Crisis Counseling for Ministers: Thing to Consider with Cases Involving Major Illness and Injury

I've been working through James D. Berkley's Called into Crisis: The Nine Greatest Challenges of Pastoral Care (Carol Stream, IL; Dallas, TX: Christianity Today; Word Books, 1989). At the end of each chapter is a "Quick Scan" section where a minister can quickly consult some considerations when facing a pastoral crisis. Here are the considerations from the book when a minister is facing situations involving major illness and injury.

MAJOR ILLNESS AND INJURY

Immediate concerns:

1. Allow the medical personnel to do their work unimpeded.

2. The shock of sudden illness or injury affects not only the patient but all those around him or her. If you can’t get to the patient immediately, minister to the family.

3. Timing is important; get to the people as quickly as possible.

Keep in mind:

1. People with terminal diseases probably know it. Our failure to talk about it doesn’t shelter them; it isolates them. Whether now or later, they need to talk about it.

2. The adjustment to a new (and often inferior) body image can be a great crisis for illness or injury victims.

3. People need to grieve their losses or approaching death. The five stages of grief—denial and isolation, anger, bargaining, depression, and acceptance—can be expected in both patient and 

loved ones. These are normal, acceptable, and even therapeutic.

4. Hospitalized children need opportunities to be victors over the oppressors of pain, loneliness, and fear, to be recognized for little victories and significant steps.

5. With children, although hospitalization is traumatizing, it often is no indicator of future emotional difficulties.

Things to do or say:

1. Provide emotional and social support for the hospitalized and their families. Transportation, meals, baby-sitting, companionship, help with bills—all are part of the crisis response of caring churches.

2. Help patients sort the probable results of their injury or illness from the irrational or overstated fears, and then help them decide how to cope with impairment.

3. Give patients human touch, control over their situation, someone to talk with about what they want to talk about, the sense of being important.

4. Offer realistic hope. Help build the will to live.

5. Listen to the person who is ready to talk about death. Help her put life and faith in order so that death becomes a natural transition to real life, not a dread doorway to terror.

Things not to do or say:

1. Do not normally withhold information from the patient. In extreme circumstances (for instance, a car accident where a family is killed except for a lone member fighting for life) it may be prudent to time the release of all the details, but normally people have the right and the need to know the facts.

2. Do not make light of the adjustments an injured person may have to make to a new body image.

3. Do not talk about a patient in his presence—even one in a coma—as if the person were not there.

4. Do not give patients a sense of abandonment. Let them know when they can expect to see you, and make every effort to visit regularly.

Crisis Counseling for Ministers: Thing to Consider with Cases Involving Domestic Violence and Abuse

I've been working through James D. Berkley's Called into Crisis: The Nine Greatest Challenges of Pastoral Care (Carol Stream, IL; Dallas, TX: Christianity Today; Word Books, 1989). At the end of each chapter is a "Quick Scan" section where a minister can quickly consult some considerations when facing a pastoral crisis. Here are the considerations from the book when a minister is facing situations involving domestic abuse and violence.

DOMESTIC VIOLENCE AND ABUSE

Immediate concerns:

1. Be aware of the potential for continued or more severe violence and abuse. The victim’s safety—and your own—are of primary concern

2. A victim should not stay in a situation where violence or abuse threatens. Pleas of “It won’t happen again!” are suspect.

3. Call the police for any violence or abuse in progress, and follow their instructions.

4. Do not promise strict confidentiality. You may not be able to keep the promise, either legally or morally.

Keep in mind:

1. Abused children won’t necessarily expect you to believe them. They may not divulge information harmful to the abusing parent.

2. Small children nearly never make up sexual abuse charges. They cannot make up something about which they know nothing.

3. Spouse abuse is rarely a chosen response. It is a response born in passion and frustration. Self-hatred and poor coping mechanisms often underlie the problem.

4. Spousal sexual abuse is not something an unconsenting spouse must bear. A spouse should not be violated sexually merely because he or she is married to the violator.

5. The presence of genuine guilt doesn’t necessarily indicate the end of a battering problem. Most batterers express remorse when anger subsides; many repeat their behavior.

6. Reporting abuse, as difficult as it is, must be done. Families will need support as they go to the authorities.

Things to do or say:

1. Secure the bodily safety of the victim.

2. Show love, concern, warmth. Remain unshocked by what happened. The victim needs to be able to relate the story without inhibition.

3. Listen for cryptic comments from children. Role playing, using anatomically correct dolls, and having them make crayon drawings are other ways to obtain information.

4. Remove the notion that “Christians never do such things.” All victims need to be believed, even when the accused is a Christian.

5. Help the victim and victimizer find specialized care.

6. Use a tape recorder with the permission of the victim. Tapes may well convince a skeptical parent or other authorities.

7. Report child neglect and abuse to the proper authorities. It’s required by law in most states.

Things not to do or say:

1. Do not assume an innocent parent was unaware of child abuse. Denial is common.

2. Do not castigate the abuser. You may lose the cooperation of the victim, who often loves the abuser anyway.

3. Do not ask a child “Why?” questions. They are not sophisticated enough for analysis of the problem. Stick to finding the facts.

