The Wiley-Blackwell Companion to Practical Theology, First Edition. Edited by Bonnie J. Miller-McLemore.© 2012 Blackwell Publishing Ltd. Published 2012 by Blackwell Publishing Ltd.

PART III

Curriculum: Educating for Ministry and Faith in Classroom, Congregation, and Community

25 Pastoral Care 269 Barbara McClure

26 Homiletics 279 John S. McClure

27 Worship 289 Don E. Saliers

28 Religious Education 299 Carol Lakey Hess

29 Religious Leadership 308 Michael Jinkins

30 Evangelism 318 Jeffery L. Tribble, Sr.

31 Spirituality 328 Claire E. Wolfteich

32 Ethics 337 Miguel A. De La Torre

33 Contextual Education 347 Emily Click

268 PART III

34 Systematic Theology 357 Mary McClintock Fulkerson

35 Historical Theology 367 James M. Brandt

36 Biblical Theology 377 Michael Joseph Brown

37 Integration in Theological Education 386 Kathleen A. Cahalan

The Wiley-Blackwell Companion to Practical Theology, First Edition. Edited by Bonnie J. Miller-McLemore.© 2012 Blackwell Publishing Ltd. Published 2012 by Blackwell Publishing Ltd.

CHAPTER 25

Pastoral Care

Barbara McClure

Defi nition

The term pastoral in “ pastoral care ” comes from the Latin Pastorem , meaning shep-herd, and includes in its deep etymology the notion of tending to the needs of the

vulnerable. Since the Hebrew scriptures and the New Testament were the products of pastoral societies, it is perhaps not surprising that the metaphor of the shepherd emerged as a principal image for religious leadership: Jesus was the good shepherd, the church his fl ock. In the early history of the church, Christian leaders took on the role and identity of the shepherd, caring for the members of their congregations as a shep-herd tends its sheep. Similarly, the term care specifi es further the theme at the heart of pastoring – attentive concern for another. To care for someone includes the notions of affection, solicitude, accompaniment, and protection. Pastoral care continues to connote these early themes, though in different forms in contemporary society. Put simply, pastoral care is religious attention toward another. Institutionally, it is one of the primary works of religious leadership.

Rather than being a specifi c technique or set of discrete practices, pastoral care indicates various responses of a person or persons motivated by God ’ s love for another or others. It assumes that the love of God is enfl eshed in love of neighbor and love of self. As a set of practices of attention, pastoral care is not restricted to Christianity. Indeed, one historian of the fi eld identifi es forms of spiritual direction and long histories of “ wise religious guides ” in non - Christian religious traditions, particularly in the Jewish, Hindu, Buddhist, and Muslim contexts (McNeill 1951 ). However, while the practices extend beyond the context of the Christian church, the term pastoral care is particular to the Christian tradition, and grew out of the exigencies of congregational life. Pastoral care is thus elemental to religious life and organization.

Within the curriculum of theological education, pastoral care is a subset of practical theology and denotes a form of religious engagement aimed at integrating theory,

270 BARBARA MCCLURE

theology, and practice within the context of a faith community for the purposes of spiritual healing. Pastoral care courses prepare students in the various skills and capaci-ties necessary to care effectively for others. As such, they tend to focus on areas of human frailty and vulnerability, including but not limited to issues of death and dying, marriage and family dynamics, sexism, racism, and economic and political injustice. However, because both the realities of human suffering and the form of religious organ-ization are historically and culturally specifi c, the concerns of pastoral care have been different for different people at different points in history. Still, all persons, whether young or old, sick or healthy, rich or poor, have ongoing needs for meaning, love, rela-tionship, and community, and pastoral care is the form ministry takes as it strives to help people meet these needs, regardless of context. Pastoral care can thus be defi ned as a form of practical theology specifi ed as an intentional enacting and embodying of a theology of presence, particularly in response to suffering or need, as a way to increase among people the love of God and of neighbor.

