Recently, Catherine had a conversation with Dr. Jim and Heather Sells, authors of the new book “Beyond the Clinical Hour: How Counselors Can Partner with the Church to Address the Mental Health Crisis.” Jim, Heather and their co-author Dr. Amy Trout offer a valuable resource to both mental health professionals and ministry leaders as a way to meet the heartfelt mental health needs impacting both churches and our culture. Take a listen to this thought-provoking conversation.
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Catherine Boyle: Welcome to Key Ministry the Podcast. I'm this week's host, Catherine Boyle. If you've heard some of my interviews before, you know I always enjoy talking with guests, and getting to introduce our audience to new people who are doing good work in ways that really support the individuals, families and ministries that we serve. So today, I'd like to introduce to you Dr. Jim and Heather Sells. Jim is a professor at Regent University in Virginia Beach, VA, and he's a licensed psychologist. Heather is a managing editor for CBN News. They and their co-author Dr. Amy Trout have a new book that released March 19th, and it's titled Beyond the Clinical Hour: How Counselors Can Partner with the Church to Address the Mental Health Crisis.
Jim and Heather, welcome to Key Ministry the Podcast!
Jim Sells: Catherine, delightful to be here.
Heather Sells: Thanks, Catherine.
Boyle: Wonderful. So I have read probably about 1/3 of this book, and I thought it was really well done. As I'm reading, I'm always really curious about—what’s the “why” behind the book? What's the back story to Beyond the Clinical Hour? Because it could be many things. We see the mental health crisis in our culture, but there's often that personal reason behind why a new book comes forth, so I'd love to hear that for this book.
J. Sells: I’ll start with that one. I've been in counselor and psychology training for 30 years, and over the past 10 years I've observed a unique emergence: one was the emergence of desperation from parents or from couples or from individuals who encountered the pain from mental health concerns, but had nowhere to go—because everybody was full. To see a child psychiatrist often is months in waiting, and well, my kid can't wait six months! They need help now. Second is emerging in this same 10 year period: churches forming grassroots ministries and programs to attend to the needs of their congregations, kind of like mom and pop saying, ‘We lost a young adult to suicide; we have a story to tell, and we're able to listen to other people's stories. Can we do that in this church?’ And churches providing corners for these little ministries to come to take root, oftentimes without much structure or without much training or without much knowledge; it's just the passion of caring.
So I carry then the sense of—wait a minute: these two things are happening at the same time—and recognizing the inadequacy of ‘15 minutes per individual per professional,’ when there are thousands and thousands out there who have need. And that was what prompted the book with Heather, inviting her as a storyteller. Go ahead and share how you joined in with this.
H. Sells: So Jim and I were talking about just the problem [the lack of needed mental health supports] and some of what we saw organically happening, in terms of people at the grassroots level responding in churches. So Jim asked me if I could start looking to see what people were really doing, around this collaborative arena of church and Christian counseling professionals coming together to meet needs in local communities. So I put on my reporter hat, which I'm used to, and started talking to people around the country, and found really—as Jim was just alluding to—really a bubbling up, if you will, in different pockets of the country, people saying, ‘There's our need, and what can we as a church do—along with Christian counselors—to address needs that are right in front of us?’ And these are not needs that are really surprising to most church leaders. Most church leaders are very, for the most part, very aware or at least beginning to be aware somewhere along the continuum [of mental health needs].
Boyle: Yes, and what's interesting to me in that—what you guys just said—was we, our culture and our churches, are recognizing there's this problem, and God is raising up solutions and approaches—maybe not a fix for the mental health issue, or whatever the need is—but bringing alongside support, which is what the church models in so many other beautiful ways for other issues.
So that's really great, that you're seeing both the problem but also the solution that's starting to emerge. If you would, just share what the main thesis or idea of the book is, and why—for the people who are listening, who are ministry leaders—why this would be of interest to them? And then also, if you're a mental health professional, why this book should be of interest to you?
