts which can lead to emotional detachment. Examples of such events include sexual or physical assault, a natural disaster, or the unexpected death of a loved one. [footnoteRef:24] [23: Mental Health Definitions, 1. ] [24: Mental Health Definitions, 1.]

Psychotherapeutic counseling is described by rules that prevents any personal relations in the therapeutic bond for both parties involved. This type of counseling is characterized by consideration of two types of unconscious subtleties, conveyance and counter- conveyance.[footnoteRef:25] [25: Avent, Janee, Cashwell, and Brown-Jeffy, African American pastors on mental health, coping, and help seeking, 87.]

Symptom Attribution

Symptom attribution represents one’s beliefs about the possible causes of the symptoms. Researchers argue that when people face physical, cognitive, or emotional symptoms, they try to place the symptoms in well-defined categories and to label them as psychological, physiological, or normalizing (i.e., nonharmful) in nature. [footnoteRef:26] Symptom attribution has a significant role in determining the course, the clinical presentation, and the outcome of the illness[footnoteRef:27]. People who attribute their symptoms to a medical condition are likely to focus on their physiological sensations, to seek help from medical professionals, and to actively search for other medical symptoms. In contrast, people who attribute their symptoms to a mental condition are likely to seek the help of mental health professionals and to look for a constellation of psychological symptoms. To date, the roles of psychological, physiological, and normalizing symptom attributions in explaining group differences in help-seeking behaviors have not been explored. [26: Liat Ayalon and Michael A. Young, “Racial Group Differences in Help-Seeking Behaviors,” The Journal of Social Psychology 145, no. 4 (2005): pp. 391-404, https://doi.org/10.3200/socp.145.4.391-404, 391.] [27: Ayalon and Young, Racial Group Differences in Help-Seeking Behaviors, 392.]

Statement of Limitations

Every attempt is made to limit researcher bias during the implementation of this project; however, responder bias can still occur given the contextual matter of the subject. Research has been limited to churches only with positive intent that the churches included in this study will comply with instructions set in this study to prevent responder bias. The researcher’s ethnicity, personal ministry locality, denominational affiliation delimited research restrictions.

Thesis Statement

Research insinuates that license professional counselors intellectualized pastor’s role concerning the church. These perceptions are denounced by several factors that separate the two professions: unfulfilled training, deprived communications, and fallacy related to the level of professionalism in the church. Pastoral Counseling equips ministers with skills and practices which help Pastors recognize behavioral and emotional changes in members. The spiritual oneness with God, coupled with pastoral counseling skills, pastors are able to intervene during a members’ mental health crisis. Ministers might also be able to identify religiously influenced symptoms of psychological disorders similarly to religious delusions.

What is Pastoral Counseling?

Individuals may obtain both spiritual and psychological guidance from chaplains who are trained through clinical pastoral education, spiritual directors, and clergy offering pastoral care.[footnoteRef:28] Studies denote additional spiritually oriented descriptions including spiritual or religious empathetic counseling, psychospiritual counseling, Christian therapy, and religious counseling. [28: Walker, Scheidegger, End, and Amundsen. The Misunderstood Pastoral Counselor: Knowledge and Religiosity as Factors Affecting a Client’s Choice, 7.]

Distinguishing pastoral counseling and other forms of spiritually oriented counseling produces complications, for instance, some research studies used the term pastoral counselor without exploring the definition, using the term interchangeably with religious or Christian counselor.[footnoteRef:29] According to the dictionary of pastoral care and counseling, pastoral counseling is defined as a twentieth century phenomenon notwithstanding further definitions such as the North American Protestant pastors who included new psychological information into their ministries which claim new genealogy based on Hebrew and Christian understanding of care.[footnoteRef:30] Religious and social changes restructured pastoral counselor practices, training, and identity.[footnoteRef:31]Observations denote that there is no universally accepted definition for pastoral counseling. [footnoteRef:32] [29: Walker, Scheidegger, End, and Amundsen. The Misunderstood Pastoral Counselor: Knowledge and Religiosity as Factors Affecting a Client’s Choice, 7.] [30: Townsend, Loren. Introduction to Pastoral Counseling. Nashville: Abingdon Press, 2009.] [31: Townsend, Introduction to Pastoral Counseling, 3.] [32: Walker, Scheidegger, End, and Amundsen. The Misunderstood Pastoral Counselor: Knowledge and Religiosity as Factors Affecting a Client’s Choice, 7.]

Chapter 2

Conceptual Framework

Literature Review

The article, Pastors’ Counseling Practices and Perceptions of Mental Health Services: Implications for African American Mental Health, the writers conducted an exploratory study to determine the practices, behaviors, and desires of African American pastors utilizing the first level service delivery model. Their research found a link between pastors who have optimistic views about mental health facilities and documentation of parishioner counseling sessions on a broader variety of subjects several days a month. Participating pastors in this study reported counseling their members on a wide range of subjects, the most common being marital and family issues (91.7%), spiritual problems (87.5%), sorrow (79.2%) and work problems (70.8%).[footnoteRef:33] While they currently teach on a range of topics, all but one of the pastors surveyed said that they could receive additional instruction in one or more fields. The minister’s topics selected the most were marital and family issues (72.9%), emotional (70.8%), drugs (54.2%), domestic and sexual abuse (45.8%) and sexual problems (45.85%).[footnoteRef:34] While work problems and spiritual issues were two of the most frequently reported topics of advice, they were two of the lowest perceived need for additional training. This finding suggests that pastors are more prepared than some other areas of interest to address these two subjects.[footnoteRef:35] [33: Brown, Jessica Young, and Micah L. McCreary. “Pastors’ Counseling Practices and Perceptions of Mental Health Services: Implications for African American Mental Health.” Journal of Pastoral Care & Counseling 68, no. 1 (March 2014): 1–14. doi:10.1177/154230501406800102, 10] [34: Young Brown and McCreary. Pastors’ Counseling Practices and Perceptions of Mental Health Services: Implications for African American Mental Health, 10.] [35: Young Brown and McCreary. Pastors’ Counseling Practices and Perceptions of Mental Health Services: Implications for African American Mental Health, 10.]

