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A woman walks out of your office and you have no idea she’s worse off than when she walked in.
She came to you because she hasn’t slept in weeks. Her mind races at night. She feels jumpy all the time. She told you about the accident she witnessed as a child, the one she’s never told anyone before.
You listened. You prayed with her. You opened Scripture and showed her verses about peace. You told her to cast her anxieties on God because He cares for her.
She left feeling grateful for your time. She also left believing that if she still feels anxious tomorrow, it’s because she didn’t pray hard enough or trust God enough.
She came to you for help. She left with shame layered on top of her anxiety.
You have no idea.
Why Good Intentions Aren’t Enough
Most of us in ministry genuinely want to help. We’re not trying to hurt anyone. We’re not careless or unfeeling. We love the people we serve.
But loving someone isn’t the same as knowing how to help them.
I sat down with a licensed mental health counselor Katie Quigley who also happens to be part of a small church. We talked about where things go sideways. She said something that stopped me.
“We started missing the mark when we started getting into territory we don’t have enough training and expertise in.”
That’s it. That’s the whole thing. Not bad intentions. Not lack of compassion. Just good-hearted people stepping into spaces they weren’t trained for.
And people get hurt.
3 Ways Pastoral Counseling Causes Harm
1. Misreading Trauma As A Spiritual Problem
Someone sits across from you and they’re describing things that sound like panic attacks. Their heart races. They can’t breathe. They feel like they’re dying.
You’ve been trained to reach for Scripture. So you do. You talk about peace that passes understanding. You remind them that God has not given us a spirit of fear.
But here’s what you don’t know. Panic isn’t just a spiritual problem. It’s also a nervous system problem. The body gets stuck in survival mode. And no amount of Scripture quoting will regulate a dysregulated nervous system on its own.
The person leaves your office still panicking, now with an extra layer of shame because they think their anxiety means they don’t trust God enough.
That’s harm.
2. Opening Wounds Without Healing Them
Someone finally gathers the courage to tell you about the abuse they experienced as a child. They’ve never said it out loud before. Their hands are shaking. They’re watching your face to see if you’ll flinch, if you’ll judge them, if you’ll look away.
You don’t flinch. Good. You don’t judge them. Good. You listen. Good.
Then you respond with something about God redeeming their pain. Or about forgiveness. Or about how God works all things for good.
You mean well. You’re trying to offer hope.
But here’s what you don’t know. Just telling the story without addressing what’s happening in the body does nothing for healing. In fact, it can make things worse. They’ve opened the wound and you’ve handed them a band-aid. Now the wound is exposed, and they have to walk out of your office and back into their life with it open.
That’s harm.
3. Keeping People Stuck In Cycles
Someone has been coming to you for months. Same struggles. Same patterns. Same confessions. Same prayers. Nothing changes.
You tell them to surrender deeper. To have more faith. To try harder.
They go home and try harder. Again. Still nothing changes.
Here’s what you don’t know. If someone has been stuck in the same pattern for years despite prayer, Scripture, and accountability, the issue probably isn’t just lack of faith. It might be trauma locked in the body. It might be a nervous system stuck in survival mode. It might be something no amount of trying harder can fix.
But they don’t know that. They just know they’re failing. Again. And now they’re convinced the problem is them.
That’s harm.
Why Pastors Miss The Harm They Cause
Here’s what makes this so tricky. The harm isn’t visible in the moment.
Someone walks out of your office and they seem fine. They thanked you. They said the prayer with you. They nodded along with the Scriptures you shared.
You have no idea they went home and cried for three hours. You have no idea they’re questioning whether God even hears them. You have no idea they’ve decided not to tell anyone else about their pain because this is how it went when they tried.
Kati put it this way. “Someone who doesn’t know how to handle these things can cause more harm without meaning to.”
And we don’t know because no one tells us. The people we hurt don’t come back and say, “Hey, that thing you said actually made things worse.” They just disappear. Or they keep coming but stop sharing anything real. Or they leave the church entirely.
We never connect the dots.
Unlike therapists who have supervision and licensing boards, most of us in ministry have no one checking to make sure we’re handling things well. That’s part of why harm happens without us realizing it.
Red Flags Pastors Miss In Pastoral Counseling
So how do we know when we’re in over our head? What should have been blinking red lights that we just didn’t see?
Here are some things that should make us pause.
- Trauma. Not just hard times. Abuse. Accidents. Violence. Losses that fundamentally changed someone.
- Suicidal thoughts. Ever. At all. In any context.
- Panic attacks. Heart racing. Can’t breathe. Feeling like they’re dying. Feeling outside their body.
- Long-term stuckness. Same patterns. Same struggles. Nothing changes no matter what they try.
- Your own gut. That feeling that says I have no idea what I’m doing here.
Kati said if there’s risk involved that should be a red flag. Okay hang on I might need some more help with this.
The problem is most of us don’t know what counts as risk. We think risk means someone might hurt themselves right now in our office. But risk is bigger than that. Risk is someone leaving our office and going home to a life that’s not getting better. Risk is someone staying stuck for years because no one recognized when they needed more than we could offer.
The Lasting Impact Of Harmful Counseling
Let me be really honest about what happens to the people on the other side of these conversations.
- They question their faith. They tried what you said. They prayed the prayer. They claimed the verse. Nothing changed. So they assume the problem is them. They must not have enough faith. Slowly, quietly, they start to believe God doesn’t care about them.
- They stop trusting the church. They came to you vulnerable. They shared their deepest pain. They left feeling dismissed or shamed. They don’t come back. Not just to you, but to any church. They’ve learned that church isn’t safe for people like them.
- They stay stuck longer. They needed professional help years ago. But they were told to pray harder, so they did. Years go by. The trauma gets deeper. The patterns get more entrenched. All because no one recognized when they were in over their head and referred them to someone who could actually help.
- They harm themselves. This is the one we don’t want to think about. Someone came to you with suicidal thoughts and you told them to trust God. Or you told them that was the enemy talking. Or you prayed with them and sent them home. They left your office still suicidal, still alone, still without the help they desperately needed.
I know that’s heavy. I know that’s hard to read. But we have to be honest about the stakes. This isn’t abstract. This is life and death.
How To Counsel Without Causing Harm
So what do we do? We can’t all become licensed counselors. Most of us in small churches don’t have a therapist on staff. We have us. Volunteers and leaders who love Jesus and love people and want to help.
That’s okay. That’s actually beautiful. But we have to do it differently.
- Learn the red flags. Trauma. Suicidal thoughts. Panic. Long-term stuckness. If you hear these, pay attention.
- Know who to call. Build relationships with therapists in your community. Find out who does good work. Have a list ready.
- Be honest about what you offer. If you’re not a counselor, don’t call it counseling. Call it spiritual support. Call it pastoral care. Call it walking alongside someone.
- Learn to say these words. “I’m so glad you told me this. I think you need someone with more training than I have and I want to help you find that person.”
That’s not failure. That’s love. That’s doing no harm.
What Hurting People Deserve From Pastors
People come to us because they trust us. They believe we can help. They believe we’re safe. That trust is a gift. It’s also a responsibility.
We owe them more than good intentions. We owe them the humility to know our limits. We owe them the courage to refer when we’re in over our heads. We owe them the honesty to call what we offer what it actually is.
We owe them our willingness to learn, to grow, to get better at this.
Because they deserve better than harm wrapped in good intentions.
If you’re a small church leader trying to figure out how to support your people well, 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.
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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