J. Sells: We laid out the book—Heather and I with Dr. Amy Trout, who I should say also was one who was early in the trenches of this, looking at church mental health collaboration with her mentor at Wheaton College in his IP program, Dr. Mark McMinn.
She was starting to write about this, really 20 years ago, and Amy has created a consulting service to churches around the formation of mental health care policies and programs within churches; she's located in Florida. So she had a common vision that Heather and I also carried around: how we can take this—our thesis is that the current structure of mental healthcare—the clinical hour—is not capable of addressing the expanded need of mental health within the culture. I'm a psychologist; I see clients every week; I love the clinical hour. There's just not enough of us, and there's not enough money to fund the required workforce to address the mental health need, at one hour at a time, with one person at a time. The line out the door is 20 million people. And when I see 25 clients a week, 20 million is a very long line.
Boyle: Yes, it is.
J. Sells: That suggests that the Church is the only institution within our society where there is a pervasive presence of people with a willing heart to attend to the problem, and a place within the community—there’s eight churches in every zip code, on average—a place where people can go, where people are already going. It’s far easier for someone to go to church and talk with a helper than to go to a psychologist and procure our mental health resources. It’s more approachable and it's broader in its scope to be able to attempt [to help] the problem.
Boyle: And I would add to that that the Church is the only one that has an ongoing relationship with the person who needs help. The doctor, the psychologist like yourself, or the public assistance kinds of services that are out there are just reactive, and they wait for the person to have the crisis to come to them, typically. But the Church is there before—hopefully before the crisis, [the Church] can be there during and long after, as well.
H. Sells: That's why I love the title, Beyond the Clinical Hour, because even if someone is able to find a therapist and it's helpful, their church is still really vital in their life. As I know you know in your ministry, they need the church before the counseling, during the counseling and after the counseling. So it really should always be a collaborative effort in our view, but that need is especially pronounced right now.
J. Sells: I'm not seeking to replace mental health; I'm seeking to supplement and to collaborate with ministry and professional care.
Boyle: Absolutely. Every one of those has their own role, in trying to help people get not only a fix for the crisis of the moment, but to that place of Shalom.
One of the things that I loved about the book—and again, I've only read about 1/3 of it—but you have some really powerful quotes. You started off the book with a quote from Admiral James Stockdale, who—if the listener doesn't know, he was a prisoner of war in Vietnam. He said, “You must never confuse faith that you will prevail in the end, which you can never afford to lose, with the discipline to confront the most brutal facts of your current reality, whatever they might be.” I just recently heard this paraphrased as basically a good gauge of mental health, which is you have to accept reality, whatever it is—not what you want it to be—to have good mental health. So why do you think that is so relevant for the state of mental health in our culture right now? And why should the Church care so much about accepting reality, in 2024?
J. Sells: It’s hard, it's complicated, it's difficult. And hard and complicated and difficult make us prone to give up, or not even take it on. Stockdale was—as the commander of—the highest ranking officer at the Hanoi Hilton. And the quote I took came from the “Good to Great” book, and he used that to inspire those that were prisoners, to prevent the discouragement of the situation they were in, to prompt a sense of [not] giving up; we will get through. We don't know when, we don't know how; that will require creativity and our resolute determination to figure this one out.
When you're faced with complicated physical or psychological issues within a family, and trying to render them effective care, there has to be a commitment like we will figure this out, and ‘there is a way through this, with us, and we will not give up.’ That's the kind of tone, particularly when families or individuals are so discouraged, because they have lost hope. They've tried everything. They've been to multiple therapists, and it's still hard. So if anything, the Church provides a context where we will be resolute in our determination to overcome this thing with you.
Boyle: That's beautifully said. And I think that is so true, that discouragement can set in. We've worked on a couple of projects in the last couple of years that have really helped people focus more on the hope—the hope that the Church and relationship with Jesus provides, because you don't find that hope elsewhere. And that's another reason why the Church is just so critical, when we're talking about these kinds of things that may not have—they certainly don't have the silver bullet kind of fix, the magic whatever that makes the situation better.
