PASTORAL INTERVIEW · GROUP GUIDE
Video summary, answers to slides 18–19, the six boxes from slide 20, and a ready-to-run group activity.
Source: Dr. Todd Grande, CBT Role-Play – Depressive Symptoms and Lack of Motivation, 24:08. Reviewed using the video’s auto-generated captions. The supplied PowerPoint provides the questions and six-part format.
0:14–7:59. Elizabeth is a married mother of two boys, ages 8 and 10. She has stayed home for 10 years and previously found that role satisfying. Over roughly six months, she has felt persistently down, isolated, and unmotivated. Friendships and activities have faded. Household and parenting routines have become harder, and she feels guilty about her husband's increased workload.
8:02–15:19. The counselor compares a recent day with the day Elizabeth wishes she could have. Sleeping late briefly shields her from sadness, but afterward she feels guilt and frustration. He clarifies that her family has commented on reduced activity, while Elizabeth supplies the label lazy herself.
15:22–22:26. The counselor links thoughts, feelings, and behavior. Elizabeth practices more helpful self-talk and considers getting up to see her children off to school even before motivation returns. The goal is one manageable action, with the possibility that satisfaction may gradually return.
22:30–24:08. They agree to practice over five school mornings and review progress in one week. The counselor emphasizes that a missed day does not erase earlier successes. He suggests depression and says further assessment is needed. The clip does not demonstrate a full diagnostic or safety assessment, referral, or discussion of faith.
Main lesson: Listen without blame, explore the relationship between thoughts and behavior, and help the person choose a manageable next step. Clinical assessment and consent-based spiritual care are additions we would consider in a pastoral setting.
Persistent low mood, diminished interest or pleasure, and lack of motivation, with difficulty getting out of bed and carrying out usual family routines. Elizabeth says she feels stuck. This is a concern about depressive symptoms, rather than proof of laziness or a confirmed diagnosis.
Yes. Social isolation, faded friendships, self-criticism, guilt, and family strain accompany the main complaint. Sleeping to avoid distress appears to maintain the cycle. The transition to both boys being in school provides context, but the video does not establish it as the sole cause.
Yes, through listening, companionship, support for meaning and hope, and practical connection, alongside clinical care. Six months of symptoms and reduced functioning call for professional assessment. A deacon should work within training and ministry boundaries. Pastoral support can continue during treatment.
Empathic reflection, open questions, clarification, summaries, and gentle exploration of self-critical thoughts. Also needed: recognition of depression and risk, direct safety inquiry, referral coordination, sensitivity to the client's faith preferences, and collaborative goals. Formal CBT treatment requires appropriate clinical training.
Begin by listening and clarifying her priorities, functioning, supports, and safety. Explain the role and confidentiality limits. Arrange clinical and medical assessment. Ask permission to explore faith. Help her choose one feasible daily step and one manageable connection with a supportive person. Agree on follow-up in one week and review progress without blame. Coordinate with other providers only with appropriate consent.
Yes, in this case formulation, recommend assessment by a licensed mental health clinician and a primary care clinician. Persistent symptoms and impairment warrant evaluation, including possible medical contributors. Ask about thoughts of suicide or self-harm rather than assuming safety. Immediate danger requires urgent help under the setting's crisis procedure. The video itself does not show a referral.
Faith has no explicit role in this clip. Elizabeth's beliefs, church participation, and spiritual concerns are unknown. A pastoral caregiver can ask whether faith offers comfort, raises difficulties, or matters to her care. Do not infer that low mood indicates weak faith.
Yes, if Elizabeth wants it and it serves her goals. Prayer, Scripture, sacramental life, lament, or parish companionship may support hope and belonging. Ask permission and explore both support and spiritual struggle. Keep clinical assessment and treatment in the care plan.
