Toward men and toward God, she maintained a respectful attitude, lightened by the belief that in a crisis she could deal adequately with either of them.
Robert Nathan
Every crisis is different. That means there’s no single way to help someone through one. There are, however, some tested approaches. Let’s look first at a framework for the counseling process, and then the theological underpinnings for crisis intervention.
The Stages of Counseling
Gerard Egan, in The Skilled Helper, spells out in layman’s language a manageable and practical course of events for counseling that makes a team of the helper and the one in need. Egan’s scheme divides counseling into three stages — problem definition, goal development, and action — each of which he further divides into three steps.
Egan wants helpers to remember who is the central figure in each stage of the helping process. He feels “clients should ‘own’ as much of the helping process as possible. The steps of this model are actually tasks the clients need to accomplish, with the help of counselors.”
Stage I: Problem Definition. The job at this stage is to uncover the nature and dimensions of the crisis. We can be of no help if we don’t know what’s wrong.
In crisis counseling, determining this may be done more quickly than in more routine situations. Problem definition may be sketchy as you pull on a coat and hurry out the door, but at least you want to know if the person you’re rushing to help is more apt to commit suicide or adultery.
• Step I-A: Helping clients tell their stories. In crisis situations, it’s not always easy to get people to talk — or to talk coherently. Shock, trauma, anguish, emotion — many things contribute to the difficulty of getting the story. Some people say little, others so much that you don’t know where to begin.
The first assessments are made at this step by both the pastor and the person needing help. The pastor is beginning to put together an accurate picture of the needs. The person in crisis will need to understand that picture soon, but first is busy assessing the helper: Does she have the skill to help me? Does he look like he knows what he’s doing? Can I depend on her?
Trust must be built on the spot in many cases. Often it’s based on your appearance, body language, physical presence, and command of the situation. Sometimes a relationship exists, but the crisis often adds a dimension that has to be negotiated with skill.
The task at this step is to facilitate the telling of what has happened and is happening, to get information on the table. A pastor may need to draw out one person, separate another from a distracting situation, or calm another.
Charles Shepson provides an example of this kind of sensitivity. Shepson, founder of Fairhaven Ministries, a counseling and retreat center in Roan Mountain, Tennessee, finds people often break down in tears when they call with a problem. If someone starts crying, he’ll say gently, “Go ahead and cry as long as you want. You won’t hear me saying anything, but I’ll be praying for you. We can talk some more whenever you feel ready.” With that thoughtful response, he spares them embarrassment — and gives them the sense he’s handled situations like this before and knows what he’s doing.
• Step I-B:Focusing. This step involves screening, focusing, and clarifying.
Many clues present themselves to the helper: bits of stray conversation, things the helper sees, information given by others, conversations with the counselee. The pastor needs to perform a kind of information triage to decide what really is being said, and the person in crisis needs to determine what to talk about. This is screening.
When an alcoholic comes to a pastor for help, his problems may involve a crumbling marriage, a job on the rocks, acute health problems, legal entanglements, financial difficulties, depression. Not every one of those problems can be handled at once, and not all of them contribute equally to the crisis. The pastor and alcoholic need to determine which problem demands first attention. Criteria such as perceived importance, apparent solvability, the relative pain it is causing, and the counselee’s willingness to work on it all help determine where to begin. And that’s focusing.
Clarifying is the process of probing a problem to add to one’s understanding of it. Exactly how bad is the alcoholism? When did it start? How does it affect life?
• Step I-C: Blind spots and new perspectives. Parts of the crisis may not be known or recognized even by the one in the crisis. Everyone has blind spots, and a crisis can exacerbate them. The alcoholic may think the whole crisis revolves around his messed-up marriage. An accident victim may be crying about a smashed car, not realizing a sore wrist is actually broken. A homosexual may think that recovering from an assault is his major need.
