What is clinical spiritual counseling?

Clinical spiritual counseling is structured pastoral care for grief, faith questions, moral injury, spiritual distress, anger at God, church harm, hard decisions, disaster exposure, and meaning-level concerns. It is not psychotherapy, diagnosis, or medical care.

Is this Christian counseling?

Yes, for clients seeking Christian counseling. The work can include Christian faith, scripture, prayer, theology, church experience, anger at God, grief, doubt, calling, and meaning when the client wants those included.

Can I talk about anger at God?

Yes. Anger at God, doubt, numbness, loss of belief, guilt, grief, and the question 'How could this happen?' are welcome here.

How is this different from spiritual direction?

Spiritual direction often focuses on spiritual practice, prayer, discernment, or relationship with God over time. Clinical spiritual counseling is more focused on a presenting issue such as grief, moral injury, church harm, disaster exposure, anger at God, hard decisions, or spiritual distress.

Do you take insurance?

No. Sessions are private pay. Texas Spiritual Counseling does not bill insurance directly.

Can I submit receipts?

Yes. Upon request, an itemized receipt can be provided for clients who want to attempt reimbursement through insurance, EAP, HSA/FSA, employer assistance, church assistance, disaster-relief, or other benefit programs. Reimbursement is not guaranteed.

Board Certified Chaplaincy and Clinical Spiritual Care

What Is a Board Certified Chaplain?

A Board Certified Chaplain is not a volunteer visitor, a generic minister, or someone who “just knows how to comfort people.” A Board Certified Chaplain is a clinically trained spiritual care professional prepared for grief, death, moral injury, anger at God, spiritual distress, medical crisis, disaster exposure, family conflict, and the moments when easy answers can do real harm.

This page explains the difference between Board Certified Chaplains, pastors, volunteer chaplains, therapists, spiritual directors, and private clinical spiritual counseling.

Texas Spiritual Counseling provides pastoral counseling and clinical spiritual care. This is not psychotherapy, diagnosis, medical care, psychiatric care, emergency care, or treatment of mental-health disorders.

Schedule an Initial Spiritual Counseling Consultation

What a Board Certified Chaplain Is

A Board Certified Chaplain is a professional spiritual care provider who has completed graduate theological education, supervised clinical pastoral education, board review, written competency work, oral examination, continuing education, and professional accountability.

A Board Certified Chaplain is trained to provide care across crisis, grief, illness, death, family conflict, moral injury, spiritual distress, disaster exposure, and moments when a person’s belief system or meaning system is under pressure.

The work is not built around giving religious answers. It is built around understanding what the person in front of the chaplain is carrying.

That person may be Christian. They may be Jewish, Muslim, Buddhist, Hindu, interfaith, spiritual-but-not-religious, agnostic, atheist, unsure, done with church, or carrying no formal belief system at all.

Clinical chaplaincy is trained to meet the person inside their own meaning system. It is not the work of forcing the person into the chaplain’s belief system.

Why This Difference Matters

Not every minister is a chaplain. Not every chaplain is board certified. Not every kind person at a bedside is trained for spiritual care in crisis.

That distinction matters because the wrong spiritual language can cause harm.

In grief, disaster, death, medical crisis, moral injury, child loss, suicide loss, church harm, or anger at God, a person does not need to become the audience for someone else’s theology, fear, discomfort, or need to make the moment feel better.

Clinical spiritual care is trained to protect the person in crisis from that kind of harm.

The goal is not to make the suffering sound acceptable. The goal is to stay with the person long enough to understand what is happening, what is being carried, and what kind of care is needed next.

What Board Certification Requires

Board certification is not a title someone takes because they are compassionate. It is a professional credential that requires education, supervised formation, demonstrated competence, ethical accountability, and ongoing continuing education.

The path normally includes:

graduate theological education, often through an MDiv or equivalent graduate theological degree
clinical pastoral education through qualified CPE programs
supervised clinical ministry in real care settings
direct work with patients, families, staff, or clients under supervision
written reflection, case material, theology integration, and competency essays
peer feedback and supervisor evaluation
board review by experienced professional chaplains
oral examination and defense of clinical competence
professional ethics and accountability
ongoing continuing education to maintain certification

Board certification is demanding because chaplaincy is demanding. The work often happens in rooms where death, fear, grief, guilt, belief, anger, family conflict, medical decisions, and institutional pressure are all present at once.

That kind of care requires more than sincerity.

What Clinical Pastoral Education Is

Clinical Pastoral Education, often called CPE, is supervised professional education for spiritual care. It is where spiritual care stops being an idea and gets tested in real rooms with real people.

