Answer: There may be as many answers to that question as there are counselors, but I will take a shot at answering it from my perspective.
People enter counseling with a history that reveals something about their “relational patterns.” These “patterns” reflect an accumulation of decisions that have been made over a lifetime. The further we get from loving God with all our hearts and loving our neighbor as ourselves, the more those “relational patterns” become “behavioral ruts” that keep us stuck and frustrated. The vast majority of people that enter counseling do so because relationships are not working effectively.
From my experience, counseling is most successful when a person develops awareness that the present way of life is not working and requires personal change. As long as one blames circumstances or other people or God, the rut continues to control life direction. Pastoral counselors are trained to know how to enter these relational ruts, and lead clients on a spiritual journey to freedom and abundant life in Christ.
The journey normally begins with some small step of approaching life situations differentlv than before. These small changes that the counselor facilitates become like crowbars that pry people out of the rut just enough to experience the anxiety of change. The counselee is then supported and encouraged in this slight shift of thought or behavior. There are times when this minute change becomes like a snowball rolling down a hill. The momentum builds into an avalanche of power and people transform before our eyes.
More often, the change process seeps into life almost unnoticed. Inch by inch, these building blocks of new relational style squeeze out the destructive or ineffective pattern. People who have suffered severe abuse, neglect, or dysfunction from childhood may need a couple of years of spiritual journeying with a counselor because the “relational habits” are so deeply etched upon their hearts and minds. This long term counseling is much like re-parenting the person because they may have no trusted models for what God is like and as a result struggle intensely to be able to love Him, or anyone else.
I try to design each counseling case as a spiritual journey. We define the “as is”. The Bible describes the destination, and the journey between those two points is an adventure for counselor and client alike. God has promised to bless those committed to seeking His will. We are also blessed to be a part of a church that is in the powerful flow of the Holy Spirit. Once a person gets out of the rut, it is only a matter of time before we are nudged along toward spiritual growth and abundant life.