Pastor, You Don’t Have to Carry This Alone

Pastors are often among the first people someone turns to when life begins falling apart.

After the diagnosis.

During the panic attack.

When a marriage is unraveling.

When a teenager says they don’t want to be here anymore.

When a parent whispers, “I don’t know what to do.”

That trust is sacred. But it can also create an enormous amount of pressure.

As a pastor or church leader, you want to help. You want to respond wisely. You want people to experience the hope of Jesus in the middle of their pain.

But sometimes the need in front of you is bigger than what you know how, or were ever meant, to carry.

I understand that tension from both sides.

As a trauma therapist, I spent COVID sitting with people experiencing fear, grief, isolation, parenting stress, relationship strain, and exhaustion, while walking through many of those same things myself.

And as part of a pastor’s family, I watched church leaders try to care for an overwhelming number of mental health needs, often without the training, resources, or trusted referral partners they needed.

Pastors were trying to shepherd people through spiritual questions, trauma disclosures, suicidal thoughts, marital crises, parenting concerns, addiction, anxiety, depression, and complicated family dynamics—sometimes all in the same week.

And many were quietly struggling themselves.

That season clarified something for me:

People need people. But no one person can meet every need.

That conviction became part of the dream behind Love Your Story Therapy. I wanted people to have somewhere safe to land, and I wanted pastors to have trusted people to call when a situation became bigger than what they could carry alone.

Pastors have an essential role in supporting the mental health of their communities. But that role is not to become everyone’s therapist.

Your role is often to help people feel seen, respond with Biblical wisdom and the compassion of Jesus, and build bridges to the additional care they may need.

Here are three practical ways to begin.

1. Listen Before You Try to Solve

When someone shares something painful, it is natural to want to make it better.

You may feel pressure to offer an answer, find the right Scripture, develop a plan, or say something profound enough to bring immediate relief.

But people often need to feel understood before they are ready to receive direction.

A simple framework I teach is:

Welcome. Wonder. Walk With.

Welcome: “I’m really glad you told me.”

This communicates:

Your pain is not too much. You are not a burden. You do not have to hide here.

Shame often tells people that their struggles make them weak, unfaithful, or difficult to love. A warm welcome interrupts that story and reminds them they are still worthy of care.

Wonder: “Can you tell me more about what this has been like for you?”

Ask gentle, open-ended questions. Resist the urge to immediately interpret, correct, compare, or explain their experience.

You might also ask:

• “How long have you been feeling this way?”

• “How is this affecting your daily life?”

• “Who else knows what you’ve been carrying?”

• “What feels hardest right now?”

• “Do you feel safe?”

These questions help you understand what someone is experiencing without requiring you to diagnose it.

Walk with: “Let’s think together about what kind of support would help.”

This communicates care without promising that you will personally meet every need.

Walking with someone may mean praying together, checking in later in the week, helping them connect with a therapist, inviting a trusted family member into the conversation, or involving crisis support when safety is a concern.

Listening is not a lesser form of ministry.

Jesus consistently noticed people. He asked questions. He allowed individuals to name what hurt and what they needed. His presence communicated dignity before a problem was solved.

Prayer and Scripture can be life-giving parts of pastoral care. But they should never be used to hurry someone through pain, silence difficult emotions, or imply that a mental health struggle reflects inadequate faith.

Sometimes the most Christlike thing we can say is:

“I believe you. I’m here. And we’re going to help you find support.”

2. Know Which Lane of Care You’re In

Not every difficult conversation requires a therapist. But not every mental health concern should remain solely within pastoral care, either.

It can help to think in terms of three lanes.

Pastoral Care

Pastoral care may include:

• Spiritual questions or doubt

• Ordinary grief and life transitions

• Prayer and spiritual encouragement

• Relational support

• Discernment

• Connection to community

• Short-term guidance through a difficult season

In this lane, you may be able to listen, pray, follow up, connect the person with a group or ministry, and continue walking alongside them.

Collaborative Care

Collaborative care may be appropriate when someone is experiencing:

• Persistent anxiety or depression

• Trauma symptoms

• Significant changes in sleep, appetite, work, school, or relationships

• Ongoing marital deterioration

• Disordered eating

• Substance misuse

• Intense emotional or behavioral concerns

• Questions about ADHD, autism, or another mental health condition

In collaborative care, the pastor does not disappear. Additional support is brought in.

You can continue offering prayer, spiritual guidance, community, and relational care while a licensed clinician provides assessment and treatment.

