Enrichment > Summer 2010 > A Pastors Guide to Crisis Management


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A Pastor's Guide to Crisis Management in the Rural or Smaller Church

How can pastors of smaller churches be better equipped to help people in crises?


by Nancy A. Walker

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Someone bullies a child. A teen attempts suicide. A man learns he is dying. A woman has a panic attack in the congregation. A spouse’s mental illness ruins a marriage. A marriage has domestic abuse issues. A husband is incarcerated for stealing. A home is chaotic due to a pornography addiction. A home is experiencing challenges due to chemical addictions. A teen is bulimic. A mother finds her daughter cutting. A husband is diagnosed as clinically depressed. A woman is raped.

These are common situations today. They are also common situations in our churches. Churches are becoming critical-care facilities. But are churches equipped to handle such situations? Megachurches handle situations like these by incorporating professional counselors, support classes, and counseling centers.1 Small, rural churches, however, often do not have the same resources or access as larger churches. The pastor in a small, rural church is often the person ministering in these situations. While the above challenges are commonplace in both large and smaller churches, many pastors of smaller, rural churches are not prepared to handle the day-to-day crises and pastoral care issues that confront them. How, then, can pastors of smaller churches be better equipped to help people in crises?

The Pastor’s Role: Supplying Hope to the Hurting Church

The pastor’s initial task in any crisis is to pave a way for the individual(s) to see and experience hope. In the Old Testament, the Hebrew word translated “hope” is tiqvah. It means “a longing or an expectation.” The primary root is qavah, which means “to wait for.” In Psalm 62:5, David experienced respite as he waited for the Lord to act on his behalf. When conditions for hope are met, individuals feel hopeful. The pastor’s role is to supply such hope.

In Renovation of the Heart: Putting on the Character of Christ, Dallas Willard states: “Most of the conditions we commonly speak of as feelings are in reality not feelings at all; but the feeling tones or sensations that accompany those conditions are so powerful that the conditions themselves become identified with the associated sensations. We must choose and act with regard to the conditions, good or bad, and allow the feelings to take care of themselves, as they certainly will.”2

Initially, pastors can offer hope to those in crisis regardless of the person’s situation. Hebrews 6:19,20 notes that hope is the anchor for the soul. Hope enables action, which evokes feeling. The individual can then begin the journey to healing and growth.

Hope comes as the individual chooses to walk through the healing process. In crises, the first defense line of the soul that necessitates care id feelings. As a pastor guides the individual through his emotions, transformation into Christ’s image during suffering can occur. Although suffering may challenge the intention of hope, pastors can apply a mind, body, and spirit approach to the care of the individual. This basic approach begins with the individual’s thought process.

Mind, Body, Spirit Connection: How Does This Work in Pastoral Care?

Pastors are in a unique position when counseling individuals to weave together the mind, body, and spirit. The emotions of a person in crisis often result in distorted thinking, confusion, and possibly delusion. Pastors can evaluate a crisis situation by looking for distortion of thought and asking questions that explore core beliefs and values. By sorting out the thoughts of the individual, pastors can aid the individual’s thinking to be in line with Philippians 4:8,9. The Lord’s command to change one’s thinking process is key in healing the mind and the heart. The next step is to act out this new thinking process.

As an individual’s thoughts and behaviors change, his heart undergoes transformation. In turn, positive habits and spiritual fruit form as healing is under way. The physical body also becomes healthier. There may be instances, however, when pastoral counseling alone cannot change thought patterns that create a heart change and consequently a behavior change. In such cases, mental health care and even emergency mental health care may be relevant.

Critical Care in Pastoral Counseling: Involuntary and Voluntary Commitment — How To Utilize Emergency Medical Personnel

You may need to voluntarily or involuntarily aid an individual to seek critical care. A voluntary commitment is where anyone 14 or older experiencing a mental health crisis feels an inpatient stay is necessary for safety. Someone may refer this individual or take him to an emergency room for assessment to verify if he needs treatment. If needed, the individual signs a form agreeing to treatment. The individual agrees to a 72-hour stay. In most states, a parent or legal guardian can voluntarily admit individuals under 14.

Care providers enact an involuntary commitment of someone to emergency care due to danger or threatened injury to self or others, including attempted/threatened suicide or homicide. Care providers can use this process in cases of hallucination or delusion. Due to the involuntary nature, family, crisis professionals, police, or EMS may need to assist. The court requires the petitioner to sign and appear in any hearing on behalf of the committed individual.

