Pastoral care emergencies: a book review

¶ … Pastoral Care Emergencies

In the following review, this author will review Pastoral Care Emergencies by David K. Switzer (2000). We will see how the author reshaped and spurred thinking about ministry and pastoral care in the present post-modern culture. We will also see how his thoughts have reshaped and sharpened pastoral identity, awareness, and development in the present day and have become standard fare. His work has become cutting edge for pastoral care that translates flowery sermons into saintly examples for members of the flock to follow and rally around. The book is highly practical in approach, but still extremely sensitive to the theological issues at hand in ministering to those experiencing great emotional, mental, and physical distress.

Included in this review will be three fresh insights from the reading about the Christian church and its response to the needs of pastoral care clients. First, one must know when and where to intervene without being patronizing. Secondly, pastors must be able to minister to the whole person. Thirdly, although the book does not address the issue of terrorism and catastrophic emergencies, we can infer lessons from Switzer's insights to deal with these horrible problems of the present age.

Switzer presents a clear and practical manual for pastoral caregivers . This covers the entire gamut of pastoral care emergencies typically faced by clergy, pastoral counselors and lay caregivers, The book includes sections that deal with issues such as situational crises, hospital emergencies, ministry to the dying, bereavement, suicide, divorce, domestic violence, substance abuse and psychiatric emergencies.

Indeed, Switzer has established a triage system for pastoral care with this manual. This is particularly true in hospital settings. The crucial question of when and how to refer is discussed in the final chapter (Switzer, 175). Highly practical in approach Switzer is still extremely sensitive to the theological issues at hand in ministering to those experiencing great emotional, mental, as well as physical suffering.

The two intervention processes closest to a practical definition of pastoral crisis intervention are crisis chaplaincy and crisis ministry. As commonly defined in the practice, crisis ministry has as its expressed method and goals to not only restore functionality within a practical life system. In addition, it also addresses the theological aspects and implications of the critical incident and corresponding crisis response (ibid, 36)

The goals of pastoral crisis intervention as defined here are fundamentally the same as those of non-pastoral crisis intervention, In other words, the reduction of human distress is paramount. This is the case whether or not the distress concerns a loss that is catastrophic for the victim, crises of meaning or of faith, or something far more mundane. What is important is that concrete and objective infringements upon adaptive psychological functioning are mitigated so that the client can heal (ibid).

This corporate body of "value added" ingredients is especially important to people who have come from Western societies with their value on the individual person and their rights in society as a whole. Such mechanisms of spiritual action or agents of spiritual change are not unique to the pastoral perspective. Rather, this perspective employs spiritual and theological resources in an effort to "shepherd" an individual from distress and dysfunction to a state of restoration. Due to these unique strengths and their ministry to the whole person, some form of pastoral crisis intervention option should be integrated into all critical incident stress management teams, community crisis and intervention response efforts (ibid, 1-5).

It is therefore necessary to define what pastoral care is and what it is not. Pastoral care is the ministry of care and counseling provided by pastors, chaplains and other religious leaders to members of their church or congregation, or to persons of all faiths and none within institutional settings. This can range anywhere from home visitation to formal counseling provided by pastors who are licensed to offer counseling services (ibid, 17-18).

This is also frequently referred to as spiritual care. This is what we might call ministering to the entire person. Pastoral care is also a term that is applied where people offer help and caring to others in their church or the wider community. Pastoral care in this sense can be applied to listening, supporting, encouraging and befriending. This term can also be a term generally applied to the practice of looking after the personal and social well-being of children or students under the care of a teacher (ibid).

Literally defined, pastoral care may be seen as the basic function of providing a spiritual, religious, or simply faith oriented leadership. Pastoral care is typically provided by someone who has been commissioned or otherwise as selected by a faith group or other organization. They are picked to provide interpersonal support, religious educational purposes, worship, issuance of sacraments, community organization or related activities that provide spiritual support. More formally, pastoral care is commonly professionally provided by congregation-based clergy possibly formally trained laity), chaplains, pastoral counselors, or clinical pastoral educators. This is done while recognizing that these terms and functions are not mutually exclusive. In other words, people (especially pastors) may wear several hats, especially in small church organizations (ibid, 17-35).

One specialized form of pastoral care which has emerged of late is pastoral counseling. The process of pastoral counseling generically may be thought of as the utilization of psychological, spiritual, and theological resources to aid persons in psychological and/or spiritual distress. This then is the practice of pastoral crisis intervention. Simply stated, pastoral crisis intervention is the functional integration of any and all religious, spiritual and pastoral resources with the assessment and intervention technologies germane to the practice of emergency mental health (ibid).

In his first chapter, Switzer asks this basic question as well when he asks "what does it mean to say we care?" In his analysis, he links this up with the total history of the coming into being of the Jewish people and their relationship with the God of Israel. God made a covenant with them that demonstrated the relationship of the flock to the divine shepherd who guides them along to and from the spiritual pastures (Switzer, 6-7).

The covenant that God entered into with the people of Israel was reflected in the cohesiveness of the nation as a people, the group commitment that they accepted and their sense of relationship to each other in the group. The quality of their relationship to each other as a nation by their worship of God and the foundation their nation through the dramatic foundation events mentioned in relationship with the Exodus from Egypt. In this covenant, the individual was taken care of by the community at large and by the "shepherds" in place over them (ibid).

This raises similar issues in Christianity as well. Jesus was born into the Jewish faith. Like Moses before him, he is the archetypal shepherd leading his flock. The quality of the pastoral care that is extended to the individual is based upon the covenant relationship of the pastor with the people of his flock.

The Church throughout history has followed Jesus and his representatives on the earth as they led the Christian flock on its march. Pastors perform the same function as Jesus in leading the flock. In addition, they see themselves performing in the role of Jesus as the healer. The reason for the Christian faith is represented by these selfless acts of loving kindness (or hesed in Hebrew) (ibid, 8-9 and 11).

These duties are of course not this simple. They are variegated and Switzer spends much of the rest of book breaking them down, including what to do in situational crises, visiting the physically ill, hospital visits, how to minister to the dying, ministering to those suffering from bereavement, responding to suicide, family counseling and of course where and when to intervene.

This is particularly true with regard to depression. Clergy must have help from professional mental health for assistance in the difficult and often multi-dimensional task of assessing depression in people who seek them out for help. There are two basic facts to keep in mind when identifying depression. This author seeks to investigate some of the possible forms of relationship between religion and emotional disorder instances in which a person's religious life appears to have been one of the sources of an emotional disorder, the influence of faith as seen as an organizing center for one's life. This is true even in the midst of emotional disorder, delusional situations and hallucinatory experiences in which traditional religious material in some form is an obvious component (ibid, 118).

One of the most important of these is to support the family of the client in its various crisis and life events. This could be broken down into marriage and family life issues, family systems, counseling and divorce (ibid, 134). Finally, this also includes mitigation of problems of families who need to be ministered to marriage and family emergencies that include situations that end up in family violence and psychiatric emergencies (ibid, 160).

When to intervene is of course critical to determine. Certainly, the best counseling is proactive and for one to really keep up with a situation is to stay ahead and to be able to anticipate how events will develop as the pastor gains more experience. As the book title implies however, even the best training can not always prepare the pastor for every possible emergency situation. For instance, terrorism and disaster types of situations have evolved since the book came out in the year 2000.