Mental Well-Being

Fully Alive Guide helps clergy define, assess, and practice a flourishing ministry

Which one of four mental health profiles fits you best? A comprehensive new guide from the Clergy Health Initiative distills four identified behaviors of "Flourishers" into actionable steps.

Explore Our Resource

Resources

Loved and Cared For: A Handy Guide for P/SPRCs Who Want to Support Their Pastor Well

This guide is intended to help P/SPRCs engage in practices which support their pastor feeling loved and cared for. The ideas in this guide can be explored in more detail as a committee through the resource Keeping the Faith.

Fully Alive: A Resource to Guide Clergy Towards Four Behaviors of Flourishing

A comprehensive resource for clergy and faith leaders that defines Christian flourishing, guides clergy to assess their current well-being, distills four identified behaviors of flourishing into actionable steps, and creates room for reflection.

Stress Management Practices from the Selah Study

This Stress Management study (Selah) identified three stress reduction practices that allow pastors to fully live into the work that God is calling them to do with creativity, insight, and energy – even during the most stressful times.

Deepen Your Discernment with the Daily Examen

The Daily Examen is a method of prayerful reflection on the day's events to see where God has been present and discern God’s current direction for you. It is a simple but powerful prayer that can be practiced by anyone, including congregations.

Resilience Writing for Stress Management

Resilience writing is a 20-minute expressive writing exercise conducted over multiple days that can help clergy process the stressful emotions and thoughts of ministry. It has outcomes as good as therapy and is free and more convenient.

Love Thy Neighbor with Loving Kindness

Loving Kindness Meditation is an effective tool for building compassion during times of stress. In this resource, we share stories from clergy who have used this meditation practice to care for their own health, while caring for others.

Cyclic Sighing for Stress Management

Cyclic sighing is a breathing practice that can be done anytime and anywhere. There is no cost and zero side effects. What's more, this practice was found in a rigorous trial to reduce anxiety symptoms, lower heart rate, and improve positive mood.

Tending the Shepherds: Mental Health Support for Clergy

This report examines mental health care among UMC clergy, shines a light on the current gaps, and offers encouragement for those who are looking to get professional mental health counseling.

Supporting Congregants Through a Robust Referral System

Proactively reduce clergy stress by creating a set of referral sources to share with congregants in their time of need. This self-guided training includes videos, worksheets, and guides designed in collaboration with Partners in Health and Wholeness.

List of Recommended Well-Being Practices for Clergy

Evidence-based practices designed to increase your resilience, protect against burnout, and free up energy to do God's work with a renewed sense of creativity and insight.

Research Summaries

Mental Health Profiles Help Clergy Assess Their Own Flourishing

Drawing on survey data from over 1,200 North Carolina United Methodist clergy, we identified four profiles of positive and negative mental health symptoms and determined how those profiles changed during the intense stress period of COVID-19.

Childhood Abuse Associated with Greater Spiritual Struggles in Seminarians—What We Know and What Can Help

For students with significant trauma in their backgrounds, struggles with God can further amplify struggles with mental health. Addressing both together rather than separately can aid the path to healing.

Rates of Adverse Childhood Experiences Among Seminarians

More than 7 in 10 students enter divinity school with at least one Adverse Childhood Experience. Read more on why the upstream factors of mental health matter for theological education.

Spiritual Well-Being Protective Factor against Depressive Symptoms

Stressful work can lead to feelings of discouragement. Our study among UMC clergy in North Carolina showed that depressive symptoms often arise before work-related distress, with spiritual well-being acting as a buffer against these challenges.

The Resilience of Clergywomen

Clergywomen experience more on-the-job stress than clergymen. But as their stress increases, they're less likely to show depressive symptoms than men, suggesting that women may be particularly well-suited to cope with the challenges of the profession.

Key Findings from Our Disaffiliation Report

Based on NC-UMC clergy’s assessments of their own congregations, 57% of churches remaining after disaffiliation were purple, 25% were red, and 18% were blue. Read up on other key findings from our 2024 report in this summary.