A police officer can enact an involuntary commitment without a petitioner. Once enacted, police/ambulance take the individual to an emergency room where doctors evaluate him for involuntary psychiatric inpatient treatment. Doctors cannot keep the individual in the hospital for more than 120 hours unless the hospital files a petition for extended involuntary treatment.

Check your state regulations on voluntary and involuntary care, including age limitations. In most states, the above regulations and procedures apply.

How To Prepare for Unexpected Situations: Treatment Referral Networks and Emergency Plans

The following steps apply in the smaller church.

Proactive preparation tips:

  1. Have scriptural handouts (depression, anxiety, family) to give to those under your care. A good reference is “Quick Scripture Reference for Counseling” by Kruis.
  2. Have a reliable suicide-assessment tool with a written plan to follow if someone threatens suicide. Know how to use voluntary/involuntary commitment.
  3. Familiarize yourself with psychosis, delusion, and hallucination so you can recognize their signs.
  4. Make contacts to refer individuals to mental health professionals, hospitals, nursing homes, or residential treatment facilities. Community contact and networking are essential for well-rounded care.
  5. Have emergency numbers and referrals accessible. Establish a treatment referral network with professionals to assist you. Set up advance meetings instituting plans with each professional in your network. Establish professional boundaries with agreed upon cojoint pro-bono and professional care.
  6. Professionals are often willing to offer pro-bono services to churches and ministries.
  7. Make a public policy explaining how you will provide care to suicidal/violent individuals.
  8. Plan for alternative care for suicide or traumatic situations (in-person care, counseling, hospitalization, hotlines, classes, support groups, professional groups). Make a local/national contact list of organizations, nonprofits, and hotlines.
  9. Keep written, confidential documentation of your counsel of individuals in case of incarceration, hospitalization, church and individual safety, ethics, and for legal circumstances.
  10. While under pastoral care, have the individual sign a consent form noting confidentiality with exception of certain situations. Have consent-to-pastoral-care forms available to all individuals.
  11. Understand and maintain confidentiality limits within reason of the crisis and your church board policy.
  12. Read your state’s policy on abuse. Have a plan to report and document abuse.

Before an emergency occurs:

  1. Establish contact with a counselor/psychologist in locality of the individual you are counseling in case he needs in-person mental health care.
  2. Obtain accurate information including name, location, and permanent address of the individual.
  3. Obtain backup contact methods, including contacts of several people the individual knows and trusts.
  4. Obtain contact information of emergency services in locality of the individual. If the individual calls you, you can call for emergency aid, if there is a need.
  5. Create an agreed-upon emergency plan with at-risk individuals. This can include family members with confidentiality.
  6. Refer individuals to community/church classes, support groups, and nonprofit organizations to come alongside the individual while under your counsel.

Conclusion

“Blessed is the man who perseveres under trial, because when he has stood the test, he will receive the crown of life that God has promised to those who love him” (James 1:12). Perseverance, instilling hope, and wise counsel assist individuals on their earthly race to cross that heavenly finish line. The Lord empowers. The pastor evangelizes, disciples, encourages, counsels, directs. Whether you are a pastor of one or many, may you take the above information and implement it to assist your church and community in the continued growth, development, and healing of individuals in crisis. Restoring hope, instilling healing through mind, body, and spirit counsel, and implementing mental health care for our churches increasingly ministers to an ever-changing society. Churchesare in the business of critical care for the soul.

Notes

  1. Scott Thumma, Overview of Megachurches in the United States. (Hartford, Conn.: Hartford Institute for Religious Research, 2006). http://hirr.hartsem.edu/megachurch/definition.html
  2. Dallas Willard, Renovation of the Heart: Putting on the Character of Christ. (Colorado Springs: Nav Press, 2002), 123.

Emotions Sometimes Reveal
Confused Thinking

In Jonah 4:2,3 Jonah told God: “O Lord, is this not what I said when I was still at home? That is why I was so quick to flee to Tarshish. I knew that you are a gracious and compassionate God, slow to anger and abounding in love, a God who relents from sending calamity. Now, O Lord, take away my life, for it is better for me to die than to live.”

Jonah started out praising the Lord, only to end in a harsh complaint. He told God, “You are just and merciful, and I do not like it.” Steve Viars notes in this instance how a prophet of God would speak such words, shows how confused a person’s thinking can become.1 As a pastor counseling in a crisis, many times an individual’s thoughts become radically confused and possibly even disillusioned. Jonah’s experience shows this can be a normal occurrence in stress and emergency. How people handle the situation is what matters.

Philippians 4:8,9 is key: “Finally, brothers, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable — if anything is excellent or praiseworthy — think about such things. Whatever you have learned or received or heard from me, or seen in me — put it into practice. And the God of peace will be with you.”