I also recently heard someone say that—and I don't know who [originally] said this—but that sometimes the miracle is that you don't get a miracle as you go through the situation, whatever it is. And I would argue that mental health is certainly one of those situations, that Jesus is with you through it, and He brings people alongside to help you through it, even if you don't get the instant healing that we all tend to want.
One of the important concepts that you mentioned in the book was faith articulation. This was not a familiar term to me, but it makes perfect sense, now that I've read about it a little bit. If you would, just describe what that means, and then how is that something that should impact the Church? And then also for a person who's a mental health professional?
J. Sells: Yes. Every Christian counselor, psychologist, social worker, marriage and family therapist, psychiatrist, everyone in the mental health field who carries faith is seeking to—the words we use is seeking to integrate faith with the theory of our profession with our Christian experience, and to allow one to inform the other, and the other to inform the one. That's why people who attend Regent University and study with me, or in any Christian training program, they want to learn, they'll say, “I want to learn how to integrate.” That's in our Christian mental health theory: books, seminars, training; I'm trying to learn how to integrate. Integrate is often an internalizing experience; it’s helping me organize who I am as a Christian and who I am as a psychologist, as a counselor, combined, so I'm speaking with one voice with these two traditions.
But integration probably isn't sufficient, because articulation suggests it's really the story—the speaking out of this Christian experience, in the context of mental healthcare. So the therapist, the counselor has to be able to speak it, and the Church is the podium by which that can best be spoken—spoken being the metaphor, not just verbally but physically. We have a place for you to be, and we have program for you to address your needs, and it is the best evidence of our science of mental health practice, with our human practice of the care of Jesus.
So it's a speaking or a performance—a demonstration of the integration that occurs in our brains, theoretically. Heather's job was then to find the articulation stories—the examples, the demonstrations of this exhibiting within ministry already.
Boyle: Heather, are there one or two [stories] that you'd like to share? Or just some insights about that?
H. Sells: Sure. That was really exciting to see what is going on and the enthusiasm that people have. I have the image in my mind of the metaphor of a wave coming to shore, and it's kind of small right now, but it's picking up height and speed. I'm thankful for the timing of Beyond the Clinical Hour because I think it's adding to this wave.
Some of the things that I found—and they really ranged from small to big—some of the groups that are out there are doing really great work. There's peer groups, there's several organizations that have started peer groups and churches, for both people who are experiencing mental health symptoms and/or their families. They’re training lay leaders to lead these groups in churches, and then they are also providing them with curriculum. And people—whether they are experiencing the symptoms or caregivers—are finding such great encouragement from finding other people on the journey with them, and other people who have a similar faith. In some cases, it is bringing people to the church. So it's just a win-win for the Church.
So these are groups that right now exist on a relatively small scale. They are aware that to meet the ultimate demands in this country, there needs to be a scaling up, but these are groups that have started and that are viable, and there is research showing that people are reducing their symptoms by attending these groups. I'm talking about Fresh Hope, Grace Alliance, Anchor International, to name a few of the key ones.
I also was encouraged to find small examples of people who have mental health on their radar—church leaders who are making a difference. That could be a pastor who's preaching about it, or making an announcement that if you are maybe having some of these symptoms, please come for prayer. Or it could be a pastor who's meeting with someone that offers to pray for their therapy appointment, who just affirms them on the journey. So even the smaller examples that I was finding can be so powerful, but it requires a different mindset for church leaders. I think we're beginning to see that. And I think, even in the course of writing this book, I saw from my vantage point just a lessening of stigma around mental health issues, and more of a willingness for people to talk about it, especially post pandemic. So that's just adding to this wave, if you will, that I see coming to shore.
