Table of Contents

Referral: Safeguarding the Integrity of the Counseling Relationship

By Ron Turner

People looking for help with life’s problems often turn to a minister as a source. One study showed that 80 percent of those with family and marital problems turned first to their pastors. People trust ministers to care about their concerns, to be honest with them, to keep their confidences, and to give them sound counsel that is consistent with God’s Word.

Ministers are presented with a multitude of questions about the Bible, theology, ethics, personal and family relationships, God’s will, medical problems, finances, real estate, vocational concerns, and legal issues. Yet most do not have the expertise to give competent counsel in all of these areas. Therefore, one of the wisest time investments is for ministers to develop and use a referral network of other professionals in the community.

KNOW YOUR LIMITATIONS

Paul admonishes us to recognize our limitations: “For through the grace given to me I say to every man among you not to think more highly of himself than he ought to think; but to think so as to have sound judgment, as God has allotted to each a measure of faith” (Romans 12:3, NASB). Paul goes on to explain that we are one body with many members. We are not expected to know it all or do it all, but we are to exercise our gifts and allow others to do the same.

To represent ourselves as having competence and expertise beyond our training or qualifications is dishonest, unethical, and illegal in most states. Thus, building a referral network of other competent professionals becomes an issue of good ethics and integrity. (See sidebar on Defining Competence.)

WHY REFER?

A minister should make referrals for two reasons: (1) to provide the church member or counselee with competent care and (2) to safeguard the ministerial relationship with the layperson.

We are all familiar with medical referrals and usually appreciate it when our physician refers us to a specialist, someone more qualified to diagnose and treat our condition. Personally, I would not care to be treated by physicians who did not understand the limits of their expertise and who viewed themselves as competent in every area of medicine.

In order to ensure that church attendees are receiving competent care, ministers should carefully assess their counseling competency and establish clear guidelines for what issues or problems they are qualified to counsel. A minister should ask: What qualifies me in this area? What training have I had that applies to this issue? It would be helpful to discuss this assessment with a licensed professional or with a trusted friend with whom the minister has established accountability.

A clear understanding of the minister’s competencies and limitations helps safeguard the integrity and appropriateness of the counseling relationship and will likely spare the minister some frustration, pain, and even a lawsuit. It also allows the minister to more clearly define the kind of referral sources that need to be built.

The second reason for referrals is to protect the minister/layperson relationship. We do not pastor long before we experience the pain and frustration of having people leave the church because we have helped them through a crisis or problem and now know too much.

Ministers would be wise to consider whether counseling church members will leave them feeling too vulnerable and exposed to remain in the church.

WHEN DO YOU REFER?

Professional ethics provide three circumstances that require making a referral: (See also side article on The Ethics of Referral.)

1. When a lack of expertise or training results in an inability to provide professional assistance to a person.
2. When a dual relationship exists between the counselor and the counselee (e.g., close friends, family members, or employees over whom the counselor has an administrative or supervisory position).
3. When the counselee is no longer being helped by the counseling relationship.
   Some specific types of persons that warrant referral are persons:
   
   • who are suicidal or are a threat to others,
   • who are unable to manage their lives and are no longer effective at home or on the job,
   • who have addictions,
   • whose thinking is confused, sluggish, or irrational,
   • who are experiencing sexual dysfunction.

Ministers who have professional counseling training and expertise in managing these issues and who are confident that doing so will not harm the minister/layperson relationship may elect to counsel these problems.

It is important to remember that some emotional difficulties are caused by physical problems. It is sound judgment to refer those who have experienced a change in their emotional health to a physician for a complete physical.

TO WHOM DO YOU REFER?

Developing a successful referral network requires an investment of time and energy on the part of the minister, but it is time and energy well invested. In addition to those who provide professional counseling services, the pastor’s referral network should also include names of attorneys, physicians, real estate agents, and financial planners. The following are some practical ways to build a referral network:

1. Ask other professionals (pastors, school administrators, physicians) in your community about their referral sources. Ask laypeople about professionals who have helped them.
2. Meet other professionals and establish a rapport with them.
3. Ask counseling professionals if they will honor the client’s Christian values.
4. Don’t assume that all secular mental health professionals are anti-Christian and have wrong motives.
5. Become familiar with the services provided by community mental health agencies.

HOW DO YOU REFER?

Explain to the layperson or counselee the reason for the referral and obtain consent for the referral. I used to tell those in my congregation, “Sometimes being your counselor gets in the way of being your pastor. If I have to make a choice between being your counselor or being your pastor, I will choose to be your pastor. I can refer you to another for counseling, but I really don’t want to refer you to another for pastoring.” Or I have said, “I’m not qualified to give you sound counsel about this. Let’s find someone who is a specialist.”

If a minister has been involved with counseling an individual, it is imperative to get signed permission from the counselee before sharing information with the referred professional. Provide the counselee with the name and phone number of the professional; instruct him or her to call for an appointment; check to make sure the appointment was made and kept; and later, check with the counselee to see if the referral was a good source of help.

Remember, the reason for making referrals is to ensure that people in your church get the best care possible. Referrals should not be viewed as limiting the pastor’s ministry or hindering the fulfillment of the pastor’s calling. When managed properly, referrals become a reflection of the minister’s love and maturity. They also allow the minister to focus more energy on specific ministry gifts.

Ronald Turner was a pastor for 16 years and is counseling services coordinator for EMERGE Ministries, Akron, Ohio.