CPE may include hospital units, emergency departments, ICUs, palliative care, hospice, labor and delivery, pediatrics, oncology, trauma settings, behavioral health settings, long-term care, disaster response, congregational systems, and other settings where people face crisis, loss, fear, illness, death, or major decisions.

In CPE, the chaplain learns through direct clinical practice, supervision, peer review, written case reflection, verbatim reports, theological reflection, didactics, group process, behavioral science integration, and repeated evaluation.

A student does not simply read about grief. They sit with grieving people.

They do not simply study theology. They learn what happens when theology enters the room too soon, too loudly, or in service of the helper instead of the person receiving care.

They do not simply learn to be nice. They learn to listen, assess, intervene, refer, document when needed, collaborate with interdisciplinary teams, and recognize when the presenting issue is outside their scope.

CPE also forms the chaplain. It requires the chaplain to examine their own anxiety, assumptions, religious reflexes, family system, biases, rescue patterns, authority issues, grief history, and limits. That matters because unexamined helpers can harm people without intending to.

My Clinical Spiritual Care Training

Dr. Charlie Michele Hornes, DMin, BCC, MCPC, is a Doctor of Ministry, Board Certified Chaplain, ordained PC(USA) minister, and clinical spiritual counseling provider.

Her training and experience include graduate theological education, doctoral ministry work, board certification, 3,600+ supervised clinical hours, hospital internship and residency training, trauma and palliative rotations, ICU, emergency, pediatric and perinatal loss, COVID ICU support, crisis response, higher education, pastoral counseling, leadership environments, and nearly two decades of hospital-based and institutional spiritual care experience.

Her work is not generic religious conversation. It is clinical spiritual care, pastoral counseling, spiritual assessment, moral injury support, grief care, and referral-aware care direction.

Board Certified Chaplain vs Pastor

Pastors and chaplains are not interchangeable roles.

A pastor usually serves a congregation. A pastor may preach, teach, lead worship, administer sacraments, offer pastoral care, provide spiritual formation, organize community life, and lead within a specific faith tradition.

A Board Certified Chaplain is trained to serve people who may not share the chaplain’s religion, denomination, theology, assumptions, language, culture, or belief system.

That difference matters in hospitals, crisis settings, disaster recovery, family meetings, death notifications, emergency response, hospice, trauma, and private spiritual counseling.

A pastor may be excellent at church ministry and still not be trained for clinical spiritual care across pluralistic settings.

A Board Certified Chaplain may also be ordained. Many chaplains are ministers, rabbis, priests, imams, spiritual leaders, or religious professionals. But the board certified chaplaincy role requires a different formation than parish leadership alone.

Ministers are not automatically Board Certified Chaplains.

Board Certified Chaplains often are ministers or religious professionals, but they have also completed clinical formation for spiritual care outside the narrow boundaries of their own congregation or denomination.

Board Certified Chaplain vs Volunteer Chaplain

A volunteer chaplain may be compassionate. They may be devoted. They may be sincere.

That does not make them clinically trained.

Good intentions do not replace supervised clinical education, interfaith competence, crisis training, spiritual assessment, trauma-informed care, ethics, documentation awareness, referral judgment, and peer accountability.

This difference matters when a person is in crisis. The person receiving care should not have to sort out whether the person standing beside them is trained, accountable, or simply religiously confident.

Volunteer care can be helpful when it is properly trained, supervised, and clearly limited. It can also become harmful when it brings platitudes, pressure, correction, judgment, or religious certainty into a moment that requires disciplined presence.

When Untrained Spiritual Care Causes Harm

Untrained spiritual care can add a second wound.

The first wound is the event itself: the death, diagnosis, flood, accident, betrayal, loss, emergency, or crisis.

The second wound can happen when a person in pain is met with spiritual language that makes the helper more comfortable but leaves the suffering person more alone.

Common examples include:

“God has a plan.”
“God needed another angel.”
“God never gives you more than you can handle.”
“Everything happens for a reason.”
“At least they are in a better place.”
“You need to forgive.”
“You should be grateful.”
“This will make you stronger.”
“God is testing you.”

These statements may be meant kindly. In crisis, they can shut down grief, deepen spiritual distress, and make the person feel responsible for comforting the helper.

Clinical spiritual care is trained to avoid that.

The work is not to explain suffering too quickly. The work is to listen accurately, assess what kind of distress is present, stay with what is true, and avoid turning the person’s pain into a theological lesson.

Interfaith, Pluralistic, and Non-Belief Spiritual Care

Board Certified Chaplaincy is not limited to one denomination’s answers.

Clinical spiritual care is trained to meet Christians, Jews, Muslims, Buddhists, Hindus, interfaith clients, spiritual-but-not-religious clients, agnostic clients, atheist clients, nones, dones, and people who are not sure what they believe anymore.