History

Rooted in the tradition of cura animarum , or the “ cure of souls ” in early Christianity, pastoral care as a religious practice dates back to the earliest Christian communities and represents a basic requirement of congregational life. The tasks of shepherding, or providing pastoral care, have been understood as distinct from those of organizing communal fellowship or of communicating the gospel (Hiltner 1948 ). As human insti-tutions, congregations have always and inevitably had to minister to those who were hurting and in need of care and concern.

Few historical overviews of the wide variety of practices of care have been written, and those that exist tend to present historical divisions based on typologies that are not as discrete as often presented. However, because of their useful organizations of diverse practices over centuries, these histories are widely used. For example, one of the best - known historical narratives (published in 1975 by religious historian William Clebsch and pastoral clinician Charles Jaekle) divides the history of pastoral care into eight “ epochs ” from “ primitive Christianity ” through “ Medieval Christendom ” to what they refer to as “ The Post - Christian Era. ” In addition, they present four functions of pastoral caregivers (healing, sustaining, guiding, and reconciling), tracing each one through the different epochs.

Clebsch and Jaekle (1975) propose that while all four functions are always present, certain ones are emphasized in particular epochs. For example, they argue, the apostle Paul was one of the earliest pastoral caregivers, emphasizing sustaining and reconcili-ation. Paul recorded some of the earliest pastoral interventions when he wrote his epistles to the newly forming congregations, offering them guidance and support as they struggled with the all too human realities of life even as they awaited the imminent return of their Messiah. In the fi rst few centuries following Jesus ’ death, when his return was forestalled, early Christian leaders took up the concern of preserving the faith of their followers, unifying beliefs and practices, and managing human failings and disappointments, especially around issues of sin after baptism. Reconciliation to

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the church after sin or after repudiation during persecution became a signifi cant source of anxiety and concern for the early church mothers and fathers, and pastoral practices of reconciliation were developed in response.

During the patristic period pastoral care began to become systematized. Persuading “ barbarian folk to accept Christian descriptions, diagnoses and remedies for their trou-bles ” was the focus of an elite class of priests who saw this “ cure of souls ” as the cor-nerstone of their work (Clebsch and Jaekle 1975 : 21). Purging the desires of the fl esh not just out of fear of God but through love of God embodied in the church developed as the primary purpose and means of care. Infl uential fourth - century church father Augustine of Hippo, for example, reminded pastors of their many roles: “ Disturbers are to be rebuked, the low - spirited to be encouraged, the infi rm to be supported, objectors confuted, the treacherous guarded against, the unskilled taught, the lazy aroused, the contentious restrained, the haughty repressed, litigants pacifi ed, the poor relieved, the oppressed liberated, the good approved, the evil borne with, and all are to be loved ” (Augustine, Sermon CCIX, cited in McNeill 1951 : 100). Helping Christians live a moral and upright Christian life was the primary concern.

During the medieval period religious conformity became the foundation on which social cohesion in Christian Europe was built. Religious leaders depended on divine grace to “ cure ” both the “ inherent and accidental deformities of human existence ” (Clebsch and Jaekle 1975 : 24). Now the focus of pastoral care centered on the sacra-mental system, with special emphasis on baptism, penance, and the eucharist as primary locations of care with the goal of healing through participation in the church ’ s sacramental life. Penance, confession, and absolution were emphasized during this period. The goal was to be in right relationship with God through participation in the sacraments.

During the Reformation, the sacramental system was decentered, and reconciliation with God through renouncing of sin and receipt of forgiveness through grace became the focus. Forms of pastoral care refl ected sixteenth - century reformer John Calvin ’ s assertion that the disobedience of an idolatrous heart is at the core of human distress (Holifi eld 1983 : 22). Salvation and healing were understood as reconciliation – even “ complete union ” – with God through the “ arduous but wonderful achievement of entire integrity of body, soul and mind ” (Clebsch and Jaekle 1975 : 26). Reconciling sinners to God displaced most other pastoral work, though exhibiting particular behav-iors and following certain practices became increasingly important.

