Anatomy of a Sick Church – 10 Symptoms to Watch


There are certain metrics and issues physicians check when we go to the doctor. They want to check our blood pressure and temperature. They do blood tests to see if there are any warning signs. They are looking for symptoms that might indicate real problems exist.

After working with churches for thirty years, I too look for symptoms that might point to greater concerns. The symptoms are not necessarily the problem; they simply provide warnings or cautions of potential issues.

While there are many potential symptoms of a sick church, I have found ten to be consistently common. These ten are not listed in any particular order:

  1. Declining worship attendance. Surprisingly, the majority of church leaders do not monitor worship attendance. I advise leaders to compare each month’s average worship attendance to the same month of previous years.
  2. Decline in frequency of attendance of church members. This symptom is the number one explanation for attendance decline in most churches. Members are not as committed as they once were. Their waning love for their church is reflected in their declining frequency in worship attendance.
  3. Lack of joy and vibrancy in the worship service. Obviously, this symptom is subjective. It is still, however, very important. Most people can sense when a worship service is vibrant, lukewarm, or dead.
  4. Little evangelistic fruit. As a general rule, a healthy church will reach at least one non-Christian for every 20 in worship attendance. A church with a worship attendance of 200, for example, should see at least ten new Christians a year.
  5. Low community impact. In my consultations, I attempt to find clear indicators that a church is making a difference in its respective community. I ask both church leaders and community members for clear examples and indicators.
  6. More meetings than ministry. A sick church will meet about what they should do rather than do it. Some churches have more committees than conversions.
  7. Acrimonious business meetings. Christians can and do disagree. Sick churches have meetings where the disagreements reflect obvious bitterness and anger.
  8. Very few guests in worship services. A vibrant church will attract guests. A sick church will not.
  9. Worship wars. Yes, they still exist in many churches. Those wars are indicators of an inward focus by the members.
  10. Unrealistic expectations of pastoral care. Sick churches view pastors and other staff as hired hands to do all of the work of ministry. Healthy churches view pastors as equippers for the members to do most of the ministry.

None of these symptoms are good, but churches do go through periods where they demonstrate a few of them. The key is to recognize the symptoms and respond early and quickly.

Here is my own subjective health analysis according to the number of symptoms:

1 to 2 symptoms. Normal for most churches for a short period of time. Not an indicator of poor health, but the symptoms should be addressed promptly.

3 to 4 symptoms. The church is sick and needs immediate attention.

5 to 6 symptoms. The church is very sick. If significant changes are not made, the congregation is in danger of moving into the phase of terminal illness.

7 to 10 symptoms. The church is in danger of dying in the next five to ten years. While it is possible for a church to recover from this level of sickness, it is rare. Intervention must be quick, intense, and dramatic. The amount of change necessary is often more than most leaders and members are willing to bear.

Give an honest assessment of your own church by these symptom indicators. What do you see? What should you do if there are a number of symptoms? Let me hear from you.

photo credit: Come in and take a pew via photopin (license)

Posted on June 22, 2015

With nearly 40 years of ministry experience, Thom Rainer has spent a lifetime committed to the growth and health of local churches across North America.
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  • My church displays 10 out of 10. The church I go to is very old. My husband and I are the youngest adults at 56 and 59 years old. My son at 14 is the only child in the church. My son gets alone because he sits away from everyone and vanishes. When we had a few children once the elders would yell at them. They say they want to build the church back up as without me and my family there would only be nine people, but the members always fight with me when I make suggestions that I feel are needed for us to build the church. Your website has been a God send to me because you have mentioned things I felt was important. They will do nothing for children. The don’t want any children. So nothing is there not even a corner with toys or anything for small children and I fought tooth and nail for making a Sunday school for older children. They will not reach out to the community. I feel in my heart that we should be doing things for the unchurched. But, they think things like reaching out to the community is stupid and our Priest feels the same way. I honestly think he is there for the money he gets in salary. He goes along with the majority of the members and says reaching out is stupid because no one in America wants to be Christian any more. My husband and I used to be very involved but now we are looking to planting our own church. I am glad of your site. I feel it will help me start a good church welling to reach out to the unchurched and community we live in. God bless you and this site.

    • What you have described is not a church but an exclusive and cranky “social club.” Do your son a life-long favor and find a church where he (and you) can love, be loved and grow in the Lord!

    • I have also been to a church like this where I saw no children & it consisted mostly of much older people who looked down on you for being younger. I felt so “out of place” among them. The women had their own “click”. I certainly did not go back. By all means, start your own church. Get your son out of there fast! He will have a bad feeling about church and when he gets older might not ever want anything to do with it. I feel bad for him. What I feel worse about is that we have all these discussion’s about church being this or that and its a shame. I would bet that God isn’t too pleased with his “church”.