The question is not, “How do I get this person to my theology?”

The question is, “What does this person need to be seen, heard, stabilized, and supported within their own meaning system?”

That is a major difference between clinical chaplaincy and parochial religious care.

Parochial ministry may be faithful and appropriate inside its own community. It can become harmful when it enters a pluralistic emergency setting and assumes that everyone needs the same doctrine, same prayer, same religious language, same explanation, or same spiritual conclusion.

Clinical spiritual care does not require the client to share the provider’s faith before care can begin.

Clinical Spiritual Care Assessment

Clinical spiritual care is not guessing.

Board Certified Chaplains use spiritual care inquiry, assessment, and intervention frameworks to understand what kind of distress is present and what kind of care is appropriate.

These may include models and tools such as the 7x7 Model, Spiritual AIM, SDAT, SCAI, spiritual distress inquiry, moral injury inquiry, meaning-making assessment, and structured pastoral care reflection.

The point is not to reduce a person to a form or a label. The point is to keep the care accurate.

A clinical spiritual care assessment may explore:

what happened and what the person believes it means
what grief, guilt, anger, fear, or numbness is carrying
what changed in the person’s faith, trust, identity, or sense of God
what sources of support are present or missing
what role family, community, church, work, or institution plays in the distress
what spiritual practices still help and what practices no longer fit
what moral conflict or unresolved responsibility is present
what belongs in clinical spiritual care
what may require licensed therapy, medical care, psychiatric care, emergency care, or referral

Clinical spiritual care is careful because the material is serious.

Evidence-Informed Human Care

Board Certified Chaplaincy is not religious performance.

The work draws from theology, spiritual care theory, behavioral sciences, crisis response, grief care, trauma-informed practice, patient-centered care, person-centered care, interdisciplinary collaboration, professional ethics, and reflective practice.

In plain language, the chaplain is trained to listen without taking over, assess without reducing the person to a category, support without imposing belief, and refer when the need is outside the chaplain’s scope.

The work is not to impress the client with theology.

The work is to understand what the person is carrying and what kind of care is needed next.

Board Certified Chaplain vs Therapist

A Board Certified Chaplain is not automatically a therapist.

Licensed therapists may diagnose and treat mental-health disorders. They may work with anxiety, depression, trauma symptoms, family systems, psychiatric referral, treatment planning, coping skills, and other mental-health concerns.

A Board Certified Chaplain provides clinical spiritual care, pastoral counseling, grief care, moral injury support, spiritual distress assessment, faith and meaning support, referral-aware care direction, and support alongside therapy when appropriate.

These are different scopes.

Different does not mean lesser.

A person may need therapy. A person may need clinical spiritual care. A person may need both.

Texas Spiritual Counseling does not provide psychotherapy, diagnosis, medical care, psychiatric care, emergency care, or treatment of mental-health disorders.

Different Credentials Answer Different Questions

A physician is trained for medical diagnosis and treatment.

A licensed therapist is trained for mental-health diagnosis and treatment within their license and scope.

A Board Certified Chaplain is trained for clinical spiritual care, grief, meaning, moral injury, spiritual distress, interfaith care, crisis support, pastoral counseling, and the spiritual or moral weight that can appear inside medical, institutional, family, community, and disaster settings.

These credentials are not interchangeable.

The problem is that many people understand the first two categories and have almost no public understanding of the third.

That lack of understanding keeps trained clinical spiritual care out of rooms where it is needed.

Why Chaplaincy Is Its Own Calling

Chaplaincy is not a fallback for people who could not handle church ministry.

That idea is false, offensive, and reveals a serious misunderstanding of the vocation.

Chaplaincy is its own calling.

It is the work of entering rooms where the system is under pressure, the family is afraid, the body is failing, the staff is exhausted, the belief system is under strain, and the old answers are not enough.

It requires disciplined presence, clinical judgment, spiritual assessment, humility, courage, theological depth, and the ability to serve people who may believe nothing like the chaplain.

A chaplain does not control the room with answers.

A chaplain helps the person in the room find enough language, grounding, meaning, or support to take the next step.

Why This Matters After Disaster

After a flood, traumatic loss, child loss, emergency response, or community tragedy, people may carry grief, anger at God, guilt, moral injury, loss of belief, spiritual distress, and the burden of what they saw and could not stop.

This is exactly where trained clinical spiritual care matters.

Disaster does not only damage property. It can damage meaning, trust, faith, family systems, leadership systems, and the ability to feel settled in ordinary life.