With the advent of the Enlightenment, Christian leaders accepted the immortality of the soul as the most important focus and the achievement of personal morality as the primary function of religion. Pastoral care focused on sustaining persons through the “ perplexities and pitfalls of their earthly pilgrimage ” and on guiding them on their way to personal values, morality, and proper behavior (Clebsch and Jaekle 1975 : 28). Sin and its effects continued to reign as a signifi cant pastoral concern. The emphasis on morality would decrease signifi cantly, however, as pastoral care moved toward the twentieth century. The seeds of modern pastoral care are evident in the nineteenth century, for example when reformed churches relaxed the emphasis on discipline. With the publication of British pastor John Watson ’ s book The Cure of Souls (1896), care providers began to emphasize private conversation, models of effective visitation, and

272 BARBARA MCCLURE

the importance of keeping confi dences (Mills 2005 : 841) as they sought to offer genuine compassion as well as guidance and opportunities for repentance. The goal was, as the Puritan divine Richard Baxter put it, to help persons, even the sick and dying, have a “ fruitful life or a happy death ” (Mills 2005 : 842). The meaning of and path to a “ fruitful life ” took on a different meaning as pastoral practitioners began to draw on non-religious resources to guide their care.

Perhaps the most signifi cant changes in the perspectives of pastoral care came at the beginning of the twentieth century, when the infl uence of psychology and other human sciences gained greater cultural traction and in pastoral practices in particular. In fact, it is diffi cult to overstate the impact of psychological interpretations of human experi-ence on the theory and practice of pastoral care, which has left some observers worried that psychology has supplanted theology as the orienting discipline and dominant interpretive lens of contemporary pastoral care. While some scholars see this trend as negative (e.g., as a sign of secularization), others see it as an effective response to the needs of persons to be known and accepted personally and deeply. Regardless of one ’ s evaluation, it is certainly true that pastoral care in the twentieth century and beyond has drawn heavily on the contributions of psychology and other human sciences in order to better understand the nature of human selfhood, need, and suffering (McClure 2010 ). As a consequence, modern models of pastoral care have been formed in the nexus of theology and psychology.

Perhaps no fi gure was more infl uential in the psychologizing of pastoral care than Anton Boisen, pastor, psychiatric patient, and founder of clinical pastoral education (CPE), a program of theological education in clinical settings, such as hospitals and prisons. Boison ’ s book The Exploration of the Inner World ( 1971 ) raised interest in inte-grating understandings of mental illness and religious experience. Drawing on his own experience as a pastor suffering a mental disorder, Boisen established the “ text ” of human experiences as equally signifi cant as the Bible or doctrinal theology in diagnosis of distress. Boisen infl uenced much of contemporary pastoral theology and care as well as practical theology, particularly in the UK, where pastoral theology and practical theology are not clearly distinguished. 1

In the 80 years since Boisen ’ s key writings, pastoral caregivers have come to under-stand their task as bringing together many resources to understand a situation or a person ’ s predicament, including psychology, sociology, and theology theory. Contemporary pastoral caregivers typically are willing to draw on a broad range of ideas to attend more effectively. But like those who preceded them, it is through accom-panying others , or being with them in intentional ways, that modern caregivers help create opportunities for refl ection, for deeper awareness of self and of others, and for

1 Two British scholars, for example, recognize that many people use pastoral theology to designate the “ theological underpinning ” of practices of care while practical theology is a term rooted in the German Protestant tradition that involves refl ecting theologically on Christian practice more broadly. However, they argue, there is much “ common ground ” between them. Both are ulti-mately “ concerned with how theological activity can inform and be informed by practical action ” and therefore they “ may be regarded as the same thing for contemporary purposes ” (Pattison and Woodward 2000 : 2 – 3).

PASTORAL CARE 273

deeper love and understanding. Through these activities, caregivers and recipients become more deeply and consistently aware of their status as beings with , in , and for God. Spiritual health is understood as awareness of the divine presence in one ’ s life and thus is possible when one is suffering or even dying (Kornfeld 2002 : 8). Not unlike Baxter in the seventeenth century, contemporary pastoral caregivers continue seeking to help others lead fruitful lives and possibly even to die a happy death.