The most frequently suggested issues on which professional experience was necessary included marital and family difficulties and emotional problems, fields that were usually discussed by professionals of mental health. [footnoteRef:36] Participants in those areas included improved mental health care, therapy, and/or planning. Interventions will focus on best practices to deal with social and emotional problems, and how to implement them in religious communities. Professional pastoral preparation could include ways to deliver group-level services such as seminars or gatherings that might help lighten the time pressure that pastoral therapy can sometimes bring to busy pastors. The reality that such a large proportion of pastors supported needing additional training suggests that while pastors perform a wide range of counseling tasks, they may not feel fully equipped to provide their parishioners with appropriate counseling. The study further built upon the idea to discuss clergy engaging with their parishioners ' mental and emotional needs. [36: Young Brown and McCreary. Pastors’ Counseling Practices and Perceptions of Mental Health Services: Implications for African American Mental Health, p11]

The self-efficacy of pastors around these issues directly affects the quality of care they will give their parishioners. An important aspect to consider is that pastoral care in the manner of traditional psychotherapy is not to be conceptualized. For a long time, members of religious communities used pastors as a resource that adds evidence of the effectiveness of their counseling. Conversely, certain pastors may not interpret their ability to handle any serious cases passed on to them as positive.

The article, Religiousness and Mental Health: Systematic Review Study, reviews recent empirical research to determine the role that religion plays in mental health outcomes. The most widely recognized problem is substance abuse, suicide, depression, and anxiety, impacting some 50 percent of mental cases.[footnoteRef:37] Such mental disorders are known to affect the public at large. The negative impacts of the mental problems on the general public and economy could interfere with regular daily life and inflict misery to the sufferers and their families or superiors-now and again. Severe sadness could influence people and their families ' day-to-day lives, and it could also impact their partners and influence toward religion.[footnoteRef:38] There are numerous mental medicines available for melancholy, nervousness, suicide, and abuse of compelling substances, and some are fruitful and helpful, such as treatment for intellectual conduct, relational psychotherapy, psychodynamics, and existing treatment. [37: Abdaleati, Zaharim, and Mydin, Religiousness and Mental Health: Systematic Review Study,p 1929-30] [38: Abdaleati, Zaharim, and Mydin, Religiousness and Mental Health: Systematic Review Study,p 1930]

Psychotherapeutic treatment for certain individuals is a powerful technique for treating mental dispersion.[footnoteRef:39] Through emotional and psychological literature an increased passion for the influences of faith and otherworldliness on well-being is apparent. Even though religion was intended to affect well-being, this partnership is increasingly unstable for late exams. Significant research information has suggested that strict practice with better mental and physical well-being is identified. Religiosity has been identified as an important defensive tool for well-being; research has shown a strong positive connection between rigor and psychological well-being. That connection has spread across different populations, including teenagers, grown-ups, old, general community members, workers, and displaced people, undergraduates, the immoral, terrorists, lesbians, friends, and individuals with issues of mental health and character.  [39: Abdaleati, Zaharim, and Mydin, Religiousness and Mental Health: Systematic Review Study,p 1930]

The article, Challenges to the Conceptualization and Measurement of Religiosity and Spirituality in Mental Health Research, both authors are addressing religiosity and faith to further clarify how the experiences of individuals influence their attitudes, acts and happiness generally. Nonetheless, contradictions in the conceptualization and interpretation of these patterns will affect the potential judgement of strictness and spirituality.[footnoteRef:40] [40: Baumsteiger, Rachel, and Tiffany Chenneville. "Challenges to the Conceptualization and Measurement of Religiosity and Spirituality in Mental Health Research." Journal of Religion and Health 54, no. 6 (2015): 2344-354. doi:10.1007/s10943-015-0008-7. P 2345 ]

Evidence from a study of college understudies recommends that congregations define spirituality as free from social impact and that some individuals associated with antagonistic terms with spirituality. A content study of indicators of spirituality shows that measures of spirituality contain elements that do not truly gauge the degree of spirituality. There is a discussion of ideas and plans for future research.  The reason for this inquiry was to further understand the conceptualization and evaluation of spirituality and religiosity within studies on mental health welfare. The specific points of this study were to contribute to earlier findings about the nature of religiosity and its relationship to strictness of the all-inclusive community by using a broader and more generalizable example; to analyze how individuals equate spirituality with more negative terms than religiosity, and to evaluate existing measurements of religiosity to decide whether they are surveying for religiosity.

The article titled, The Gatekeepers: Involvement of Christian Clergy in Referrals and Collaboration with Christian Social Workers and Other Helping professionals, VanderWaal, Hernandez, and Sandman conducted a report to evaluate their subjects’ perception of MH and SA requirements and their ability to comply and refer church members to medical care providers. Despite developing multiple effective clinical and psychosocial approaches aimed at neutralizing the effects of psychological distress and drug abuse, nearly 66 percent of all people despite reported mental wellbeing disorders are not looking for treatment. Social services usually offer social health and drug abuse service administrations. Barriers to individuals pursuing psychological well-being and drug misuse recovery include cost concerns, embarrassment surrounding psychological well-being issues, ignorance of psychological well-being issues, bullying over practices, and numbness over treatments. Many individuals first look at their organization for support. Two thoughts also discovered that 25-40% of Americans also tried to guide spiritual administrations. People in the church are more likely to look for ministerial assistance than others. 

Churches can alleviate service shame towards psychological well-being and the benefits of substance misuse by effectively meeting the network's emotional well-being needs. Studies show that people who go to worship houses in an uplifting frame of mind against emotional welfare administrators have increasingly optimistic mentalities to receive support, especially within minority networks. 

The article concludes that some members of the clergy within the church want to work with experts to help. There is an ambiguity in allusion to their eagerness and comparison examples. The Christian clergy has a significant role to play in recognizing people with mental health and substance abuse problems and for providing education, support and referral to the care needed. In such a study, researchers conducted an online study with over 200 Christian clergies from 50 + churches investigate their views of substance abuse and mental health conditions and their willingness to cooperate and refer members of the church to professional service providers. Findings have found that more than half of all clergy have met in their churches regularly or more frequently individuals with substance abuse or mental health problems. Nearly two-thirds believed members of the church typically feel more secure seeking pastoral support than turning to professional aid. Many clergies indicated that if they had a mental health or substance abuse problem, they would possibly refer church members to a therapist, especially a Christian psychologist. Counseling and race/ethnicity found important differences, however. Such findings show that the parishioners with the disability would receive medical care, help, and guidance from the clergy. 