Survivors, responders, helpers, families, clergy, medical workers, volunteers, public servants, and community leaders may carry the impact differently. Some may need therapy. Some may need medical or psychiatric care. Some may need pastoral counseling and clinical spiritual care. Some may need all of the above.

The care lane matters because the wrong kind of care can miss the actual wound.

How Board Certified Chaplaincy Works in Private Practice

In private practice, clinical spiritual counseling can support adults who need structured care for grief, faith questions, anger at God, moral injury, church harm, spiritual trauma, disaster exposure, hard decisions, and spiritual distress.

This work may stand alone when pastoral counseling is the right fit.

It may also work alongside licensed therapy when mental-health care is already involved or needed.

Private clinical spiritual counseling may help clarify:

what is happening and what category of care fits
what grief, guilt, anger, belief conflict, or moral weight is present
what the client still believes, no longer believes, or cannot answer yet
what support is available and what support is missing
whether pastoral counseling is appropriate
whether licensed therapy, medical care, psychiatric care, emergency care, or another referral is needed
what next step is responsible, honest, and possible now

Private Services at Texas Spiritual Counseling

Texas Spiritual Counseling provides private pastoral counseling and clinical spiritual care for adults in Texas.

Service areas include:

What This Work Is Not

Texas Spiritual Counseling does not provide psychotherapy, diagnosis, medical care, psychiatric care, emergency care, or treatment of mental-health disorders.

This practice does not provide crisis intervention, suicide intervention, or emergency response.

If there is immediate danger, call 911, go to the nearest emergency room, or contact a local crisis resource.

If the presenting concern is outside the scope of pastoral counseling and clinical spiritual care, referral or coordination may be recommended.

Available Across Texas

Virtual clinical spiritual counseling, pastoral counseling, Christian counseling support, and spiritual care consultations are available across Texas.

In-person appointments may be available by arrangement in Hill Country Texas.

When to Schedule an Initial Spiritual Counseling Consultation

Schedule an Initial Spiritual Counseling Consultation if the issue involves grief, anger at God, moral injury, church harm, disaster exposure, hard decisions, spiritual distress, or uncertainty about whether therapy, pastoral counseling, referral, or another level of support is the right next step.

The first session is a focused consultation to clarify the presenting issue, identify the care lane, and determine next steps for pastoral counseling, referral, coordination, or ongoing support.

Schedule an Initial Spiritual Counseling Consultation

Frequently Asked Questions

What is a Board Certified Chaplain?

A Board Certified Chaplain is a clinically trained spiritual care professional who has completed graduate theological education, supervised clinical pastoral education, written competency work, board review, oral examination, continuing education, and professional accountability.

Is a Board Certified Chaplain the same as a pastor?

No. A pastor usually serves a congregation or faith community. A Board Certified Chaplain is trained to provide clinical spiritual care across crisis, grief, healthcare, disaster, institutional, interfaith, and non-belief settings.

Is a Board Certified Chaplain the same as a therapist?

No. A therapist may diagnose and treat mental-health disorders. A Board Certified Chaplain provides clinical spiritual care, pastoral counseling, grief care, moral injury support, spiritual distress assessment, and referral-aware care direction.

What is Clinical Pastoral Education?

Clinical Pastoral Education is supervised professional education for spiritual care. It includes direct clinical practice, supervision, peer review, written reflection, theological integration, group process, and learning in real care settings.

What is the difference between a volunteer chaplain and a Board Certified Chaplain?

A volunteer chaplain may be compassionate and sincere, but that does not automatically mean they are clinically trained. A Board Certified Chaplain has completed supervised clinical education, board review, ethics requirements, continuing education, and professional accountability.

Can untrained spiritual care cause harm?

Yes. Untrained spiritual care can add harm when a person in crisis is met with platitudes, theological correction, pressure to forgive, forced meaning, or religious language that serves the helper’s comfort instead of the suffering person’s care.

Do Board Certified Chaplains only work with Christians?

No. Board Certified Chaplains are trained to provide care across faith traditions, spiritual frameworks, and non-belief systems, including Christian, interfaith, agnostic, atheist, none, and done clients.

What are spiritual care assessment tools?

Spiritual care assessment tools help identify spiritual distress, grief, meaning, guilt, moral injury, belief conflict, sources of support, and referral needs. They help keep the care accurate rather than vague or imposed.

Can clinical spiritual care work alongside therapy?

Yes. Clinical spiritual care can work alongside licensed therapy when mental-health care is already involved or needed. Coordination can happen with client permission.

Is Texas Spiritual Counseling emergency or crisis care?

No. Texas Spiritual Counseling does not provide emergency, crisis, medical, psychiatric, or suicide-intervention care. If there is immediate danger, call 911 or go to the nearest emergency room.