Models of Pastoral Caregiving

The dominant method of pastoral caregiving today is based on Rogerian therapy. In this method, the therapist repeats back the words of the person being cared for. The therapist may ask probing questions, but those questions are always to be based upon something that was given from the patient in the conversation.

In this method, the pastoral caregiver does not lead the conversation. The person receiving therapy will usually tell what is up with them in the first 30 seconds of any coversation. This method of therapy can produce change but it can alse leave some patients in many years of therapy with not all that many results. This method is like the Socratic method.

Leading questions are not usually allowed. When dealing with a seriously ill patient the therapist may receive a dump of all of the problems of the patient at once. To get down to the core, the therapist may as "what do you want, and how are you going to get it?" This is a very effective means of getting to the one thing that is the core issue as well as letting the patient come up with their own approach to solving their problem.

Provocative Therapy by Frank Farrelly and Jeff Brandsma uses an entirely different method. This method uses humor to show the ridiculousness of the patient's position. The patient is encouraged to take their fears to the extreme and then laugh at them. This method produces very rapid changes in people. Farrelly would sometimes use obscentities to provoke a response from his patients. His method was a bit like a shock treatment but with provocation instead of electricity.

There are times and places for each type of interchange. Not every pastoral care interchange has to be directive. The patient may never feel that they know the caregiver. Sometimes there is just a place in being quiet and being with someone in their pain. Other times draining off the pain is helpful.

In all pastoral caregiving, it must be remembered that the object of the care is the parishioner. It's not about the pastor, but about the parishioner.