Boyle: Yes, and I would very much agree with you about that wave. In fact, just recently I wrote a blog post and used that very same metaphor, and it's funny because when we were doing work—probably right before the pandemic—I kind of had that feeling that it was happening then too, but then the pandemic changed everything. And obviously the mental health needs grew worse, but it I think it also served to kind of wake up the Church, in terms how devastating those impacts can be to people.
I could belabor this, but there was a lot of innovation and ingenuity and creativity that happened throughout the pandemic, and when you see that you can be creative in one area, sometimes that kind of helps unlock the way you see about other situations that may have previously seemed like they were just too difficult as something to be able to deal with.
You know that Key Ministry is all about collaboration, and we have—that's one of the things that I love about Dr. Steve Grcevich, our president and founder—he's been willing to really listen and platform people who have good ideas, but maybe are operating in these very small pockets—as a way to help other churches, ministry leaders and mental health professionals start to see that we can be innovative and collaborate with other groups. Because the whole point is that there are too many people in crisis to be supported by the resources that we have, so let's come together. In the secular world, that's called collective impact. But mental health professionals and church leaders both have that common goal of trying to help people through their mental health crisis.
Is there anything else that you'd like to share about innovation that's being done, that you see? We're very aware of the [work of] Fresh Hope/Mental Health Grace Alliance/Anchor International; all those are doing such great work. We've actually been working with Fresh Hope for about a year and a half on a new curriculum specifically for the mental health needs of families who have children with disabilities. So there's lots of things that we see that are being done, but I'm really curious to hear what you guys are seeing.
H. Sells: Well, I'll mention a couple of the things. One is a short-term training for lay coaches—people who can meet briefly with someone, really listen to them, identify a key need and offer them hope. We're seeing Fresh Hope do this, we're seeing Jamie Aten do this at Wheaton College, so I love that model. Of course we're all about education and counseling degrees and all that, but at the same time we're seeing that you can be an effective helper with a brief training as well, and that can be a good thing. So that's been exciting to see. I will also say—and Amy writes about this quite a bit in the book—and maybe Jim wants to pick up with this—but there's models out there for different ways that Christian counselors can work with the Church—that can be an informal conversation with a youth pastor about cutting; that can be a needs assessment in a church to help the church understand—guess what? You have a lot of people with this symptom in your church. Or it can be a program evaluation: you have this peer group that's meeting; is it meeting needs? Is it reducing symptoms? So there are just a host of ways that we're hoping that Christian counselors will begin to think about how they can work with churches.
Boyle: Wonderful. Well, you mentioned—we talked about faith articulation. But another important point that you brought up was academic integration. So if you're a ministry leader or even a Christian academic listening to this podcast, Jim if you would just talk a little bit about why there is a need for this academic integration shift. When I was reading through this, at first I was like, ‘well, okay, I don't get this.’ But then it was like, ‘Oh yes I get this very much!’ Because this is actually something we talk about a fair amount in Key Ministry. But I want to hear what you want to say to our listeners about what that means.
J. Sells: Yes, if the way we attend to mental health needs is shifting from the clinical hour to the community, the Church and the collaboration between the profession and the Church to attend to the needs relationally, then we have to train the clinician for a different game, and that includes skillsets that are not part of their curriculum right now. For example, in almost no masters training program where you become licensed is there a course in supervision, certainly not supervision of lay counselors. But if a counselor—instead of seeing 200 people a year had a caseload of 10,000 people—meaning that they were responsible for the mental health care delivery of 10,000 people—that means that they have to train and oversee a small army of people who can attend to the needs, triaging ‘I’ll take care of the people who are severely hemorrhaging;” the people who need comfort at the non-critical level—that’s going to be attended to by large groups of people within the Church. That triaging skill has to be able to occur; that supervision skill has to be acquired by the person who's in charge of the community, the training, the preparation. All of those components are now new ways to think about how we have to prepare for the mental health professional, for the next generation of service delivery, not the past generation. It's a forward way of thinking. Much of this lands on the shoulders of professors who have to create training for the new world.
