"There is a loneliness in the ministry. It is the kind of loneliness that is shared by everyone in professional life who daily is confronted with issues and problems for which there is no ‘blueprint.’ It is a loneliness which wells up whenever decisions must be made that affect the lives of others, and for which there can be no definite assurance as to the final outcome. It is a loneliness which becomes increasingly poignant for ministers who realize that they deal with time and eternity—that the questions posed have to do with life and death and life again. It is a loneliness which tends to overwhelm when it emerges in a realistic consciousness of personal inadequacy."

I wrote those words almost exactly twenty years ago. We were in the struggle and turmoil of the 1960's. In retrospect I now relive those painful times; and in the process become aware of how little we knew of that which was yet to come—Watergate, world terrorism, nuclear disaster, agony in drug and substance abuse, the list runs on. And now, just over a decade from the Twenty-First Century, it is a mercy that we cannot foresee tomorrow, else we would be completely overwhelmed. And ancient words, "Sufficient unto the day is the evil thereof," bring comfort that we do not need to relive yesterday and have no way of fending off tomorrow although, properly, we learn from the former and plan for the latter as best we can.

Many will remember the opening paragraph cited above as the introductory words of my hook on referral. The book moved through several printings by three publishers, although presently it is out of print. In all likelihood I shall not revise it: its substance is, I believe, still sound but for it to be reprinted would require an update, which is not at the top of my priority list just now. So it is that I welcome the invitation from The Journal editors that I prepare this essay. Indeed. the piece might well be titled "Referral Revisited."

A case can be made for the fact that much of the professional loneliness in ministry in the mid-60's was in some sense self-imposed. We had gone from the seminaries in a kind of professional isolation marked by a hesitance to trust fellow clergy with our practice of ministry, however defined. Few submitted even fewer sermons to colleagues for critique either before or after delivery; brought verbatim reconstructions of pastoral conversations as a means for enhancing care delivery. Moreover, there was a kind of "mystique" held by the clergy in their perception of professional personnel in the helping enterprises. The physician, the psychiatrist, the clinical psychologist, the psychiatric social worker and others were often perceived as a "breed apart" who had data and experience not possessed by the parish minister. As a consequence, many felt a kind of awe marked by uncertainty when a parishioner was referred to such a person. Did the referral signify failure on the part of the minister? Did refusal to refer signify an imperialism on the part of the minister? Would referral interrupt, if not destroy, the pastoral relationship with the parishioner? These are only a few of the complex factors involved in professional colleagueship in many instances twenty years ago.

I am pleased to discover that much progress has been made, as evidenced in the situation of the mid-1980's. One of the crucial factors in this progress is the occurrence of professional consultation by the clergy in discovering the most effective means for dealing with the human situation. Increasingly it is possible to discern the extent to which the resources of the ministry are recognized and welcomed by the helping professions. Paul Pruyser's The Minister as Diagnostician (Westminster 1976) appeals to clergy to bring their own discipline to bear on the human situation and notes that it is not helpful when ministers speak only as psychologists or social workers. He expects that clergy will have a basic awareness of the advances that have been made in the behavioral sciences but notes that the true contribution of the clergy is the representation of the heritage of faith in the resolution of' human distress. Increasingly, clergy have become a part of' the "healing team" in hospitals, mental health centers, psychiatric treatment institutions and their input valued as a significant factor in human restoration.

This transition in the past two decades has done much to break clown the tacit but powerful barrier between the sciences and theology which emerged in the days of the Awakening. No longer is it necessary to see "truth" as emerging only through empirical investigation on the one hand or through revelation on the other. More and more we are aware of the fact that all truth is of God and that in wrestling with the data of investigative process we are, as the ancient saying goes, "thinking His thoughts after Him."

Even so, it is possible to paint too rosy a picture as we move toward the end of the Twentieth Century. Much progress has been made, and much remains to be done. Thus, the purpose of this essay is to take courage from the past and move toward the future

It is well from time to time for all of us in ministry to review the scope of our allies in meeting human need. The usual, although not necessarily the primary, starting point is the considerable presence of the secular helping professions. Every urban area has scores of persons and institutions which are dedicated to the relief of human suffering. These resources run the gamut of highly skilled personnel in medicine, psychiatry, guidance, counseling, nursing, substance abuse, psychology, social work, and the list runs on. Most urban areas coordinate these services through some sort of community council or human need resources organization and listings of available personnel and programs are readily accessible to clergy. But having this knowledge is only a first step in the process of pastoral care as referral. It is crucial that ministers become familiar with the exact nature of the resources and have more than a passing acquaintance with the persons who provide the services.

