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Katie’s been a licensed mental health counselor for years. She’s also part of a small church, so she sees both worlds.
When we sat down to talk about counseling in churches, she started describing something I’d never thought about. How therapists are supervised. How someone reads their notes. How they have licensing boards and continuing education.
I listened and a question kept running through my mind.
Who’s doing that for us?
Who’s reading our notes? Who’s asking if we should refer out? Who’s holding us accountable for the conversations we have behind closed doors?
The answer stopped me cold.
No one.
This gap in counseling accountability is something we don’t talk about enough in churches. But it matters. It matters because people get hurt when there’s no one checking to make sure, we’re handling things right.
How Therapists Are Held Accountable
Let me paint a picture of what happens on the clinical side.
When a therapist starts out, they don’t just hang a shingle and start seeing clients. They work under supervision. A licensed supervisor reads their notes. They meet weekly to discuss cases. The supervisor asks hard questions. Are you qualified to handle this? Should you refer out? Are you missing something?
After they’re licensed, it doesn’t stop. There’s a licensing board that makes sure they’re doing things right. There are continuing education requirements. There are ethical guidelines with real consequences.
Katie put it this way. “When you first start out, you have supervision. This person’s reading every single one of your notes. They know what you’re doing in session. You talk to them every single week to make sure you’re on the right track. And then you have a licensing board that’s making sure you’re doing all the things right.”
All of that exists for one reason. To protect the people seeking help.
Why Churches Lack Counseling Accountability
Now look at what happens in our world.
Someone comes to a pastor or a ministry leader with a story. Maybe it’s about their marriage. Maybe it’s about their mental health. Maybe it’s about trauma they’ve never told anyone. And that pastor or leader does their best to help.
But here’s the thing. No one is checking their notes. No one is asking if they’re qualified. No one is making sure they’re referring out when they should.
Katie said, “When you look over at the church, there’s really no one checking in to make sure you’re doing the right things. Make sure you have the right knowledge and right expertise. Make sure you’re referring out when you need to refer out.”
We have passion. We have good intentions. We have a genuine desire to help. And none of those things are bad. They’re actually beautiful. But they’re not the same as accountability.
And when there’s no accountability, people can get hurt without anyone ever knowing.
Why Churches Don’t Have Accountability Systems
I’ve thought a lot about why churches don’t have these systems. It’s not because we don’t care. It’s because we’ve never thought about it this way.
In medicine, the principle of do no harm is baked into the training. Doctors learn it from day one. Engineers learn it too. But in the church, we don’t always think about what could go wrong. We’re so focused on helping that we don’t consider how we might accidentally hurt.
We also tend to operate in silos. In a small church, it might just be you and a few volunteers. There’s no structure for oversight. No one to ask the hard questions. No one to say, “Hey, are you sure you should be handling that alone?”
And honestly, most of us wouldn’t know to ask for that kind of accountability because we don’t know what we don’t know.
4 Risks Of No Accountability In Church Counseling
Let me be really specific about what’s at stake here.
- We miss our limits. Someone comes to you with a story that involves trauma. You don’t recognize it as trauma because you’ve never been trained to see it. So you give spiritual advice for a clinical problem. And the person leaves no better off than when they came. Maybe worse.
- We don’t refer out. Therapists know when to refer. It’s built into their training. But in the church, we don’t always know when we’re in over our heads. We keep going because we want to help. And sometimes we keep going right past the point where we should have stopped.
- There are no checks and balances. No one reads your notes. No one asks if you should have handled something differently. No one questions whether you have the right expertise. So you keep doing what you’ve always done, even if it’s not working. Even if it’s hurting people.
- People suffer in silence. The people we hurt don’t usually come back and tell us. They just disappear. Or they stop sharing anything real. Or they leave the church entirely. And we never connect the dots. We never know that something we said or did made things worse.