4. Do not underplay the potential for continued or increased violence in domestic fights.

5. Do not reject offhand any report of abuse. Tend toward believing it first, and then seek to validate it.

Crisis Counseling for Ministers: Thing to Consider with Cases Involving Sexual Misconduct

I've been working through James D. Berkley's Called into Crisis: The Nine Greatest Challenges of Pastoral Care (Carol Stream, IL; Dallas, TX: Christianity Today; Word Books, 1989). At the end of each chapter is a "Quick Scan" section where a minister can quickly consult some considerations when facing a pastoral crisis. Here are the considerations from the book when a minister is facing situations involving sexual misconduct in others (or even themselves).

SEXUAL MISCONDUCT

Immediate concerns:

1. The emotional stability of victims and victimizers demands first attention. Deep pain, anger, or hurt are in play.

2. You may need to try to forestall permanent “solutions” (quick divorce, violence, rash acts) born in anger or despair.

Keep in mind:

1. Lies foster marriage dissolution. Truthfulness may hurt like an incision, but it begins the healing process.

2. Lust has its attraction. It needs to be replaced with something better rather than preached into submission. The shining possibilities of truly knowing God or deeply experiencing marital love offer hope.

3. Sexual deviations usually require more than volition to be healed. Much has brought the person to this place; much needs to be done to move him or her into proper relationships. Prayer, spiritual healing, and competent counseling will probably have to team up to effect a change.

Things to do or say:

1. Hear the story. Let it all come out. It’s probably been bottled up a long time.

2. Stand for righteousness, but in an inviting way that makes the right more compelling than the wrong.

3. In cases of infidelity, work with the couple if possible. If not, build up the will and emotional strength of the cooperative one to make that person prepared for the hard work of reconciliation, should it be possible.

4. Insist on the whole story being told to a spouse who knows any part of the infidelity. Buried secrets have a way of returning and destroying tentative new trust.

5. Use the power of prayer, Scripture, the sacraments, and great music to reach deeper than the intellect.

6. Radiate hope for the ability to make things right. Believe in the people even when they no longer believe in themselves.

Things not to do or say:

1. Do not denounce persons, only sin.

2. Do not neglect the seemingly strong party. Outward calm often masks seething internal emotions.

3. Do not allow confidences to be broken.

4. Do not expect easy resolution. Sexuality is a slippery creature difficult to capture and tame.

Crisis Counseling for Ministers: Thing to Consider in Marital Crises

I've been working through James D. Berkley's Called into Crisis: The Nine Greatest Challenges of Pastoral Care (Carol Stream, IL; Dallas, TX: Christianity Today; Word Books, 1989). At the end of each chapter is a "Quick Scan" section where a minister can quickly consult some considerations when facing a pastoral crisis. Here are the considerations from the book when a minister needs to help a couple facing a marital crisis.

MARITAL CONFLICT AND DIVORCE

Immediate concerns:

1. Assess the potential for physical assault. Should one of the spouses leave the premises? Might you be in danger when you intervene? If so, call the police.

2. Decide whether to wait to be asked to help or to take the initiative. Waiting may make you more effective, but it can also allow a situation to move beyond redemption.

Keep in mind:

1. Emotions will be high. Expect tears and anger. Emotions need to be vented in a controlled situation.

2. Two people, and usually a vast supporting cast, have caused this conflict. Rarely is there a true villain and victim. There are normally two sides to the story, both of which need to be heard.

3. Resolution of the problem will likely be a long process. For months and years they have built to this crisis; a snap resolution seems improbable. Crisis counseling can help them move from destructive to constructive modes of relating.

4. Your role is to open lines of communication, to help the couple hear and understand each other, to “translate” misunderstood communication and draw out the unspoken.

5. As long as each person’s focus is on what the other ought to do, the conflict will continue. When the focus turns to “what I can do to make my marriage work,” healing can begin.

Things to do or say:

1. Provide the opportunity for the controlled release of emotions, but disallow hurtful or spiteful attacks.

2. Let both parties know you are neutral. At some time talk separately with each person to get his or her unedited version.

3. Provide understanding of the issues involved. Point out options other than the drastic ones the couple may be considering, and help the couple work through those options.

4. Encourage the couple to talk with each other rather than at or about each other. Have them voice the things they would appreciate instead of saying what they don’t like.

5. Remind them of the covenant they made with God on their wedding day and help them rebuild their marriage around self-giving agape love rather than self-seeking feelings or expectations.

6. For those already divorced, help them rebuild their spiritual, emotional, and family lives with the loving care and Christian standards of the church supporting them.

Things not to do or say:

1. Resist the urge to designate villains and victims or to take sides. Although fault may not be equal, it takes two people to make a marriage crisis.

2. Do not assume the responsibility to patch up the marriage. Only the couple can rebuild their relationship.

3. Do not condemn. People with faltering or fallen marriages know their failures and are loaded with guilt.

4. Do not underestimate the potential for violence in a domestic quarrel. Use caution entering a marital fight in progress.

5. Be cautious of unhealthy attractions or dependencies that can form between you and a counselee.