Alongside these professional personnel there is a widespread network of volunteer persons who are committed to the alleviation of suffering and the providing of support in all manner of human struggle. Ordinarily these people are identified with a particular human situation for which they have a personal investment. Perhaps the most widely known of these is Alcoholics Anonymous together with the cognate services such as Alanon, Alateen, and the like. The basic idea of AA has carried over into a plethora of groups dealing with some particular human distress such as Gamblers Anonymous, Overeaters Anonymous, and the like. The primary principle in such confederations is that those who have experienced the distress and are in the process of recovery are in an excellent position to be of help to persons still enmeshed in the addiction.

A variation on this theme is the presence of groups that deal primarily with terminal disease. Many communities have a "Make Today Count" program which is designed to enable persons "to live as long as they are alive." More regionally oriented groups of the same genre are "Can-surmount" designed to support persons and their families in dealing with cancer, and similar support groups for other identifiable physical ailments. From the same perspective but with a different structure the Hospice Movement has provided support both for terminal patients and their families. I do not know of any widespread "directory" of these types of helping groups, but investigation through community agencies is ordinarily the best way to discover what is available in one's own area.

Alongside these community resources there is the often overlooked support of the People of God. Many faith groups maintain human services organizations in urban areas which include but are not limited to such things as foster care, adoption, family and marriage counseling, mental retardation, problems of aging, and the like. Pastoral Counseling Centers provide expert care delivery in increasing numbers. In like fashion, particular congregations can identify persons within their membership who have special interests and skills to function in care delivery. We are moving beyond the time when it was expected that the clergy undertake the primary if not sole responsibility for care delivery. More and more we realize that ministry is the gift of God to the people of God and not solely to the clergy. Programs have been developed to assist congregations fulfill their role as burden bearers, and books such as The Tender Shepherd by John Killinger document what can be done in a local congregation.

In light of this considerable array of resources available to the parish minister there still remains the issue of when he or she can be certain—or as certain as is humanly possible—of when direct utilization is to be made. Twenty years ago I noted that the dilemma turned on the clergy's uncertainty regarding the criteria for continuing to attempt to provide direct services or to enlist assistance from someone else in working for the welfare of the parishioner. It is not a simple issue, nor has the passage of the two decades provided an easy answer. Ordinarily, the tension emerges in the clergy being too quick to refer on the one hand or too slow to refer on the other. Who among us has not felt this dilemma and who among us can claim to have arrived at a "fail-safe" solution?

These two obvious negative responses to human suffering, i.e., for the minister to be "too quick" to refer or "too slow" to refer merit attention. In many instances, of course, these are not genuine options. Confronted with certain types of personal need, such as a sudden coronary while speaking with the pastor in the study, poses no question whatsoever. The list of these crisis-type experiences is so obvious that there is no need for elaboration. Clearly there is no way that the minister's process of referral can come "too quickly" in getting the parishioner in touch with appropriate emergency resources. In like manner, and taken from almost the same list, any responsible minister will certainly not delay to enlist professional assistance for the person.

But when we move beyond these readily apparent situations the issue becomes cloudy. Many a minister has referred a parishioner when he or she could lay hold on personal resources which would prove of value in moving toward some sort of resolution. This does not mean that referral would be postponed indefinitely. But if the situation was not one of acute crisis or if it appeared in some sense to be chronic, then the minister may be in a position to work with the parishioner in wrestling with the resistances which often are involved in moving toward resolution. The question of Jesus addressed to the paralytic as recorded in John 6 may be relevant at such a juncture. "Do you want to be healed?" (John 5:6 RSV) It is not a matter to be taken lightly. To be sure the Gospel account is not presented as a "verbatim" question in line with our own reproduction of pastoral conversations. Thus, there is no obvious reason why any one of us would ask the question in its narrative form. But the meaning behind the question is quite relevant. Who among us does not continue in some sort of health-destroying process or attitude, deploring it the while, and yet unwilling to move toward its elimination? "Do you really want to get well?" The fact is that part of us does want healing, but a part of us does not. I have never known a person who wanted to be in alcoholic but I have known personally hundreds of alcoholics. "Do you want to be healed?" The usual internal—unstated—answer is, "Well, Yes I do; but I am sure I can work it out." The arresting title of Vernon Johnson's book, I'll Quit Tomorrow, is paradigmatic. It certainly applies to alcoholics, but it also applies to all of us who are aware of those things, that disturb us, but who resist doing anything about them. All of this is not to say that the minister is the only one who can deal with such resistances; it does mean that those of us in ministry have primary access to people in a fashion not granted to our colleagues in the helping professions. Moreover, our professional work is set in the context of those values which transcend but do not ignore physical and emotional distresses. For whatever reason we may turn our backs on that which we are uniquely prepared to fulfill, i.e, , an awareness of the grace of God in enabling us and our parishioners to respond positively to life as a means toward but not a substitute for specific specialized processes.

