Often in church ministry, pastors are faced with numerous needs and heart-breaking situations in their congregations. One question we hear often from them is “When do I refer out? When do I know that a person in the church needs a level of care or a type of expertise or skill that I don’t have?” Perhaps the church member needs a professional counselor, someone skilled in a particular struggle such as addiction, pornography, or an eating disorder. Maybe the level of care that is required means considering an intensive program or there is a crisis that takes a team of wise people to guide the person through a complex situation.
When such a problem arises, pastors often struggle to know how, when, and to what degree to come alongside a person. When it seems the person needs more than they have to offer, there are likely resources outside the church that can give skillful guidance; however, this raises other concerns. Can I trust the care this person will receive? What if we disagree with the advice given? These concerns can make some pastors hesitant to refer out.
For others, it may be easier to refer out, but then they find it hard to know how to stay involved. It is tempting to take a hands-off approach. Yet this does not feel like pastoral care either, and those referred out can unintentionally feel forgotten by the church.
So what are churches to do when faced with so much brokenness and so many hurting individuals? What if pastors took a slightly different approach? What if instead of referring out, pastors asked, "How can I refer 'in'? How can I bring a more skilled helper into the pastoral care process to help someone who needs it?" Referring “in” takes the posture that you retain the role of caring for your people and do not stop shepherding when things get hard. To do so, you widen the circle of helpful caretakers and proactively choose who serves in what roles for the care of the individual.
For example, a pastor may connect an individual to a vetted, “outside” counselor for an eating disorder,1 while also providing a church mentor and encouraging the involvement and support of the person’s small group. If the problem is more severe, the pastor could set up a church care team for this specific purpose.2 In any case, he personally checks in regularly to see how this individual is doing. The shepherding continues while embracing the help of other individuals.
There still can be disagreement on how to best help and support someone especially when outside help is involved, but a team approach will bring these issues to the surface quickly and allow for dialogue and course correction if needed. The more collaborative the effort and understanding, the more likely there is to be consensus.
Proverbs 19:20 tells us to seek wise advice and instruction and we see many passages that make it clear that those in shepherding roles are responsible for the care, protection, and loving guidance of their sheep. But pastors do not have to go it alone. Instead, they can invite competent people into the situation who share their vision and can assist them in offering wise, experienced care for their sheep.
1Getting a recommendation from a trusted source should avoid some of the problems raised earlier.
2For more on how to form a care team see Brad Hambrick’s article: “How to Create Effective Care Teams at Your Church,” Journal of Biblical Counseling 35:1 (2021):21-38.