Service workers commonly provide mental health and substance abuse treatment services. According to National Association of Social Services a 2006 survey sponsored "Social workers in behavioral health are the primary specialization sector within the frontline social workforce with mental health being the many prominent (37%) specialty research category of social work." Social workers are the nation's largest group of professionally qualified mental health service providers... providing more mental health services than psychologists, psychiatrists, and psychiatric staff combined, according to the Drug Abuse and Mental Wellbeing Care Administration. Nevertheless, with this strong association with MH and SA matters, people with MH and SA disorders are often ignored by social workers along with other care providers. 

Barriers to people seeking mental health and substance abuse include financial issues, mental health stigma, denial of mental health problems, personal shame and lack of treatment options. Possible reasons for the low rate of structured mental health services received may be the level of help that clients receive, and the belief that therapy will not succeed.

Most people seek assistance from their clergy. Two studies found that the priest treatment was sought by between 25% and 40% of People.[footnoteRef:41] Evidence from the National Comorbidity Survey has found that, in a given year, almost one-fourth of those seeking mental health support from the clergy have a severe mental illness, but most of these individuals are seen only by clergy, not by mental health professionals or other health care providers.[footnoteRef:42] Many members of the church are more likely to seek help from the clergy than others. Analysis of data from the General Social Survey shows that regular church leaders, religious literalists and the elderly are all the more likely to seek clergy as a source of advice particularly assistance. Americans see the church as less suitable sources of assistance for more severe problems such as autism, and for people who may be a threat to themselves or others.[footnoteRef:43] [41: Ayalon and Young, Racial Group Differences in Help-Seeking Behaviors, p.392] [42: VanderWaal, Curtis J., I Hernandez Edwin, and Alix R. Sandman. "The Gatekeepers: Involvement of Christian Clergy in Referrals and Collaboration with Christian Social Workers and Other Helping Professionals." Social Work and Christianity 39, no. 1 (Spring, 2012): 27-51, http://ezproxy.liberty.edu/login?url=https://search-proquest-com.ezproxy.liberty.edu/docview/928068206?accountid=12085) p 29 ] [43: VanderWaal, Hernandez, and Sandman, The Gatekeepers: Involvement of Christian Clergy in Referrals and Collaboration with Christian Social Workers and Other Helping Professionals.p 30]

The clergy needs to be aware of their shortcomings and make references where possible to trained mental health professionals. One study showed that some clergy has difficulty identifying emotional distress or suicidality, especially in comparison with other professionals in mental health. [footnoteRef:44] Other scholars have expressed concern about whether clergy can properly recognize people who may pose a risk to others. [footnoteRef:45] Through consciously serving the community's mental health needs, churches will help to remove the cultural stigma of mental health and substance abuse programs. Research suggests that individuals attending churches who have a positive attitude towards mental health services have more favorable attitudes towards obtaining assistance, especially in minority communities. Definitions of such church-based services could include encouraging community groups to take place inside the church, allowing social workers and other supporting people to make short lectures or weekend workshops in the church, offering adequate counseling services within the church, or hiring a case manager to make service referrals. [44: VanderWaal, Hernandez, and Sandman, The Gatekeepers: Involvement of Christian Clergy in Referrals and Collaboration with Christian Social Workers and Other Helping Professionals.p 30] [45: VanderWaal, Hernandez, and Sandman, The Gatekeepers: Involvement of Christian Clergy in Referrals and Collaboration with Christian Social Workers and Other Helping Professionals.p 30]

  While some clergy has expressed a willingness to collaborate with helping professionals, there is a discrepancy between their willingness to refer and referral patterns. Consequently, a more thorough understanding of the factors influencing their willingness to make referrals is important. Besides, greater awareness will lead to the development of programs designed to improve access to the mental health and substance abuse resources that are required. Representatives from Kent County, Michigan, community mental health centers, local clergy, and researchers met in April 2008 to discuss several mutual concerns, including the low number of people receiving mental health and substance abuse treatment, particularly in the Black and Hispanic communities, lack of availability of services and connections to SA and MH treatment in the community. As a result of this meeting, the primary authors, together with representatives of the CMHC and local clergy, developed a survey to assess clergy perceptions of mental health and substance abuse problems in their churches, their actions in the face of mental health or substance abuse challenges in their congregations and their willingness to refer congregations to mental health and substance.

This study concludes that Christian social workers have a special opportunity to provide the clergy and their congregations with qualified, socially informed training and education. Social workers should communicate with the clergy before offering such help and seek their support in designing and delivering curriculum and educational materials. Besides, Christian social workers can strengthen connections with religious leaders by providing additional training in mental health education and collaboration, especially among less educated and minority clergy. 

Another important way for Christian social workers to help churches address mental health and substance abuse challenges is to provide these congregations with culturally competent counseling services. Social workers provide most of the professional mental health care, as noted earlier. Christian social workers will continue to look for ways to increase the use of mental health services within the religious community, particularly within ethnic minorities, while churches scan their communities for Christian counselors. Collaboration with the clergy, however, is one way of removing some of the current obstacles to mental health services and increasing the opportunities for culturally competent treatment. Improving these collaborative relationships could go a long way towards ensuring that people with mental health and substance abuse challenges receive the assistance they need in a relationship that values their faith and provides the adequate treatment.

The article The Integral Role of Pastoral Counseling by African American Clergy in Community Mental Health, suggest that little is currently learned for the spiritual practice of African American Church pastors. This research focuses on the study of how pastoral counseling identify and help individuals with problems. The writers interviewed the pastors of nearly all African American churches in a metropolitan area about their pastoral therapy work and their work-related aspects. African American churches prioritize the cure for psychological illnesses (1,2). Much of this healing occurs at liturgical rituals through which participants identify specific psychological symptoms that are erased or replaced with positive feelings. However, very little is known about the softer pastoral counseling ministry performed by African American clergy.

In this research, they describe how African American clergy, including receiving and making referrals, conceptualize, structure and experience their pastoral counseling. Face-to-face interviews were held at the option setting for each participant. The interviews utilized a structured format that included open-ended response opportunities. The interview duration ranged from 45 minutes to six hours; the median interview duration was 90 minutes. The pastors offered demographic statistics about their churches and themselves as well as identifying their structured and continuing education, including training in counseling. Spiritual counseling was defined as counseling of a duration of much than 15 minutes intended to "provide care, counseling, compassion, or counseling primarily concerning emotional, psychological, or moral problems."