The variations on the theme of being too quick to refer are quite numerous. There are times when we, as clergy, sell ourselves short, being unwilling or unable in affirm our own strength and resources. It is patently false modesty for us to defer when there is no valid basis for deferring. Through the years as I have had occasion to participate in certification processes both in the Association for Clinical Pastoral Education and the American Association of Pastoral Counselors, one of the issues that has been high on my priority is whether the person can honestly certify himself or herself. This is not designed to suggest or promote some sort of self-aggrandizement; it is to affirm that unless and until a person is able to "own" professional strength and competence along with an awareness of limitations, that person is in some sense unfit for ministry.

From the polar opposite perspective, there are ministers who delay referral overlong. There is here the same sort of subtle unwillingness to face reality as observed in the situation of those who refer too quickly. For some there is the misguided notion that faith is—or should be—adequate for any and all human problems. Most of us have deplored this attitude on the part of some of our brothers and sisters in certain sects which resist any and all medical interventions, and who discount the positive value in psychotherapy on the basis that certain therapists are not "religious people." One can admire the zeal of such persons but raise question about their judgment.

But having stated this extreme form of resistance to working with colleagues in the clinical spheres, there yet remains for all of us to be aware of subtle ways this point of view tends to beset us in one form or another. Who of us in the clergy has not at one time or other felt as though we were "second-class citizens" when it comes to dealing with human suffering? The competence of our colleagues in medicine, in psychiatry and psychology, in social work and vocational counseling has often tended to intimidate many of us and blind us to our own pastoral resources and skills. One of the subtle responses to this sense of being intimidated is our incorporating the vocabularies of these disciplines as our own. We have known (have been?) ministers who became adept in speaking of complexes and neuroses, of unconscious and subconscious, of behavioral patterns and personal resistances; we have known (have been?) those who were more familiar with the latest approach to therapy than with new developments in theology, we have known (have been?) those who felt somewhat uncomfortable with prayer or scripture in pastoral conversations and tended to avoid all "God talk" in working with persons. And woe betide us when we are more familiar with DSM III than with Scripture!

The variations on this theme are as subtle and as pervasive as the variations on the deference ploy. Through these and other strategems we have sought to become (or appear) omnicompetent, and thus under no necessity to enlist the skill and experience of those who do "not follow with us." (Luke 9:49 RSV) In so doing, we found ourselves in danger of causing more harm than good, and sacrificing the well being of our parishioners on the altar of our own egos. The tragic outcome of the threats to our personal and professional competence is not only the perpetuation of human hurt but also the loss of our own integrity and identity.

When we move away from these two polar responses to referral, the question still remains regarding the indices which suggest referral. Most discussions I have read or heard put the focus on the situation of the person involved, and there is certainly a great deal to be said for the validity of this type of consideration. At the same time I am convinced that the primary indices are those to be explored in the person of the parishioner. As set forth in the 1960's discussion, these indices turn on significant limitations which may be found in the minister, limitations which may in some sense or other be functions of the situation but from whatever cause strongly indicate that referral is needed. Incidentally, following the elaboration of these factors, it is gratifying to see how many other writers in the field of pastoral care have incorporated them into their own consideration. The three limitations are (1) time, (2) skill, and (3) emotional reserve or stability. Since these are spelled out in some detail in my book on referral, my purpose here is simply to elaborate on them briefly as a means for reminders in working with persons in trouble.