How To Build Counseling Accountability In Your Church
So what do we do? We can’t just copy the therapy world’s systems. Most of us in small churches don’t have the resources for licensing boards and weekly supervision. But we can build something.
1. Find A Peer To Process With
Is there another pastor or ministry leader you trust? Someone who will ask hard questions? Someone who won’t just tell you you’re doing great.
Set up a regular time to talk through the conversations you’re having. Not with names. Just the situations. Ask them: Was I in over my head there? Should I have referred? Did I miss something?
2. Build Relationships With Local Therapists
Get to know the counselors in your community. Take them to coffee. Ask what they wish pastors knew. Ask if you can call them with questions.
Some of them might even be willing to serve as informal consultants. Not supervision exactly. But someone you can bounce things off of.
3. Create A Referral List
Find out which therapists in your area are taking new clients. Which ones take insurance. Which ones offer sliding scale. Which ones work from a faith perspective if that matters to your people.
Have that list ready before you need it. Because when someone’s in crisis, you don’t want to be searching Google.
4. Start One Conversation This Week
Pick one thing from this list. One therapist to call. One peer to ask. One name for your referral list. Just start somewhere.
Accountability isn’t built in a day. It’s built one conversation at a time.
Why You Should Stop Calling It “Counseling”
I keep coming back to this language piece. Because I think it matters more than we realize.
When we call it counseling, people come with certain expectations. They think we have training we don’t have. They think we can help with things we’re not equipped to handle. And when we can’t deliver, they don’t just get disappointed. They get hurt.
I don’t love using the word counseling in churches anymore. I think it can be a little deceptive. When people hear counseling, they think they’re going to somebody with advanced training. They think they’re getting something closer to what a licensed therapist would provide. But most of the time that’s not what’s happening.
Katie wondered about this too. “Maybe even starting with the language, is there a better term for that so people don’t get confused?”
I told her I don’t think we should use the word counseling in church at all. Not unless we actually have a licensed counselor on staff.
She agreed that maybe we need a better term. Something honest.
I think spiritual support fits. Or spiritual friendship. It’s not flashy. It doesn’t sound as impressive. But it’s true. And truth matters when people’s hearts are on the line.
Small Church Solutions For Counseling Accountability
I know what you might be thinking. This sounds great for big churches with budgets and staff. But what about those of us averaging sixty people on a Sunday?
Here’s the good news. Most of this doesn’t cost money. It costs humility and intentionality.
Find one person. Just one. Another leader who will process with you. It could be a pastor from another small church in your area. It could be a trusted volunteer who has some life experience. It just needs to be someone who will ask honest questions.
Build one relationship. Pick one therapist in your community and reach out. Most of them would love to connect with a local pastor. They see the aftermath of what happens when people don’t get good care. They want to help.
Create one list. Start with three names. Three therapists you know something about. That’s enough to start.
Change one word. Stop calling it counseling if you’re not a counselor. Call it what it is. Spiritual support. Pastoral care. Walking alongside someone.
Start Building Accountability This Week
If you’re a small church leader reading this, you might feel overwhelmed. That’s okay. We’re all figuring this out as we go.
But here’s where we start.
We start by admitting that good intentions aren’t enough. We start by acknowledging that we need help to see what we can’t see. We start by building one small piece of accountability this week.
Find someone to talk to. Reach out to one therapist. Make one list. Change one word.
It doesn’t have to be perfect. It just has to be a start.
Because the people coming to us for help deserve more than our good intentions. They deserve our humility. They deserve our honesty. They deserve a system that protects them from harm, even when that harm is unintentional.
They deserve better than good intentions with no accountability.
If you’re trying to figure out how to build better systems in your small church, you’re not alone. We’re all learning this together. The goal isn’t to have all the answers. The goal is to do no harm while we’re figuring it out.
Want to keep learning alongside other small church leaders navigating these same tensions? Join us in the Small Church Ministry Facebook group where we have real conversations about ministry, mental health, and doing no harm.
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