Little Druid on the Prairie

Crisis Response was designed to provide clergy students with the knowledge and skills necessary to identify and temporarily intervene in a helpful and effective way in a crisis situation.

The primary goal of this course is for students to enhance their knowledge and skills for crisis response. Please note that this course will not lead to professional certification.

Course Objectives

1. Students will be able to identify an individual in crisis and the precipitating event(s) of the situation.
2. Students will demonstrate an increased knowledge of effective crisis response.
3. Students will utilize their knowledge and skills to develop a list of appropriate crisis referrals for their locality.

1.    Provide both an objective (from a source e.g. dictionary, textbook) and subjective definition (in your own words) for the following terms: “crisis” and “precipitating event.” (minimum 50 words each, excluding the objective definitions)

Crisis

• a :the turning point for better or worse in an acute disease or fever

b :a paroxysmal attack of pain, distress, or disordered function
c :an emotionally significant event or radical change of status in a person’s life – a midlife crisis

2             the decisive moment (as in a literary plot) The crisis of the play occurs in Act 3.

3             a :an unstable or crucial time or state of affairs in which a decisive change is impending; especially :one with the distinct possibility of a highly undesirable outcome – a financial crisis the nation’s energy crisis
b :a situation that has reached a critical phase the environmental crisis – the unemployment crisis

(Merriam Webster Online Dictionary)

A crisis is an emergency situation that must be dealt with immediately. It is more than an inconvenience, and may require the skills of outside participants in order to resolve. A crisis is “usually brief, limited by nature, and [demands] care that matches [its] structure” (Kennedy 387). However, some crises “occur outside any discernible time frame” and thus require different and more intensive care to resolve (388).

Precipitating Event

2             to bring about especially abruptly – precipitate a scandal that would end with his expulsion

(Merriam Webster Online Dictionary)

A precipitating event is the event in a timeline that brings about a crisis situation. It “follows the burned powder trail back from the explosion to that place where the match was struck and touched to it” (Kennedy 388). Understanding this event allows for better understanding of the crisis situation and also directly impacts the ability to aid a person in crisis.

2.    Describe at least three different categories of emergency situations and provide a clear example of each. Please ensure you include a source citation. (minimum 50 words each).

Emergencies can arise from the following different situations:

Psychic crises are when an individual experiences a “breakdown in their psychological function” (Kennedy 387). Onsets of diseases like bipolar disorder and schizophrenia, or even the deceptively simple depressive episode can trigger a psychic crisis and these types of crises can be of the sort (as mentioned in the definition) that takes a particularly long time to resolve, especially with the challenges in medicine surrounding psychological health.

Physical crises occur when “body systems fail, as in heart attacks or strokes” (387). While we typically like to see these crises as “simple”, the human body is a complex organism, and many people fall through the cracks of the healthcare system. Especially with as difficult as it can be to obtain health insurance and preventative care, physical crises are likely to be more and more common in our society.

Interpersonal crises occur between people, such as within families or in marriages (387). These crises may be solved simply through problem-solving and other communication strategies, through the external help of a therapist or counselor, or ultimately may result in the dissolution of the relationship, depending on the severity of the crisis and the nature of the individuals involved.

Intratemporal crises happen when “the emergency is specific to some time period, such as adolescence or old age” (387). When the crisis occurs between these life stages it is classified as intertemporal.  A classic “life-stage” crisis is the mid-life crisis, which current studies are showing has actual psychological and physical elements, making this type of crisis something of a combination of the first two types.

3.    Describe at least five possible events or situations that may cause an individual to experience a crisis in his or her life. (minimum 100 words)

The causes of crisis in an individual situation are myriad, and can stem from both positive and negative events. Life stage events, such as graduation, marriage, buying a home, and the birth of a child all dramatically challenge an individual’s way of life, dreams about the future, and understanding of their place in the world and society. While these are generally considered positive events, each involves a great deal of stress, and any stressful situation can be enough to trigger a personal crisis. Similarly, stressful life situations like divorce, moving, illness, and death often provoke crisis responses in the people experiencing them. These crises are typically better accepted within society – my recent divorce, and subsequent desire for therapy, was not only respected but fully supported at my job – but are no less troublesome and require just as much care of the people involved. Traumatic situations like being the victim of abuse, assault, robbery, or other crimes are also potential triggers for crisis situations, and these must be handled especially delicately, as poorly handled traumatic situations can turn an individual crisis situation (which can be dealt with provided the person gets the proper care) into Post-Traumatic Stress Disorder (which can be a psychological disorder that may affect the person for the rest of their life).

4.    Discuss how an individual’s ability to appropriately cope and/or problem solve may be affected by crisis and explain the process you would use to assist this individual. (100 words).