Elements of Effective Pastoral Care

While this history demonstrates shifts in concerns and foci, it also reveals persistent themes: careful attention, theologically informed diagnosis, and compassionate support or intervention. Indeed, these remain the basic elements of pastoral care. Every good pastoral caregiver needs to know how to give attention (to observe and to listen), how to make a diagnosis (to be able to interpret theologically the cause of suffering and to discern what is needed), and how to intervene (to offer accompaniment, guidance, and support). Such skills are, at their most fundamental, relational skills requiring knowl-edge of both theory and technique, and effective pastoral care requires these above all else. In relating theory directly to practice in the development of these skills (and allow-ing practice to inform theory), pastoral care shares a hermeneutical circle of refl ective praxis with practical theology.

The fi eld of pastoral care assumes that good relationships are at the heart of good care and, further, that “ relationship is the beginning of theory ” (Thornton 2002 : 123). Good pastoral care has always attended fi rst to fl esh and blood relationships and then refl ected on the meaning of the encounter (Thornton 2002 : 123), often allowing human experience to challenge and inform accepted theological understandings. As a result, contemporary pastoral care takes human experience, including religious experi-ence, as its primary text for study, similar to the more typical texts of scripture or doc-trine. This “ theology from the ground of human experience ” approach has had signifi cant effect on other, more traditional forms of theological refl ection that often have privileged ideational or doctrinal approaches to the exclusion of human experi-ence and is a value pastoral care shares with practical theology.

Accurate assessment of what is going on and why, or diagnosis, requires the “ prac-tice of strategic knowledge, ” and is a critical skill since how a situation is interpreted “ has everything to do with the interventions one develops in order to respond ” (Ramsay 1998 : 2). All caregivers engage in interpreting situations, whether consciously or not. Being clear about one ’ s tools of analysis makes more explicit the resources one brings to bear on efforts to care. Some questions caregivers have learned to ask include: What is going on? What has led to the need for support now? What is the familial or historical context of the need? What am I equipped to offer? What is the person asking for my support hoping will be the outcome? Such questions clarify the issue(s) at hand, the resources available to address them, and the goal of any modes of care and support.

While the most familiar form of pastoral care – the person - to - person conversation – remains central to pastoral care, pastoral care can also occur in the midst of congre-gational activities, like fellowship suppers and meetings, as well as in areas related to other practical theological subdisciplines, such as preaching, liturgy and ritual, worship,

274 BARBARA MCCLURE

and prayer. Rituals, for example, create sacred space in the midst of the ordinary, thus deepening awareness of ourselves as beings in and for God. Rituals have psychological function as well. They name the unspeakable (e.g., death and loss), deal with ambiva-lent emotions (e.g., funeral rituals help us hold both relief and sadness in the death of a loved one), and set personal experience within the context of a community and within a historical narrative (e.g., coming to understand that death and loss, painful as it often is, is a normal, God - given part of life) (Ramshaw 1987 ).

Pastoral care is a subject of study as a fi eld, undertaken by the discipline of pastoral theology. Different traditions and communities of faith practice pastoral care differently. In spite of their differences, congregations can serve as “ repositories of wisdom ” about how to support change or to overcome suffering (Dunlap 2009 : 3), and recent studies have analyzed particular, culturally located forms of care as a way to deepen under-standing of extant practices. Particular practices of care, which include laying on of hands and anointing with oil, providing food, praying, taking up love offerings, as well as individualized counseling, are worthy subjects of investigation as they examine how different “ belief - practices ” can encourage fl ourishing and healing or discourage it (Dunlap 2009 : 12). Indeed, some pastoral practices are, in the end, uncaring and thus unhelpful (Capps 2003 ). (Using the Bible for one ’ s own personal agenda, or preaching at people through prayer, are oft - cited examples of poor pastoral care.) Studies of care practices are also useful insofar as they illuminate the larger power matrices in which a particular church is embedded, revealing how they often “ subvert, reinforce, or leave untouched social power structures ” (Dunlap 2009 : 12). Pastoral care theories and practices, then, are subjects worthy of analysis and development as persons and com-munities seek to embody God ’ s love more effectively.