  • S. Beeman says on

    How do you lead a change?

    • David Troublefield says on

      (A x B x C) > D = Change

      Change: a self-sustaining new condition (ie, if the pastor must sustain the “change,” then it wasn’t change–instead, the pastor created a fad/trend that can’t outlive its own lifetime); if change is needed, then Change is the most important part of the equation.

      D: resistance to change; the lengths people will go–even painful lengths–not to change (God hard-wired us for latency, or the tendency to wind down physically, emotionally, spiritually, etc–and to require winding up again fairly continually via divinely-created compensations such as nighttime, functional rather than dysfunctional relationships, revival/regeneration; note: solve the latency/homeostasis issue so that it stays solved = become a zillionaire!–every leader always deals with folk not motivated for what is offered by them).

      > : part of the left side of the Change equation must overcome the other part for change to happen…

      ( and ): the factors of the left part of the left side of the equation each must exist and function together synergistically in order to overcome D.

      A: dissatisfaction with current reality–and enough of it to willingly consider alternatives; diagnosing dissatisfaction as “dissatisfaction” is a function of management–ie, nobody acting as a manager auditing current reality and saying, “This isn’t satisfactory,” then no Change (pastor, feel free to raise the congregation’s level of dissatisfaction via prayer, preaching/teaching, informal conversations, and sightseeing trips to places where better things are happening).

      B: awareness of the probable existence of a preferred future–that, even if many things are ok, the surrounding population of the church’s location supports every church growth-related measurement being even better (e.g., baptisms, attendance, total designated receipts); B is a function of leadership–ie, nobody casting a vision of an even greater future = no leader is present (an observation: the SBC today has a great many more problem-finding managers than it does solution-discovering leaders; c.f. the present state of the denomination in terms of its potential for sustained growth as reported this summer).

      C: a knowledge of first steps to take in order to go from A to Change; this is a function of administration, not just of management or leadership (ie, even where leaders cast vision, in 2015 too few seem able to execute the steps of a plan–like Flake’s Formula–to achieve that vision, and most seem to have no plan at all [not to choose a destination = the church goes in circles, if anywhere–and anybody can lead it in circles, not just a well-paid, seminary-trained pastor ])–so, nobody serving like an administrator does = no Change (ie, everything rises and falls on: management, leadership, and administration–not just on leadership as so often is said).

      x: the A, B, and C must function together synergistically–and the absence of even one of them means D can’t be overcome (like multiplying by zero; 0 x 100000000 x 34977543378 = 0).

      Short version of the above: Implement Andy Anderson’s “Sunday School Growth Spiral” in your church–it provides guidance with each part of the Change equation and leads to sustained growth anywhere it can be had (there was nothing like the Growth Spiral before it–or since it, again as evidenced by the current condition of almost all SBC congregations; Thom’s staff at LifeWay understands all about it, and can help you get the Spiral started where you serve).

      David Troublefield, DMin
      [email protected]

      • David Troublefield says on

        I only would add:

        After 25 years in full-time vocational Christian ministry serving SBC congregations, I now work as one of a nearby county hospital’s executive team members (and speak/consult in my spare time . . .). Our hospital has a fairly active Emergency Room; if the physicians serving patients in the ER only were able to diagnose illnesses or injuries (ie, “Yes, sir–worst broken leg I have ever seen!” or “No, ma’am; this typically is not a life-threatening illness . . .”) without also offering specific insightful prognoses and commonly-recommended prescriptions/treatments based upon years of medical study/practice (with all necessary follow-up visits scheduled, to check for progress made by patients), then the hospital’s Emergency Room would not be the useful place our clinical and nonclinical staffers know that it must be for the population of our service area (we say, “Heaven touches earth–literally–at the address of our hospital in this town!” and exceptional holistic healthcare consistently delivered to those in need is our team’s aim). It’s the same with identifying “10 Symptoms of This” and “15 Symptoms of That”; without specific how-to’s for addressing the ills of a church following its diagnosis, the congregation will struggle to proceed toward change (because “effective processes” is one of six characteristics of the only kind of team ever achieving exceptional results like those needed by the USA today, our churches simply can’t do without “ways” or “processes” that work and understanding the specifics of them).