Positive effects of pastoral counseling in African American churches may help to explain a crucial paradox: compared to white persons, black people do poorly inter African Americans, for example, have higher death rates compared to whites from 13 of the 15 leading causes of death in the United States. Further studies are needed to assess whether the situation in New Haven is unique, or whether African American churches in other cities are likewise involved in mental health promotion. When the interaction trend found elsewhere is different, so this will be very interesting to determine the causes of the disparity to promote optimum improvements in the United States.

Additionally, expanding parallels to include the African American clergy in remote areas would be informative. Certainly, there is a need for the viewpoints of church leaders and other outsiders to complement those of the clergy, particularly concerning the outcome. Because the clergy's role is now known to be big, effectiveness is becoming a crucial issue. Similarly, more needs to be known about a lot of clergy's pastoral counseling work in both urban and rural settings. Efforts to improve the continuing development available to them would provide a significant contribution to the quality of the services they provide. This takes some ingenuity to identify realistic support structures. Incorporating a clergy intervention explicitly into public mental health contexts is one indication of demonstrated worth. In this regard, responsible bodies including church authorities, seminary officers and foundation boards may all contribute. The results presented here provide a basis and direction for the support of faith-based organizations, both public and private. The increasing pressure on public and private mental health care services may require that the work of secular mental health professionals be integrated with that of their colleagues in the African American clergy. These findings and possibilities emphasize the need to study the African American population's health-promoting resources including the role of the church. Religious involvement, for example, might support behavior that is more conducive to health. Indirect health benefits can come from church and group involvement. They may help share religious culture between counselor and client. Also, the African American clergy's ability to make mental health recommendations adds to the resources the African American community has to offer.

The article, Spirituality and Religion in Recovery: Some Current Issues, evidence suggest that symptom-related stress may lead to increased use of religious coping methods for some patients and, over the longer term, reduced severity of the symptoms as demonstrated in fewer hospitalizations. In psychiatric hospitals study, both public faith worship and private spirituality were associated with depressive symptoms that were less intense. Those who attended service regularly also had shorter average stay periods in the hospital and higher life satisfaction compared with less regular or non-attendants. that subjects repeatedly pointed out that religion and spirituality can serve as important recuperation tools.

Faith and spirituality can be described as among the most outstanding sources of assistance to many people served by public mental health and substance abuse services. For example, in a Los Angeles area survey of people diagnosed with severe mental disorders, over 80 percent indicated that they used religious beliefs or behaviors to cope with everyday problems, a percentage greater than that seen in many general population polls, and 65 percent indicated that religion helped deal with their psychiatric symptoms to a moderate or large degree These religious activities were deemed the "most significant things which kept them going for 30 percent of the respondents. 

Some recent studies have started to explore the correlations between specific aspects of religious-ness to spirituality and indices of mental health more thoroughly. Patients with a higher frequency of the symptoms and lower overall performance were more likely to use certain religious activities i.e. prayer and reading of the Bible, as part of their coping. Furthermore, these persons who relied on divine therapy more when their conditions deteriorated reported fewer hospitalizations in the previous year.

This article addresses emerging views on faith and religion positions in healing from severe mental health issues. Public views, as well as those of mental health and faith practitioners, are examined, based on a variety of discussion groups and workshops in addition to the published literature. Consumers remember in healing the potentially helping and burdensome functions in religion and spirituality. In the sense of mental health services, experts express both optimism for and frustration with those realms. Key recommendations about the appropriate place of spirituality and religion in psychiatric rehabilitation and related supports emerge from every perspective. These latter studies are more similar to the large body of research that examines the relationships between spirituality and well-being in community samples and among people with medical illness. There is a growing consensus that many aspects of religion and spirituality are favorably linked to welfare metrics. This research addresses links between certain aspects of spirituality and the functioning of mental health, it may provide indirect evidence that is useful in working with people diagnosed with severe, persistent mental disorders. 

Findings involving affective disorders may be particularly relevant. For instance, medically ill elderly people who were diagnosed with depressive disorder and found that intrinsic religiousness (following religion' for its own sake' rather than providing social or emotional support) predicted a shorter time for remission of depressive symptoms after control of demographic, physical health. Other studies have reported similar relationships between some form of religiousness and fewer symptoms of depression.[footnoteRef:46] Pargament examined the role of religious coping methods in the control of stress. His research shows strong links between positive forms of religious activity and better mental health.[footnoteRef:47] Taking into account demographic factors, such attitudes and beliefs as perceived solidarity with God, seeking spiritual support from Christ or religious communities, and favorable moral views of negative situations were associated with less pain, less depression and anxiety, and more positive effects. Spirituality or religion may be related to important sources of community and social welfare. [46: Fallot, Roger D. "Spirituality and Religion in Recovery: Some Current Issues." Psychiatric Rehabilitation Journal 30, no. 4 (2007): 261-70. doi:10.2975/30.4.2007.261.270. p 262 ] [47: Fallot, Spirituality and Religion in Recovery: Some Current Issues, p 264]

The promoting practices of many religious or spiritual organizations not only have functional and emotional aspects, but the impact of the assistance can also be increased by beliefs that it is justified in a theological or transcendental form. A culture that sees itself as rooted in friendship with the divine, belongs to and seeks acceptance in it, and is often ignored, alienated or stigmatized.[footnoteRef:48] Even if the spiritual experience and values are not directly related to an established religious community, they stress and encourage the development of the fundamental sense of connection with the self, with others, and with the supreme or the sacred. Optimistic coping strategies for some users can lead to negative coping consequences for others, both religious and spiritual.  [48: Fallot, Spirituality and Religion in Recovery: Some Current Issues, p 263 ]

Prayer or other religious rituals can become compulsive and interfere with everyday overall operations. This article also cites findings of cross-sectional support for this type of adverse effect of religious activity in consumers who are associated with greater impairment of worship and Bible reading. Customer perspectives-based guidelines. The desires and concerns of customers have led to certain specific recommendations on the role of spirituality and religion in the context of mental health services. Firstly, mental health programs, an approach that explicitly incorporates the spiritual dimension of life, should adopt a holistic approach to both assessment and intervention. 