Boyle: I think it sounds like a great opportunity; I know it sounds like a lot of work, too. But we're already here in this place where the current models are not meeting the needs, so it's well past time, in some ways, to be thinking about some of these things, and how to move forward perhaps in a different direction than the way the current training is taking us. That's not a negative about anybody. Systems rise to take care of certain needs, and then over time, they need to adapt; they need to be applied in a different way.
J. Sells: So we used the metaphor—the story of Charles Taylor—in the book. No one has ever heard of him. He was a bicycle mechanic that worked for Orville and Wilbur Wright. The Wrights were creating a new culture: the culture of aviation, and they got stuck. They needed their engine to propel their airplane; it was too heavy, and it couldn't get off the ground. They realized this while they were in Kitty Hawk.
They sent Charles Taylor a telegram and said, ‘Make us a new engine.’ In six weeks, Taylor had designed, cast and constructed an aluminum engine light enough for it to be flown, and carried it out by train to Kitty Hawk.
So it's like that—if you think about academics: we have to build the engine for this new plane, and like Taylor, they need it right now. And it's like they're on the sand dunes in Kitty Hawk practicing their kite, but they need a light engine, and I've got to figure out how to do it, put it together and get it down to them right away. So that's where we are with altering the academic curriculum, to be able to address the need that exists, as it exists today.
Boyle: Wonderful. You are both Christ-followers; you understand very deeply—from not only professional levels, but also personal levels—how important all of this is that we're talking about. For a ministry leader who's listening to this and is somebody who likes to be creative, what do you say are some really important spiritual qualities for the person who wants to step out into this, in their local church? Or they’re a mental health professional who wants to reach out to their pastor and talk about some opportunities within their own church?
J. Sells: Yes, we used the metaphor of the divorced—the child of divorce—the child who has to live in two worlds that historically have not gotten along well together at all. And the mom and dad are not communicating very well, but I have to form a new identity as someone who is both my mom’s child and my dad's child. I am both a Christian and a one who holds the profession of mental health delivery. So that means for that person, for the pastor, it requires us to be resolute in our creativity and our willingness to share, to collaborate, to be very humble with ‘I need you to help me achieve this, and I have resources. You need me because I have the people, and you have the empirically validated competencies; you have the skill sets.’ The injuries from historic occurrences that prompted psychology and mental health professions to be separated from the Church—I shall lay that down for the sake of the mission that's in front of me. There is a humility that takes place, a desire like—I can work with you. Find me those people who are willing to collaborate with the mission of the Church, who carry the expertise of the profession.
How about you? What do you think about the spiritual maturity part?
H. Sells: The word humility for sure came to mind, and I do see this as the future. I think for ministry leaders who don't engage around mental health, I think it's going to make ministry harder in the long term. So I think there's a lot of—hopefully—reasons that ministry leaders will see in meeting the needs of their congregation and meeting the needs of their community how the church can ultimately point people to Christ. And it really can be evangelism, it can be compassion ministry, it can be all of these things ultimately.
Boyle: Yes, and just to add to that—I think that the Church as a whole kind of has a bad reputation for maybe not playing well across all these little artificial divides that we have—of denominations and what have you. I’m not minimizing the differences—but we see within Key Ministry, when ministry leaders collaborate across those divides, that really is powerful; it's a powerful witness to the world. So I think in addition to all the benefit that can come not only to churches, but also to individuals and families, from stepping into this [mental health ministry] it creates a different picture for the world of who the Church really is, as well.
My view? Most ministry leaders that I encounter are very well aware of mental health needs now, but for the ministry leader who might say, that is just outside of our wheelhouse; that's not something that we need to do, what would you say to that person? Make it nice!
H. Sells: We want to be sensitive to the Church that is just strapped. We know that pastors are experiencing burnout, especially in the wake of the pandemic, so we don't want to add a huge item to a pastor’s To Do List, who already feels overwhelmed, who already feels like they can't meet the needs of their congregation, and they're drowning.
