Pastoral Care for Healthy Churches (and Pastors)

I’m sure there are a few leaders who want to keep their churches small, or who don’t care about church growth.

But most small church leaders and pastors I meet actually want to reach more people. They want to see their mission fully realized. They hope and pray for the day when they can reach as many people as possible in their community.

But that’s simply not reality.

The Barna Group reports the average Protestant church size in America as 89 adults. 60% of protestant churches have less than 100 adults in attendance. Only 2% have over 1000 adults attending.

As a result, the dreams of pastors of most small and even mid-sized churches go unrealized. Why?

There are many reasons churches don’t break the 200 attendance mark, but today I want to drill down deeper on one that kills almost every church and pastor: pastoral care.

If pastors could figure out how to better tackle the issue of pastoral care, I’m convinced many more churches would grow.

Here’s why. And here’s how.

What Is Pastoral Care?

Pastoral care is the practice by which a pastor cares for the emotional, physical, and spiritual needs of their congregation. It has a long and storied history within the church, rooted in the idea that a pastor is the “shepherd” of their congregation. This makes a lot of sense, considering that the Latin root of our word for “pastor” means “shepherd.”

What Is the Goal of Pastoral Care?

In Psalm 23, we’re given the powerful image of a shepherd tending his flock. The shepherd nourishes, protects, and comforts his flock of sheep. While the psalm is meant to reflect God’s relationship with his Chosen People, it also gives us an ideal model of how a pastor should relate to their congregation.

The goal of pastoral care is to nourish, protect, and comfort the congregation. A pastor does this through pastoral services, such as teaching the Bible, making disciples, and investing in the personal lives of those who are members of the church. Pastoral care is an act of service performed on behalf of the congregation. 

However, if a pastor isn’t careful, pastoral care can lead to compassion fatigue and burnout. 

How Pastors Die Trying

When the pastor has to visit every sick person, perform every wedding and funeral sermon, make regular house calls, attend every meeting, and lead every Bible study or group, they become incapable of doing almost anything else.

Sermon preparation falls to the side, and providing organizational leadership for the future is almost out of the question.

The pastoral care model of church leadership simply doesn’t scale.

It’s somewhat ironic, actually.

If you’re a good pastoral care person (and many pastors are), people will often love you so much that the church will grow to two hundred people, at which point the pastoral care expectations become crushing.

Inevitably, pastoral leaders with larger churches can’t keep up and end up disappointing people when they can’t get to every event anymore.

Providing pastoral services for 30 people personally is possible. Caring for 230 is not.

Many pastors burn out trying.

The pastoral care model most seminaries teach (and most congregations embrace) creates false and unsustainable expectations.

Consequently, almost everyone gets hurt in the process.

The pastor is frustrated that he or she can’t keep up. And the congregation is frustrated over the same thing.

Eventually, the pastor burns out or leaves, and the church shrinks back to a smaller number. If a new pastor arrives who also happens to be good at pastoral care, the pattern simply repeats itself: Growth, frustration, burnout, exit.

It’s ironic. The very thing you’re great at (pastoral care) eventually causes your exit when you can no longer keep up.

Or, if you stay for a long time, your church settles down to around 100 people, and you simply can’t grow it beyond that.

Why? Because you haven’t structured your church to grow bigger.

Complication 1: Pastors Who Won’t Let Go

Several factors make pastoral care complicated.

Many pastors I know are people-pleasers by nature, and that can undermine your leadership. Wanting to not disappoint people fuels conflict within leaders: people want you to care for them, and you hate to disappoint them.

In some respect, pastoral care establishes classic co-dependency. The congregation relies on the pastor for all of its care needs, and the pastor relies on the congregation to provide their sense of worth and fulfillment: the pastor needs to be needed.

Complication 2: Congregations That Won’t Let Go

Many congregations define the success of their leader according to how available, likable, and friendly their pastor is.

It’s as though churches want a puppy, not a pastor.

Since when did that become the criteria for effective Christian leadership?

By that standard, Moses, Jeremiah, Ezekiel, Hosea, the Apostle Paul, and perhaps even Jesus, failed the test.

The goal of Christian leadership is to lead, not to be liked.

That’s no excuse for being a jerk or insensitive, but still, leadership requires that, at times, you need to do what’s best, not what people want.

If a church is going to grow, congregations have to let go of the expectation that their pastor will be available for every medical emergency, every twist and turn in their lives, every family celebration, and every crisis.

That’s a tough sell for many congregations, but if a church is going to grow, it has to happen.

Too Scared to Change How You Lead?

Too scared to have the conversation?

If you’re a people pleaser, do what you need to do to get over it. Go see a counselor. Get on your knees. Do whatever you need to do to get over the fear of disappointing people.

If you’re afraid to have the conversation, have it anyway.

Courageous leadership is like courageous parenting. Don’t do what your kids want you to do; do what you believe is best for them in the end.

Eventually, many of them will thank you.

And the rest? Honestly, they’ll probably go to another church that isn’t reaching a lot of people, either.

I’m convinced that if we changed how we do pastoral care, we’d reach more people. And in the process, we’d care for people much better than we do now.

Try Starting Something New

Many churches plateau because they keep doing what’s familiar instead of embracing what’s next. If your church feels stuck, it may be time to innovate.

Innovation doesn’t mean abandoning tradition—it means finding fresh ways to accomplish your mission. This could look like:

• Expanding your digital presence with online groups, interactive content, or a stronger social media strategy.
• Reworking your ministry structure to engage people in new ways, like shifting from large gatherings to micro-communities.
• Refreshing existing programs by applying the “new, improved, improving” mindset—consistently evaluating and updating what you offer.

Momentum is fueled by movement. The churches that thrive are the ones willing to step into something new rather than simply maintaining what already exists.

Ask What Your Successor Would Do

If you stepped aside today and a new leader took your place, what’s the first thing they would change? 

Leaders often hesitate to make big shifts because of personal attachment, fear of pushback, or a preference for comfort over risk. But a fresh perspective can expose necessary changes that you might be avoiding. Instead of waiting for a transition to spark new ideas, ask yourself three questions:

1. What’s not working, and why haven’t we fixed it?
2. Where have we settled for “good enough” instead of “what’s best”?
3. What bold decision would a new leader make that I need to make now?

Great leadership requires the courage to disrupt your own status quo.

Focus on Your Sweet Spot

Churches often dilute their impact by trying to do everything. The most effective churches know what they’re great at—and lean into it.

Ask yourself: Where do we see the most fruit? If your church excels at building relationships, prioritize small groups, hospitality, and personal connections. If you’re gifted in teaching, double down on discipleship and deep biblical training. Trying to be everything to everyone leads to exhaustion and mediocrity.

To operate in your sweet spot, align gifting, passion, and strategy:

• Gifting – What is your church uniquely great at?
• Passion – What energizes your leaders and congregation?
• Strategy – How can you structure your ministry to maximize impact?

Growth isn’t about doing more—it’s about doing what matters most, with excellence. When you focus on your sweet spot, your church will have more influence, more momentum, and ultimately, more impact.