Approach faith directly; considering the understandings of spirituality and whether religion or spirituality is important for individuals; challenge spiritual or religious history; consider whether and how the consumer would like to have spiritual problems or priorities included in their work. The individualized approach means doctors become aware of the many and complex ways in which religion can work in the lives of people with mental health problems. Faith and religion can vary enormously in different times, contexts, and in dealing with various types of problems and stressors. Faith and spirituality as a muddle. Although many practitioners are very optimistic that spirituality is theoretically an extended and visible component of mental health services, significant issues within mainstream and often critical professionals reoccur. Obviously, given the pervasive mistrust and if not absolute hatred of faith and some psychiatric philosophies, the fears of some clinicians in mental health are not surprising.

Religious with spiritual values both attitudes, taking some respects inherently dysfunctional, illustrate particular neuroses and an inability to face harsh realities or stagnant conflicting convictions. But even clinicians with a more neutral or positive recognition of religion, including differentiated views to this topic, question if spirituality should be given a more prominent position in service delivery. Taking a view of the nature and effect in trauma on the lives of individuals receiving health services, they distinguished between trauma-specific and trauma-information treatment.

The effects of injuries and the recovery process primarily rely on trauma-specific care such as ambulance and medical treatments like EMDR. Similar to these services, trauma-specific programs may solve a wide range of human issues, but their trauma experience makes the programs hospitable, compassionate and helpful for trauma patients. Here is a valuable comparison to religion and spirituality. The report, patterns, and causes of pastoral counseling contact with psychiatric illnesses in the United States. If we are to understand and address these questions, then we can ensure that people with behavioral and drug concerns religious receive appropriate care. One of the few epidemiological researches carried out in mid-1960 of group groups, Gurin and colleagues in 1960 showed that 42 percent of those who seek assistance with emotions were receiving support from clergy members, even more so than those who visited psychiatrists, mental health practitioners or some other occupation. This percentage dropped twenty-five years later in a follow-up report but is also very high (34%). [footnoteRef:49] [49: Philip S. Wang, Patricia A. Berglund, and Ronald C. Kessler, “Patterns and Correlates of Contacting Clergy for Mental Disorders in the United States,” Health Services Research38, no. 2 (2003): pp. 647-673, https://doi.org/10.1111/1475-6773.00138, p.648 ]

In the early 1980s, the Epidemiologic Catchment Area (ECA) report found that about 20% of the people seeking mental illness treatment had contact with clergy and other providers of human programs. Particularly in light of growing literature, it is important to consider what mental health services are offered by clergy services. The priestly studies have shown that many individuals have not properly been educated in psycho-pathological understanding and severity and pastoral therapy.[footnoteRef:50] [50: Wang, Berglund, and Kessler, Patterns and Correlates of Contacting Clergy for Mental Disorders in the United States, p.666]

The pastoral ministers spend less than 10 percent of our time on this interpretation and because of their conflicting perceptions.[footnoteRef:51] Past studies suggested that the clergy transfers fewer than 10 percent of those with relational problems to other mental health professionals.[footnoteRef:52] Fewer the efforts to enhance the mental health of the clergy have had a positive impact on the quality of pastoral care and healthcare professionals are still lacking in teamwork.[footnoteRef:53] The findings of this study reflect the clergy's important role in U.S. mental health services. The results suggest that the use of clergy in the 1960s and 1970s has diminished.[footnoteRef:54] However, the use of the clergy increased in the 1980s and early 1990s, with about one-fifth of those with a mental health condition searching for priests first time. The explanations for the national renaissance after decades of' secularization' remain unclear but are related to the increase of religious belief and behavior. Americans and an increasing interest in divine healing. National recent research results also indicate a gradual decrease in outpatient sessions, and a drastic increase in the use of mental health nonpsychiatric professionals and the alternative, self-help and non-traditional types of mental health care. [51: Wang, Berglund, and Kessler, Patterns and Correlates of Contacting Clergy for Mental Disorders in the United States, p.649] [52: Wang, Berglund, and Kessler, Patterns and Correlates of Contacting Clergy for Mental Disorders in the United States, p.649] [53: Wang, Berglund, and Kessler, Patterns and Correlates of Contacting Clergy for Mental Disorders in the United States, p.649] [54: Wang, Berglund, and Kessler, Patterns and Correlates of Contacting Clergy for Mental Disorders in the United States, p.663]

The article titled, Racial Differences in Attitudes Toward Professional Mental Health Care and in the Use of Services, the study of the second section of the National Comorbidity Survey explored the disparities in attitudes towards medical mental health and the use of mental health services. Before using them, it was found that African Americans had a more positive attitude toward these programs than Caucasians but were less likely to use them. [footnoteRef:55] Once used, their views were less positive than those of the whites.[footnoteRef:56] The goal of this research was to resolve this need by examining racial differences in attitudes towards treatment and their connection with MHS in a representative sample of the U.S. population. Based on previous findings, the following hypotheses had to be examined: African Americans generally have fewer positive attitudes toward professional mental health care than the whites; African Americans with a high incidence of depression similar to that of whites have fewer positive attitudes toward such care. [footnoteRef:57] Family income, which reflects economic resources allowing the use of health services, has been clustered at five annual averages.[footnoteRef:58] The distribution of household wealth over household income is more uneven, and variables like ancestry cannot imply a strong positive association of wealth with employment, schooling or profession proved in the stratified data sample.[footnoteRef:59] [55: Chamberlain Diala et al., “Racial Differences in Attitudes toward Professional Mental Health Care and in the Use of Services.,” American Journal of Orthopsychiatry70, no. 4 (October 2000): pp. 455-464, https://doi.org/10.1037/h0087736, p.455) ] [56: Chamberlain Diala et al., Racial Differences in Attitudes toward Professional Mental Health Care and in the Use of Services., p.456  ] [57: Chamberlain Diala et al., Racial Differences in Attitudes toward Professional Mental Health Care and in the Use of Services., p.457  ] [58: Chamberlain Diala et al., Racial Differences in Attitudes toward Professional Mental Health Care and in the Use of Services., p.458  ] [59: Chamberlain Diala et al., Racial Differences in Attitudes toward Professional Mental Health Care and in the Use of Services., p.458  ]