Faith and therapy do not have to compete with each other. Excellent clinical care can help people understand their experiences, learn new tools, heal relational wounds, and become more available to the life and community God is inviting them into.

Crisis Care

Crisis care is needed when there is concern about:

• Suicide or self-harm

• Danger to another person

• Abuse or neglect

• Psychosis

• Severe impairment

• An inability to remain safe

These situations require immediate crisis or emergency support.

If you believe someone may be suicidal, ask directly:

“Are you thinking about killing yourself?”

Clear, compassionate questions help you understand the seriousness of the situation and communicate that you are willing to hear the truth.

Do not promise secrecy or leave someone alone when there is an immediate safety concern.

In the United States, you can call or text 988 with the person—or contact 988 yourself for guidance about helping someone else. The service is free, confidential, and available 24 hours a day. If there is immediate physical danger or a medical emergency, call 911. Learn more from the 988 Suicide & Crisis Lifeline.

Knowing your lane is not about caring less.

It is about caring wisely.

Referral is not rejection. It is one of the ways we steward someone’s trust.

3. Build the Bridge Before the Crisis

The middle of a crisis is the hardest time to begin searching for help.

Churches can prepare by developing a simple mental health care plan before it is needed.

Start by asking:

• Who are the trusted therapists in our community?

• Who works with children, teens, couples, families, trauma, or neurodivergence?

• Where can someone receive an ADHD or autism assessment?

• Who can provide psychiatric evaluation or medication support?

• What will our leaders do if someone discloses suicidal thoughts, abuse, or immediate danger?

• Who needs training in crisis response and mandated reporting?

• Who is responsible for making referrals?

• How will we follow up after connecting someone with outside care?

And remember: a referral list is not the same thing as a relationship.

Call the providers. Learn what they offer. Ask whether they are accepting new clients and how quickly they respond. Understand their approach to faith, evidence-based care, confidentiality, and collaboration.

You don’t need an enormous list.

You need a few trusted people you can confidently call when someone asks:

“Do you know someone who can help?”

A strong referral process should also help people understand what comes next. Reaching out to a therapist can feel intimidating, especially when someone is already overwhelmed.

Whenever possible, provide a specific name, phone number, website, and simple first step. With the person’s permission, you might sit with them while they make the call or ask a trusted care-team member to follow up.

The goal is not to hand someone a list and send them away.

The goal is to build a bridge, and make sure they know they do not have to cross it alone.

Pastor, You Need Care Too

Pastors are not immune to anxiety, depression, trauma, marital strain, grief, or burnout.

Being the person others turn to does not remove your own need to be known and supported.

You need places where you are not responsible for leading the room.

You need relationships where you can tell the truth before you reach a breaking point.

You may need a therapist, mentor, spiritual director, physician, or trusted circle of friends who will care for you as a whole person... not only as a pastor.

You may also need clearer boundaries around when and how you are available. Healthy boundaries are not a failure of compassion. They make sustainable compassion possible.

Needing care does not make you less faithful or less fit to lead.

It makes you human.

And honest, appropriately vulnerable leadership gives others permission to be human too.

Churches Don’t Have to Figure This Out Alone

This is why I care so deeply about helping churches build healthier systems of care.

I want people to experience the hope of Jesus through their church community. I also want pastors to know where to turn when someone needs clinical care beyond what the church can provide.

Churches can become places where people are known, supported, and cared for as whole people: mind, body, relationships, and spirit.

But no single pastor, leader, or ministry team can provide every kind of care.

You do not have to wait until the next crisis to build the bridge.

Love Your Story Therapy supports churches through mental health workshops, ministry-team training, consultation, trusted referrals, therapy, psychological assessments, and psychiatric care. We can help your church develop a healthier response to the emotional and relational needs you are already seeing.

If your church needs help creating a trusted mental health referral network, equipping staff and ministry leaders, or bringing practical mental health education to your community, we would be honored to come alongside you.

Explore Church Workshops and Start a Conversation →

The needs may be great, but God never intended for one pastor, one leader, or one church to carry them alone.

About Sarah

Sarah Proemsey, M.S., LPCC, is the founder and Clinical Director of Love Your Story Therapy. After more than 20 years as a trauma therapist (and plenty of time spent in both counseling offices and church hallways) she understands the beautiful, complicated intersection of faith, mental health, and being human.

Sarah helps pastors, families, and communities pair the hope of Jesus with practical tools that actually help. She is a therapist, storyteller, speaker, pastor’s wife, mom of three, and firm believer that no one should have to carry everything alone.