Pastoral Mental Health Research Articles

Ah, To Be a Psychiatrist

Back to table of contents Previous article Why I Aspired to Be a PsychiatristFull AccessAh, To Be a PsychiatristRobert McAllister,M.D., Ph.D.Robert McAllister,Search for more papers by this authorM.D., Ph.D.Published Online:18 Sep 2018https://doi.org/10.1176/appi.pn.2018.9b7AbstractRobert McAllister, M.D., Ph.D., is a retired private practitioner and author. His latest book is Predator Priest.My desire to help others came early in life. It was an uncertain path with no fixed goal. Growing up on a cattle ranch in Montana during the years of the Great Depression, I was aware of the marked poverty in the area. I was inspired by my mother and father who never let a stranger or a neighbor go hungry and who characteristically helped the “needy” out of their own sparsity. Their goal became my goal. Through the years “needy” was variously defined. In the 30s, it was poverty. I studied to be a priest (to respond to spiritual need?) but left the seminary, for want of a life companion (my own neediness). After basic training, I was a combat infantryman in Austria. (Peace was the need.) It was a world of destruction and decay, disorder and death, concentration camps, POW camps, DP camps. After the war I earned a Ph.D. in psychology from Catholic University. Dr. Robert Odenwald, a psychiatrist teaching there, encouraged me to study medicine and become a psychiatrist. I had depleted my G.I. bill, but various jobs made Georgetown possible. I got my M.D. in 1956 at the age of 37. Four more years: internship one, residency three. I began the practice of psychiatry on September 1, 1960. It’s difficult to explain how it felt. It was clearly the goal I’d been looking for. I can’t say I was inspired to become a psychiatrist; it’s more like I stumbled into it, thanks to Bob Odenwald. The truth is that psychiatry has been an inspiration to me. I’ve learned the depth of sorrow, the breadth of goodness, the delicacy of childhood, the harshness of prejudice, the wickedness of abuse, the bitterness of vengeance, on and on. With compassionate psychotherapy and whatever medicines were appropriate, I’ve tried to mend damaged lives, lift shattered spirits, and bring peace to broken hearts (all DSM-4 labeled). The world opened quickly for me. In 1966 I became superintendent of the Nevada State Hospital in Reno. We got the hospital accredited. We obtained a grant for the first comprehensive community mental health center in our region. We obtained a federal grant to educate staff. Howard Rome, Frank Braceland, Dana Farnsworth, George Valiant, Chet Pierce, and other notables honored us with their lectures. I met these stalwarts of the psychiatric world as fellow summer faculty at the Pastoral Mental Health Institute at St. John’s University in Collegeville, Minn. I published Conflict in Community (St. John’s University Press, 1969) and Living the Vows (Harper & Row, 1986). Both were well received by Catholic religious. As a result, much of my work related to the treatment of Catholic religious, consulting with and lecturing to their communities throughout the United States. I taught at Catholic University, Gonzaga University in Spokane, Loyola University in Baltimore. I closed my psychiatric practice on December 31, 2005. My life’s love had Alzheimer’s (Jane’s need was my need). Then it all ended—almost.After my wife’s death, I began “supervising” a social worker whom I knew from Taylor Manor Hospital. After she retired, I “supervised” her psychologist friend for several months. Then she retired. The three of us still get together every two weeks to discuss old cases, people who could be cases, and sundry aligned matters. Once you’re a therapist, the fire never goes out. It smolders. At the age of 100, I attempt to communicate peace and calm and a sense of personal worth to those with whom I live in an adult care community. It’s what I was inspired to do and have done since I began life as a psychiatrist in 1960. ■ ISSUES NewArchived

Self-Disclosure and Spiritual Well-Being in Pastors Seeking Professional Psychological Help

Pastoral mental health is a topic that has only rarely been researched empirically in the psychological literature, yet a pastor’s mental health can have a significant impact on churches, communities, and even nations (Royal and Thompson, Journal of Psychology and Christianity,31(3), 195–204, 2012). One of the thoughts prompting this research is that evangelical pastors might be expected to resist the findings of psychological research and lack understanding of specific mental illnesses they are potentially facing. Combined with historical and cultural dynamics that could influence resistance to professional psychological help, evangelical pastors have personal, internal factors that could also strengthen resistance, including the researched issues of self-disclosure flexibility and spiritual well-being. A correlational research design with multivariate regression was used to determine potentially significant or predictive relationships between the relevant factors. Among evangelical seminary students (N = 251) preparing for parish-based pastoral ministry, this research determined that no significant relationship, predictive or otherwise, existed between self-disclosure flexibility, spiritual well-being, and attitudes toward seeking professional psychological help. Implications include a shift in focus toward external factors influencing pastors’ help-seeking attitudes, such as the need for the mental health community to develop connections with evangelical pastors and the development of more support for Christian mental health professionals in the larger evangelical community.

Attitudes toward Empirically-Supported Treatments among Pastoral Mental Health Care Providers: Exploratory Findings and Future Directions

The current study describes the findings of an online survey of pastoral mental health care providers The survey included brief demographic information, and a validated measure of attitudes toward empirically-supported psychological interventions, the Evidence-based Practices Attitude Scale (EBPAS; Aarons, 2004). The responses of 55 pastoral providers' are described and compared to national norms (Aarons et al., 2010). Recommendations for future collaboration between EST developers and pastoral clinicians are provided.

An Empirical Study of the Pastoral Mental Health Involvement Model

This study investigates the utility of a conceptual model—the Pastoral Mental Health Involvement Model—in understanding and predicting pastoral mental health activities (counseling, referral, and consultation). This model, based on previous research findings and logical speculations, includes four sets of external factors (church organization, church membership status, types and severity of presenting problems) and three sets of internal factors (clergy's attitudes, mental health skills and knowledge, and demographic variables). Data were collected from 231 clergy of the United Methodist Baltimore Conference in 1984. Hierarchical multiple regression analyses in terms of sets were performed. The results partially validated a multi-factorial interactional model in understanding and predicting pastoral mental health involvement with the external inputs, that is, church membership status and presenting problems being the most significant predictors.

The development and practice of pastoral counseling.

The practice of pastoral counselors is not well understood by secular mental health professionals, although evidence suggests that advantages can be gained by increasing the interaction between the two groups. Trends in the historical development of pastoral counseling are summarized, and a typology that distinguishes three major thrusts among its practitioners--religious counseling, pastoral mental health work, and pastoral psychotherapy--is offered. A clergy malpractice case that raises issues of joint concern to secular and religious therapists is discussed.