In regard to time, there are many instances when the minister is quite competent by reason of study and experience to deal with many of the difficult issues of life; nevertheless, it would be a poor stewardship of time for him or her to do so. The parish minister's primary task is focused on preaching, teaching, administration and pastoral care. Pastoral care, in this context, is the incorporating of the grace of God into the on-going issues of life, the common ventures such as birth, childhood, adolescence, young-adulthood, marriage, middle-age illness, aging and death. These personal situations are, to some extent, part and parcel of all of our lives although one or more of them may never confront all of us. As the minister makes available the means of grace through whatever appropriate fashion in the care of the people, little time is "left over" for "in-depth counseling." Many a minister has discovered, belatedly, that the calendar becomes filled with week-to-week counseling appointments, leaving no opportunity for calling in the homes of parishioners, hospital visitation, and the maintenance of structures for day-to-day living in the lives of parishioners. Thus, although the minister may be quite prepared to do long-term counseling, referral is indicated to some community pastoral counseling service or similar group precisely because of the variety of things, to be done in the parish. And. for all of us, the finding of ourselves gravitating toward time in the study, time in the counseling room, time in the administrative affairs of the congregation to the neglect of other matters gives serious cause for reassessing our priorities. In such circumstance, a careful look at the calendar over time can be quite revealing as to what (and why) we are avoiding and what steps are necessary to fulfill our whole ministry.

The variations of this theme are many but the basic point is clear. It is not helpful to vitiate one's schedule of caring for the whole people of God simply because one has the skill to do so in emergency. The laying hold on available resources for ministering to human suffering is one of the most significant dimensions of ministry. Admittedly, the geographical location of the parish presents issues and problems in terms of some types of resource. Nevertheless, the rapidity of modern transportation puts all or most of us in touch with specialized services; and we do our people no favor by neglecting this dimension of ministry.

In the second, referral is indicated when the minister has a limitation of skill or experience. Many clergy are able to work—at least for awhile—with persons whose distress is severe. The crucial question for us is, "Have I been down this road before and do I understand the meaning of the data which are being presented verbally or behaviorally?" If the answer is "yes," then it is possible for specialized ministry to be performed on a limited basis. Many ministers today have had extensive experience in hospitals and mental health facilities and are well qualified to deal with human misery. But the matter is governed by reference to the first limitation, i.e. time. One possible solution that I have observed among qualified colleagues is to designate a definite block of time for such purposes, perhaps four hours a week on Monday morning and limit their long-term counseling to those hours. This means, of course. that over time only a relatively few persons can be seen. But the regimen has been perceived as beneficial for the minister in keeping in touch with the pervasive dimensions of human suffering at a depth level and thus being potentially more sensitive to those human ills which are of less pervasive nature. No hard and fast rule can be identified. But the basic consideration is the balancing of the whole scope of ministry against this one particular area of competence.

Incidentally, the same principles apply whatever the special interest and competence may be. All of us know some ministers who spend an inordinate amount of time in the study working through intricate theological issues and preparing scholarly articles for journals along with the publication of books. Such activities. preclude much time for pastoral care and referral seems to be the only answer. There is much to commend study and writing in ministry; but the issue here also turns on balance. Each of us has gifts and interests; the crux of the matter is the way we follow these creative dimensions of ourselves without neglecting the "whole counsel of God."

The third limitation which indicates the necessity for referral is quite personal rather than strictly professional. When I discussed this factor in 1966, 1 was unable to find a word or a term which would adequately describe it. The designation given above, "limitation of emotional reserve or security," still is about as close as I can come; but I am not happy with it. "Time" and "skill" are clear-cut and descriptive. "Emotional reserve or security" is not. In 1966, I asked whether anyone could improve on the matter. And, although—as noted—many writers have made use of these three categories, the designation of a term has apparently eluded us all. Of course, someone may have devised such a term and it has escaped me. In any event, I am still "looking" and welcome any suggestions.