On the positive side, new perspectives can provide the first glimmer of hope for those in crisis. A counselor may help the alcoholic consider the effect his alcoholism has on every other part of life. The homosexual may be led to believe for the first time that there’s hope for his greater healing. Sometimes counselees need to be challenged to look at things a different way, to own their problems, to look for a way to change their situation. This final step of the first stage prepares the way for stage two.
Stage II: Goal Development. In this stage, the counselee, having understood the problem, starts to imagine what he’d like to replace that problem. Egan writes, “Counseling is successful only to the degree that it leads to problem-managing action.” In other words, in Stage I the problem is identified and clarified, but most people don’t want a clear problem; they want a solved problem. That’s why Stage II leads toward beginning to solve the problem.
• Step II-A: Constructing a new scenario. No one wants to remain in crisis. However, it’s possible to go from the frying pan into the fire. Drowning in alcohol the loss of a child may temporarily make the parent forget, but it brings on a worse crisis. Counselees need to think about which direction is up.
Egan calls that activity constructing a new scenario: “A new scenario is not a wild-eyed, idealistic state of affairs, but rather a conceptualization of what the situation would be like if improvements were made.” This scenario becomes the goal.
For instance, getting arrested for indecent exposure forces a man to realize that he needs help. In talking with his pastor he may construct a scenario with two elements: the ability to live without succumbing to hurtful urges and a life without a sense of constant shame. He isn’t envisioning never to be tempted, nor does he expect Miss America as a companion. He is looking toward a reasonable and obtainable future.
• Step II-B: Critiquing the new scenario. This step makes the counselee look closely at the newly envisioned scenarios. Will they work? Are they obtainable in a reasonable amount of time? Which one is most realistic? If I could have only one, which would it be?
Pastor Gary Gulbranson of Glen Ellyn (Illinois) Bible Church devised a unique way to help a young woman look at new scenarios. The woman was hospitalized after almost overdosing on laxatives. At the hospital she took too many sleeping pills and nearly died. Her major problem appeared to be anorexia and bulimia, but Gary realized the roots of her problem went deeper.
To help her, Gary gathered key people in her life: a boyfriend, her parents, two roommates, and church members she was close to. Together they conferred with her about her problems and broke them down into smaller, manageable parts such as her binge eating, her problem relating with people, her lack of employment. Each of the seven people agreed to work with her on one of those problem areas. The church also paid her way to a treatment program. With that kind of creative help, the woman had several ways to improve.
“Goals, if they are to be translated into action,” Egan writes, “need to be clear, specific, realistic, adequately related to the problem situation, in keeping with the client’s values, and capable of being accomplished within a reasonable time frame.” A parent who has lost a child to suicide would have to throw out a goal “to have everything as it was.” It’s unrealistic. Likewise, a goal “to feel better” needs to be more specific. “To be able to appreciate the happy times we had, unhindered by remorse” is a good goal.
Counselees then need to consider the consequences of the choices they will make. This isn’t always easy for the pastor to enable or the counselee to do. Sometimes painful choices will have to be made — temporarily leaving an abusive spouse, telling an employer of a drug dependency, deciding to end futile efforts to maintain a child’s life. Even considering the choices is not easy, much less making them, which is the next step.
• Step II-C: Choice and commitment. This final step of Stage II may demand more than some counselees feel able to give. An alcoholic often balks at this point. A suicidal person may feel unwilling or emotionally unable to choose to live. While pastors cannot choose for the person in crisis, they can make the choice easier. Egan lists several ways that choosing and commitment are made easier. For instance, clear and detailed scenarios give greater incentive than fuzzy ones; several options give greater incentive than just one; harder, more substantial, goals are actually more motivating than small plans.
In this step counselees need care and support in order to make tough decisions.
Stage III: Action. Once people know what the problem is and have an idea where they want to head to get out of it, they can move toward the preferred scenario. It’s a long way from wanting to do something, though, and accomplishing it. That makes this stage so important.
