Americans are struggling with their mental health.
More than 31% of people in the U.S. experience an anxiety disorder at some point in their lives, according to the National Institute for Mental Health. About 18% of American adults have or are being treated for depression, according to Gallup polling. One third of high school students in the U.S. said their mental health was not good most of the time or all the time in the last 30 days, according to the Centers for Disease Control and Prevention. In 2023, the CDC reported more than 49,000 Americans died by suicide. In 2022, a CNN/Kaiser Family Foundation Poll found that 90% of Americans believe the U.S. is experiencing a mental health crisis.
Christians expect that hurting people will not just live in their community but also sit in the church pews, and many PCA churches have developed counseling services to bring hope and healing.
Here’s a look at some of the PCA ministries currently doing what they can to help their members and communities.
Redeemer Counseling
Affiliated church: Redeemer Presbyterian Church, New York City, New York
It wasn’t long after Tim Keller founded Redeemer Church in New York City in 1989 that church leaders saw the need and opportunity to open a counseling center in the city.
Redeemer Counseling opened in 1990 as an extension of pastoral care. The ministry is still under the legal umbrella of the church and now serves approximately 1,700 people a year while also offering training for other churches that want to develop gospel-focused counseling ministries. The center has nearly 50 counselors who offer their services on a sliding scale pay structure.
Judy Cha, executive director of Redeemer Counseling, started working at the counseling center in 1998 when the entire staff was just five part-time employees. Growth has been steady since then, but was particularly noticeable after Sept. 11. In the aftermath of 9/11, the center saw clients facing the usual challenges that bring people to counseling, but also people seeking help dealing with the effects of the attacks: lost buildings, lost jobs, lost loved ones. Redeemer was poised to help.
“We had a lot of funding coming through from other parts of the nation to help those who’d been affected, and part of that funding was set aside for sessions,” Cha said.
They were able to give out free counseling sessions and set up a phone line for people to call in for prayer and other things.
“That was really hopeful for those who’d been directly impacted,” Cha said.
Over time, Cha helped Redeemer Counseling develop an approach to ministry which is known as GIFT (Gospel-Centered Integrating Framework of Therapy). She wrote about the approach in her book, “Who You Are: Internalizing the Gospel to Find Your True Identity.”
She said the GIFT approach provides a theological framework for evaluating modern psychological practices to discern what is true and usable from them, but it prioritizes helping people internalize the gospel.
“We cannot separate our mental health from our relationship with God, because we were created to be in a dependent relationship with him as his image bearers,” Cha said.
This approach is not just repeating the gospel to people until their problems go away, but meeting people with mercy and helping to relieve the symptoms they are experiencing by facilitating heart change, she explained.
“We help clients engage God directly with their pain and receive comfort from him directly. … That will lead to rejoicing in their new identity, repenting of their sins, and reflecting who they are in a deeper way,” she said.
When the pandemic hit in 2020, she said it highlighted the need for mental health services across the U.S., and Redeemer Counseling has been contacted by numerous churches that want to start a counseling ministry.
“Nearly a hundred churches have utilized our training to equip pastors and ministry leaders,” Cha said. “I think the pandemic was horrific, but it really did raise that awareness about mental health issues.”
Bell Tower Counseling
Affiliated church: Trinity Church, Seattle, Washington
Katie Ribera, executive director of Bell Tower Counseling, first felt the call into Christian counseling while working in a community mental health setting. That experience showed her there were gaps in access to care, and she saw a need for Christian support for Christian clients.
She decided to pursue a counseling degree at Covenant Theological Seminary and interned with a church-affiliated counseling center in St. Louis. It was a chance for her to see how a church counseling center can not only support church members, but also other churches and the broader community.
“Once I was graduating from seminary, I had a number of conversations with folks across the country who were doing something similar,” she said.
Ribera’s husband is from Seattle, Washington, so when she graduated from seminary, they moved back to the Pacific Northwest, and she joined the staff at Trinity Church, which had recently moved into a new building. She said the church’s leadership was already thinking about how they could use the new building as a “third place” to benefit the community, and one option they were considering was an onsite counseling center.
In her new role, she set out a plan to try it and see if it would take root.
That vision and buy-in from the leadership spread organically to the congregation. When she started taking on the project, one of her biggest questions was, “Will the average Seattleite even consider the option of walking into a church building to receive counseling services?”
The answer turned out to be a resounding “yes”.
She started seeing clients in January 2020, just weeks ahead of the pandemic. While there were challenges that came with the timing, she said it also helped them grow.
“I do think that the pandemic honestly kind of helped to fuel that because it meant that there was a lot of need in the community and a lot of the counselors who are available through people’s insurance were all running long wait lists.”
The church’s scholarship program attracted people who might not otherwise be able to afford the counseling. In the six years since they started, the center has grown to a team of 10 part- and full-time counselors.
Though Bell Tower Counseling is a separate entity from Trinity Church, the church and counseling center maintain a strong partnership. The church provides free office space and contributes generously to the scholarship fund to help make the ministry possible. Ribera divides her time between working as Trinity Church’s adult ministry director and serving as the director and a counselor for Bell Tower.
