Thursday, March 18, 2010
As a Master's level professional counselor who has worked for years in mental health crisis intervention, I had some difficulty revisiting concepts and techniques that I use everyday. The text relies heavily on anecdotal examples of the concepts and tasks of the pastor in crisis situations. Because of this I found it somewhat repetitive and sometimes oversimplified. But, perhaps because of the repetition, I had little difficulty understanding the intent of the writer and the concepts being presented. What is new to me is the view of crisis from the perspective of the minister.
As I stated above, I have been a crisis intervention counselor for many years but never from the role of minister or chaplain. I can see immediately that I may have to work very hard to understand and compartmentalize my roles in some situations. Within my professional community I am known as a mental health first responder. In my capacity as a chaplain I must be aware that there is the possibility of role confusion by others. One way I can "show" in which capacity I am functioning is to wear my "chaplaincy" attire. Another is displaying my "CHAPLAIN" badge. My biggest challenge will be to separate these roles in practice.
Dr. Switzer breaks down pastoral crisis management into a few separate but equally important areas. In this approach he is able to distinguish what is and what is not part of the job. Again, relying heavily on anecdotes and personal examples, he is able to present these concepts in a workable and easily understandable fashion.
Before we put ourselves "out there" as a care provider, we must have a sound spiritual as well as specialized knowledge base. Not to do so puts others at risk of further injury and crisis. A caring individual knows what his/her limitations are and has a firm grasp on what is being asked of them. We must ask and answer the question, "What makes me a caring person?". Is it enough to just want to be helpful? Well, sometimes this is enough. Filling sandbags during a flood requires little more than a strong back and a willingness to help. Almost everyone can help out at a food pantry in some capacity or another. But to promote ones self as a spiritual leader and helper to those in crisis requires much more.
First of all, we must adopt the rule to, at the very least, do no harm! This comes from the medical Hippocratic Oath and for good reason. When we are asked to intervene in a crisis situation we are being asked to be helpful, not to cause more problems. A crisis situation is not the time to evangelize or criticize someone for past behaviors. We must also know our limitations. I like to think of myself as an educated man. However, I have very little understanding of some other faiths and there rites and rituals. I would be less than helpful for me to try to assist in the death rites of a faith that is foreign to me. In that situation the but practice would for me to offer compassion on a personal level while helping the family connect with a practitioner of their faith. It would be very important to ask the family what they need from me, knowing that I respect them and their faith.
Addressing crises in hospital environments is my forte'. But my experience in this area is limited to the role of mental health crisis first responder and counselor.
However, in this capacity I have had the opportunity to witness the chaplains in their work with the same families. I found that they had one special function that I was not comfortable using, Prayer. The ability to offer a grieving family or patient a prayer is far and away more valuable in most situations than all of the explanations about the illness or treatments any doctor or mental health counselor could provide during the emergency. Everyone brings some form of belief system to the table. Some may have a deep faith in God and practice it in their daily lives. Some may not be able to put a name or face on what they believe, but they may feel very strongly that what they believe is correct, even if what they believe is that there is no God at all. In these cases it becomes the role of the chaplain to offer an ear to the sadness and anger of those effected.
A chaplain will also be called upon to assist in crises of faith. When that happens the individual chaplain must be strong in his beliefs if he is to be able to assist those who are experiencing a period of weakness. A chaplain who is unsure of his faith will not be effective in helping others.
A lot of content is dedicated to what is (or could be) appropriate to do and say in hospitals, hospices, and when attending to the dying. I found this information both accurate and appropriate to this discussion. Many times I have witnessed a minister taking on the role of advocate in their attempts to minister to the sick, injured, or dying patient. This is almost never the role of a minister or chaplain. To do so is to tell the medical and nursing staff that they are inept and incapable of making the correct decisions on behalf of the patient. It is of vital importance to remember the scope and limitations of the role of chaplain. It is never appropriate to second guess the doctors or to recommend a course of treatment. It is always appropriate to support the patient and family as they make difficult decisions and to offer the spiritual perspective to those decisions.
Conclusion: Pastoral Care Emergencies is a well thought out and presented text book for those of us who are contemplating entering the world of the crisis intervention chaplain. It addresses the general issues of faith as a tool of healing and the specific functions and responsibilities of the chaplain in emergency situations. The text deals with some "do's and don't" when attending in a hospital of other medical environment. As a practitioner of mental health crisis intervention in these venues, I found this information both accurate and complete. This text helped me to put into perspective the differing roles of crisis intervention counselor and chaplain, and how I will be challenged to keep these roles separate in familiar settings.
Rev. Robert Shand
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