The clinical counselor demonstrates transferable skills: reflecting feelings (0:32–0:42 and 5:38–5:39), clarifying what others actually said (5:17–5:38), asking for a concrete day (8:02 onward), summarizing the avoidance cycle (13:36–14:32), examining thoughts, collaboratively developing a small goal, and encouraging her after setbacks (23:03–23:28). No specifically religious intervention appears. Present-moment encouragement is not enough to establish the relational skill of immediacy. Self-disclosure and humor are not clear teaching examples here.
In a pastoral setting, offer licensed mental health care and medical evaluation, with practical help to access them. If her current counselor is already providing qualified clinical care, coordinate or supplement that care rather than assuming a duplicate referral is needed. Ask about safety and escalate if necessary. Parish or community support can address isolation with her consent.
Elizabeth, an adult of unstated age. Married, with sons ages 8 and 10. A stay-at-home mother for 10 years. Her husband is supportive but increasingly frustrated. Her mother comments on reduced activity. Neighborhood friendships have faded. Faith life is unstated.
She reports feeling down, stuck, and unhappy, with little motivation for about six months. Sleeping late, withdrawing from activity, and struggling with usual routines affect family life. Assessment is needed to establish a diagnosis.
Isolation, guilt, harsh self-judgment, family strain, and loss of rewarding activity. Sleeping temporarily avoids distress but leaves more guilt afterward. School-age children and faded friendships have changed her daily social contact.
Empathic reflection, clarification, concrete questions, and summaries. Comparing current and desired routines. Exploring automatic thoughts, gentle confrontation of the avoidance cycle, helpful self-talk, collaborative goals, and homework. Faith-specific skills are not demonstrated.
Proposed addition: listen, clarify priorities, ask about safety, and arrange clinical and medical assessment. Support one chosen action and gradual reconnection. Ask permission before spiritual care. Follow up in one week. Continue companionship alongside treatment.
Explain the pastoral role, confidentiality and its applicable limits. Work within competence. Refer for mental health and medical evaluation. Obtain appropriate consent for coordination. Use urgent crisis procedures if immediate danger emerges. Do not diagnose from a role-play or frame symptoms as a spiritual failure.
Purpose: Practice the six parts of the case presentation through choices, explanations, and short role-plays. The competition rewards sound reasoning and care skills.
Group and time: 6–24 participants in 2–4 teams. Allow about 35 minutes after viewing the video: 3 minutes to introduce the case, 24 minutes for eight rounds, and 8 minutes for the final case presentation and discussion. For 20 minutes, use rounds 2, 4, 5, 6, and 7, then a short debrief.
Materials: The offline game on a projected screen, paper, pens, and the filled slide 20. Without a screen, read the rounds below and keep score on paper.
Participation: Use Elizabeth's fictional case. Anyone may pass or observe instead of performing a role. Focus feedback on the response, and avoid personal disclosures.
Assign one of the six slide-20 boxes to each team or pair. Allow 2 minutes to prepare and 30 seconds per box to present. Then discuss: What facts did we know? What did we infer? Which response protected Elizabeth's agency? How can faith and clinical care work together? What would you do before agreeing on a plan?
Facilitator emphasis: The video demonstrates clinical CBT. Do not equate symptoms with laziness or weak faith. Distinguish present-moment encouragement from relational immediacy. Treat safety inquiry and referral as proposed care steps. A small action is an experiment, not a guaranteed cure.
Slide 20: box 1
Which statement can your team support from the video?
Answer: A. Her age and faith are unstated. She says she does not want to return to paid work. Her husband is supportive but frustrated.
Explanation point: Name one important fact you would still need to ask about.
Practice point: Ask one respectful question about her support system.
Criterion: The question is open, relevant, and does not assume a fact.
Evidence: 2:04–2:35; 4:32–4:47
Slide 18: presenting problem; Slide 20: box 2
What best captures why Elizabeth needs help?
Answer: C. She reports persistent low mood and impaired functioning. A full assessment would be needed for diagnosis. Moral labels add blame.
Explanation point: Distinguish a symptom description from a diagnosis.
