Psychiatrists, Psychologists, Psychotherapists: Are You Referring to the Right People?

In 2014, Lifeway Research and Focus on the Family partnered on a project called “Study of Acute Mental Illness and Christian Faith.” This research project yielded many interesting and important insights into the current response to mental illness within churches, and some of their findings confirmed the results of my own (far less formal) research, whose findings I reported in my book Troubled Minds.

Among the results was this interesting discrepancy: When asked whether their churches “maintain lists of experts to refer people to” for mental health care, 68 percent of Protestant pastors said yes. But among family members of people living with acute mental illness, only 28 percent said yes. This suggests many churches have lists their congregations (or at least the people within their congregations who most need them) don’t know about. This is a problem.

But there’s another problem with some of those lists. In conversations with various church leaders and people in congregations, it’s become clear to me that many people create these lists haphazardly, without a real understanding of the differences between various types of mental health professionals. To some, the Christian counselor in the congregation looks the same as the psychologist across town or the psychiatrist at the hospital. But these are very different professionals with dramatically different qualifications and specialties. Furthermore, individual practitioners tend to specialize within their areas of expertise, so, for example, a therapist who focuses on generalized depression and anxiety would not necessarily be the best referral for someone with an eating disorder.

These professionals know how they differ from each other, and most are willing to acknowledge their limitations, make new referrals, and encourage people to find the right kind of care. But it’s much more helpful if churches who make referrals can send most people to the right place from the beginning.

Mental health care is the kind of thing most people don’t know much about until they need it–for themselves or someone they love. And in that time of crisis, churches are the first place many people go for help–in fact, clergy are the number-one place people have gone for help with mental illness. Unfortunately, churches aren’t always providing the referrals to professional care that many people need–but many do. And if churches are serving in this role as front-line triage centers for mental health care, we really ought to take this responsibility seriously. One way to do so is to understand the differences between professionals.

I encourage you to get more (and better) information somewhere else, but here’s a starting primer:

Social workers have masters degrees. They are qualified to provide counseling and care for emotional difficulties and problem-solving. They also often serve as case workers or case managers, addressing circumstances that threaten people’s well-being, especially helping establish healthier and safer environments for vulnerable people.

Qualified counselors also have masters degrees. They help clients work through difficulties of various kinds, and they typically focus on addressing a specific area of life that needs a solution or a new approach. They help people with emotional difficulties, coping strategies, and finding new ways to look at life.

Psychotherapists can have masters or doctoral degrees. Many counselors provide psychotherapy in addition to counseling, simply employing different techniques. Some are trained in specific methods and focus on providing therapy for certain issues, such as trauma, grief, diagnosable mental disorders, and self-destructive patterns. Therapy focuses more deeply on the root causes of dysfunction and strives to help clients find healing and build healthy and productive lives.

Psychologists have doctorate degrees in psychology. Some psychologists don’t do therapeutic work at all, focusing instead on research and study or on improving workplaces or other organizations. Some work with clients in clinical settings, and they are qualified to do psychotherapy and to diagnose and treat all forms of mental health problems. However, they cannot prescribe medication.

Psychiatrists also have doctorate degrees, specifically in medicine. They are licensed medical doctors who specialize in psychiatric medicine. Psychiatrists, like other medical doctors, can prescribe and manage medications for their patients. They might choose specialties, such as child psychiatry or forensic psychiatry.

This list doesn’t cover every possible specialty or profession, and these categories all contain subsets (such as neuropsychiatrists and neuropsychologists). But this basic list provides a starting point for the main distinctions every church should understand.

Churches who want to be equipped with referrals for people who need them must do more than simply write down a list of names they’ve heard or people who happen to attend their church. They really need to do more homework and include a variety of people who can provide mental health care, including people in different professions and with a variety of specialties. Some communities have more available than others, and we face a serious shortage of mental health care professionals, particularly psychiatrists. But I don’t think we can justify a failure to do our best on behalf of people who come to our churches for hope and help. A few hours of research could make a huge difference to someone in crisis.

  1. Matthew Dexter says:

    Jesus Christ is qualified in all of these and the greatest qualification of renewing anyone’s mind if they are in agreement with another and they claim what is already inside of them which is greater than any issue that’s outside of them…..all referrals need to go to Jesus, there is no plan B or C….blessings.

    The greatest issue is that the Church has forgotten who jesus is, how we have the same power inside of us that raised Christ Jesus from the dead that’s inside of us, peoples faith is dead……people need to start having faith and living by his grace and start focussing on him and praising him.

    He is the answer, people need to start seeking him, not the world and that’s why there are so many sick Christians worldwide.

    • Amy says:

      Matthew, let me make sure I understand. If my mother, an evangelical pastor’s wife, were standing in front of you, you would tell her that if she had only spent more time praising God, she would not have developed schizophrenia, an inherited disorder that causes the brain to literally disintegrate? And I assume you would tell her she should not take her medication, which enables her to comprehend Scripture, to pray with reasonable clarity, and to stay off the streets and alive. You would tell a war veteran that if he or she had simply focused harder on Christ, the trauma of repeated concussive blasts would not have been able to injure that soldier’s brain? I challenge you to produce convincing biblical evidence for your belief that Christian brains are not capable of the same injuries, diseases, and disorders that affect the rest of the human race. That a brain scan showing the devastating impact of serious mental illness on the brain is merely showing a deficiency of faith. You are correct: Jesus is the one most qualified to serve as a psychiatrist, therapist, and counselor. He is also the most qualified to serve as your medical doctor, computer technician, car mechanic, or veterinarian. I assume that when something goes wrong with your car, computer, or favorite pet, you simply bring those problems to Jesus rather than seek the help of a professional. If you are consistent in your theology, I suppose you have never gone to a doctor since the Great Physician is a more qualified healer than any human. Jesus is the answer–and that answer will come in the form of his redeeming presence, making our bodies and minds new. That does not mean Christians aren’t capable of getting sick. Having faith and living by grace is perfectly compatible with going to a doctor and managing a medical condition with the best forms of treatment we have been able to discover and develop, using the remarkable intelligence and curiosity God has placed within us.

      • Shirley says:

        Well expressed! Unfortunately, under the guise of a split between the world and God, some churches are eager to refer members only to Christian counselors who do indeed advise just that: prayer, church attendance, repentance, etc. as the ex-wife of a paranoid schizophrenic minister, let me assure them that this misguided approach only prolongs the agony and prevents believers from seeking needed treatment.

  2. Lynn says:

    If Jesus is all that’s needed to heal my son’s malformed brain that causes him anxiety, how come He isn’t all that’s needed to heal my aunt’s malformed brain that causes her to be in a wheelchair? If she can take medication and use a therapist to help her brain function better and slow the progression of her disease, why can’t my son take medication and see a therapist to help his brain function better and counteract the effects of his injury?

    The brain is a body part. It gets injured. It gets sick. It needs medical attention at times. It needs therapy at times. Just like the other body parts do.

© 2016 Amy Simpson.