Teaching Pastoral Care and Wisdom

Courses in pastoral care are central elements of contemporary theological education, and it is widely recognized that effective parish ministry requires both theological per-spective setting and therapeutic skill building. In addition, those who teach pastoral care courses recognize the important role of formation of persons for the tasks of min-istry and discipleship. In other words, teachers of care practices recognize that basic abilities such as empathy, self - awareness, and interpersonal sensitivity are fundamental to effective care - giving. At the same time these skills are diffi cult to teach, and it is not unusual to fi nd pedagogical methods that differ signifi cantly from those in more research - driven courses (Miller - McLemore 2008 ).

To “ develop wisdom ” is one way pastoral theologians articulate the goals in pastoral care courses. Similar to the practical theological emphasis on phronesis , or practical wisdom, pastoral care as a fi eld has been concerned with more than just cognitive understanding or the acquisition of certain techniques. Developing wisdom means integrating relational, spiritual, and academic knowledge; it integrates all of these in the formation of deep (and often intuitive) understandings of persons and their situa-tions as well as experience - driven responses. Wisdom here refers to the deep or insight-ful understanding of life and people achieved through refl ective and integrated

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experience. Wisdom is distinct from practical knowledge; it is grounded in insight into life ’ s “ ultimate features, ” whereas practical or technical knowledge refers merely to how to do things. Qualities of wisdom thus necessarily include self - awareness, personal and interpersonal maturity, a sense of the whole, and a “ capacity to fi nd a certain dialectical wholeness in the contradictory aspects of experience (i.e. good and evil) ” (Hunter 2005 : 1325). It is the result of spiritual formation, and not simply the acquisi-tion of theological and therapeutic knowledge. Practical knowledge requires wisdom for its effective deployment.

The development of wisdom is a complex task, and there are many approaches to it. Minimally it requires openness on the part of the learners to accessing and analyzing their own experience in the service of understanding others. Effective pastoral care requires a willingness to relinquish the hope of solving problems for those who seek support. Not moving into the role of “ expert ” but rather empowering those with whom one sits requires great skill, including “ static [or anxiety - ]free listening ” (Kornfeld 2002 : 47) and the ability to be a witness, empowering persons to make their own deci-sions and to solve their own problems. To be a witness is to provide care that does not try to “ do ” anything. A witness “ is not trying to make something happen, to make repairs, or to make changes ” (Dittes 1999 : 137), but supports persons in distress as they come to their own understandings. The caregiver does not suggest new tactics and does not assert her agenda on another ’ s life or healing process. Rather, she offers a reliable witness to the healing the person seeks to undergo. Effective caregivers are persons who have refl ected on, come to terms with, and integrated their own experi-ences of suffering. For this reason, then, Henri Nouwen ’ s (1972) infamous image of the pastoral care provider as a “ wounded healer ” captures something important in the practice. As wounded healers, pastoral caregivers often understand their role as facilita-tors rather than as fi xers. Such wisdom can take years to learn, and sometimes is never mastered, but it is required for effective care. Sometimes this quality stands in tension with the pastoral function of moral and spiritual guidance where more direction is appropriate. Knowing when one is more fi tting than the other is another signature characteristic of a wise guide.

New Horizons in Pastoral Care

In the last 20 years, pastoral care has benefi tted from various fi elds of analysis, includ-ing race and gender theory, sociology, and cultural studies. Three distinct developments represent the most signifi cant changes as pastoral care moves into the twenty - fi rst century: (1) the move away from the model of care for an individual by ordained profes-sionals toward the model of care for the community and its members by the community and its members; (2) the development of pastoral care as a public theology; and (3) strategic participation rather than personal insight as the fi nal goal.