        Everyone: don’t stop with symptoms or signs; insist on steps and specific how-to’s. In this day and age of so much unnecessary decline in SBC and mainline churches–when fully 50 million more people live all across the US than was true only 20 years ago–all congregations everywhere can experience significant biblical growth (as defined by Gene Mims, formerly of LifeWay), and a future that is utterly fantastic is possible for each of them! Don’t wait; your Cooperative Program contributions annually are meant to aid congregations like the one yours may now have become–avail yourself of the resources/resource persons on the local/state/national level in denominational life (ie, your DOM, or state Baptist convention staffers, or NAMB staff members) that you already are paying for (we’d never otherwise leave that much money on a table and simply walk away . . .). Those dear brothers and sisters in the Lord know their stuff (just ask Thom) are aching to assist you and your church today! :- }

        Have a super Saturday,

        David Troublefield, DMin
        [email protected]

      • Kobuk Volbane says on

        Very interesting comments. The trouble is, a doctor can’t write a column about what to do about a specific patient’s broken leg. Neither can someone write a column about what a specific church should do.
        My church is in trouble. We used to be a mill town, like many other towns in my state. Our attendance has declined just like everyone else’s. We have a church that costs tens of thousands of dollars to maintain. I’d like to get rid of the building, and have my tithe go to people, not to a building. I don’t know if we’ll get there. There seems to be some interest in doing that, and also a lot of resistance, and a lot of desire to somehow go back to what we once were. But if that is what we do, I will leave, and find a more functional church, or simply mail my money into the local United Way or some such thing. I hope that doesn’t happen. I believe you can’t really be a Christian outside of a Christian community.

      • David Troublefield, DMin says on

        After assessing the situation well “on the ground,” an info piece indeed can be written about how a Christian congregation can address its difficulties. To insist otherwise is to deny SBC church and denominational history.

        Things obviously change over time, but God wants for all churches to experience biblical growth–that is: spiritual growth (becoming more like Christ in character), numerical growth (increases in attendance and membership), ministry growth (more or better meeting of known needs of others, in Jesus’ name), and mission growth (increased number and/or support of gospel mission points). Clearly, an unreached population must be available to be reached for Christ and His church in a community, but nothing at all has to stop the other 3 kinds of growth. Southern Baptists of decades ago searched a town for one remaining lost soul, like DL Moody did (not a Baptist pastor himself). Things change, but the approach to finding solutions is exactly the same and very specific, and being used by lots of congregations to capture their futures–whatever that future may be–with the Lord. It is too soon to quit if an unreached population surrounds the church building, in my opinion.

        Not all church growth problems are spiritual ones; most of them are matters of organizational administration, at least initially.

        David Troublefield, DMin

  • Great insight. However, I think your ratio of members to new believers is too low at 5%. That number can… and should be… much much higher. The goal I recommend is 12%. How do I get to that?

    – At least 10% of members evangelize one person at least once each month
    – At least 10% of those reached accept Christ

    If the SBC (15 million) did this, there would be:

    – 1.5 million evangelistic conversations each month
    – 18 million evangelistic conversations each year
    – 1.8 million people saved each year (that’s 12% of the SBC membership)

    I believe that this goal is not only achievable, it should be the actual goal (not 5%). I’ve written about this at

  • I’m in an all-day budget meeting at LifeWay, so my interaction in the comments will be limited for the time being. My team will be approving comments, however, so continue to share your thoughts. Thanks,

    Thom Rainer

  • We have a relative who played in a Christian band with a leader who turned out to have a fear of failure. So even though they were phenomenal musicians, with good hearts, this individual would sabotage things (ironically to prevent any possibility of failure), including being unresponsive to venues that wanted to host them. In the meantime, this leader started insisting that the band needed to do more Bible study (led by him of course), to meet more for talk and study, rather than for active rehearsal and scheduling and public playing. In other words, as per #6, he used meetings to avoid real activity and ministry, under the guise of piousness and Godly devotion. It destroyed the band, the potential they had, the ministry they had begun. It was tragic, selfish, and so wrong. Christians like to blame the devil when things go wrong, but too often people do their own damage, without any help from him.

  • What does it mean when many of these items follow a new pastor to a church?

  • Alex Clayton says on

    The Apathetic Generation
    The majority of the population in the U.S. is going to be retiring “boomers” who are checking out of the church because the church has not adapted a vision for them. They will miss 3 out of 4 Sundays to visit their children and after 25 years still label their Bible Class as Young Families. Since the young people are questioning their denomination, the boomer is going where the grand kids are going. In all the focus on reaching the young people; the generation that was raised on goal setting, bullet points, and mission statements have quit. Take a look at the apathy in your church among the “empty nesters.” Re-engage this generation with a vision for their children and watch the church take off.

    • I see this in one of our members. She comes once in a while to our church and spends the rest of the Sundays going to the church her children go to

  • Mark Dance says on

    I think it is interesting that even though your order was random, the first few symptoms were worship related. Perhaps intuitively so, because at the heart of every sick church is a a lack of vertical focus (first love/first & greatest commandment).