Even without a concise term, the concept is easily recognized in our own ministries. There are times in the lives of all of us wherein certain issues or situations press in upon us with such force that we are unable to be objective. This has to do with matters that are still unresolved in our own lives to such an extent that we find ourselves dealing with our agenda rather than with the agenda of the parishioners. By a similar token, there are times and circumstances in our lives when we find ourselves personally enmeshed in the lives of the parishioners to the extent that we cannot maintain our appropriate perspective in terms of what is happening to them. This relates to the time-worn dictum that no physician "treats" family members, just as no surgeon ever operates on someone whose life is essential to his or her own. Any of us could come up with an exception to the matter; nevertheless, the basic thrust is clear. Our own lives are inevitably involved in the process—as is appropriate; but when the involvement is intense, then our competence is diminished.

There is another dimension to this index for referral and that is the situational circumstance that may be our own at the time. At particular points in the lives of all of us we are "drained" by reason of stress, anxiety, overt or covert pressure, the list runs on. In such times we do parishioners no service to act as if we can be available to them in their trouble. To start walking "through the valley of the shadow" with a parishioner only to reach the point where our own struggles incapacitate us to continue is a poorly devised attempt to be caring. There are, of course, those times when we do not assess ourselves accurately and find ourselves coming too close to the brink to be of help. Nevertheless, it is usual that we know from the outset that we are vulnerable. and it is a matter of caring not to proffer more that we can produce. We can provide pastoral care on another occasion—to the same person or persons in similar situation. But for now the burden is too great, and we do well to acknowledge it. My own experience is that although this type of event is disappointing to ourselves and to the parishioner, they tend to understand and welcome a suggestion that they allow someone else to bear the burden with them just now.

All that we have said until now assumes that our primary concern is that the parishioner receive the most responsible and constructive help available and not that we will, necessarily, be the primary source of that help. In a word, our hope is that the person be helped rather than seeing ourselves as the only best channel for that help. Once this has been resolved in our own thinking, the process of referral is set in proper perspective.

It is essential that care be taken lest it seem that we are dismissing the persons at a crucial phase of their lives. Such a perception is easily interpreted as rejection and people in pain are particularly sensitive at that point. The best way of avoiding any notion of rejection is to assure that the process of referral becomes a "partnership" or "corporate" event. The minister's primary commitment, as noted above, is that the person find resources; and if the minister is not the prime provider of these services; he or she, nonetheless, is eager to enable the parishioner to lay hold on them. Thus the paradigm phrase is not "you go to such and such a person or facility," but "let us discover together the person or facility that will be of most value to you." This avoids the pitfall that thc minister may seem to "take over" the person's life on the one hand or dismiss the person out of hand on the other. Rather. They—together—move toward the healing that the parishioner so sorely needs.

One asset that the minister has is a knowledge of what is available and some assurance that this or that person or service is effective. Since the parishioner often does not have access to this information, the minister becomes a resource for "where to look." There are times when the minister finds it necessary to make a preliminary call, although my own experience is that far more can be accomplished when the parishioner is able to do that. If the minister is to make the call. it seems essential, except under the most extraordinary of circumstances. that the call be made in the presence of the parishioner. Nothing more than the bare details of setting up the appointment need be included. The colleague is then in a position—together with the parishioner—to delve into the disturbing matters toward moving toward release. A simple word such as, "John Wilson is experiencing some personal distresses in which he and I believe that you and he can best determine the situation and what is needed if that seems well to you." To be sure, on many occasions the area of the distress, may be mentioned. such as "having trouble sleeping," or "experiencing worry about a teenage child," or the like: in any instance it seems more productive if details are left to the conversation between the parishioner and the person to whom the parishioner is referred.

In the first edition of 1960’s book, I listed a general category of places and resources useful to the minister in referral. These included groups such as psychiatrists, physicians, family counselors, and the list ran on. I also noted community organizations, private groups, and particular services that were available. Wherever possible I listed addresses and phone numbers where information could be obtained.

As would be expected, the list was "out of date" before the ink was dry! Thus, in a second edition some ten years later, I included an update of referral resources. Expectedly, that met the same fate. The scene changes regularly as new groups replace outmoded ones, and as new interests become the focus of specialized help. The comments here are of a general nature rather than specific.