• Step III-A: Discovering strategies for action. In a way, it’s brainstorming. Suppose a new widow feels paralyzed with the prospect of managing her financial affairs. She realizes that her grief centers around her fear of going it alone. She envisions herself able to manage the checkbook and make investment decisions that won’t damage the nest egg her husband and she had accumulated. How is she going to get there?
Her list might include reading books on personal finance from the library, getting her daughter to show her how to do the books, hiring a financial consultant to advise her, paying for someone to keep her books, taking a class at the senior citizens’ center. Getting the widow to explore these options, and even come up with more, is one way to motivate her to work through this aspect of her grief in a productive way.
Go for a number of possibilities, says Egan: “Coming up with as many ways of achieving a goal as possible increases the probability that one of them or a combination of several will suit the resources of a particular client.”
• Step III-B: Choosing strategies and devising a plan of action. With the various strategies on the table, pastor and counselee collaborate to decide which course of action best meets the counselee’s needs, fits his or her values, and seems likely to succeed.
The widow mentioned above may decide she doesn’t want to burden her daughter and can’t afford professional help. So she decides to get some library books, talk to her friends, and, if necessary, give the class a try. These strategies fit her mood and her sensibilities.
So next she needs to set up a plan: When will she check out the books? Who among her friends will she ask for advice, and how? Where is that senior citizens’ center, and when do they offer the class? If she can break down her larger decision into smaller steps, she finds she can accomplish her decision. Putting the mini-steps into a realistic time frame keeps her moving toward her goal: I’ll go to the library on Friday, and by Tuesday, I want to have the first book skimmed.
It’s important at this point, and throughout the process, that the plans be the counselee’s. The pastor wants to encourage and support, but only the person in crisis can do what is necessary to move beyond that crisis, which is the final step.
• Step III-C: Action. Eventually the rubber must meet the road. It won’t necessarily be a smooth trip, and pastors are wise to stick close by to offer help and encouragement.
If a good plan was formulated in the previous step, obstacles and ways around them were probably anticipated. Still, Murphy’s Law enters into crisis counseling, and probably some unforeseen setbacks will occur. If the counselee is forewarned of this possibility, he or she won’t be taken by surprise.
The widow learning to manage her financial affairs may find her math rusty. Her seemingly proficient friend may be better at doing books than teaching how to do them. The class may move too quickly or too slowly, or the widow may find it embarrassing to allow someone else to see her income and expenses. But these setbacks are minor. Her plan is good, and she basically needs help over these little obstacles.
A counselor can take into mind the principal facilitating forces and restraining forces and then help the counselee work through these. Negative forces could arise from the environment (It’s difficult to get to the senior center), the counselee’s thinking (Burt said I’d never have to worry about these things!), imagination (Everybody here knows more than I do), or emotions (I cry whenever I see Burt’s handwriting in the ledgers).
Facilitating forces are reinforcements such as a checkbook that balances, the encouragement of fellow senior citizens in the class, or the sense of accomplishment following a good investment.
It’s the rare crisis case, of course, that glides through this process without some fits and starts. Some crisis cases actually end somewhere in the first stage. Once the counselee tells his story, he has the personal strength to fly through stages two and three. Some crisis situations compress the three stages into one marathon session that proves sufficient.
Pastors actually view crises differently from most helpers: they’ll live with the people long after the crisis is past. They’d like to use the crisis event as a springboard for ongoing pastoral nurture and spiritual development. They want not just happy people but committed disciples of Jesus Christ. And so they add a tenth step to the process: follow-up.
This ten-part pattern can serve as a model for what usually needs to be done over the entire process of care. It allows pastor and counselee to work together systematically to alleviate a problem, but it keeps the major work of the problem where it belongs: in the hands of the person in crisis.
Counseling Theologically
Charles Lake, pastor of Community Church of Greenwood, Indiana, says, “I work out more theology in the automobile on the way home from a funeral home than I ever do in my study.” Crises have a way of bringing out issues and making theological understanding of critical importance.
