Strategic Counseling in Depression

Introduction

As pastors, counseling is a necessary part of what we do. If there was no need for counseling, then we would all be out of a job and we would be in the New Jerusalem. We have all heard other pastors tal about counseling. Some hate it, some love it, and there is a mass amount of opinions. I will simply say it this way, if you have been called to pastor then you have been called to counsel. Bob and Sue just lost there son to addiction. Gary lost his job. Mary is depressed and cant leave her home. Todd and Sarah are struggling through there marriage of 20 years because Todd was unfaithful. Who are they going to approach first? If they are a part of your church, then most of the time you will be the first line of defense. You may not be the end all, but you will most definitely play a key part in reaching people through counseling. Strategic Counseling will take you to three steps with each counselee or counselees.

Encounter Stage

This is the first stage in which you begin to build rapport or a relationship with your counselee.

Engagement Stage

These are the middle sessions where you are diving deeper into the issues at hand and exploring what is at hand.

Disengagement Stage

This is the final step. You do not cease being their pastor, but you have an end to your focused time on this counselee and help move them forward to either a referal or a solution.

Depression

Today we will be speaking on depression specifically. Ten percent of adults will go through a serious bout of depression. So if you are a pastor of 150 and you ignore every other counseling issue in your body, you would still have at least 15 people in your church that will be walking through the darkest days in their life and dealing with depression. That number is truly staggering and one that should humble us all. For some of you it could be even more depending on your specific church. This is something that every church must discuss and address. Not only is this true but you yourself may deal with it as well. The clergy is no exception to this rule of thumb and we must be prepared to model a Christ-honoring method in our suffering.

So if we recognize that this is a major threat and an issue in our church bodies than we must be prepared to deal with this situation. When a quarterback gets ready for a game, he watches hours of game film in order to be prepared for the upcoming game. When a baseball player has a game coming up, he spend hours studying the pitcher to know what makes him tick and how to get an advantage on the game. I believe the church must be retroactively preparing for mental disorders and especially depression. It is unfaithful and ignorant of us to ignore that responsibility. So, before we get to the steps of encountering, engaging, and disengaging, let’s talk about what NOT to do and how to not start on the wrong foot.

The DONT’S of Counseling Depression

Dont assume the presence of a relationship with God.

Just because people are in your congregation doesnt mean they are a believer. I know most of us know that to be true, but we often forget that and do not counsel as if we believe that. Whether a person is a believer or not can drastically affect your approach to the counseling situation. If a person is dealing with depression that has been brought on by great amounts of guilt then they may have no clue of what the grace of God or His forgiveness feels like. You must test the waters from the get go to know where your starting point is. After all, we believe in a soverign God and we must be willing to recognize if He is using this bout of depression to lead them to Him. He has worked this way through scripture and works this way today as well.

Dont be a professional

There are some things that we are just simply not trained to do. There are people that have spent their whole life studying the brain and have forgot more than we know about mental disorders. This is one of the reasons that your counseling must be short term. There are some issues that you simply wont be able to solve and that you simply wont have an answer for. That is ok. You are a pastor, not a psychiatrist. You have to be able to recognize where professional help is needed and when to release someone for a referral. When questions of suicide come into play, you have to be able to report this to the right place or agency in order to seek and find medical help. The brain can have imbalances in chemicals and that can sometimes need the use of medicine. Do not recommend a type of medicine or try to play Pastor MD. It is best to suggest they speak to a physician and have them do an analysis and then go from their. Your job is to focus on what you have been trained to do and that is the connection from the brain to the heart

Dont force feed scripture and prayer as an end all solution

If someone walks into your office and needs counseling for depression, then believe me when I say it was a hard step for them to just take that step. Whether they are a believer or not, the worst step you can take is to say, “here is some scripture and lets pray”. I know that may sound strange coming from a pastor and no I am not saying God is not sufficient in dealing with our grief. What I am saying is that most people have already prayed until they cannot pray anymore and sought scripture more than ever to find relief from their grief. The most frustrating them for be is to sit and your office and to hear it all again. I spent hours crying out to God and asking him to save me from this. My heart was broken and hurting and I began to doubt him because I was looking for relief rather than a purpose. I am not saying we wont get to times of prayer and scripture, but we must cultivate their heart to recieve and know the subtext of scripture and the purpose behind their depression. This is not a problem you will simply pray away and push away from your office. That solution can be defeating and push someone with a serious bout of depression into a dangerous tailspin.

Dont guilt the counselee for being depressed.

This seems like an obvious statement, yet we do it subconsciously. There have been people in the church that have talked about how Christians shouldnt or have nothing to be depressed about. Thankfully this is phasing out and is being said less and less. Sometimes we say this in our subtext by saying things like, Are you failing in areas of your life? How is your quiet time with God, or your prayer life? It is true that these may be factors in ones depression, but stating it off the bat that this person has brought on their own depression is a bad place to start. Rather than guilting a counselee that is strugling with depression, we have to make them feel comfortable enough to where we can engage with them. Guilt is never the right place to start and we must remain sensitive to this.

Next we will end by going through the process in three steps. Where do I start? Where do I take them? Where do I leave them?

Where do i start?

Asking the right questions.

