Treat or Refer?

Practical advice for ministering to emotionally and spiritually wounded group members.

I have spent the last 14 years serving as a chaplain or in some form of pastoral ministry in the local church. During that time, I have taught and trained literally hundreds of small-group leaders on the subject of Christian care and counseling. My advice is usually to love people until it hurts, perhaps love them some more, and make sure they are getting help somewhere in addition to the small group. Throughout my training and education, I was taught one rule: refer, refer, refer. I am not a licensed counselor, and I should not try to be one. I let the experts handle the hard stuff.

Advice for Pastors

If you are a pastor in a church, then you know your time can get eaten away doing nothing but counseling. And there may be necessary seasons of that. However, I do not advise entering into a long-term counseling situation with parishioners (keeping in mind that mentoring and discipling are different than counseling).

Instead, I tend to stick with a three-session rule. If someone comes to me and we determine that some amount of counseling will be helpful—or if someone continues to schedule meetings with me and we end up discussing the same issue(s) over and over—I will only meet with that individual three times before I assist him or her into a more structured setting, such as a support and recovery group or meeting with a licensed counselor. Wherever I live, I keep the names of a few counselors and resources that I have pre-screened, and to which I feel comfortable referring.Â

Advice for Small-Group Leaders

Issues like death, divorce, addiction, sexual sin, depression, job loss, and so on can all be dealt with at some level within a small group. However, the weightier issues of life—those that will take longer periods to heal and those that are more deeply rooted in a person's past—will ultimately need a pastor, coach, and/or counselor to get involved.

If you are a small-group leader, I advise you to be careful about counseling your group members. "Doing life together," "living in community," or whatever phraseology you use to describe small-group life is not the same as professional counseling. But that doesn't mean you need to cut a wounded person out of your life, or out of the life of the group. A listening ear is good medicine for every soul, and the greatest thing you can do for your wounded group members is to love them, be with them, and go with them—literally and figuratively—through the counseling and healing process.

Indeed, anyone struggling with issues, regardless of the problem, needs a loving community that will accept them as they are and love them through the process of healing. Validation, prayer, and accountability are essential for growth and healing. When everything in life is turned upside down, people need an anchor to keep them stable. A caring and compassionate group of friends can provide that anchor.

I also advise small-group leaders not to attempt any kind of medical diagnoses with their group members. Never tell them they need medications or medical treatments. Remember: refer, refer, refer. A group leader's job is to provide a safe environment for all small-group members.

Practical Applications

At times, one person's needs may sidetrack an entire meeting. However, this should be rare, not regular. You as the leader must establish healthy boundaries for your entire group within which they can have their needs met. If you allow the pastoral care needs of one or two persons to sidetrack the meetings, then you have neglected the rest of the group.

When such monopolization happens, the easiest way to correct it is to set up something after the meeting—the next morning, the next day, or the next week. Meet with the person outside of the regularly scheduled time. If it sounds like something serious, give your pastor or small-group coach a call and give them a snapshot of the situation without breaking confidentiality. If your pastor or coach thinks more involvement is necessary, then go back to the group member and ask permission to talk about him or her to your coach or pastor. Be sure to let the small-group member make that choice.

When people are in crisis, they need assistance in many areas, but often times they will not ask for it. Your response (and that of the rest of the group) should be to actively and caringly try to help that person. If appropriate and needed, provide for their basic needs—meals, rides, chores around their house, and so on.

It's also important to provide accountability to that person. Call them several times a day if necessary. Help them find a counselor if the situation warrants, and offer to attend the first meeting with them. Ask them if they are keeping their appointments. Ask them if they are following up on making the necessary changes in their lives. Invite them over for dinner. Be their best friend for a short time, if necessary.

During crisis mode, people need more attention, more direction, and more reminders to do the things they need to accomplish. After a few days, maybe as long as a few weeks, things should normalize and the crisis may become manageable. At that point, you and your group can back off somewhat.

There's no doubt about it: loving people is hard sometimes. Yet we are called to sacrifice for one another. Doing life together may mean giving up some of your free time to be with someone who is in need—to show them that you care beyond just your words. Your presence and willingness to listen are tangible ways you can love your neighbor as yourself.

However, as a final reminder, be sure not to try and "fix" any members of your small group. If they have issues with their past, and those issues are preventing them from being healthy in the present, then my advice is to refer, refer, refer.

Free Newsletter

Sign up for our Weekly newsletter: Regular access to innovative training resources, Bible-based curriculum, and practical articles.


Come One, Come All

Small groups are for all broken people, including the physically challenged

Danger Signs

Understanding wisdom and pride in the context of small groups
Dealing with Divorce in Your Small Group

Dealing with Divorce in Your Small Group

Be prepared for a crisis that impacts a high percentage of small groups.

Why Bother if Extra Grace is Required?

With love and God's grace, significant healing can happen.

Handling Difficult People: When Extra Grace is Required

Difficult people can be confusing and overwhelming to lead, having a framework in place can make the situation easier for you both.