Journal Articles

2025
Tice, L., Salgado, G., Johnston, E., Nascimento, B., Lee Bo-Hyeong, J., Proeschold-Bell, R. J., & Eagle, D. (2025). The weight of the yoke: a qualitative analysis of the stressors for clergy across a mental health continuum. Mental Health, Religion & Culture, 1–17. https://doi.org/10.1080/13674676.2025.2536533

Holleman, A., Eagle, D., Lee, B. H. J., & Proeschold-Bell, R. J. (2025). A Brief Report on the Prevalence of Adverse Childhood Experiences among United Methodist Clergy. Psychological Trauma: Theory, Research, Practice, and Policy.

Kim, E. T., Lee, B. H. J., & Proeschold-Bell, R. J. (2025). Does Flourishing Mental Health Improve Perceived Quality of Life? Journal of Happiness Studies, 26(6), 95. https://doi.org/10.1007/s10902-025-00929-w

Sohail, M. M., Yao, J., Jane Lee, B. H., Nascimento Salgado, G., & Proeschold-Bell, R. J. (2025). The relationship between burnout and Outlook, resilience, and other emotional styles: Evidence from United Methodist clergy. Journal of Workplace Behavioral Health, 1-21. https://doi.org/10.1080/15555240.2025.2459276

2024
Lee, B. H. J., Holleman, A., & Proeschold-Bell, R. J. (2024). Stability and shifts in the combined positive and negative mental health of clergy: A longitudinal latent class and latent transition analysis study of united methodist pastors before and after the onset of COVID-19. Social Science & Medicine, 116651. https://doi.org/10.1016/j.socscimed.2024.116651

Upenieks, L., Eagle, D.D., & Holleman, A. (2024). Childhood Abuse and the Mental Health of Seminary Students: The Mediating Role of R/S Struggles. Review of Religious Research. https://doi.org/10.1177/0034673X241302420

2023
Holleman, A., Upenieks, L., & Eagle, D. (2023). Adverse Childhood Experiences Among Seminarians: Personal Experiences of Trauma and Implications for Pastoral Well-Being and Ministerial Training . Journal of Psychology and Theology, 0(0). https://doi.org/10.1177/00916471231206361

Holleman, A. & Eagle, D. (2023). Is there a crisis in health?: Reorienting research using a national sample. Journal for the Scientific Study of Religion. https://doi.org/10.1111/jssr.12859

Holleman, A. (2023). "Programming Provided by Religious Congregations in the United States to Address Mental Illness and Substance Use Disorder." Journal of Religion & Health. https://doi.org/10.1007/s10943-023-01804-9

Proeschold-Bell, R.J., Eagle, D.E., Tice, L.C. et al. (2023). The Selah pilot study of spiritual, mindfullness, and stress inoculation practices on stress-related outcomes among United Methodist Clergy in the United States. Journal of Religion and Health. https://doi.org/10.1007/s10943-023-01848-x

Proeschold-Bell, R. J., Eagle, D. E., Tice, L. C., Platt, A., Yao, J., Larkins, J. S., Kim, E. T., & Rash, J. A. (2024). The Selah trial: A preference-based partially randomized waitlist control study of three stress management interventions. Translational Behavioral Medicine, ibae017. https://doi.org/10.1093/tbm/ibae017

Proeschold-Bell, R.J., Miles, A., Toth, M. Adams, C, Smith, B., & Toole, D. (2013). Using effort-reward imbalance theory to understand high rates of depression and anxiety among clergy. Journal of Primary Prevention, 34(6), 439-453. https://doi.org/10.1007/s10935-013-0321-4

Upenieks, L. and Eagle, D.E. (2023). “Divine Struggles Among Those Doing God’s Work: A Longitudinal Assessment Predicting Depression and Burnout and the Role of Social Support in United Methodist Clergy.” Sociology of Religion. https://doi.org/10.1093/socrel/srad014

