Moving Past Spiritual Triage

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Ever been a church leader? A missionary? If so, then you know about spiritual triage.

Triage is the process of determining the most important issues to tackle. In a medical setting, triage determines who must be seen first and which emergencies are the most severe.

In the local church and on the mission field, there is no end to the spiritual health issues. If you are in leadership, then guess what, it is up to you to meet those needs. Like that poor nurse that sits at the front door of the emergency room, it is easy to find yourself running from one emergency situation to the next, trying to weigh the urgency of each. Unfortunately, our approach to pastoral care is too frequently reactive instead of proactive.

If I’m honest, I think there may be piece of us that likes it that way.

It makes us feel busy and important to run from one fire to the next. It makes our ministry feel urgent and, when we actually do put out a fire, gratifying. When we are about the work of spiritual triage, people see church leaders as specialists in the tradecraft of fixing their spiritual woes. And at the end of the day, it gives us something to complain about. You read that right; we get to complain. We get to complain about how busy we are and the emotional weight we must bear by being in leadership. 

Perhaps I’m wrong. Perhaps you hate it. For the rest of you out there who are more like me and trend toward a hero complex, let’s talk about why we need a new ministry paradigm.

Our paradigm is backwards: From reactive to proactive spiritual care

I said it above: far too often, our approach to discipleship is reactive instead of proactive. It makes sense, just like the nurse in the emergency room, we think our job is to run after the sickest first. We look out across our church or mission field and assess the health of the people we shepherd. Then, our gut reaction is to chase down the ones in the most acute situation. After all, we have very limited time, and we want to make the most of it. So, we roll up the sleeves and stick our hands in the nastiest mess we can find.

It may sound like good logic, but it isn’t. 

While this may be noble, it is rarely effective. When we are reactive with discipleship and spiritual care, we wind up with lots of half-finished projects. We are constantly juggling severe cases and rarely stitching up healing wounds. 

A better way: Discipleship as leadership development

We need pastoral care that leads to multiplication. A reactive discipleship paradigm that always rushes acute spiritual cases to the front of the line will not do. Pastor, if you desire to see spiritual growth in your entire body, then you will never get there by letting these severe cases dictate your time. Missionary, if you hope to plant churches that will then plant churches, only dealing with the hard cases will see your churches stay in their infancy.

Why is that? Simply put, a reactive discipleship model is not multiplicative. 

In his work, The Trellis and the Vine, Collin Marshall addresses spiritual triage and gives a helpful framework. He suggests that every individual moves along a discipleship timeline. In any church, any church plant, any mission field, people fall somewhere along this timeline. Marshall then provides this nugget:

Training is the engine of gospel growth. Under God, the way to get more gospel growth happening is to train more and more mature, godly Christians to be vine-workers — that is, to see more people equipped, resourced and encouraged to speak the word prayerfully to other people, whether in outreach, follow-up or Christian growth.

Unfortunately, in most churches and for most pastors, hardly any effort goes into training. It’s basically seen as the pastor’s job to do the gospel growth, and since that is virtually impossible at a personal level, it is all done at the general and large-group level.

We need to stop running around putting out fires, and start training up fellow laborers. Too often, discipleship stops short. Our goal should be to train up trainers, to raise up men and women who can do share in the labor. Marshall calls them vine-workers, people who can lead and teach and see their job as training people to do the same. With such a proactive discipleship paradigm, we do more than meet immediate spiritual needs, we raise up a workforce to aid in the task. 

At first, such an approach appears to be overlooking emergencies to focus on people that seem to be further along in their faith. However, if you put the necessary care into these people, they will soon be able to grab the plow next to you. I assure you, seeing discipleship as leadership development will multiply your ability to shepherd.

Where to begin?

So, how does a church leader of missionary shift the focus from spiritual triage to leadership development? Let me give you a hint: it’s not a program. This type of leadership development does not start through a church-wide training program. 

Instead, consider these action steps:

  • Place your people on a discipleship timeline – This may sound like you are grading them, but that is not really the point. Do identify where they are in their gospel growth. Are they a brand new Christian or are they showing signs of confidence in their faith and fruits that could be leadership potential?
  • Identify your next leaders – As you map out the people you lead, pay special attention to the ones who could quickly train others. This is not simply a question of who is the smoothest talker. Instead, consider their character and understanding of the gospel. Then, begin to pour your efforts into these individuals.
  • Take them with you – Do not shepherd in isolation. A common critique of leadership development is the misunderstanding that it is an added time commitment. Take them with you when you make a house call. Have them along for the ride when you are doing the normal work of ministry.
  • Get them started – What better way to learn than by doing? As spiritual needs arise, these new leaders can shoulder the weight as well. Soon, they will be sharing responsibility instead of you bearing it all, and you can watch as these new leaders begin to train their own.

Have you seen this play out in your own ministry? Do you have specific examples? If so, share them with us in the comments.

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Keelan Cook Administrator
Senior Church Consultant
Keelan leads the Peoples Next Door project and is a Senior Church Consultant with the Union Baptist Association in Houston, TX. He is working on a PhD in Missiology at Southeastern Baptist Theological Seminary. In previous years, he spent time as a church planter in West Africa with the IMB and doing ethno-graphic research in Washington, DC with NAMB.
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