    In my pastoral experience, while the inwardly and outwardly focused symptoms can be improved on, the real solution to the sickness is personal and corporate worship.

  • I would add an 11th common symptom and that is: Having a leadership that would rather deny that any of these symptoms exist rather than acknowledge them and seek to remedy them.

    • I have found if you discuss spiritual health issues you get labeled as an outsider and a problematic individual. I do not understand why leaders refuse to admit the obvious spiritual health problems. Is it we are hiring unqualified leadership?

      My church is sick but they can recognize problems with the deterioration of the physical church building; they want to fix those things. The deeper spiritual issues are all ignored.

      • Steve –

        Your observations are on target, and all too common in many churches.

      • David Troublefield, DMin says on

        According to NAMB statistician Richie Stanley, presently (reported since 2010) 72% of all SBC congregations are plateaued/declining in terms of their biblical growth; 100% of those 33,000+ churches are led by: Senior Pastors (at least, that is what those men tell their associate pastors!). NAMB’s revitalization efforts, and those such as the SBTexas’ Ezekiel Project (e.g., here:, have begun with senior pastors because their involvement in revitalization is key (not the total solution–or even close to it, fortunately–but key as potential change agents; cf. the research of Dr. Pat Morley of several years ago). What I have not seen are: reports of the successes of NAMB and state-level initiatives which include those senior pastors . . . But LifeWay’s stats prior to the summertime SBC annual meeting do not seem to point to a positive trend developing . . . And my consulting experience is that senior pastors do not want to talk about it.

        An observation: nothing seems to take as long to die as a Southern Baptist church. It may be one more way God demonstrates His presence and plan; He is committed 150% to do His part for church growth–and does it!–and He is committed 150% NOT to do our parts . . . And so, 3000+ churches close/fail annually, while the populations of their zip codes continue to increase. But, initially, the problem is an administrative–not a spiritual one (people do not know what they do not know about organizational administration, etc.–but, again, Andy Anderson’s Sunday School Growth Spiral provided the answers . . . No better answers have been offered by anyone at any level since Andy retired from the BSSB in 1993).

        David Troublefield, DMin
        [email protected]

  • I see many of these symptoms. I could add a few.
    1. Church has become too programed. No time for the Holy Spirit.
    2. Leadership no longer allows joyous praise.
    3. Taken out testimonies
    4. No longer have evangelistic Sunday night services
    5. Congregation no longer invites lost friends, neighbors.
    6/ How can a church effectively preach on sermon on Sunday morning and minister both to the congregation and to the lost?
    When the church was alive, most Sunday mornings were encouraging to the saints, and Sunday night was Evangelistic.

    • Robert,

      The changes you have noted are definitely significant. It may be that some of the items listed are being given priority in a different venue or meeting. If they are, the issue might be more one of preference. For example, a church might not do Sunday night outreach services (because attendance dwindled down to a few church members) and instead make a concerted effort to refocus on congregation wide personal evangelism.

      While this may or may not be the situation in your church in particular, it is wise for church leaders to keep in mind the difference between true signs of declining Church health and a strong preference for doing things the way they have always been done. I pray your church is seeking growth and health, not just the changes you mentioned.

  • My I add:
    Having the same leadership for decades. There is oftentimes a fear of bringing in new leadership even when the church is “sick.”

    New ideas are quickly shot down. The people that suggest doing anything different are immediately labeled as heretics.

      • In the UMC churches, drive through fast food baptisms, no mention of salvation, no invitation to acceptance of Christ given at the end of a service. Pastors who read the same prayer every Sunday. My lord, don’t ppl know how to pray to Jesus from their heart.? Nobody brings a bible with them 2 church any more. Ppl don’t know the books of the bible. No focus on learning scripture. Trying to normalize or ignore sin&expect congregants to accept it. Services are like a country club. In groups. Out groups. Famous words it’s always been done that way, nobody asks why? I’ve been faithfully attending&active in music&chaperoning teens. Still over half the church doesn’t even call me by name or call me at all when I had 3 major surgeries in less than 6 months. What do you do? Keep going &feel ignored&invisible? Work harder? Give more? I’ve tried everything.

    • Rev. Ralph Yeager Roberts says on

      That is a great example and quite telling in my experience.

  • M Saunders says on

    My church displays 10 out of 10. It is a very difficult place to be the pastoral leader. I do not believe that they enjoy being sick. I do not believe that God wants them to be a sick church; however, they continuously make choices and kill actions that might make positive change. They need more than a diagnosis, they need a prescription and a life-coach.

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