To be pastoral has, as I have spoken before, come to mean something different. Pastoral has come to mean flexible, accepting, welcoming, friendly, understanding, etc... Classically, however, pastoral was a word more closely associated with and more tied to the specifics of the pastoral office. In other words, pastoral referred to the pastor exercising the care of the people in his parish through confession and absolution, preaching and teaching (catechesis), intercession and supplication, correction and rebuke, and the not quite sacramentals (anointing the sick, for example). I am not sure that this is the typical expectation of the people today and I am also this is not the first thing a pastor thinks of when he thinks of pastoral care.
In particular, the arenas of social justice and the fast pace of change with which so many personal choices seem to be thrust not only upon individuals but churches have blurred this direction. Pastoral care has become the support of and advocacy for individuals (in everything from the cause of the poor and the oppressed to the newer categories of sexual attraction and gender identity). Even more so, those doing pastoral care are, in many cases, not pastors at all. So when we speak of pastoral care we may or may not even be describing what it is that pastors do and are more likely, in fact, to be speaking of how this care is provided than what this care looks like.
One definition that pops us puts it this way:
For Lutherans, it is imperative that we be more specific. Preaching is pastoral care, perhaps the most universal and central way we engage the people of God. The Word of God proclaimed from the pulpit works to create, sustain, and grow the faith in a person. It is uniquely pastoral and it is the first line of spiritual care that your pastor provides. With this ministry of the Word, comes the pastoral care provided not only through the actual baptism itself but the nurturing of that baptismal life. The pastor reminds the baptized who they are when feelings and circumstances cloud that identity. The pastor reminds the baptized of the fruits of this new life and identity God has and continues to provide. Through the Sacrament of the Altar, the pastor provides the blessed food of Christ's own body and blood for the forgiveness of sins and as the pledge and token of the heavenly banquet anticipated in this communion. The Office of the Keys is not simply confession and absolution but it is no less. It is where we are directed by God's Word, corrected by His voice, and restored to a right relationship with Him.
Pastoral care is not simply a helping service or caring but serving and caring with the Means of Grace! The more we remember this the better people will understand not only the pastoral office but also how the Lord watches over and cares for them in their life in His Church. The therapeutic model is limited by its own intent to listening and affirming while the means of grace provide the very presence, rescue, and renewal God's people seek and need.