The process of crisis intervention

Crisis intervention is an art of restoring human beings to their God-given dignity and potential.

Martin W. Feldbush, D.Min., is associate director of Adventist Chaplaincy Ministries, General Conference, Silver Spring, Maryland.

Recently my wife and I took sailing lessons. The most memorable point of our lessons was an incident in the classroom, in which our instructor put everything in perspective. He gave us a simple conceptual frame work into which we could fit everything we were learning. He said there are three basic things one needs to know to sail: (1) how to , read the wind, (2) how to set the sails, and (3) how to steer the boat. Learn those, our instructor assured us, and you'll be a sailor! Pastors who want to respond to crises also need a conceptual framework from which to work. This article will deal with a theory of caring relationship, types of crises, constituents of pastoral care, a model for helping, and an evaluation process.

A caring relationship

A caring relationship is built on helping others grow and actualize themselves instead of using them to satisfy your own needs. 1 It is based on genuine love. It is not an isolated feeling or momentary relationship, but a process of development toward wholeness. Milton Mayeroff suggests that caring consists of the following ingredients: knowledge and competence, the ability to evaluate ourselves critically in the helping process, the gift of patience in "staying with" the person in need, trusting counselees' ability to grow so that we do not overdo for them, honesty, the humility to know our limitations, a sense of hopefulness about the potential for growth, and the courage to invest ourselves in caring for others.2

David Switzer argues that caring is pastoral when the minister's caring is seen as an expression of the whole life and purpose of the Christian community.3 He outlines three ways in which such an expression becomes possible:

Empathy. Empathy is the ability to understand and share in the emotions and feelings of another person. The goal is to understand the other person from his or her point of view, assuring him or her that he or she is heard and appreciated.

Respect. Respect involves communicating to others that they are of value. This is crucial since people in crisis often have low self-esteem. Unconditional acceptance of the other person enhances self-esteem.

Self-disclosure/vulnerability. When we communicate that we too are human and have the same feelings and needs, we convey to people in crisis that vulnerability is not unique to them.

To these factors one may add the quality of being nonjudgmental. Help in crisis aims at understanding the individual and not judging. The main point is that before we do anything to help the person in crisis, we need to create an environment in which caring and healing can take place.

Types of crises

Two types of crises are predominantly discussed in literature today. First are developmental crises, experienced at the transitional or turning points of life that produce stress. They are fraught with a need to adapt, to find new meanings, and are often (but not always) predictable events we know will happen someday. Included are marriage and birth of children, adolescence, career changes, aging, bereavement, etc. Second are situational crises. These are reactions to specific, external, and often unanticipated events in our lives. Included are traumatic events such as accidents and natural disasters, failure and breakup of relationships, loss of a job, unexpected death of a loved one, and so on. Of course, there can be some overlap between these types of crises. A situational crisis differs from a developmental crisis in the source of stress and in the element of time.4

Most researchers see a crisis as a result of a sequential process:

1. A precipitating event occurs, often external in nature.

2. The individual examines the situation to determine if it threatens some basic need. The degree of threat will depend on whether the person has experienced the threat before, its impact then, the available coping resources, and so on. At this phase the person interprets the event and assigns it meaning threatening, mildly threatening, nonthreatening, etc. Thus what the person believes about the event is as important as the event itself.

3. Having deemed the event a threat, the person employs coping methods and resources to deal with the matter. The adequacy of these will determine the extent to which the event will be internally experienced as a crisis.

4. Last, if the coping mechanisms fail, the individual enters the crisis phase, reacting internally to the hazard.5

Thus, a crisis has more to do with a person's internal response than with the external situation. Since we are dealing with situational crisis intervention, it is essential to know whether or not a person is experiencing that kind of crisis. Determining this will decide the degree of help we might feel we are able to give to the person. Switzer gives a three-question diagnostic procedure: 1. Has there been a recent (within the past few days or weeks) onset of troublesome feelings and/or behavior? 2. Have these symptoms grown progressively worse, leading the person to the pastor for help? 3. Can the onset be linked with some external event or change in the life situation or in the person's perception of the circumstances?6

Constituents of pastoral care Since there are varying types of crises, pastoral intervention must vary accordingly. We will look especially at the pastor's response to situational crises, utilizing a model recommended by most specialists. This involves four steps.

1. Pastoral presence. When a person in crisis comes to the pastor for assistance, the pastor should make available those attending skills that show his or her interest in the individual. These skills are primarily nonverbal. They communicate in the first few moments of the interaction that the pastor is there for one purpose to be with that person and provide compassionate care.

2. Identifying needs and resources. The pastor uses general leads and appropriate questions to let the person tell his or her story. Being a listener is the heart of pastoral care, because in that act the person externalizes his or her understanding of the circumstances, perceptions about them, and knowledge of available coping resources. By listening, the pastor gathers information and impressions that will form the basis of the next step.

3. Pastoral diagnosis. Although this article does not deal with pastoral assessment theory and methods, it is important for pastors to understand common models of diagnosis that can be used in counseling and shared with practitioners of other disciplines. Basically this involves understanding and utilizing biblically based pastoral concepts of caring and compassion to hurting people.

4. Pastoral interventions. Only after valid pastoral assessment should the pastor utilize the spiritual therapies at his or her disposal. To do otherwise would be like a surgeon performing an operation without examining the patient or doing any diagnostic studies. The pastor has a "kit bag" similar to the physician, except that it does not contain instruments. It contains spiritual therapies that become operative through the ministry of the Holy Spirit and the healing balm of loving interpersonal care. Among those therapies are the use of Scriptures, prayer, the caring Christian community, pastoral counseling, the ceremonies and rites of the church, etc. The pastor's therapies thus become the natural outgrowth of a relationship based on mutual trust.