First, while historically much pastoral care has focused on the pastor, it is increas-ingly understood as a communal responsibility of church members in a model of care for all by all rather than the privilege of the ordained. This is often referred to as communal - contextual pastoral care. As a foundational responsibility, good pastoral care

276 BARBARA MCCLURE

builds a community in which members accompany one another through the many complexities of life, creates a welcoming and inclusive place where the faithful and seekers alike convene to fi nd God and each other, mobilizes the community to give sanctuary in which the wounded can rest when buffeted by life ’ s storms, and takes up the task of cel-ebration and remembrance , retelling the stories of the community, thus “ re - membering ” it (Gunderson 1997 ). In this model, then, the community becomes both the subject and the agent of care.

Second, pastoral care has increasingly become engaged, in theory and in practice, with issues in the public arena. Especially since the 1980s, with the increased publica-tion of works by persons of color and by women, pastoral care perspectives and practices have begun to widen their horizons to include the analysis of public policies and sociocultural structures, investigating their contributions to persons ’ oppression and therefore suffering. This marks pastoral care as a public theology, or the recognition that the personal has public implications and vice versa (Miller - McLemore 2004 ).

This shift is closely related to the model of communal - contextual pastoral care. Indeed, whereas mid - twentieth - century perspectives on the tasks of the care provider were infl uenced by focus on the “ living human document ” (Boisen 1971 ; Gerkin 1984 ), the end of the century and the beginning of the twenty - fi rst have seen the rise of a more contextually conscious approach. This stance, which often draws on feminist and other underrepresented perspectives, recommends attending to the “ living human web, ” or understanding personal need or distress within the context of social analyses of oppression, exploitation, and alienation (Miller - McLemore 1996 : 14). Such a per-spective invites care providers to understand persons as participants in a web comprised of personal, internal, social, political, and cultural structures that are intertwined and interdependent. It is the responsibility of pastoral practitioners to understand distress both as personal and as often socially derived. As pastoral theologian Pamela Couture puts it, “ As caregivers, we can become seers who . . . can interpret the relationship between the suffering of individuals and the structures and policies of our social eco-logical web ” ( 1996 : 102). Pastoral care in this vein encourages the diagnosis of oppres-sive structures and power imbalances, and understands advocacy and policy change as appropriate interventions. Lobbying on behalf of underprivileged children, advocating the full inclusion and acceptance of GLBTQI persons in the church or their right to receive the legal benefi ts of marriage, and undoing racist structures including white cultural privilege (Butler 2006 ) become viable forms of pastoral care.

Pastoral care as a public practice recommends developing pastoral care practices “ from the ground up, ” or as Latino/a pastoral practitioners call it, teologia en conjunto (theology as a group) (de la Torre 2009 ), a strategy of listening carefully to those who are on the margins of the power structures of the church. It also encourages the indi-genization of pastoral care. This means that theologies, theories, and practices of inter-vention must be sensitive to and emerge from the cultural and social contexts with which the recipient is most familiar (Lartey 2004 : 90).

With these developments, the image of caregiver as shepherd has been challenged for its sense of dependency wherein the caregiver has more power and knowledge than the dependent sheep. As a consequence, some contemporary care providers reject this

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image in favor of a model in which both caregiver and care - receiver journey together on an agenda set by the recipient of care. As Latino scholar Miguel de la Torre writes, “ The experience of most faith communities is that the greatest wisdom appears to emanate from the underside of the church ” ( 2009 : 69). Indeed, seeing pastoral care practices as ideally public as well as private events assumes an interdependent and deeply entwined human condition. Well - being is understood holistically and corpo-rately, and includes personal as well as social and structural components.

Such an understanding and the practices it suggests point to the importance of participation as both a means to and a sign of healing (McClure 2010 : 231). In other words, in today ’ s world, practices of care and healing at their best hold promises for transformation and for liberation, both personal and social. They deepen our awareness of the divine presence in the world and our lives, and (re)activate our faithful responses to that presence. Pastoral care in this perspective, then, understands all persons as loved by God, embedded in contexts that can embody or inhibit that love. Health or wholeness (the appropriate goal of pastoral care) enables us to respond to God ’ s invitation to love more fully, and to participate together in building God ’ s gift of life for us all.

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