The article, Use of Clergy Services among Individuals Seeking Treatment for Alcohol Use Problems, research explored the frequency and features of people accessing religious treatment with alcohol consumption problems. State epidemiological survey data are given on drug and related conditions. 14.7% of people seeking certain drug-related services (n=1.910) reported using clergy services.[footnoteRef:60] In a multi-variable regression logistic model, Black aged 35–54 years, a lifetime history of alcohol dependency, major depressive disorder and personality disorders were all variables associated with increased service likelihood.[footnoteRef:61] Religious can take advantage with training to identify problems with alcohol use and play a role in making referrals for care. The problem of alcohol use consists of behaviors of overuse such as heavy drinking, binge drinking, and psychiatric conditions operationalized in the Mental Disorder Diagnostic and Statistical Manual.[footnoteRef:62] [60: Bohnert, Amy S. B., Brian E. Perron, Christopher N. Jarman, Michael G. Vaughn, Linda M. Chatters, and Robert Joseph Taylor. "Use of Clergy Services among Individuals Seeking Treatment for Alcohol use Problems." The American Journal on Addictions 19, no. 4 (2010):345-351.doi:10.1111/j.1521 0391.2010.00050.x. http://ezproxy.liberty.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=20653642&site=ehost-live&scope=site. p. 345 ] [61: Bohnert et al., Use of Clergy Services among Individuals Seeking Treatment for Alcohol use Problems, p.345] [62: Bohnert et al., Use of Clergy Services among Individuals Seeking Treatment for Alcohol use Problems, p.345]

The traditional description of pastoral counseling is psychotherapy conducted by ordained clergy serving as emissaries to particular faith groups.[footnoteRef:63] For example, clergy become pastoral counselors in a mechanism that combined mainstream clerical positions with psychotherapy training, culminating in certification by the American Association of Pastoral Counselors (AAPC) and related clinical credential associations.[footnoteRef:64] Towards the end of the 1990s, this clerical model was met by shifts in culture, spirituality and pastoral therapy practices.[footnoteRef:65] Emerging focus on pastoral theology, which has historically promoted pastoral counseling, has now questioned traditional practices by raising questions of gender, racial and ethnic diversity, internationalization, and the increasingly public presence needed for pastoral theology. [footnoteRef:66]Voices within AAPC raised questions about justice: pastoral therapy defined as an ordained profession omitted many women, gay and lesbian counselors, some who were called to advise but not to ordination, and counselors from different than Christian traditions.[footnoteRef:67] [63: Townsend, Loren. Introduction to Pastoral Counseling. Nashville: Abingdon Press, 2009. p.1] [64: Townsend, Introduction to Pastoral Counseling, 1.] [65: Townsend, Introduction to Pastoral Counseling, 2.] [66: Townsend, Introduction to Pastoral Counseling, 3.] [67: Townsend, Introduction to Pastoral Counseling, 1.]

Rules were adjusted to accommodate exceptions, however, fundamental documents retained a Protestant clerical bias in 2000 states that few university or seminary pastoral counseling programs expected graduates to be ordained or associated with clerical office.[footnoteRef:68] Religious communities and potential clients have been confused about what is "spiritual" about pastoral counseling without specific references to the position established by ordination. The confusion became compounded when skilled educators started practicing in complex social environments. They had to express their particular presence in these new locations, and to define themselves methodologically among a wide range of other practitioners. Spiritual practitioners, unlike other fields, have little scientific basis to support their claim in specific methods, tactics or experiments. Worthington noted about a quarter of a century ago that little is understood about how pastoral therapy varies from therapeutic counseling or benefits clients. Gartner et al argued in a study of the pastoral literature between 1975 and 1984 that pastoral therapy did not develop as a definable discipline because it found empirical research to be negligible. As a result, there is inadequate research to identify interventions or prove effectiveness. Only 55 articles recorded any use of instruments or techniques for empirical research, most of which were of little value due to methodological shortcomings. [68: Townsend, Introduction to Pastoral Counseling, 1.]

The research on clinical psychology shows few scientific papers. Less than half of these have been impacted by technical deficiencies. A decade earlier, Henderson and Gartner noted, in 1991, that "virtually nobody has a structured curriculum for empirical research on pastoral therapy. This has contributed to a" rechercherche void "that means that both ecclesiastical and public structures are indefinitely blocked. Failure to undertake empirical research implies that existing pastoral counsellors do not have clear definitions of clinical methods, can not empirically identify or describe core concepts, have little part in the development of new public care theory and are not exposed to important research in faith and mental health. The research employed a validated hypothesis that identified the pastoral consultants ' actions as a qualitative scientific definition, their social environments and experiences as" pastoral "and how they say that they offer a specific contribution to the field of public mental health. The aim was to define the limits of an initial philosophy of pastoral counseling, irrespective of contributions to psychotherapeutic templates. This study was developed with established qualitative methodology (based theory), attention to a multitude of forms of data (interviews, affidavits, interpretive consultations and focus groups), attention to questions of qualitative validity and established coding and the observation of O'Conner et al. (2001) that the greatest amount of qualitative pastoral research lacks methodology. Many results of this study were previously published.

Grounded Theory (GT) is a qualitative research methodology designed to analyze individuals and structures throughout their natural sense. Spiritual therapy had historically been described when emissaries of some religious leaders through psychotherapy by an ordained clergy. For starters, clergy is considered psychiatric counselors by way of a procedure incorporated by the American Spiritual Counsels Association (AAPC) into traditional clerical positions and psychotherapy instruction. This clerical trend experienced shifts in culture, religion and religious counseling in the late 1990s. In the field of contemporary theology, which traditionally promoted theological rehabilitation, the orthodox approaches is questioned by the concerns of sex, race and ethnic diversity. AAPC voices raised concerns about justice: the treatment of a certain number of women, gay and bisexual counselors, non-Christian counselors, not ordination counselors were removed from the concept of an organized service. However, Fundamental papers1 maintained a preference towards the Catholic clergy, since few universities and seminary pastoral therapy services required that students be ordained or elected by 2000. Despite direct links with the agency, Christian groups and prospective customers have not understood what pastoral counseling is. When doctors began to study in complex social environments, confusion became exacerbated. They had to share their own particular knowledge at these different locations and distinguish methodologically from a wide range of other experts. Unlike other topics, pastoral advisors have no scientific basis in support of arguments regarding particular procedures, methods or outcomes. A quarter of a century ago, Worthington recognized that little is understood regarding practical counseling rather than professional advice or helping customers. Gartner et al. stated in a 1975-1984 study of pastoral literature that pastoral therapy was not a certain science, since scientific analysis was thought negligible. No research is carried out to identify or explain improvement protocols in the event of a failure. Only 55 publications study empirical research methods or procedures, most of which were of little interest because of methodological deficiencies. In the clinical therapy literature, there are few scientific papers. Less than half of these were influenced by analytical shortcomings. 10 years earlier, it was discovered that no organization has a systematic empirical research program for pastoral therapy, which contributed to "a science void" that would forever obstruct the circumstances of the Church and the country.