Practice point: Offer one sentence that reflects her distress without judgment.
Criterion: The response names a feeling or difficulty and avoids blame.
Evidence: 0:20–1:51; 7:19–7:59; 20:48–21:01
Slide 18: secondary problem; Slide 20: box 3
Which pattern best explains how her difficulties may maintain one another?
Answer: B. The counselor explores temporary relief from sleeping and later sadness and guilt. Isolation and self-criticism also matter. The clip does not establish a single cause.
Explanation point: Name one secondary concern beyond the sleeping pattern.
Practice point: Ask a question that explores what happens after she stays in bed.
Criterion: The question explores the pattern without accusing her.
Evidence: 12:07–14:32
Slides 18–19: counseling skills; Slide 20: box 4
Elizabeth interprets comments from family as calling her lazy. What is the strongest next response?
Answer: D. Reflection acknowledges pain. Clarification separates what family said from Elizabeth's interpretation. The counselor uses this distinction in the clip.
Explanation point: Name the two skills in the strongest response.
Practice point: Rewrite a blaming statement as an empathic, clarifying response.
Criterion: The response acknowledges emotion and asks for clarification.
Evidence: 4:50–5:44
Slide 18: plan; Slide 20: box 5
Which first plan most closely fits the counselor's approach?
Answer: B. The demonstration pairs one chosen behavior with helpful self-talk. Small steps can precede motivation. In pastoral care, support that goal alongside appropriate clinical care.
Explanation point: Explain why the plan should reflect Elizabeth's choice.
Practice point: Offer a small-step invitation and a realistic, compassionate self-talk sentence.
Criterion: The invitation preserves choice and the self-talk avoids promising an instant cure.
Evidence: 15:36–17:25; 21:05–21:33
Slide 19: role and focus of faith; Slide 20: box 5
How could a pastoral caregiver introduce faith into this case?
Answer: C. The video gives no information about her faith. Spiritual care should follow her preferences and can accompany clinical care. This round adds a hypothetical pastoral response.
Explanation point: Name one spiritual resource that could be offered if she wants it.
Practice point: Ask permission to discuss faith or offer prayer.
Criterion: The invitation allows an easy yes or no and does not judge her beliefs.
Evidence: Faith is not discussed in the transcript.
Slides 18–19: setting and referral; Slide 20: box 6
In a pastoral setting, what is the most appropriate care arrangement?
Answer: A. About six months of symptoms and reduced functioning warrant assessment. Pastoral companionship can continue. Explain confidentiality limits and use urgent procedures if immediate danger emerges. Referral and safety inquiry are proposed additions, not events shown in the clip.
Explanation point: Name one limit of your pastoral role and one reason for referral.
Practice point: Offer a referral in a sentence that also communicates continuing care.
Criterion: The response offers professional help without abandonment or an unsupported diagnosis.
Evidence: 7:19–7:59; 8:18–9:29; NIMH depression guidance
Slide 18: follow-up plan; Slide 20: box 5
After two helpful mornings, Elizabeth struggles on the third. What should you say?
Answer: D. The counselor explicitly says setbacks do not erase successes. Review obstacles and adjust the step with Elizabeth, without shame.
Explanation point: Name one obstacle you would explore before changing the plan.
Practice point: Give a supportive response to a missed day.
Criterion: The response acknowledges earlier effort and supports a feasible next step.
Evidence: 23:03–23:28
Original video and caption transcript. Caption timestamps identify discussion segments, and auto-generated wording may contain errors. No diagnosis or nonverbal findings were inferred from the transcript.
NIMH: Depression supports professional evaluation for persistent symptoms affecting daily functioning and consideration of medical contributors. NIMH: Psychotherapies describes clinical treatment and the role of trained professionals. NIMH: Suicide—How You Can Make a Difference supports direct inquiry about suicide without assuming that asking causes suicidal thoughts.
The pastoral recommendations and game are educational applications to the supplied slides. They do not describe interventions actually shown in the video.