I'm very aware—especially through my work at CBN, too, of pastoral fatigue and exhaustion. I think that one of the hopes with this book, too, is that there would be some synergies that via collaboration that it wouldn't be a huge burden on ministry leaders, but it could be a partnership that would feel life-giving. And I think that would be my hope for the person who feels like ‘I just can't take this on.’
J. Sells: That is so important. I recently had a conversation with a pastor of a small church—less than 200 people—and he said ‘I have had in the past 18 months—I’ve documented every one—more than 500 calls to my church for help with mental health issues. They come at one a day, at least.’ And this is from the church that’s active in the community, not the church itself. This is people calling the church and saying, ‘Can you help me?’
And the sense of the pastor being overwhelmed—because we're so overwhelmed, it's quite easy to say, ‘this is not something that we can do.’ Therefore these supplementary ministries, like what you do at Key—and thank you—you are providing a service, a ministry to families that the pastor is not capable of creating and implementing, or the church staff on their own. So emerging, popping up all over the country are these programs that say, ‘We are here to collaborate with you.’ And this is a cultural shift, a cultural creation; we're making a new product.
And so the pastor can have that vision of—I'm in the culture-making phase here, with people in my community who share the same vision for the care of the church. I liken it to the Dionysius who wrote in the 3rd century concerning the bubonic plagues of the cities of the Roman Empire. He wrote how the Church ‘stayed and ministered and died’—the people of the church. And that was the accelerant of the gospel message. Because even Julian the Apostate, this evil Roman emperor wrote, ‘why can't we do it like those Galileans do it? They are attending to the suffering of others in ways that just make us sit in awe as to their commitment and care for others.’
So that's the message of ‘no, this is our shared industry: church and professional together.
Boyle: Yes, it reminds me of—I'm not going to be able to call to mind what passage it is, but it talks about bearing one another's burdens; it's New Testament. And in that same passage, earlier or later, it's talking about each one bearing his own burden, and then it says bear one another's burdens. And there's a difference in the language there: the one [burden] that we're supposed to bear on our own is something that a person is responsible for, but those other burdens? They are too heavy for one person by themselves, and so that's very much what we're talking about, in this kind of—what we're talking about with so much of mental health work.
So wrapping up our conversation—and I just really appreciate the depth and the richness of what you guys are talking about; it can be so instructive for anybody in the Church, not just ministry leaders. If you could just leave the listener with maybe one or two simple steps that can show them today—or soon—how they can come alongside clinicians to jointly support individuals who are in their churches who really need some mental health help?
J. Sells: I'm impressed with the words ‘yes’ and ‘no.’ Anybody who is embarking on this ministry—yes, I will become present in the lives of other people. That's an important step, and that doesn't require you to have a degree; that requires you to show up. Second piece is no. ‘No, I cannot do everything, no I cannot—I do not know what to do in sitting with someone who is actively suicidal.’ That's going to be given over to someone else who is trying to attend that need.
I don't know how to bear the emotional consequences, or the detailed interventions of what I'm supposed to do. The word is no.
So that yes and no is both an invitation to join, and a specific limit that those in the Church have to respect, lest they become overwhelmed, burned out and ultimately harmful things could happen. So that no is just as important as the yes in the pursuit of this kind of ministry.
Boyle: Perhaps even more so; those proper boundaries are there for a reason.
Well, Jim and Heather, this has just been phenomenal. Thank you so much for your time today. When this podcast is out, the book will be available. We will have a link through our social media. If listeners follow that link, you'll be able to get a discount on your purchase. We'll also have the link to the book in the show notes today, and some of the other resources that were mentioned; we will definitely also include those in the show notes.
Jim and Heather, thank you so much for your time and for your great insights that you shared with our audience. For the Key Ministry team, I'm Catherine Boyle. Thanks so much for listening to the podcast.
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