A small group gathered at 9:30 am on Sunday July 9 to discuss the new counseling service that St. Paul’s will offer beginning August 15. The Claude W. Ahrens Charitable Trust, a private foundation established in 1991 to promote religious and faith-based organizations within central Iowa, has funded the program to the extent that, beginning August 15 Charles will devote 1/2 day per week to this ministry to offer cash-based counseling to community members who need it.

Charles described the problem this service is intended to solve. While the local Mental Health Center offers a sliding scale to the needy and insurance-based counseling to those with insurance, there are still those in the community who may lack access to this service. In addition, insurance-based counseling requires that the counselor assign a diagnosis, which may deter someone with problems from coming in. Charles’ counseling will focus on those with problems who need help temporarily to get through bad patches and who otherwise would not have access to counseling. He can base the diagnosis, if any, on clinical indications, not on insurance company policies. Charles will have to do an assessment at the first to assure that the client is in the right place; people with long-standing history of mental health treatment or who can afford other counseling will be discouraged so that the service can provide help for the underserved population.

Clients will be expected to pay $10 per hour and then the grant will subsidize the remaining $80 per hour charge for the counseling. Charles would not be prescribing medications, but would refer those who need them to someone who could prescribe them.

Charles distinguished between this new counseling service and the ordinary pastoral counseling that he currently offers and will continue to offer to church members. This pastoral counseling is part of his job as priest and will not be affected by the new service. Now, as with the new service in place, Charles must make a decision about when more than just pastoral counseling is needed, and must refer people to others for more intensive mental health counseling. That will not change—Charles wants to be primarily our priest, not our mental health counselor. However, if a church member meets the criteria to be served under this grant, Charles may contract with another mental health professional to provide the service under this grant.

We discussed how this service might continue to be funded once the Claude W. Ahrens Charitable Trust funding runs out. While we may hope for some continued funding from this same source, we will begin now to seek out other sources of funding, such as agencies like the Lily Foundation and its support for Emerging Churches, the diocese or other Episcopal sources, and granting agencies interested in rural health issues. While the Bishop’s Committee is currently the board in charge of the service, we may think about having a board devoted specifically to the counseling service. If this becomes a permanent part of St. Paul’s ministry, the church will have to consider how it can continue to support it.

Charles is planning on advertising the availability of the service perhaps through brochures, perhaps through newspaper ads, and certainly by contacting MICA, Mid-Iowa Community Action agency, an anti-poverty agency.

Laura Van Cleve has discussed with Charles how emergencies will be handled. Charles mentioned the use of the phone to talk with clients, and referral to other agencies if the client or another is in danger.

We discussed the issue of confidentiality. Charles will take steps to insure confidentiality for the clients, except in cases where someone is endangered, when he may call in police, hospital, or mental health workers to help. We discussed having clients use the northwest door (and having a small sign indicating that entrance) for clients, and setting up a small but comfortable waiting room in St. Dunstan’s chapel. Charles will try to cluster the appointments so that he can devote a chunk of time to this service; we will have to have someone else in the building when he is counseling. We even discussed the possibility of having it operate at night, when AA or other groups are using the building. Charles mentioned the possibility of offering group therapy, which insurance typically does not pay for.

We discussed the need to keep the Claude W. Ahrens Charitable Trust apprised of our progress in this ministry through frequent and comprehensive reporting that respects the confidentiality of the clients. (We discussed developing a form for the assessment and running it by the Trust board to see if it works for them). We should similarly keep the congregation apprised of our progress through reporting to them.

While the counseling service will be small in scale at first, if the need materializes, we might think about adding another counselor on a part-time basis; Charles wants to be sure that he remains our priest, and that this service does not detract from his ministry as our priest.