But what are the key theological concepts for a crisis counselor to think through?
Gary Sweeten, associate pastor of College Hill Presbyterian Church in Cincinnati, identifies four. He believes the Christian counselor has a leg up on secular counterparts because Christians understand the results of the fall: bondage, rebellion, guilt, and shame. Some counselors focus on only one of these problems, and in so doing, miss the wide spectrum of reasons for people’s crises. Those with theological understanding can work on all four areas.
“Being in bondage,” Sweeten writes, “implies that we are blind to our sinfulness and impotent to change those things of which we are aware.… we cannot, by our own works, do anything to redeem ourselves from our sinful condition.” People facing problems of homosexuality, alcoholism, or sexual addiction certainly know what Sweeten is talking about.
Rebellion involves our decisions to go against the will of God. The quip, “Sin is revolting,” proves literally true. Many of the crises people face are the result of someone’s rebellion against God.
Guilt is not just a feeling; it is the result of violating God’s law. Whether we feel guilty or not is more a matter of how we were socialized. But when God’s standards are broken, we stand condemned and guilty before God. Only confession and repentance remove the legal guilt we’ve accrued.
Shame is what we feel when we understand our shortcomings, and shame can ruin a life and cripple recovery. Shame says, I am an awful person. It’s a natural consequence of a sound conscience mixed with a violation of God’s standards. While confession breaks the hold of guilt, it may not ease shame. People need the understanding of their new position in Christ as God’s child to rid themselves of the shame occasioned by the Fall.
The theologically astute counselor can attack problems in all four areas. For instance, a drug addict has reached a place of bondage to drugs. He cannot free himself. He got there partially by acts of rebellion. He stands guilty of that rebellion, and, if his conscience isn’t seared, he feels shame for his actions. Attack only the rebellion, and the very real aspect of bondage sabotages the efforts. Deal only with the shame, and the guilt remains. Work through all four aspects, and you can end up with a person set free from bondage, rebellion, guilt, and shame.
David Seamands, professor of pastoral ministry at Asbury Theological Seminary in Wilmore, Kentucky, adds a final, fundamental area of thinking for the crisis counselor. He told me, “I want all the students who leave my classes to have worked out an adequate theological understanding of suffering. Otherwise they will be ambushed when they run into people experiencing difficult circumstances. They need to realize how God relates to this world and works through secondary causes to get through to them.” Seamands wants pastors to have the theological understanding needed to undergird their work with people in crisis — including themselves.
The Desired Result
In Crisis Counseling H. Norman Wright speaks of Jesus walking the road to Emmaus with two of his former followers, both in deep crisis following the Crucifixion. He built rapport with them by listening to them. He confronted them after a while and gave them a new reality in order to change their thinking. “Then an interesting thing happened,” Wright observes. “It is something that every helper dreams of doing with some of his helpees — especially the more difficult ones. Jesus ‘vanished from their sight’ (v. 31)! In so doing, Jesus left them on their own and spurred them to action. This is the ultimate goal of all helping — to move the helpee to a point of independence where there is no longer any need to rely on assistance from the helper. This … is the crux of crisis counseling.”
Perhaps we can go one step further. The ultimate result of our caring for people in crisis is to draw them to wholeness of life in Jesus Christ. They need not depend on us when we help move them beyond crisis to Christ.
For Further Study:
Egan, Gerard. The Skilled Helper: A Systematic Approach to Effective Helping. Monterey, Cal.: Brooks/Cole Publishing Company, 1986.
Kennedy, Eugene. Crisis Counseling: The Essential Guide for Nonprofessional Counselors. New York: Continuum, 1981.
Swihart, Judson J. and Gerald C. Richardson. Counseling in Times of Crisis. Waco, Tex.: Word Books, 1987.
Wright, H. Norman. Crisis Counseling: Helping People in Crisis and Stress. San Bernardino, Cal.: Here’s Life Publishers, 1985.
Copyright © 1989 by Christianity Today