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However, counselors must be careful not to take advantage of a suffering individual" in their moment of need (Monroe, 2007).
In fact, recent developments in the world of counseling seem to suggest a merging of secular science (psychology, etc.), postmodern world-views, humanism, and Biblical therapy. While there are always definitive characteristics that set Biblical therapy apart (reliance on a higher power, goals towards spirituality, etc.) one of the most important differences is that "therapists must relate to their clients from a position of equality (Blanton, 2005, 97). The uniqueness of the individual, again, cannot be overemphasized because "the person to whom I talk is created in the image of God, which means that he or she is fascinating, worthy of respect, and just plain likable" (Johnson, 2007).
Crisis Intervention Techniques -- a Seven Layered Approach -- Since each crisis situation is quite different, the professional still needs a toolbox from which to glean appropriate tools that may be utilized in different situations. By determining the level and category of the person in crisis, this toolbox will act as a template for the robustness of intervention, whether outside assistance is required, what the short- and long-term affects might be, and finally to address a plan of action. These layers do not assume any one way of intervention, but are simply roadmaps to begin a therapeutic approach.
Level 1 -- Somatic Distress- Usually defined as manifesting in a biomedical disease or minor psychiatric symptom; often expressed by anxiety and depressive symptoms. Usually, these symptoms come about based on an external fear, but are often seen as a result of a specific worrisome diagnosis or development in one illness. Unresolved grief or abandonment issues can also contribute to this type of distress. For the most part, somatic distress is usually handled through addressing the physical symptoms, and then talking out the issue so that the unresolved fear, anger, or other emotion can be laid to rest (Guiffrida, 2007).
Level 2 - Transitional Stress Crisis -- Transitional crisis occur in persons of all ages, particularly young people, and are directly related to normative life events. It is the individual's response to the issue that causes the failure to master the physical or emotional task required for development. The primary intervention is educational -- explaining that certain changes have, or will, take place and exploring why these are necessary and/or part of life's maturation process. Self-help groups are often used in this type of issue once the initial crisis point has been diminished (Wainrib, 2006).
Level 3 -- Traumatic Stress Crisis- Extreme and usually unexpected trauma trigger Level 3 stress. This involves experiencing, witnessing or learning about an unexpected and uncontrollable life-threatening situation that overwhelms the personal power of that individual. This also occurs in crime-related victimizations of assault, rape, arson, hostage taking, victimization, or otherwise clear event that causes individual alarm (the 9/11 bombing, etc.). Intervention in this case is primarily concerned with helping individuals return to a life of safety and normality. The person is in psychological shock, does not trust the external world, and may manifest anxiety, confusion, anger, loneliness, and confusion. Thus, the therapist must bring the patient back into understanding that events do not define them -- that there is trauma in life, but it is part of a phase. Often, depending on the degree of traumatic stress, certain anxiety medications may be needed to mitigate the situation (Ford, et.al., 2009).
Level 4- Family Crisis -- Within the longitudinal structure of the family, it is likely that at one time or another, some sort of a crisis will occur. That may be something in dependency, values, identity, intimacy, external or internal, and be part of a wide variety of incidents or behaviors. Because of the nature of the family crisis, the level of intervention is entirely dependent upon the seriousness of the crisis: family violence and fear is treated differently than a breakup with finance'. In family violence, though, the goal of the intervention is to help individuals reestablish their lives, strengthen their interpersonal relationships, and resolve the event(s) that caused the crisis, whether that be loss or change. Whatever dysfunction occurred must be addressed, and a plan of action occurs. This is often the place in which Biblical counseling or the ministry is most effective. Since the family structure is singularly important to the Church's viewpoint, the idea of using Christian-based viewpoints to show the importance of what a family means is often critical (Cutrer, 2009).
Level 5 -- Serious Mental Illness -- Diagnosis of a serious mental illness is contingent upon many things; for certain the inability to have normalcy in one's life. This type of illness may include psychosis, dementia, bipolar depression, or schizophrenia. The seriousness of the pathology usually results in the individual being unable to function within their environment and, at times, be a danger to themselves or others. The crisis therapist in this situation must take a broader, long-range approach. The illness will not likely be cured with 1-2 therapy sessions, or even a short-term pharmacological protocol. Instead, the intervention must be to mitigate the situation as much as possible, to give reasonable support, and to work more with the neurologist or psychiatrist to provide supportive therapy (Dipman, 2006).
Level 6 -- Psychiatric Emergencies- These involve crisis situations in which general functioning of the individual has been severely impaired. Usually, the individual is rendered incompetent, unable to assume personal responsibility, and unable to exert control. There is imminent threat of harm to self or others. Examples include drug overdose, attempts at suicide, rape, homicide, or assault. The individual has loss of control and may be within a variety of consciousness. Again, the level of seriousness will dictate the particular crisis intervention, but just as with a medical emergency, the goal is to assess the actions, and bring the individual back to a state in which they can adequately communicate with the individual. These are often the most difficult and perplexing types of issues, since information is often incomplete, missing, or simply unavailable (Roberts, 2005, 137).
Level 7 -- Catastrophic Crisis -- This ultimate tier is a combination of stressors above level 4. The crisis may be one of temporary or fleeting issue, and can be dealt with by intensive, but limited therapy; or it may be something long-term (a diagnosis of AIDS or terminal cancer, for instance). It also may be of such traumatic nature that it will require long-term care and possible medication (loss of a limb, traumatic loss of family member through violence, etc.). This tier requires the interventionist to assess the situation thoroughly, and then typically form an intervention team and mid-to-long-range care plan (Ibid., 138-40).
Conclusions- as we have noted, there are numerous ways in which crisis situations require differing levels of intervention. The type of crisis, whether it is a serious medical issue, or an important, but non-life threatening psychological event. The key to the intervention paradigm, though, is to be able to use the appropriate level of language and persuasiveness to bring the situation under control so that some sort of therapy or appropriate assessment can occur. Often the techniques required for this are the same that hostage-negotiators use to build rapport with the kidnappers, etc. And require a level of empathy and ability to place all judgments aside in order to establish a more meaningful dialog, in this case, with the patient (Charles, 2007).
There are two major approaches to Biblical crisis intervention. One focuses on the event and attempts to alter the client's view of the originating issue. The other, sometimes called Brief Biblical Therapy, focuses on the solution and seeks to use the individual, God, and the originating issue as catalysts for change. Of course, both of these approaches presuppose a level of engagement, literacy, and cognition that is not always available for persons in crisis. Regardless of the approach, it is important, of course, to recognize the cause of the crisis. Then, the assessment must be made as to the likely understanding of the crisis by the individual. If the goal is to return the individual to a pre-crisis level of coping patterns, which is a standard therapeutic goal, the counselor must attempt to either settle for a comfort zone or to stretch that zone to a level of greater self-actualization. This is only possible, for Biblical intervention, if the patient is able to perceive morality, decision making, and a reasonable definition of the crisis (Popovich, 2007). Indeed, the approach to assessing and defining the broader view of the actual crisis is imperative when issuing a level of crisis, as well as the appropriateness of a plan -- and what therapeutic methodology to employ (Meyer and Moore, 2006).
Biblical crisis intervention and counseling are often not the end of the required therapy or interventional issue. Indeed, while the Biblical counselor can intercede in all seven levels, the ability of the…[continue]
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