When Not to Use a Residential Program

To assist clergy or religious in need of psychological and/or spiritual help, Catholic leaders make referrals to a variety of resources. A good referral requires that leaders have an initial sense of what kinds of issues are facing the individual and what resources are available and appropriate for dealing with each of these issues.

For example, the priest who is involved in a sexual relationship with one consenting adult would likely need a different referral than a priest engaged in dozens of anonymous sexual contacts. Similarly, a religious sister suffering from a mild depression has different needs from a seriously depressed sister contemplating suicide. Finally, a religious pondering leaving religious life would evoke a different response than a religious whose chronic interpersonal dysfunction has wreaked havoc on community after community. Some of these should be referred to outpatient psychotherapy; others might find a sabbatical program helpful; some might benefit from a directed retreat; while others would be best served at a residential treatment center.

What complicates the referral problem is the difficulty religious leaders often have in getting a firm handle on what the individuals' problems actually are. Their root problems can be complex, confusing and largely hidden. Leaders with some clinical training and experience are at an advantage. Those without a clinical background often find it helpful to have access to a clinical consultant. These professionals can provide an initial consultation on how to handle the issue and what resources might be brought to bear. Should the problems be found to be complex and significantly serious, a thorough assessment at a residential center may be indicated.

When considering using a residential program, some initial questions might be helpful:

• Is the priest/religious currently able to function in ministry?
  

If the individual is not able to function adequately, it is likely important for the individual, and to those whom s/he ministers, to find a safe place without distractions such as a residential program to address his/her problems. Individuals who are functioning well and whose problems are less severe might be best served by remaining in place and seeking local assistance.

• Will outpatient therapy likely be successful?  Has it been tried?
  

Individual outpatient therapy is often indicated for many kinds of problems such as mild depressions, anxiety disorders and interpersonal conflicts. Individual outpatient sessions are less likely to be helpful if the person is in the throes of an active addiction, in a strong state of denial, and/or has multi-layered and complex problems. It is not uncommon that priests and religious will be referred to Catholic residential programs after a history of unsuccessful outpatient therapies.

• Is there a possibility of scandal? Of destructive behavior?
  

Priests and religious are public figures often in direct ministries to hundreds of people. Should they be engaged in destructive behavior such as drug/alcohol addiction, compulsive sexual acting out, or compulsive gambling or spending, the potential danger to themselves and others is significant. Immediate removal from their situations and placement in a residential program may not only be clinically helpful, it may be pastorally imperative.

The religious leader has to assess the quality and appropriateness of differing resources and then seek out  the right referral for each individual in need of assistance. Thus, the leader will need to take stock of the wide variety of possible options. Of particular concern to religious leaders is the Catholic spiritual dimension, that religious vocations not be subtly undermined and inappropriate behavior not be encouraged. Developing a list of reliable resources is important.

Catholic residential centers offer in-depth healing programs of several months including a wide variety of individual, group, verbal and non-verbal therapies. The constant presence of a challenging and supportive community are a major strength of such centers. The communal setting and frequent group treatment modalities are often most helpful to individuals who have been isolated or are in need of learning better interpersonal skills. Most important, such centers should offer a spiritual program that is informed and strengthened by its whole-hearted commitment to Catholic values. The Church offers many wonderful avenues of healing grace. Any comprehensive attempt to assist a priest or religious in need of healing should make direct use of these healing moments. Combining the best of psychological treatments with a Catholic healing spirituality provides a powerful healing regimen.

Catholic residential programs are not always appropriate referrals. At other times, they can be a life-saving and vocation-saving grace.

Rev. Stephen J. Rossetti is the President and CEO of Saint Luke Institute