2022
Biru, B., Yao, J., Plunkett, J., Hybels, C.F., Kim, E. T., Eagle, D. E., Choi, J., & Proeschold-Bell, R.J. (2022). The gap in mental health services utilization among United Methodist clergy with anxiety and depression symptoms. Journal of Religion and Health, 62(3), 1597-1615. https://doi.org/10.1007/s10943-022-01699-y

2021
Eagle, D.E., Rash, J., Tice, L., & Proeschold-Bell, R.J. (2021). “Evaluation of a remote, internet-delivered version of the Trier Social Stress Test.” International Journal of Psychophysiology, 165: 137–144. https://doi.org/10.1016/j.ijpsycho.2021.03.009

Proeschold-Bell, R. J., Stringfield, B., Yao, J., Choi, J., Eagle, D., Hybels, C., Parnell, H., Keefe, K., & Shilling, S. (2021). Changes in Sabbath-keeping and mental health over time: Evaluation findings from the Sabbath Living study. Journal of Psychology and Theology, 50(2), 123-138. https://doi.org/10.1177/00916471211046227

Tice, L. C., Eagle, D. E., Rash, J. A., Larkins, J. S., Labrecque, S. M., Platt, A., Yao, J. & Proeschold-Bell, R. J. (2021). The Selah study protocol of three interventions to manage stress among clergy: A preference-based randomized waitlist control trial. Trials, 22(1), 892. https://doi.org/10.1186/s13063-021-05845-x

2020
Hybels, C. F., Blazer, D. G., Eagle, D. E., & Proeschold-Bell, R.J. (2020). Age differences in trajectories of depressive, anxiety, and burnout symptoms in a population with a high likelihood of persistent occupational stress. International Psychogeriatrics, 34(1), 21-32. https://doi.org/10.1017/S1041610220001751

Keyes, C., Yao, J., Hybels, C. F., Milstein, G., & Proeschold-Bell, R. J. (2020). Are changes in positive mental health associated with increased likelihood of depression over a two-year period? A test of the mental health promotion and protection hypothesis. Journal of Affective Disorders, 270, 136–142. https://doi.org/10.1016/j.jad.2020.03.056

2019
Case, A. D., Keyes, C. L., Huffman, K. F., Sittser, K., Wallace, A., Khatiwoda, P., Parnell, H. E. & Proeschold-Bell, R. J. (2019). Attitudes and behaviors that differentiate clergy with positive mental health from those with burnout. Journal of Prevention & Intervention in the Community, 48(1), 94-112. https://doi.org10.1080/10852352.2019.1617525

Hough, H., Proeschold-Bell, R.J., Liu, X., Weisner, C., Turner, E.L., & Yao, J. (2019). Relationships between Sabbath observance and mental, physical, and spiritual health in clergy. Pastoral Psychology, 68(2), 171-193. https://doi.org/10.1007/s11089-018-0838-9

Lutz, J., & Eagle, D. E. (2019). Social networks, support, and depressive symptoms: Gender differences among clergy. Socius, 5, https://doi.org/10.1177/237802311987382

Milstein, G., Hybels, C., & Proeschold-Bell, R.J. (2019). A prospective study of clergy spiritual well-being depressive symptoms and occupational distress. Psychology of Religion and Spirituality, 12(4), 409-416. http://dx.doi.org/10.1037/rel0000252

2018
Case, A.D., Eagle, D.E., Yao, J., & Proeschold-Bell, R.J. (2018). Disentangling race and socioeconomic status in health disparities research: An examination of black and white clergy. Journal of Racial and Ethnic Health Disparities, 5(5), 1014-1022. https://doi.org/10.1007/s40615-017-0449-7

Eagle, D., Hybels, C., & Proeschold-Bell, R.J. (2018). Perceived social support, received social support, and depression among clergy. Journal of Social and Personal Relationships, 36(7) 2055-2073. https://doi.org/10.1177/0265407518776134

Hybels, C., Blazer, D.G., & Proeschold-Bell, R.J. (2018). Persistent depressive symptoms in a population with high-level of occupational stress: Trajectories offer insights to both chroninicity and resilience. Journal of Psychiatric Practice, 24(6), 399-409. https://doi.org/10.1097/PRA.0000000000000337