NANCY A. WALKER, Pittsburgh, Pennsylvania

Note

1. Steve Viars, “Talking to Your Emotions” in Transformation, 1 (2). Forest, Va.: American Association of Christian Counselors, (2007).

What To Do When Someone Is Experiencing a Mental Health Crisis

  1. Call a mobile crisis service, or police/ambulance, if the situation deems appropriate.
  2. Promote voluntary admission to a psychiatric unit, making sure the individual follows through.
  3. In severe cases due to delusions, psychosis, or hallucination, adhere to an involuntary psychiatric evaluation at a hospital emergency room. Have someone go with the individual, contact family members, and call for the assistance of EMS/police.
  4. Document the event in writing with date and signature. Keep the document in a private, locked place.

NANCY A. WALKER, Pittsburgh, Pennsylvania

5 Suggestions for Pastoral Care
in the Single–Staff Church

The pastor in a growing, single-staff church, while desiring to meet as many needs of his people as possible, may find himself exhausted and frustrated, which in turn may lead to low self-esteem.

Following are five helpful suggestions:

1. Organize for caregiving.

Church members’ homes often cluster in geographical areas. This factor allows you to organize your calling geographically. Visit one cluster of homes at a time. Some church members will have unusual schedules. This may result in another grouping. Some people are embroiled in crises (hospitalization, convalescence, moving, work layoffs, etc.). These persons make up another cluster.

Decide how you may best see the most people with the least amount of time between calls. How can the telephone, mail, and e-mail supplement this process?

2. Research congregational needs.

Develop skills in keeping with your congregation’s present and future needs. Look at the age distribution of your congregation. In the next 5 years who is likely to marry? Who will start families? Who will start school or leave for college? Who is likely to go into a nursing home? Who is likely to pass away? Knowing the information will help you plan.

Without fanfare or becoming a snoop, collect data on families within the congregation. Persons seem to volunteer this information to a trusted minister who knows how to use it redemptively.

3. Program for pastoral care.

Using the church calendar, work with church organizations to provide over a period of years a balanced menu of caring experiences. Programs may focus on personal and spiritual development, marriage enrichment, improving family relationships, grief management, and so on. Some programs can center on developing caring skills. Persons may realize that caring is a ministry of the church and not the exclusive domain of the pastor.

4. Have a place for pastoral care.

Decide where you will meet when someone requests to talk to you. This place should afford comfort and security for all involved. You will need a place to receive telephone messages without being overheard. Have by the phone a list of community helping persons with their telephone numbers and addresses.

5. Learn from your record keeping.

Record keeping provides several benefits. Early on, a pastor collects data that sets the stage for an ongoing pastoral relationship. Even brief notes following a pastoral call, when compared to earlier notations, can define a person’s progress through an episode of grief. Such records help maintain a flow in pastoral conversations.

FRED MCGEHEE, pastoral ministries consultant

Adapted from D.G. McCoury, ed., Pastoring the Single-Staff Church (Nashville: Convention Press, 1990), 30–32. Taken from Lifeway.com. Used by permission of Lifeway Christian Resources, 2009.

Crisis Management Resources

for Pastoral Care Implementation

Books

Wright, H. Norman. 2003. A New Guide to Crisis and Trauma Counseling: A Practical Guide for Ministers, Counselors, and Lay Counselors. Ventura, Calif.: Regal Books.

Rowatt, G. Wade. 2001. Adolescents in Crisis: A Guidebook for Parents, Teachers, Ministers, & Counselors. Louisville: Westminster John Knox Press.

Clinton, Tim, Archibald D. Hart, George Ohlschlager. 2009. Caring for People God’s Way: Personal and Emotional Issues, Addictions, Grief, and Trauma. Nashville: Thomas Nelson.

Weaver, Andrew J., Linda A. Revilla, Harold G. Koenig. 2002. Counseling Families Across the Stages of Life: A Handbook for Pastors and Other Helping Professionals. Nashville: Abingdon Press.

Weaver, Andrew J., Laura T. Flannelly, John D. Preston. 2003. Counseling Survivors of Traumatic Events: A Handbook for Pastors and Other Helping Professionals. Nashville: Abingdon Press.

Weaver, Andrew J., John D. Preston, Leigh W. Jerome. 199. Counseling Troubled Teens and Their Families. Nashville: Abingdon Press.

Floyd, Scott. 2008. Crisis Counseling: A Guide for Pastors and Professionals. Grand Rapids: Kregel Academic & Professional.

Hittner, Jo. 2006. Helping Kids in Crisis: Recognize, Respond, Refer (Help Series). Winona, Minn., Saint Mary’s Press.

