Michael Milton

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September 25, 2016

Pastoral Assessment, Diagnosis, and Treatment of Congregational Pathologies

The American Church in Paris

[This is part of a lecture to theological doctoral students from a course on the Shepherding the Church in Context. ]

20130810-222447.jpgThe Christian shepherd is constantly confronted with the challenge of pathologies in the local church. Parish problems arise from (thinking of the Book of Common Prayer’s way of putting it) the Devil, the Flesh, and the World. Inevitably, the problem surrounds people. We may speak of ­­­­­­reframing organizations or structural alignment within the congregation, but at its heart, since the Church is about the Kingdom of God invading the Kingdom of Man, it must have to do with fallen human beings, their environment, and spiritual realities seen and unseen, known and unknown, admitted and undisclosed. Yet, this is the work of the under-shepherd of Christ: to evaluate, diagnose, and treat these maladies through Word, Sacrament, and Prayer. I make no apologies for disclosing my theological card at this point. We will look in some depth in the class at how to pastorally assess problems, how to pastorally diagnose those pathologies, and how to devise treatment plans, including on-going assessments.

The following table illustrates the three phases of pastoral treatment and the concrete steps within each necessary phase.

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A Model for Pastoral Assessment, Diagnosis, and Treatment of Congregational Pathologies. © 2016 Dr. Michael A. Milton.

Case Study No. 1

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A new congregation is planted by a larger church in metropolitan Seattle. The church plant’s mission is to reach millennials—young, educated urbanites—who have moved back into a formerly depressed section of the downtown area. The young congregation is comprised of the Mother Church members who have committed to the new church development as a “mission” for one year. They give, work, worship, and witness to the surrounding area. The associate pastors of the Mother Church give pastoral leadership to the fledgling parish until a permanent pastor can be called and seated. After six months of worshipping as a new church with the associates sharing pastoral duties and the members expressing great excitement about their mission, the provisional oversight committee calls a pastor. The fit seems perfect. He arrives with a background in student ministries and has served as an associate on a mid-size congregation of 500 in the Santa Barbara area. He is married with three children, from five to fifteen years of age. He is an enthusiastic preacher  and an even more enthusiastic organizer and administrator. He immediately becomes engaged with “planting a daughter church” of this new work. The church plant in the urban area grows, but much of the growth is from believers leaving more traditional churches for this new “liturgy in Birkenstocks” culture of this chic new community of faith. Area pastors are somewhat disturbed by the trend of their members having a “mid life crisis” (as one senior pastor put it confidentially), leaving years of association in their church of record for this new church plant. Nevertheless, there is excitement in the young mission congregation. Some of the “mission members” of the Mother Church return to the birthing congregation. Others decide to remain with the new millennial church. The outreach of this new mission church consists of concerts, small groups, and Bible studies. Yet, the majority of the members do not reflect the younger urban intellectuals and professionals. They are, for the most part, suburban Christians, who have moved churches out of a desire to be part of something new.

By year two, the pastor, without any prior indication of dissatisfaction, announces his departure to become an associate pastor of discipleship at a large church in Portland. The young mission congregation continues. A new pastor is called. He is less entrepreneurial, but, with his family from the area, more connected, and more likely to remain for a longer period necessary to build trust with the community. Yet, the community, in large part, seems to ignore the presence of the new church, even as new members join from other suburban churches continue, now in a somewhat slower rate.

Some relationship troubles emerge between the new church, after four years a self-governing congregation, and the surrounding sister parish churches. The new church moves forward with its church planting program. The new church pastor tells the adjudicatory that the “older congregations just need to get over it that their members want something more than they are giving them.” Quiet discontent becomes undeniable conflict.

You are a pastor in a neighboring ecclesiastical district. You are known to have studied the matter and to a wise and thoughtful practitioner with experience in unraveling the seemingly endless ball of twine that has become “this mess we face.” You are asked to provide help. What will you do?

Research Groups

Image © 2016 Faith for Living.
Image © 2016 Faith for Living.

Assess the situation: What are your tools? How can you listen to this congregation? What are symptoms or presenting issues? List them. These are variables that must be examined for any relationship to each other, any trends, any signs of a singular concern. Now, in light of Scripture and your own theological reflection and prayer, you are prepared to state the problem. Only then can you move to make a diagnosis.

Diagnosis: Having stated the problem, you must apply pastoral wisdom, Biblical insight, theological study, collegial insights, and, perhaps, even time, to arrive at a diagnosis: of the soul, of the organization, or of the conflict. The diagnosis should be stated clearly.

Treatment: You treatment paradigm is fixed: the ordinary means of grace that God has given the Church: Word, Sacrament, and Prayer. But this does not mean that your treatment is, necessarily, listen to more sermons, attend more Communion services, and pray more and you will find healing (although some more thoughtful, reflective, substantive form of that hyperbolic example might be appropriate). Instead, the Word, Sacrament, and, Prayer is a ruling motif for healing. It is the larger “pharmacy” from which you will draw your respective balms and ointments.

For instance, “Word,” could be anything from reading sacred poetry in the Psalms each morning, with a special emphasis upon the Psalms of Ascent to a more existential understanding of the faith (“Sacrament”), in which the parishioner, or community, seeks renewal in creation (washed in the renewing power of the wind and the sea) or a pilgrimage. “Prayer” might be personal time with the parishioner to teach her how to prayer the Psalms that she is reading each day. It could be a retreat at a local monastery for a time of quietness and prayer, followed by a commitment to journaling.

The key is that the Treatment will only correspond to the pathology of the soul or the community if the pastor has walked through the steps of assessment, diagnosis, and treatment.

One thing that should be addressed is what Martyn Lloyd-Jones, a British medical doctor who became a quite famous pastor and preacher of the mid to late twentieth century (Westminster Chapel, London) called “differential counseling.” At any point in the assessment you may come upon a place where the wounded soul has created infection that has seeped into physical or even psychiatric pathologies. Indeed, the wise pastor understands that we are all body and soul and illness in one sphere will invariably influence or infect the other. Look for and expect this and be reader to refer. To refer for physical or other specialized work is not to “give the parishioner away.” Indeed, it means that you have wisely created a caring team of physical and pastor, treating body and soul.

For further consideration of the movements from assessment to diagnosis to treatment see my model, “Pastoral Assessment, Diagnosis, and Treatment of Congregational Pathologies” (© 2016 Dr. Michael A. Milton).

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Faith For Living
Faith For Living

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Cooperation Without Compromise
byDr. Michael Milton

Faith For Living with Dr. Michael Milton
February 7, 2023
– A study from Acts 17:16-34.


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Cooperation Without Compromise
Cooperation Without Compromise
February 7, 2023
Dr. Michael Milton
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Faith for Living is the 501c3 North Carolina non-profit ministry of the Rev. Michael A. Milton, Ph.D. that exists to advance the Gospel of Jesus Christ to as many people as possible, through every means available, so that there will be a multitude caught up to be with Jesus Christ when He comes again. Faith for Living reaches out to support individuals, the Church, and other non-profits through communication, discipleship, and education.

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