2017
Adams, C., Hough, H., Proeschold-Bell, R.J., Yao, J., & Kolkin, M. (2017). Clergy burnout: A comparison study with other helping professionals. Pastoral Psychology, 66(2), 147-175. https://doi.org/10.1007/s11089-016-0722-4

Eagle, D., Miles, A., & Proeschold-Bell, R.J. (2017). The honeymoon is over: Occupational relocation and changes in mental health among United Methodist clergy. Review of Religious Research, 59 (1), 31-45, https://doi.org/10.1007/s13644-016-0263-4

Proeschold-Bell, R.J., Turner, E. L., Bennett, G. G., Yao, J., Li, X.-F., Eagle, D. E., Meyer, R. A., Williams, R. B., Swift, R. Y., Moore, H. E., Kolkin, M. A., Weisner, C. C., Rugani, K. M., Hough, H. J., Williams, V. P., & Toole, D. C. (2017). A 2-year holistic health and stress intervention: Results of an RCT in clergy. American Journal of Preventive Medicine, 53(3), 290-299. https://doi.org/10.1016/j.amepre.2017.04.009

Smith, T.W., Eagle, D.E., & Proeschold-Bell, R.J. (2017). Prospective association between depressive symptoms and the metabolic syndrome. The Spirited Life study of United Methodist pastors in North Carolina. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 51(4), 610-619. https://doi.org/10.1007/s12160-017-9883-3

2015
Blouin, R., & Proeschold-Bell, R.J. (2015). Measuring stress in a clergy population: Lessons learned from cognitive interview testing of the Perceived Stress Scale with clergy. Research in the Social Scientific Study of Religion, 26, 141-154. https://doi.org/10.1163/9789004299436_010

Proeschold-Bell, R.J., Smith, B., Eisenberg, A., LeGrand, S., Adams, C., & Wilk, A. (2015). The Glory of God is a human being fully alive: Predictors of positive versus negative mental health among clergy. Journal for the Scientific Study of Religion, 54(4), 702-721. https://doi.org/10.1111/jssr.12234

2013
LeGrand, S., Proeschold-Bell, R.J., James, J., & Wallace, A. (2013). Healthy leaders: Multilevel health promotion considerations for diverse United Methodist church pastors. Journal of Community Psychology, 41(3), 303-321. https://doi.org/10.1002/jcop.21539

Miles, A., & Proeschold-Bell, R.J. (2013). Overcoming the challenges of pastoral work? Peer support groups and psychological distress among United Methodist Church clergy. Sociology of Religion: A Quarterly Review, 74(2). https://doi.org/10.1093/socrel/srs055

Proeschold-Bell, R.J., Swift, R., Bennett, G., Moore, H. E., Li, X., Blouin, R., Williams, V., Williams, R., & Toole, D. (2013). Use of a randomized multiple baseline design: Rationale and design of the Spirited Life holistic health intervention study. Contemporary Clinical Trials, 35(2), 138-152. https://doi.org/10.1016/j.cct.2013.05.005

2012
Wallace, A., Proeschold-Bell, R.J., LeGrand, S., James, J., Swift, R., Toole, D., & Toth, M. (2012). Health programming for clergy: An overview of protestant programs in the United States. Pastoral Psychology, 61, 113-143. https://doi.org/10.1007/s11089-011-0382-3

Wallace, A., Proeschold-Bell, R.J., LeGrand, S., James, J., Swift, R., Toole, D., & Toth, M. (2012). Health programming for clergy: An overview of protestant programs in the United States. Pastoral Psychology, 61, 113-143. https://doi.org/10.1007/s11089-011-0382-3

2011
Proeschold-Bell, R.J., LeGrand, S., James, J., Wallace, A., Adams, C., & Toole, D. (2011). A theoretical model of holistic health of United Methodist clergy. Journal of Religion and Health, 50(3), 700-720. https://doi.org/10.1007/s10943-009-9250-1