Crisis Intervention, Using Biblical Intervention

Crisis Intervention, Using Biblical Intervention Techniques

There are numerous ways to define a crisis. It may occur on an individual level, a community level, a societal level, or in the worst cases in a regional or country level, even on the global level, although thankfully rare. It may be instability in political, economic, social, or military issues; it may be environmentally related (e.g. weather or event). Regardless of the contributing factor though, it is a term that has come to mean "a time of testing" or "an emergency or vital situation." There are, however, five defining characteristics that make up a crisis and explain the manner in which humans react to such defining events. A crisis is a specific, (1) unexpected, and (2) non-routine series of events that create (3) anxiety, (4) uncertainty, and (5) perceived threats to either the status quo, important goals, or tangible assets (Seeger, et.al., 2006). Others see crisis as a need for change -- usually socially or culturally oriented, something that needs to occur so the individual organism (self) or group (society) can evolve into something more positive and/or productive (Lundgren and McMakin, 2009).

For the purposes of this essay, however, we will concentrate on those crisis situations that are not predetermined by weather, natural disasters, or even something such as the regulatory failures of business policy in the Global Financial Crisis of 2008. Instead, we will concentrate on what may be termed a "personal crisis." This type of crisis, of course, may occur in reaction to one of the natural disasters, etc. (extreme weather or medical emergency), but for our purposes focused on those that are related to change in everyday events -- loss of a job, fiscal hardship, substance abuse, addiction, marital or relationship issues, children, job stress, etc. -- anything that causes hardship and consternation from daily life. Of course, there is a wide range within this paradigm -- from a minor behavioral issue with a child to something far more serious; death or serious illness of a loved one ("Coping With Crisis," 2009).

Crisis Intervention- Generically, crisis intervention may occur as an orchestrated attempt by anyone to convince an individual to seek professional help in a situation that is crisis oriented (addiction, trauma, etc.). Intervention usually applies to a situation in which the individual is unwilling or unable to seek appropriate resources for themselves, or perhaps does not acknowledge the damage the particular behavior is having upon their lives (drug abuse, compulsions, and destructive personal habits). This, of course, is quite dependent upon the personal views of the counselor, family member, or person who is instituting the intervention.

My personal view, which will be part of this essay as alternatives for crisis intervention, is the use of the Bible and a Christian approach to intervention. The basis for this comes from the New Testament, and the ways one can turn to the Bible to help understand crisis, and to offer comfort to those experiencing trauma. Many Christian counselors describe the very nature of the Christian life as a means of attainting grace through compassion and the reaching out to help others. By using the Bible as a guide to the way of living, one can reach into contact with God's grace and power that help us inwardly have the courage and restitution to be enabled to do outwardly what we cannot do on our own. Using the Bible and the Christian worldview to help individuals, however, does not imply that the counselor has all the answers. Rather, it is the strategy that the vision of the individual will improve through open communication with God -- one can ask how Jesus might have responded to the crisis, or, if there are words of comfort that might offer a solution to the situation at hand (Gaultiere, 2005).

In utilizing the Biblical view of counseling, we must remember that it focuses on how to live faithfully, act justly, love mercy, and use the basic principles of the New Testament to pattern a good life (Monroe, 2007). Many Biblical counselors are reminded that the Christian view is that humans sinned, and that the nature of humanity is to rise above sin and reestablish their nature of a union with God. Suffering is a very real, and as most counselors know, palpable experience. Intervention's goal is to minimize this pain and establish a manner of personal growth -- hopefully combining spirituality -- but nevertheless the predominant goal of easing the pain (Barbanel and Sternberg, 2006).

Direct and Indirect Interventions -- Interventions are either direct -- involving an confrontational meeting with the individual, or indirect, working with a family or spouse to encourage them to be more direct with the person at risk. The process of psychological intervention, in fact, originated in the 1960s with Dr. Vernon Johnson. In the contemporary world, though, the Johnson model is often criticized because it involves a level of "ambushing" -- seen as necessary at the time in order for the intervention to even occur (Johnson, 1986).

The two major paradigms of intervention used in the contemporary counseling model are the a.R.I.S.E. And Systemic models of intervention. Both use an invitational, non-confrontational approach and rely heavily on family or peer group to mitigate and help enter a process of recovery. This often helps take th4e focus off the addicted person and acknowledges the need for the entire peer unit to change in order for health to occur. Both models also emphasize that it is imperative to treat the individual with love, dignity, and respect -- not to allow them to see their addiction as shameful or something degrading or in need of hiding (Heymann, 2006).

The ARISE model uses a three-phase process to allow the individual to find appropriate treatment. The addicted or individual in crisis is invited upfront with no surprises, coercion, and with absolute respect for their privacy and individual needs. The first step is getting the individual into treatment without harm or trauma. Step 2 focuses on external peer and familial support, Step 3 only if necessary and only if Step 2 does not work. Step 3 supplies consequences toward the individual if treatment is not sought voluntarily ("Arise Intervention," 2003). Similarly, the Systemic Model is invitational, everyone is invited to the event -- leading to recovery rather than pushing. It is systemic in that the original 2 day series requires the peers or family to attend, and sees the personal universe of the addicted as tied to the manner in which family dynamic models work in tandem to create a world view -- either of addiction, enabling addition, or support ("Intervention Models," 2006).

Biblical counseling and intervention are unique when compared to more secular theological methods. Just as each individual is unique in their quest for therapy, the differences of Bible-based therapy allow the counselor to go beyond some of the psychological issues of the patient and address the spiritual basis for behavior. One basic principle is that in Biblical intervention, a client can be returned to pre-crisis coping levels and be healed within a continuum; but the reestablishment of a relationship with God as a prevalent goal is not always tangible, and must often be seen as a long-term, almost life-long issue (Reiner, 2005).

Crisis Paradigms and Treatment Goals -- There are a number of stressors in contemporary society. These complex issues act to cause stress, crisis, and trauma -- although the terms themselves are difficult to precisely define since they are individual interpretations of events by their very nature. For example, many report that stress helps them work more productively -- indeed, the reason for stress from a biological point-of-view is to heighten senses to get the body through an event. Crisis, too, can mean many things to many people. Individuals do not respond to stress in the same manner. The individual is unique, and often what causes a crisis for one person may be a minor difficulty with others. It is important to understand then, that there is no generic rule for crisis -- no absolute for understanding how an event or series of events might cause a reaction in an individual. This, by its very nature, then is the real issue with crisis intervention -- one can develop some basic skills and tools (e.g. listening, guidance, etc.) but each and every intervention is unique, and must be treated in that manner (Seaward, 2008).

Most clients have two main needs when they are in distress: to communicate their unresolved pain and to be assured they are still, somehow connected to the human race. In Biblical counseling, this connection is crucial -- providing the spiritual guidance that the individual is a child of God and therefore, connected to humanity and to the nature of God. There is, of course, not one way of accomplishing this, rather, "it is important to reestablish the faith of the individual. If the individual is not a person of faith, or has since lost their faith in God, the crisis, once dealt with, may be a good opportunity to bring the client to Jesus. 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).