By Heidi Goehmann

There is a lot of language to sort through when you need help with a mental or relational health problem.

And we should be asking for help. We all have problems. In this sinful world not a one of us will escape the need for help. We confess it every Sunday in our churches:

“Most merciful God, we confess that we are by nature sinful and unclean. We have sinned against You in thought, word, and deed, by what we have done and by what we have left undone. We have not loved You with our whole heart; we have not loved our neighbors as ourselves. We justly deserve Your present and eternal punishment. For the sake of Your Son, Jesus Christ, have mercy on us. Forgive us, renew us, and lead us, so that we may delight in Your will and walk in Your ways to the glory of Your holy name. Amen.”

(Lutheran Service Book, Divine Service Settings One and Two)

Confession assumes we have need before God. In light of that common need, we are freed from any concern we might have about showing our need before people.

Finding help for our need, however, is often a great challenge. One of the most common questions I get asked is:

“But who should I talk to?”

Pastors are a really good start, and so are deaconesses and other workers who offer spiritual care and encouragement within our congregations. Pastors and church workers want you to know, though, that they are not counselors.

Pastors are given to us to shepherd, to lead the Body, and to proclaim truth and love to us through the Word of God. This Word is highly relevant for the problems that assail us and taunt us in this broken world.

They also bring us comfort and care that we cannot receive elsewhere in the physical presence of Christ when we receive His Body and His Blood.

When we let them care for us in our time of trouble, I think the Holy Spirit opens our eyes anew to see Immanuel, God with us, in new ways, even in the rockiest of times.

There are many other professionals who can also help us, particularly with mental health issues, overwhelming emotions, or struggles in our relationships.

Not all professionals are created equal. There are a lot of professionals involved in realm of mental health care, or what insurance likes to call “behavioral health care,” just as in a hospital you find radiologists and lab technicians and registrars, etc.

In order to alleviate barriers to getting the help we all need and to take a little of the mystery out of engaging in mental and relational health care, the following is a list of the most common providers for therapy or other forms of mental, emotional and relational health care.

  • Alternative Medicine Practitioner — Takes any approach to therapy or medicine that is not considered orthodox or mainstream, including acupuncture, chiropractic, massage, herbal medicines, etc.; with each approach the practitioner may engage in spiritual practices associated with that approach or may not engage in such practices.
  • Case Worker — Usually an individual with a bachelor’s degree in a field relevant to psychology or social work; employed by a government or private agency to advocate, communicate regularly and access resources for an individual or family.
  • Christian Counselor — Uses mental and emotional health resources, alongside biblical teaching, to intertwine the disciplines of psychology and the Christian faith to guide the counselee through challenging life issues; should be licensed.
  • Licensed Clinical Social Worker — A mental health professional with a master’s degree, specializing in a strengths-based approach; especially considers the impact of the environment and the systems interacting with a person, family or organization; has a license to practice therapy with individuals, couples or families and often has a specialty.
  • Licensed Professional Counselor — A mental health professional with a master’s degree, usually practicing direct therapy with clients utilizing various therapy methods and tools; may specialize in individual, couples or family concerns and often specializes in certain struggles or diagnoses.
  • Licensed Marriage and Family Therapist — A licensed mental health professional with a master’s degree specializing in the dynamics of, as well as creating change and promoting growth within, a couple or family system; may also treat individual struggles within the context of their relational units.
  • Pastoral Counselor — A licensed mental health professional and spiritual care provider, usually practicing direct therapy with clients using a variety of tools as well as offering spiritual insight and care; has completed theological education and supervised clinical hours and has a license to practice therapy.
  • Pastoral Psychotherapist — A licensed mental health professional and spiritual care provider who applies the insights of theology and psychology within a dynamic psycho-social-spiritual healing process designed to advance personal and interpersonal health and well-being.
  • Psychiatrist — A medical doctor specializing in the brain and mental health; can prescribe medications; may also practice psychotherapy, or refer patients to a therapist for therapy in conjunction with medication; licensed by a state medical board, and likely has further specialties in specific mental health concerns.

As with any life concern, good care requires a little research — and that can be hard when you are struggling.

Therapy is also for wellness. It’s good to seek a relationship with a professional in our struggle, but it’s also good to seek a relationship with someone outside of our struggles.

It can be easier to objectively assess the quality of the therapeutic relationship when we aren’t in distress, and it also helps us to deal with the impact of the brokenness in our lives and the world around us proactively rather than reactively.

As you begin or renew your search for the right mental or relational health care fit, may this verse give you peace and hope in the knowledge that God goes with you in this, as He does in everything you do or encounter, including every joy and every sorrow:

“Our help is in the name of the LORD, who made heaven and earth.” (Ps. 124:8) programs

Listen to “The Coffee Hour” on every Monday at 9 a.m. to hear topics related to mental health.

KFUO Radio “Mental Health Mondays?”

KFUO Radio — “Should I Talk to a Pastor or Psychologist?”

Resources Church LocatorSelect “Locators” in the top right corner of to find a church and/or pastor near you.

Concordia Plans Employee Assistance Program (EAP)LCMS employees and families can find resources and receive six free visits to a licensed professional. You or your spouse do not need to be covered by Concordia Health Plans to utilize the EAP.

Concordia PlansWellness Programs

Church worker wellness