McMinn, Mark. 1996. Psychology, Theology, and Spirituality in Christian Counseling. Carol Stream, Illinois, Tyndale House Publishers.

DVD Training Series

American Association of Christian Counselors
(See: www.aacc.net)
Caring for People God’s Way
Stress and Trauma Care (with military application)
Christian Crisis Response Training CISM

National Phone Hotlines:

Billy Graham Evangelistic Association, Guidance Department 877-247-2426
Focus on the Family 719-531-3400, ext. 2700 (weekdays 9:00 a.m. to 4:30 p.m. MT)
Salvation Army 703-684-5500

Crises Hotline:

Covenant House Nineline 1-800-999-9999 (24 hours)
Crisis line for youth, teens, and families. Locally based referrals throughout the United States. Help for youth and parents regarding drugs, abuse, homelessness, runaway children, and message relays.

National Youth Crisis Hotline 1-800-448-4663
Provides counseling and referrals to local drug treatment centers, shelters, and counseling services. Responds to youth dealing with pregnancy, molestation, suicide, and child abuse. (24 hours)

Child Abuse and Domestic Violence:

ChildHelp USA National Child Abuse Hotline 1-800-4-A-CHILD (1-800-4-422-4453)
Provides multilingual crisis intervention and professional counseling on child abuse. Gives referrals to local social service groups offering counseling. Has literature in English and Spanish. 24 hours

Boys Town National Hotline 1-800-448-3000 (TDD); 1-800-448-1833
Provides short-term intervention and counseling and refers callers to local community resources. Counsels on parent-child conflicts, marital and family issues, suicide, pregnancy, runaway youth, physical and sexual abuse, and other issues. (24 hours)

Children of the Night 1-800-551-1300 (24 hours)
http://www.childrenofthenight.org/

RAINN Hotline (Rape, Abuse, Incest National Network) 1-800-656-HOPE (1-800-656-4673)
A national number that automatically transfers you to the rape crisis center nearest you, anywhere in the nation.

International Child Abuse Network 1-888-224-4226 (Not a crisis line)
http://www.yesican.org/

National Domestic Violence/Abuse Hotline 1-800-799-SAFE (1-800-799-7233)
Emergency help in communities, including emergency services and shelters. (24 hours)

Eating Disorders:

Eating Disorders Awareness and Prevention (EDAP) 1-800-931-2237
http://www.nationaleatingdisorders.org

National Association of Anorexia Nervosa and Associated Disorders (ANAD)
847-831-3438 (long distance)
http://www.anad.org/

Families

Parent Hotline 1-800-840-6537
For families who are in a crisis situation.

Family Support Network
(families and children with special needs)1-800-TLC-0042

Mental Health

National Mental Health Association: 1-800-969-6942
Mental health information, referrals, access to specialists

Depression Awareness, Recognition, and Treatment Helpline 1-800-421-4211

Grief Recovery Helpline 1-800-445-4808

National Institute of Mental Health Information Line 1-800-647-2642

Missing Children

National Hotline for Missing and Exploited Children 1-800-843-5678

Self-Injury

1-800-DONT CUT (1-800-366-8288)
This is NOT a crisis line. If you or someone needs immediate help, it is best to call 911. This information lines provides information to those who harm themselves. It is a free service run by the SAFE Alternatives Program.

Substance Abuse

Al-Anon for Families of Alcoholics 1-800-344-2666

Alcohol and Drug Abuse Hotline 1-800-729-6686

National Drug Information Treatment and Referral Hotline 1-800-662-HELP (1-800-662-4357)

National Help Line for Substance Abuse 1-800-262-2463

Recovery Connection 1-800-993-3869
Find drug rehabilitation or drug addiction treatment centers near you.

Suicide

Suicide National Hotline 1-800-SUICIDE (1-800-784-2433)

National Youth Crisis and Suicide Hotline 1-800-621-4000

Mental Health Ministry Referrals for Counseling, Healing, Training, and Additional Information

American Association of Christian Counselors
Christian Care Referral Network, training, resources
http://www.aacc.net/

New Life Ministries
Counseling intensives, national Christian Counselor Referral Network www.newlife.com

Mercy Ministries (female adolescents)

www.mercyministries.org

Remuda Ranch (female adolescents eating disorders, anxiety, depression)www.remudaranch.com

National House of Hope (adolescents)
www.nationalhouseofhope.org

Capstone Treatment Centers (drug and alcohol young men 14–24) http://capstonetreatmentcenter.com/

Cleansing Streams Ministries (healing and deliverance for adults/adolescents) http://www.cleansingstream.org/