As a testing technique GT will not test existing theories. In alternative, an explanation scheme or an intermediary theory is used to evaluate raw data and to create a gradually systematic, continuous comparison approach. These takes place by: simultaneous data collection and analysis, two-stage data coding processes, comparative methods, memoranda writing aimed at improving empirical analysis, sampling for refining new researchers' theoretical ideas and incorporation into the theoretical framework. The general principle begins with a limited volume of data from a criteria-based sample. The first evidence for this research came from two sources: interviews from five pastoral advisers and five written statements of pastoral identification with approved AAPC applications.

Applicants are chosen on the basis of competence as medical clinicians AAPC Fellow or Professional associate with active clinical practice. Because the survey goal was to achieve maximum variability, differences in class, age, geographical region and operational position were addressed. Interviews were performed as necessary in the office of professional advisors. This involved major visits to all nine AAPC areas with respondents. The consultation in vivo with pastoral counselors offered valuable historical details on the nature of procedures and structured representations for pastoral counsellors. The moral counsellors ' understanding of her or her nature tended to depend on the context of professional practice. Many who served in civic centers or church divisions tended to clearly connect roles.

Community moral practitioners generally described themselves as state license (LMFT, LPC, LCSW or psychologists) and referred to themselves as "economic theologians" who mixed spiritual values with social and professional services. Personal therapists and the most various whose jobs rely on the reimbursement of third parties. Many identified themselves simply as theological advisers, many as state-licensed practitioners concerned with spiritual issues and some as clinicians, without regard to religious or pastoral matters. Another observation was that in areas where religion is of little prevailing cultural importance (North-Eastern, North-West and South-West America), respondents were more inclined to describe themselves as spiritual counselors and philosophical consultants in the workforce and use religious symbols. Several people noted that they are differentiated from other doctors by transparency.

Conversely, throughout regions where religion has a strong cultural meaning, respondents overwhelmingly opposed religious symbols and did not recognize themselves as spiritual or religious unless questioned or affiliated with specific religiosity cultures that provided them with references. A small group in theological leaders saw each other as evangelists who gave unchurched people the light of God. In the sample, pastoral counselors also underpinned the expertise of training in pursuit of psychiatric competence guided by personality. This blurred strong reciprocal connections between practice, development and identity. Training and integrity are deeply integrated into human schooling and service practices.

Community events have a platform on mechanisms of collaboration and recognition. These activities reflect those principles, moral beliefs, ethical standards and requirements for customer service that are part of a consultant's formal understanding. A number of individuals who have interacted and shared their teaching practice via long-standing relations showed this. Parental counseling requires a therapeutic relationship that is systematic and qualitatively special to many practitioners. The principle expands the reach of the psychological method by focusing on the use of oneself in counselor therapy. Many of those interviewed alluded to "pastoral engagement" as a relationship which stretched beyond clinical experience and served as "the avenue of grace." The question also drew respondents to the position of the therapist's integrity or ability to sustain his professional image. The pastoral involvement often explained the execution of religious conferences or extra-session encounters, such as marriages or funerals, hospital visits or home gatherings, in order to solve suicide threats. Two cross-sectional dimensions are required for one side of the study. Everything, including the one mentioned here, is kept. The analysis illustrates the questions posed in a single study by a central scholar.

Reflexivity, a central principle of post-positives studies, calls on scientists to ask whether they are rooted in science and knowledgeable facts and interpretation of a Black, Catholic, seminary, pastoral counselor taught in non-traditional contexts in this situation. The joint consultants and the confirmatory interview lead to the analysis of how my own experience and social status as the primary investigator could influence perception and hypothesis development.

The authors investigated the disparities in Black and White activity and the function of cognitive-affective influences as mediators for these variations. 70 Black students and 66 Caucasian population students completed an updated multidimensional health care locus, a symptom interpretation questionnaire and a demographic comparison. Among White College graduates, medical and social services were used slightly less often, and faith activities were somewhat more available. The scientists have clarified disparity in religious actions by confidence in God's powers and symptom normalization. The cognitive-affective factors studied did not consider differences of psycho-logical actions. The authors argue that cooperation between mental health and religious services is likely to help Black University students meet their needs. To date, several researchers have sought to understand these differences in the steps to assist in looking for the apparent need and for social and spatial limits as explanatory variables. Nonetheless, insurance-related Black people are far less likely than Whites, who have the same benefits, to have ambulatory mental health care. Programmes that are historically open to supporting ethnic minorities often do not operate in contrast with financial and geographical obstacles. Others suggested that the tendency of Black people to rely on indirect signals and that social institutions hamper their access to mental health services. Although the majority of scholars have tested three different aspects of medical, psychological and religious aid-seeking practices in the current study, they have also examined all three fields to see whether the behavior of both populations varies in their search for help in the three areas. Moreover, the role of cognitive affective factors in understanding these differences has been hardly given much attention following a well-documented disparity in traditional healthcare indicate behaviors between Black and White. Such principles reflect values and ideas for the perceptions of one's planet. The majority of researchers focused on access obstacles such as financial, geographical, mobility or perceived needs, with no account given to the role of cognitive affective factors in establishing and maintaining the support gap between the two groups. It is especially important to be aware of the function of cognitive affective variables because they are likely related to the cultural and social variations between them. The findings would, in turn, help to develop fiscal, non-service and psychiatric programs to serve the specific needs of Blacks. There have been many potential reasons for high use of healthcare resources in Black mental health, including Black people who prefer to focus on somatic problems than psychiatry, Black people who seem to have more confidence in, and appreciation of, drugs than mental health professionals and derogatory mental stigma. Nonetheless, the role of symptom perception and attitudes towards mental health clinicians was not empirically investigated. Nevertheless, the results of the study did not support a higher incidence of Black mental illness.

