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Do I need a Pastor, Spiritual Director, Therapist, or Psychiatrist?

Everyone needs help at some time in their lives and should never feel ashamed of getting help. When you are part, of the church your first thought might be pastoral care or pastoral/biblical counseling, however, that might not be what you need or what might not be best for you. I have included in this article definitions of different kinds of care and what training they are given so that you can be more aware of what would be receiving in each of these different types of care, and whether or not they are a paid service and the cost if available. I have included a special note under Pastor and Biblical counseling definition, please take a moment to read that if you are considering this type of care.

Pastoral Care Definition:

Pastoral care is something that can be provided by every pastor or church leader. This involves listening to the problems of your congregation, asking questions, and helping them find practical solutions. This also involves home visits and hospital visits.

Training Expectation and Qualification:

Very little training is offered and is usually taught through mentoring or following the example of another church leader.

*No Payment Required.

Pastoral or Biblical Counseling:

Biblical counseling is about loving people by taking the time to understand them, interpreting their life situations through the grid of Scripture, confronting them with God’s framework, and challenging them to engage in the put-off, and mind renewal.


Masters's Degree or Doctorate degree is usually an academic writing and research degree. The person pursuing this degree will usually do a thesis or project on the topic that they are interested in for their church or ministry context. There is little to no practical counseling training or supervision with clients.

*The counselor may or may not charge for this service.

***A special note about Biblical or Pastoral counseling. This is a way of counseling through the grid of scripture, meaning that your church or denomination's doctrines will inform the counseling. For example: if your church is not affirming and you go to your pastor about topics like homosexuality, transgender, nonbinary, etc. You are going to be informed about your church's non-affirming doctrines, and you might not be able to have a conversation and explore what is going on within you. In other words, it might not be a safe space.

Spiritual Direction/Companioning:

The spiritual director or companion offers the gift of holy listening—reflecting Jesus’ love and compassion for others to help them experience God and follow the Spirit’s leading while providing guidance for their relationship with God. Each session is usually 60min and occurs once every 3-6 weeks, most people meet monthly with their spiritual director.


Training can be included in Master's degree programs at a seminary and certification programs all over the country. Training includes spiritual formation training and intensive practicums in which the directors in training practice spiritual direction with each other and learn methods under the observation of a supervisor. A director in training must have their own Spiritual Director, to help them do their inner work. The Spiritual Director in Training will have their own clients and practice at least 30+ hours of meeting with clients and reporting to their supervisor once per month as their practicum.

*There is usually a charge for this service is could be between $25-$125. Most directors will do a sliding scale and some might do it for free. I personally pay $85 per session for my own spiritual director and will use a sliding scale between $50-$85, when I open my own practice shortly.

Licensed Mental Health Counselor/Therapist (Massachusetts):

Helping clients develop better cognitive and emotional skills, reduce symptoms of mental illness, and cope with various life challenges to improve their lives.


A person must complete a Bachelors's and Masters's Degree and then complete the following:

  • 3360 total hours in a minimum of two years. ( Of counseling work)

  • 960 hours of direct client contact (a maximum of 350 may be group counseling).

  • 130 hours of supervision (75 hours must be individual supervision).

  • Make sure that the licensed clinical supervisor meets the state requirements.

The Last Step: Pass the National Clinical Mental Health Counselor Examination (NCMHCE) licensing board examination.

*This is a paid service and may or may not be covered by insurance


A psychiatrist is a medical doctor (an M.D. or D.O.) who specializes in mental health, including substance use disorders. Psychiatrists are qualified to assess both the mental and physical aspects of psychological problems.

People seek psychiatric help for many reasons. The problems can be sudden, such as a panic attack, frightening hallucinations, thoughts of suicide, or hearing "voices." Or they may be more long-term, such as feelings of sadness, hopelessness, or anxiousness that never seem to lift or problems functioning, causing everyday life to feel distorted or out of control.

Psychiatrists use a variety of treatments – including various forms of talk therapy, medications, psychosocial interventions, and other treatments (such as electroconvulsive therapy or ECT), depending on the needs of each patient

*This is a paid service and may or may not be covered by insurance.

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