Core Competencies for Clergy and Other Pastoral Ministers in Addressing Alcohol and Drug Dependence and the Impact on Family Members

Report of an Expert Consensus Panel Meeting

Purpose and Scope of the Clergy Training Project

The Substance Abuse and Mental Health Administration (SAMHSA), part of the U.S. Department of Health and Human Services, joined with both the Johnson Institute (JI) and the National Association for Children of Alcoholics (NACoA) to explore ways in which the faith community can help address both the problems of alcoholism and drug dependence and the harmful impact these substance use disorders have on children and families. As part of that effort, the organizations sought to identify ways in which the topic could be incorporated into the education and training of clergy – ministers, priests, rabbis, deacons, elders, and pastoral ministers, such as lay ministers, religious sisters, among others.

To that end, in November 2001, SAMHSA supported a meeting of an expert panel on seminary education that was charged with the job of undertaking an assessment of the state of seminary training on the subjects of alcohol and drug use and dependence. The panel found that seminary curricula and training programs vary extensively across the country, and few offer specific instruc- tion focused on working with parishioners troubled with alcohol or drug use. With those findings, the panel recommended the development and implementation of a set of “core competencies” – basic knowledge and skills clergy need to help individuals and their families, who also are profoundly affected, recover from alcohol or drug use and dependence.

They concluded that a clergy training and curriculum development project was war- ranted, and delineated a series of steps that should be taken to carry it forward. The first of those steps was to bring faith leaders together specifically to delineate those “core competencies.” They recommended that the core competencies” reflect the scope and limits of the typical pastoral relationship and be in accord with the spiritual and social goals of such a relationship. The goal: to enable clergy and other pastoral ministers to break through the wall of silence that sur- rounds alcohol and drug dependence, and to become involved actively in efforts to com- bat substance abuse and to mitigate its damaging effects on families and children. (For more detail, see Appendix B, Executive Summary, pp 21-23.)

Charge to the 2003 Expert Consensus Panel

To help develop those core competencies, SAMHSA, again joined by the National Association for Children of Alcoholics and the Johnson Institute, convened a more broadly based panel meeting in Washington, DC, on February 26-27, 2003. Panelists represented diverse religious perspectives, levels of leadership, and working experience with congregations of diverse socioeconomic status, ethnicity, urban and rural location, and geographical region. This report details both the meeting participants’ deliberations and the core competencies they recom- mended for adoption in clerical training and continuing education.

The members of this panel, as the group before them, recognized that the opportuni- ties for clergy to engage in alcohol and drug abuse prevention and intervention vary based on the nature of role of the clergy and the nature of the congregation. For example, in a small congregation a pastor might have greater opportunities for one-on-one coun- seling than in a larger congregation. That pastor, thus, would be helped by a set of competencies related to alcohol and sub- stance abuse counseling for both the af- fected individual and members of the family. Clergy also can benefit from knowledge about locally available Alcoholics Anony- mous (AA), Al-Anon and other 12-step support programs, as well as about others in the community who are competent about addiction, intervention, and available sup- portive services. In contrast, a member of the clergy affiliated with a large congrega- tion might need to develop other strategies to find help for individuals or to empower others to help, either on a paid or volunteer basis. Work with children and youth requires yet another set of special skills.

Accordingly, the panelists agreed that the core competencies developed should provide a general framework that incorporates the basic scope of knowledge and skills all clergy and other pastoral ministers need. This core set then could be expanded to apply more directly to differing pastoral situations.

Definitions and Scope of the Discussion

In this document, the term “clergy” is a general term that includes individuals trained for and “called to” or “ordained for” a leadership role in their faith organizations. The term includes, but is not limited to, priests, ministers, deacons, rabbis, elders, and imams. At the same time, many reli- gious denominations also train and call individuals – among them, religious sisters, lay ministers and nuns – to fill other leader- ship and supportive religious roles. In this report, those other individuals are referred to as “other pastoral ministers.” Whatever their role, clergy and pastoral ministers often have opportunities to teach or counsel individuals about alcoholism and drug dependence or to conduct educational programs for adults and youth. The training and education described in this report, therefore, refers to both clergy and other pastoral ministers.

The term “pastoral” is used to describe the religious or spiritual care of individuals. Leaders of congregations and supportive personnel perform pastoral functions when they counsel individuals or families, visit the sick and disabled, or, in a more general way, sustain religious or spiritual relationships with members of their congregations or other recipients of their ministry. The term also may be applied to functions that do not take place on a one-to-one basis, preaching, conduct of religious education classes, and the development of mutual assistance programs by lay congregants. The term “congregation” refers to a local, specific religious institution – a particular church, synagogue, temple, or mosque, whether or not there is a specific, permanent physical edifice associated with the institution.

The overarching focus of the discussion undertaken and recommendations for the content of a core curriculum for clergy and other pastoral ministers by meeting partici- pants was defined specifically as alcohol and drug dependence and the impact on affected individuals and all family members. Many of the principles and practical suggestions recommended by meeting participants may have application in relation to other addic- tive behaviors as well.

Preparatory Activities

Establishing the Context of Deliberations

• Dependence on alcohol and drugs is our most serious national public health problem, affecting millions of individuals and their families. It is prevalent in all socio-economic sectors, regions of the country, and ethnic and social groups.
• Most individuals who abuse alcohol or drugs are productive members of society, not the stereotypical “street drunk.”
• Because they offer spiritual support to individuals and communities, faith communities are ideally situated to help solve the problem, through prevention, intervention, and recovery support.
• A “wall of silence” still stands between the faith community and people with alcohol and drug abuse and dependence, preventing faith communities from availing themselves of opportunities to help

Meeting participants received information from a broad array of presentations de- signed to reinforce their appreciation of the important role to be played by the faith community in responding to alcohol and drug abuse issues in the work of their ministries.

Sis Wenger, Executive Director, NACoA, reviewed the key findings of the report by the Center on Addiction and Substance Abuse, So Help Me God: Substance Abuse, Religion and Spirituality. She called attention to two significant “disconnects” that affect responses to addiction. Clergy often experience a disconnect between their awareness of alcoholism/addiction as a problem and the training and skills they have been given to address the problem. Health care providers exhibit a different disconnect:between knowledge and action. While they acknowledge that religion and spirituality can be important assets in the process of recovery from alcoholism and drug dependence, they generally do not emphasize the importance of faith in healing.

In an overview of the science of alcohol and drug addiction treatment, Substance Abuse Treatment: What Is It? Why Does It Seem Ineffective?, A. Thomas McLellan, Ph.D., Director, Treatment Research Institute, University of Pennsylvania, called attention to unrealistic expectations and misconcep- tions that lead to the misuse or underuse of existing community-based treatment re- sources. In his view, treatment is a long-term process, not a single “place, pill, therapy, or religion.” The real work of recovery includes helping an individual reintegrate him- or herself into the community, the success of which rests frequently on the availability of community support.

Dr. McLellan asked meeting participants to recognize the striking parallels between alcoholism and drug dependence and other chronic, debilitating illnesses such as hyper- tension, diabetes, and asthma, and to ac- knowledge that treatment of each of these chronic conditions must include elements that address both individual behavior and the community environment. He advocated the establishment of clerical training and education that would enable clergy and other pastoral ministers to present appropri- ate information to their congregations, to recognize the early warning signs of chemi- cal dependence in individuals, to motivate those individuals to accept treatment, to refer them to treatment, and to organize congregational support for those in recovery and their families.