When getting to know the counselee, we must be listening to them in order to ask the right questions. This step is pivotal in understanding where they are in life and what may be bringing on this bout of depression. These questions could look like this but are not limited to: What is the counselee’s spiritual situation? Saved?, Involved in a local church? How are the counselee’s relationships with his spouse, parents, and friends? How is her depression affecting everyday life? Does the counselee have ideas about what is causing the depression? What are they? Is this the first bout with depression? If not, has depression been a long-standing, continual problem? Or does it show up in episodes separated by periods of normalcy? Has the counselee sought help for depression before? With whom? How often? Has there been a medical exam to determine whether a chemical imbalance or other physical problem is causing the depression? Does he feel depressed to the point of being suicidal? Has the counselee made plans or thought about how he might commit suicide?

All of these questions give insight to the final picture and could be a huge breaking point for getting through to their heart. Depression is real, but it is vague. Some counselees may not know exactly what they are feeling, so some of these questions may break through the fog in helping them see what the issue is for themself.

Affirm their normalcy

I have found this to be true in my life and for the many people I have counseled in the years. People in serious bouts of depression often feel as if they are at their breaking point and that at any moment they could snap. They feel like a freak and that they are a burden to those around them. It is helpful to affirm them in the beginning. You can affirm them by letting them know the many people who struggle with depression daily. The numbers are staggering, but they are revealing for the person who feels alone in their struggle. If you have dealt with depression, this is a great time to let them know that. You do not have to tell the that you know exactly how they feel because you don’t, but you can affirm them to know they are not alone and that they are not broken and that they are not “psycho”. This is especially true for the worst cases that need psychiatric and medical help.

Shine a light to the end of the tunnel.

Someone dealing with depression is often already at the point of believing there is no end in sight by the time they come to you with counseling. If this is someone who has dealt with bouts of depression before, you can affirm that they have made it through this before and they will make it through it again. If they have never dealt with depression before, then this is a great time to tell them that depression is something that can come and go and they will survive it by taking it one day at a time and one breath at a time. They need to know that they arent cursed for a lifetime of this darkness. Do not lie that you have some solution to solve it immediately, but that you will be with them to walk them through this over the coming weeks.

Where do I take them?

Take them to safety.

In these middle sessions it is crucial that we make the counselee feel safe. Each week can change for them and we need to be a consistent safe place for them. We do this by reaffirming the truths we state in the first session. We also do this by asking simple questions on how life is going on around them. Look for small victories in each week and help them to celebrate those victories. They got out of bed this week at the first time of their alarm and they moved into their day? Great! Celebrate that.

Keep them moving

We all know what happens to anything that sits stagnant. When water sits, it grows bacteria. When a house sits empty, it will collapse. When the body doesn't move, it dies. When a counselee sits in depression, darkness grows. Each week there needs to be something new for them to move towards. This breads life in them. This also gives the opportunity for them to fail and recognzie why they fail. Failing can often be as helpful as victories. It helps us diagnose why we fail.

Deliver the subtext of Scripture

Now is the time where we have enough information about them and have had the opportunity to hear from God what they need to hear. There are many areas of scripture that are sufficient to help someone with depression, but this isnt a prescription of one size fits all. Now that you have seen what is going on in their life and what their situation looks like, then you can begin delivering them the scriptures they need. You can give verses of encouragement or even the numerous studies of Godly men in scripture that struggled with depression like Elijah. Isaiah 53 even tells us that Jesus was acquainted with sorrow and grief. This keeps us from reading scripture to their mind and now we are speaking it to their heart.

Where do I leave them?

Assess where you are.

You would never leave someone in a dangerous part of town. In the same way we dont leave counselees alone in a dangerous part of their life. Your time of counseling may be coming to a close, but your ministry to them as their pastor is forever. This is not abandonment. You have to assess where they are in the process to find the best place to leave them in your time of counseling. They may have made it through this bout and you can praise Jesus with one another that He has pulled them through the darkness. They may still be in the midst of really tough days and you are able to refer them to a professional for long term help. This is not failure or a mistake. You have created a relationship that partners with them and their therapist. Wherever you are you can now see it clearly and help them clearly see it.

Assess where you have been.

It is crucial that you help the counselee see where they have been and the progress they have made. Just the fact that they have counseled with you for 5 or more weeks is good enough to celebrate as a victory. This is a great reminder to see the fruit of their labor and for you to see the faithfulness of God in using your counseling. Progress is a great way for the counselee to see God’s work in their life. He has been with them before and He will be with them moving forward. This leads us to the final point.

Leave them in presence of a loving God.

They are not alone. You have been able to speak into their life to where they can see God at work in their life. They may not be able to say they have made it through depression, but they can say they are surviving depression. They may be leaving your counseling time, but they are not leaving the presence of God. To echo David, “Where can I go that you are not there, if I go to heaven you are there, if I go to the DEPTHS OF HELL, you are there”. In the nights that they fill their pillows with tears, God is there. You are not leaving them alone, they are with the presence of God if they are His children. You may need to refer them to someone else. You may need to refer them to a doctor. They may still be really struggling, but you can rest assured you are leaving them in the hands of a loving God that cares deeply for them. Reassuring them in this is critical.

Depression is real and depression is dark. This 25 minute presentation does not make us professionals but I pray it has better prepared us to deal with those who walk through our doors. Darkness often comes for us all, but we must be the light of Jesus for them.