In the first part of this article I noted the obvious kinds of collegial resources that would certainly be known by most clergy. These included professional persons, volunteers, private organizations, and members of the People of God. In regard to specifics, in most urban areas such groups as United Way or Community Mental Health Organizations have available lists or data about resources useful to ministers. Moreover, pastoral organizations such as the College of Chaplains of the American Protestant Health Association [now called the American Protestant Health Alliance] (APHA), The American Association of Pastoral Counselors (AAPC), the Association for Clinical Pastoral Education (ACPE), the National Association of Catholic Chaplains (NACC), and the like, publish membership data which may be helpful for clergy in finding resources in areas removed from their own. In like fashion, many ministers rely on personal acquaintances nearby and remote for suggestions and evaluations of this or that resource. Having been in the Richmond, Virginia, area for more than three decades and having colleagues in the surrounding areas I have often been asked for names of persons or groups by clergy in nearby states as well as across the country. Each of us can profit by the first-hand knowledge of groups or persons that is available to colleagues with closer contacts than we possess. In my own instance, when asked for a referral resource in a distant area, I probably will not know a specific person or group there but I can put the individual in touch with someone who does.

There are some general guidelines that are helpful to us when we refer a person or a family to some specialized group or person. Perhaps the primary "rule of thumb"' is that we make no attempt to maintain a specific "professional" relationship with the parishioner. This means that we will in no sense engage in some sort of "treatment plan" during the time the parishioner is being helped by the referral resource. Of course this does not mean that we break off our pastoral relationships with the parishioners. It does mean that we refrain from delving into the details of the treatment process.

When referral is made, it is customary to note that there is no assurance that all will he well; and if difficulties arise the parishioner may wish to consult regarding seeking help elsewhere. But the issue is complex. It is not helpful for the minister to encourage parishioners, to retreat at the first point of struggle or to seek "rescue" from personal responsibility. The ordinary constructive procedure is to encourage the person to continue so that the process may receive a "fair trial." Even so, all of us know that there is no absolute assurance that any professional relationship will always prove beneficial, and our concern for our parishioners is that they find the appropriate resource, not simply that our referral guarantees success.

Throughout, our pastoral care and concern for the parishioners remains. It is not helpful to pry into what is happening now to make repeated suggestions for process. But the "pastor-people" relationships in worship, in study, in service, in recreation are important. Indeed, these types of relationships are the ones which endure following the times with the referral resource even as they were crucial prior to the referral. The imagery is one of ongoing nurture before and after particularized emergency nurture. It is in this sense that genuine pastoral care is provided.

One final word in regard to confidentiality and privileged communication. All of us have been sensitive to these matters through the years, and rightly so. In recent times as our society has become more litigious we naturally tend to pay particular attention to that which is legal alongside that which in ethical or moral. One factor that is essential for our understanding is that the communication "privilege" is always that of the parishioner. Neither clergy nor other groups have privilege in disclosing or refusing to disclose data. It is certain that various customs, whether codified or not, have often assigned to priests. ministers and rabbis certain immunities from having to reveal confidential material, But what is involved in such matters is the privilege of the parishioner to limit disclosure. Where this becomes a matter of law, the clergyperson may elect to undergo penalty or imprisonment; but to do so is to act in behalf of the parishioner's rights and wishes and not because of one's own.

The fundamental issue always is the welfare of the parishioner and of other persons. How can the greatest good be served is the matter that confronts us at such points; and to this sort of question there often seems no absolute answer. "We ought to obey God rather than men" (Acts 5:29 KJV) is clearcut on its face. But the troublesome questions remain as to who decides what "obeying God" means in this or that circumstance, Few of us would plead an individualistic interpretation in this matter; rather, holding that there is corporate wisdom that can transcend individual decision, most of us find constructive help in consultation with colleagues even though—in the end—we are responsible for our own decisions and actions.

Referral is a meaningful aspect of ministry as we seek to discover and effect along with parishioners the most creative resources for dealing with the struggles of life. We rejoice that we are not alone, that professional skills and competencies are available to meet the traumas of life and personal relationships. At the same time, we rejoice that we, as clergy, have access to resources of grace which, although available to and often affirmed by nonclerical persons, comprise our primary responsibility in dealing with human need and suffering. This means that when we see these spiritual gifts being manifested by and in those not of the "cloth" we rejoice and have no need to introject ourselves into the relationship. But it also means that we, alone, are responsible for being certain that these resources are available and are in no position to find fault with colleagues when they do not emphasize them. It is in this holistic sense of resources for human need that we, along with colleagues, enable persons to lay hold on the means of grace—and live.

The author is Professor Emeritus of Pastoral Counseling at Union Theological Seminary in Virginia, Richmond, Virginia.