The helping model

Tom, a recent graduate of a state university, came to his pastor one day and shared feelings of low self-esteem and described physical stress symptoms. He sometimes wondered if it was worth keeping on in the face of life's problems. The pastor wisely realized that Tom needed more than a prayer and a verse of Scripture and encouraged him to talk about his situation. He especially wanted Tom to share specifically what was happening in his life and how long he had felt this way. The pastor's attitude of personal acceptance encouraged Tom to share his story, and out tumbled an account of bad financial decisions and escalating debt. His credit cards were over the limit, and three weeks earlier his car had been repossessed. The worst of his symptoms had begun at about that time. The pastor read the signs of situational crisis and moved toward helping Tom in his problems.

The pastor's basic goals were:

1. To provide symptom relief, and lower distress and maladaptive coping.

2. To help Tom return to normal functioning.

3. To provide reassurance when appropriate.

How does a pastor help people like Tom? Switzer's helping model provides some assistance to the pastor. The model has three phases.

Phase 1: Contact. Contact involves a caring and therapeutic relationship. During contact, trust is built through communication of accurate empathy along with good attending and listening skills. During this time the pastor will get to know whether the crisis is situational or not. If it is not, the pastor may have to switch gears and refer the person to another professional.

The pastor encourages the person to tell the story, asking the individual to identify the problem that precipitated the crisis. If the counselee's narration does not reveal when and how the distress began, the pastor must intentionally search for these precipitating factors through gentle questioning. By telling the story, the counselee builds trust and aids in the assessment of the situational crisis. The pastor can also begin building hope by suggesting the need for contracting an agreement that the two work together on the problem.

Phase 2: Focus. Focus helps review in detail the precipitating event and the person's reaction to it so that together you can clarify (a) what has happened and (b) why it is perceived as a threat and the reason for the kind of response it is eliciting in the counselee. The counselee must connect the event and its assigned meaning to see that the difficulty might not only be the event itself but also his or her beliefs about it. If the counselee is not able to make this connection, the pastor might state the core of the problem as he or she sees it.

Sometimes it is helpful to ask the counselee to describe the situation both before and after the crisis-producing event. Especially look for changes in behavior, emotions, physical symptoms, relationships, and mental functioning. As a result of active listening and other discovery techniques, the pastor and parishioner will come to a better understanding of what has happened, what the problem is, and why it is perceived as a threat.

Phase 3: Coping. Coping is doing something about the problem. This involves making some decisions based on information that has already been gleaned and implementing solutions that are agreed upon. The first task is to inventory problem-solving resources that the counselee can call upon, such as church, personal faith, social support systems, community agencies, and so on. Essentially this is drawing out the inner strengths and external resources that can be used in dealing with the crisis. One way of getting at this is to listen for and/or ask about similar crises that may have happened in the past and how the person coped with them. The counselee often realizes he or she has been through this before and had resources to cope then. Identify and discuss these resources.

The second task is to assist in the decision-making process. Encourage the person in crisis to identify decisions and actions that if taken would alter the situation. Initially this is brainstorming. Since we want the counselee to assume responsibility for himself or herself, we do not offer options until the person has exhausted his or her ideas. The pastor then assists in the evaluation of options. Will it work? Is this feasible? Why? Why not? What will the probable results be?

The pastor then gently yet firmly encourages the counselee to make a decision about a course of action, encouraging him or her to act upon it. The pastor does not make these decisions for the person. He or she suggests alternatives only when it is apparent that the course of action chosen might result in harm.

Part of the decision-making process is affirming the resources suggested by the counselee, especially relationships with both God and people. This is important because people in crisis often suffer from damaged relationships.

Action decisions lead to new learning. This is reviewing what has transpired and asking what the counselee has learned from the process. This helps the person add these learnings to their arsenal of resources to be utilized again in times of crisis.

Follow-up is essential, whether in the form of continued counseling sessions or informal yet regular contacts. The pastor, having encouraged the counselee to implement the plan of action, now helps to evaluate progress and make midcourse corrections if needed.7

Evaluating the helping process

How do we evaluate the helping model and its effect on the person in crisis? Switzer poses five evaluative questions:

1. Has the level of anxiety been reduced?

2. Can the person describe the plan of action in his or her own words?

3. Is the person hopeful regarding the future?

4. Does the person exhibit appreciation for the help given?

5. Is there realistic expectation that the unmet needs precipitating the crisis can be met?8

This model is not meant for every occasion, yet it helps many people to proceed in an orderly manner while retaining emphasis on the quality of interpersonal relationships. Both are needed by people whose crises leave them feeling alone and unable to sort out cognitively what is happening. The model may seem too structured to some yet refreshingly focused to others. Try it, practice it, evaluate it, and refine it.

1. Milton Mayeroff, On Caring (New York: Harper & Row, 1971), p. 1.

2. Ibid., pp. 9-20.

3. David K. Switzer, Pastoral Care Emergencies (New York: Paulist Press, 1989), p. 16.

4. The Minister as Crisis Counselor (Nashville: Abingdon Press, 1974, 1989), pp. 33, 34.

5. Howard W. Stone, Crisis Counseling (Philadelphia: Fortress, 1987), pp. 12-14.

6. Switzer, The Minister as Crisis Counselor, p. 41.

7. Ibid., pp. 65-89.

8. Ibid., p. 85.

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Martin W. Feldbush, D.Min., is associate director of Adventist Chaplaincy Ministries, General Conference, Silver Spring, Maryland.

December 1996

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