Essentially, determining the magnitude of help-searching operations using a self-reporting study with retrospect is less than ideal. As always, the evaluation to activities which require support from the review of the history when various organizations, challenges and restricts the analysis to each organization. With addition to detailed reports, diaries can provide a concise description of these activities.

This study has many risks. However, while the employment rates for participants were similar, they did not control a number of other socio-economic factors. Several socioeconomic status measures will be used for future researchers to calculate discrepancies in help-seeking behavior among ethnic minorities. Of reality, there are all risks and benefits of studying a non-clinical setting. The downside to studying a non-clinical community is that different forms of study do not preselect applicants. The downside is that a non-clinical group requires fewer social welfare standards and therefore differs from a clinical population. Nonetheless, in this study, they noticed a fairly high percentage of students in both groups to have a significant psychological need and a broad range of answers. When researching both therapeutic and non-clinical classes, we have a better understanding of the differences in the actions of help-seekers. Ultimately, retrospectively, it is less than desirable to measure the level of self-reported help-searching behaviors. The assessment of behavior that needs support by evaluating the past of different organizations is, as always, challenging and limits the study to specific institutions. A concise description of these activities may be given in relation to detailed reports. In comparison to earlier studies which did not consider the role of cognative affective variables in behavioral quest group differences, they tried to define multiple possible cognitive-affective variables to explain the help-seeking gap in the current research.

Theological Foundations

Spiritual leadership skills must be acquired to maintain one accord with God if pastoral counseling is profound. Some may wonder, what is the position of the leader? Leadership is one of the most widely viewed but least understood places in the world. "Leadership is the persuasion process through which an individual leads a group to achieve goals shared by a leader. Pastoral counselors are God's appointed members. The main purpose of shop counselling is to serve God's intent.

The next base for a spiritual counselor is a disciple Discipleship is Christ's devotion. Christ exists and must be done. Discipleship is one of Christianity's fundamental principles, and without it, there is no road. Since Jesus Christ, discipleship is the same as following one's course. Pastors need to follow God's direction with faith leadership skills to maintain a relationship with God and ensuring that faith therapy is successful. Some may ask, what is the member's role? Leadership is one of the world's most widely regarded but least understood places. "Leadership is the convincing way in which an individual leads a group to attain ideals decided upon by a member.

The next pillar for a spiritual counselor is discipleship. Discipleship is Christ's commitment. Jesus lives and it is necessary to follow him. Discipleship is one of Christianity's fundamental principles, and there is no path to follow without it. After Jesus Christ, discipleship is the same as making one's path. Pastors must follow God's course from which they are ordained.

Pastoral counseling assists people through a social interdisciplinary practice environment for religious and non-religious concerns, in particular, philosophy and human/sociology. From now on, pastoral psychology research will mentally prepare worship and church gatherings. Pastoral care is generally recognized as history and partnership in which both Parish and religious elements are clearly defined. The representative, who is essentially a member of the government, talks with the Church. In friendship, celestial estimation is a significant issue. Peaceful thinking and encouragement are thus characterized by building a relationship with God and praying. Such two subjects are common religious rituals in the consideration of pastoral care, which affirm the strong experience of this government. Matthew 22:37-39 King James Version (KJV) reads, “ Jesus said unto him, Thou shalt love the Lord thy God with all thy heart, and with all thy soul, and with all thy mind. This is the first and great commandment. And the second is like unto it, Thou shalt love thy neighbour as thyself.” The relationship that is built up in each experience is with the counselor and themself, other individuals, and God.

To perceive the individual in this way, pastoral counselors must be trained to know various methods of counseling. Colossians 1:15 King James Version (KJV) Who is the image of the invisible God, the firstborn of every creature: The pastoral care movement is also a training or education movement that transferred the idea of a charismatic pastoral counselor to a professional and competent one. Exodus 15:26 King James Version (KJV)And said, If thou wilt diligently hearken to the voice of the Lord thy God, and wilt do that which is right in his sight, and wilt give ear to his commandments and keep all His statutes, I will put none of these diseases upon thee, which I have brought upon the Egyptians: for I am the Lord that healeth thee.”

The apostle Paul in this verse sites his own experience or his fellow ministers who were going though affliction. 2 Corinthians 1:4 reads, “Who comforteth us in all our tribulation, that we may be able to comfort them which are in any trouble, by the comfort wherewith we ourselves are comforted of God.” Many troubles and afflictions of the saints in this life, but it is God’s Will to comfort those going through tribulations. 1 Peter 5:2 reads, “Feed the flock of God which is among you, taking the oversight thereof, not by constraint, but willingly; not for filthy lucre, but of a ready mind.” The pastor of the church is regarded as the shepherd, a master of the flock who protects, leads and feeds the flock with the word of God. These duties are performed in ways like preaching, setting a godly example and providing spiritual advice. Although the student community is generally aware of low levels of need and therapeutic assistance, the current results show that 24% of Blacks and 30% of Whites reported symptoms of depression close to or above the average standard of outpatient psychiatrists. There was also heavy use of psychological or social services: 34% of Blacks and 50% of white people registered to receive psychological or social services at least once in the previous year. Religious services were most often used for both races, with 87.1% of Blacks and 74.2% of Whites reporting that they were used at least once in the past year.

The current premise that black college students are more likely than white college students to use religious services is in line with arguments that black religion plays an important role in Black life. Interestingly, in the present study, we have found that religious services are high frequency, but that priest services are relatively low. The context in which the question might have given rise to different answers. Immediately after a set of questions about religious beliefs and the importance of faith, religious services were asked, whereas the question of clerical appointments included other medical and mental health concerns. Blacks appear to use religious services for spiritual or religious purposes, but not to alleviate their distress. This conclusion is supported by the fact that the extent of psychological distress does not affect actions in the current study, particularly religious or clergy. Likewise, research suggest that ethnic minorities, notwithstanding their high religious engagement, tend not to seek religious services when they are distressed.

Flaskerud pointed to psychopharmacology as a culturally inclusive treatment method in 1986, suggesting that medications were a necessary and appropriate care function of certain ethnic minority groups, including African, Hispanic, and Asian populations. The findings of this study do not support the hypothesis surrounding Flaskerud. I did not see any differences in the use of racial groups in psychiatric services, medical services, prescription medications or over - the-counter medicines. Nevertheless, according to Flaskerud, which based on this study a non-clinical population that may have indicated fewer medicinal drugs use