“About 60% of our overall clients attend church somewhere, or would say that they’re, you know, religiously Christian-affiliated. And then about 40% of our clients are not necessarily religious, but are either coming to Bell Tower because of a particular specialty that one of our counselors has, that they are wanting care in, and or they’re coming because we offer a kind of a need-based scholarship program that’s pretty generous.”
She said the church members seem thankful for the opportunity they have to help play a part in providing a needed service for the community. Their scholarship program allows people who cannot afford the full cost to receive a discounted rate. Over the last five years, she estimates they’ve awarded about $600,000 in scholarships.
“We’re trying to bridge the gap for people in that way, to be able to say … we want to help make counseling affordable and accessible for anyone who has need of it, and for that to be available in a sustaining kind of way, even if this is a long journey that you’re on,” Ribera said.
The Barnabas Center
Affiliated church: Christ the King Presbyterian Church, Houston, Texas
Christ the King is the largest PCA church in Houston, Texas. As the church grew, the leadership noticed they were often referring members to outside organizations for counseling.
They began to wonder, What if we actually started a counseling ministry here at our church to make it easier for members to come to counseling?
An in-house counseling center could give members a convenient place to get help and allow church leaders to make sure the counseling was theologically aligned with the church.
The result is the Barnabas Center, founded in 2015, which is fulfilling the vision of offering professional, biblically-based counseling to church members and the broader Houston community.
The church hired Leslie Peacock to start the counseling center, and it has grown over the last decade to a staff of 10 that occupies a wing of Christ the King Presbyterian Church. Counselors at The Barnabas Center offer services at modest rates commensurate with the counselor’s training, but the center also has financial support available for those who need it.
Peacock said the buy-in from the church’s leadership has been key to the ministry’s success. Church leadership showed a willingness to refer people for counseling and created a vision for the center and how it could bless the congregation.
“The church was very ready and excited,” Peacock said. “My very first day I had emails in my inbox from members.”
The counseling ministry has had an impact both in the church and in the broader community. Initially, about 70% of counseling clients were members of Christ the King, but now she said about 60% are non-members.
“We have good relationships with churches in the area who just want a trusted source for counseling,” she said. “Christ the King is very well known in the community, and so right now it feels more like a community counseling center even though we’re based in the church.”
She said the counseling ministry strives to bless to the church by holding seminars on psychology-related topics such as addiction and anxiety, parenting, or dealing with a loved one’s death by suicide.
“We kind of balance out professional individual services we offer with more events or seminars where people can come learn about something,” Peacock said.
Another outreach ministry for The Barnabas Center is a day camp one of its therapists offers each summer for girls ages 10 to 12. The camp focuses on topics like identity and handling emotions through a biblical lens. Peacock said the camp registration fills up within minutes each year.
“We’re able to do ministerial things in addition to the professional counseling that would be hard to offer in a private practice,” she said.
She believes the openness and willingness to talk about struggles has helped the church as a whole. Frequently Christ the King pastors will reference the counseling service as a resource from the pulpit.
“I think there’s just more kind of education around just life and living on this side of heaven and the struggles that we all face,” she said. “We don’t just have to button up, pretend, or just put a smile on our face, or even just quote a Bible verse.”
New Life House
Affiliated church: New Life Presbyterian Church, Escondido, California
Sometimes counseling ministries form quickly. Other times, their birth is a more gradual process. For New Life House, a ministry of New Life Presbyterian Church in Escondido, it was the latter.
About 18 years ago Dianna Huston started counseling a few women at the church under the oversight of one of New Life’s pastors. That ministry then expanded into marriage counseling, and staff at the church began talking about other areas where counseling would be beneficial. So they made a five-year plan.
The church was able to buy a home across the parking lot from their church and transform it to serve as a counseling center. New Life House officially launched in 2021.
Huston, who served as director during the formation of the counseling center, said they were blessed with the support of the congregation as they grew, and she believes the center has been a benefit to the church. Counseling is offered free of charge to members and regular attenders.
“I would say it has allowed the congregation to normalize the challenges that people face,” Huston said. “Not only with their faith, but personally, and saying it’s okay to talk about it; it’s okay to admit it; and it’s okay to deal with the issues.”
The counselors at New Life House are biblical counselors, not licensed therapists, so they refer people to Christian psychologists, psychiatrists, and therapists when needed. Still, New Life House has allowed the church to address many needs in-house.
New Life House Director Jason Barrie, who serves as an associate pastor at New Life church and also teaches at Westminster Seminary, believes the counseling center is a way for Christians to encourage one another and views it as a benefit to the traditional pastoral staff.
“We’re not a replacement for pastoral ministry, but really to provide a supplemental service to the care and shepherding of our people here at New Life,” Barrie said.
Huston noted that sometimes effective counseling can last for months, which may be too much for pastors, particularly in small churches, to be able to do.
She encourages other churches that may be considering creating a counseling ministry to make sure they have well defined goals, maintain good communication with pastors and the session, and make sure staff are able to get the training they need.
“Having that broad-based, good training in theology is so essential, because you can’t teach and apply the gospel to people’s lives without knowing it yourself,” Huston said.