In a previous post, I encouraged pastors that they are competent to counsel addiction. You can find that article here. However, when pastors press into addiction they will find many challenges along the way. In this post, I want to help pastors think through if and when it is appropriate to refer those battling addiction to a residential program.
I will begin with a brief reminder of the call of a pastor to care for their flock and then consider some practical wisdom for when to consider sending someone to a residential program.
In Acts 20:28, when speaking to the Ephesians elders, Paul urges, “Pay careful attention to yourselves and to all the flock, in which the Holy Spirit has made you overseers, to care for the church of God, which he obtained with his own blood.” Note the responsibility of an elder, “to pay careful attention to” and “to care for the church of God.”
Pastors (I’m using the term interchangeably with elders as I believe Scripture teaches they refer to the same office) are to provide spiritual oversight and care for those in their church. 1 Peter exhorts pastors to "shepherd the flock of God.” The pastoral care that elders are to provide must include whatever struggles their particular people battle, including addiction. This is a high calling that includes providing spiritual guidance and biblical counsel to them.
Can Pastors Refer Addiction Cases to Residential Programs?
There are three answers to this question:
Always refer addictions (The pastor is not trained/addiction is outside their scope of responsibility)
Never refer addictions (The pastor should never abdicate this responsibility)
Sometimes refer addictions (With qualifications)
I strongly disagree with A (See again previous article), sympathize with B, and stand firmly with C. This is for various reasons. First, when reading the New Testament, one would find it difficult to overlook the gospel partnership Paul shared with various churches. He wrote letters to numerous churches offering counsel and wisdom for specific situations though he wasn’t a member of those churches. In 1 Corinthians 5, for example, Paul gives specific instruction to the church in Corinth in how to handle a case of sexual sin in the church and provides a framework for church discipline. Gospel partnership means we can ask for help when we need it even when it comes to the members of our churches. Of course, Pastors want to be very careful when thinking about who to partner with (more about that point below). And this doesn’t give a greenlight to abdicating the responsibility to pastoral care. This is, put simply, humbly asking for help. The pastor must still maintain oversight of the person but he is able to ask for help. The other reasons for sometimes referring addictions are more practical so I’ll address them under the headings below.
Consider your limitations
One of the challenges pastors will face is that certain issues will demand more of the pastor’s time. Addiction ministry is incredibly demanding for several reasons. First, sin is by nature progressive. James 1:15 reminds us that sin, “when it is fully grown brings forth death.” In other words, sin gets worse and worse apart from repentance. Each sin will have slight differences in the way they progress toward death. Those battling addiction have been living a lifestyle of intense darkness that often involves lying, stealing, sexual immorality, and much more. The issues they will need counsel for are numerous. In addition, consider the physiology of addiction. Addicts are putting chemicals in their body at high levels. The substances they use change them, often with long term effects. A long-term methamphetamine user will have difficulty staying awake and focusing as their body tries to return back to normal. This often presents a challenge in counseling that requires much time and patience. Or consider the damage addictions can do in relationships. How difficult is it to counsel a husband whose addiction has caused so much damage in the marriage? There is hope and help for each of these dynamics but it takes a significant amount of thought and time. So the pastor must consider his own limitations.
For me personally, I love all the work of pastoral ministry. I love people. I love wrestling with biblical texts. I love praying for and with God’s people. But I can’t do it all myself. I need others with the same commitment to help in areas I’m weaker or simply because I am one person. I have come to appreciate the body of Christ and the gifts that others can bring to the table. At the church I serve as one of the pastors, we have a couple that has served alongside those battling addictions for years. They have opened their home and spent significant time with those trying to put their addiction to death. They are a vital part of counseling addictions at our church. More people are served well when the whole body of Christ joins together.
It’s also important here for pastors to consider their own limitations when it comes to specific areas. How well have you thought through applying the Scriptures to addiction? Is there someone who may be more skilled to meet with and help when it comes to a specific issue? This isn’t abdicating your responsibility but rather utilizing the body of Christ to help. There have been many times where I’ve encouraged someone to meet with a person who is more skilled in a particular area or, for various reasons, may be able to commit more time than I am in a particular season.
This is also where the strengths of a residential program can be very helpful. For the last decade I have probably counseled over 100 different cases of addiction. There are many things I’ve learned over the years through this experience. If, as a pastor, I am aware of a program with that kind of experience and the gospel is central to their care, I want to tap into them in any way I can.
Consider the individual
Pastors should also consider the individual person they are working with. Perhaps you begin meeting with a person and they show signs of wanting to change but then repeatedly fall back into their addiction. There are many reasons to explore as to why this happens but sometimes a change in their counseling plan or environment is needed. This is a major strength of gospel-centered residential programs. Programs can provide safe, supervised living that limits the amount of temptation a person faces so they can focus on the heart of their addiction and their relationship with Christ in a more intentional way. Many churches don’t have the resources to provide housing and practical needs that can assist in counseling.
Some helpful questions to consider are: Is a once per week meeting enough? Are they unable to gain traction in pursuing sobriety and could they use a higher level of care?
No matter how gifted we are at counseling, the Scriptures are clear that God’s people are sanctified “from one degree of glory to another” (2 Corinthians 3:18). Residential programs don’t fix addiction but they can provide a significant jumpstart for the person in ways that a once a week, hourly counseling session cannot. A change in environment is never enough to change the heart, but sometimes removing someone from a toxic living situation can be really helpful to help them prioritize the heart.
In addition, if a person has caused significant damage to the relationships around them, giving space and time for others to heal can also be very helpful for the individual and those whom their addiction has impacted. At Redemption House, we have seen this often. A wife will express much gratitude for the program and for their pastor for encouraging the men to come to our program because it brings a measure of peace to their home and now she can more easily focus on what she is called to. Again, this isn’t the heart of change but it assists in the change process.
Consider where you send them
If, when considering your own limitations and the needs of the individual you are counseling, you decide a residential program is best, where do you send them?
The challenge pastors who care deeply about their people getting solid biblical counsel is that many programs lack a gospel-centrality. On one hand, there are many programs that undermine the work of pastors by teaching unbiblical, worldly theories about addiction. On the other hand, there are many programs that rightfully call addiction a sin but have a behavioristic approach and fail to address the heart. Or there are programs that provide housing but don’t take the time to enter into the difficult work of counseling the individual.
Addiction, in one sense, is very complex and in another sense, it is pretty common to all of us. A good program understands both of those realities. We have tried to hit that balance in our teaching, “A Biblical View of Addiction” found here.
Ultimately, Redemption House exists because we want to see people set free from addiction. We have a heart for those struggling with addiction. And we want to serve churches by partnering with them as they care for their members. We pray this helps you consider if it is time to refer the person you are working with to a residential program.