People in crisis situations may experience confusion, depression, or anxiety (or all three), all of which dramatically influence their ability to cope and problem solve. Depression makes the world seem hopeless and may cause an individual to feel hopeless – like they cannot solve the problem in front of them. Anxiety often expresses itself so severely that “people in emergency situations… [may not be]… aware of the specific fear affecting them and cannot easily give it a name” (Kennedy 393). Confusion causes difficulties in special awareness, awareness of time, and awareness of sense of self (394), all of which can cause an otherwise resilient individual to be unable to appropriately cope with a crisis situation.

For a mildly anxious person – especially someone for whom the anxiety is unnamed – I would recommend exercises to calm the central nervous system, general reassurance, and then referral to a competent professional resource (Kennedy 393-4). The stronger and more aggressive the anxiety, the faster would be my response to get professional help. For depression and confusion, I would likely skip straight to referring a person to competent medical help, especially with someone who was exhibiting signs of suicidal ideation or of dementia, both of which are well outside the scope of the assistance a clergyperson can provide (Kennedy 392-5).

5.    List and discuss at least five suicide warning signs. Explain how you would respond if you were assisting an individual exhibiting one or more of these signs. (minimum 50 words each warning sign and minimum 100 words for response).

Appearing depressed or sad most of the time – Untreated depression is the number one cause for suicide, and a person acting depressed is usually a good sign that they are feeling that way. This is best addressed by a medical professional, as a combination of medication and therapy has proven to be the most effective at alleviating depression.

Withdrawing from family and friends – Withdrawal is as much a symptom of untreated depression as it is anything else, and when feeling particularly low-mood or depressed, people will often choose to shut themselves away, finding social interaction to be difficult, or feeling like they don’t want to “impose” on others while they are feeling sad.

Feeling hopeless/helpless or feeling trapped – The weight of an untreated episode of depression often comes with feeling hopeless or helpless, or like the situation is one from which a person can not escape. They feel like the world has become prison-like, and thus turn to suicide, not due to wanting to be dead, but simply because it offers an escape when they feel that there are no other ways out.

Abusing drugs or alcohol – Drug and alcohol abuse change the perception of reality, if only for a short time, and can give the impression of “making things feel better”. In reality the abuse of alcohol (a nervous system depressant) and other recreational drugs often makes untreated depression worse over time, and – in someone who is trying to obtain treatment – can negatively interact with medical modalities.

Losing interest in activities – called ‘anhedonia’ (literally “inability to feel pleasure”), this loss of interest in activities that were once seen as fun or enjoyable is sometimes the first real clue to someone’s worsening depression, and goes hand-in-hand with withdrawing from friends and family. When previous activities are no longer fun or pleasurable, it feels easier to just not do them, and thus a depressed person sinks further into their depression.

(Caruso)

Responding to a depressed person is a multi-faceted and difficult thing. It is important for a person in a clergy role to not get sucked into “playing therapist” for someone in a time of depression, but to encourage and help combat all of these warning signs. Number one for someone who is experiencing a long period of depression that is consistently worsening or does not show signs of improvement, is to get the person to a medical doctor and a licensed counselor or therapist (or social worker, depending on the state). These professionals will form a treatment team for the depressed person, alongside which their friends and family can gently encourage counters to all of the above behaviors. Providing safe spaces for a person to be sad while still feeling accepted can counter withdrawal, as can encouraging a person to try “just a few minutes” of a previously fun activity. Providing space for someone to exist with their depression without having to self-medicate with drugs and alcohol is also important. And perhaps most important is the return of agency – helping a person feel like, even though they are depressed, they still have options, choices, and control over their situation, which helps battle feeling trapped and hopeless.

(Kennedy 352-360)

6.    Choose four of the seven common misconceptions about suicide from the list below and discuss why each is a misconception. (minimum 50 words each)

 

People who talk about suicide won’t really do it.

This is demonstrably false, as often people who are feeling suicidal will go out of their way to talk about their suicidal ideas and “fantasies”. Talking about suicide – sometimes even joking about suicide – is a major warning sign that a person is actually dealing with suicidal ideation and may actively be planning a suicide attempt.

If a person is determined to kill himself/herself, nothing is going to stop him/her.

This is also false, as sometimes a person who appears determined to take their own life can be persuaded by simply realizing that one person cares about them enough to want to still see them alive. This display of care and attention may come from a friend or family member, or may even come in the form of a stranger through a suicide hotline, but sometimes all it takes is one interaction to convince a suicidal person that they are better off alive. (SAVE)

Once the emotional crisis improves, the risk of suicide is over.

Sometimes right when a crisis begins to get better is when a person attempts suicide. This may be because in the midst of a terrible crisis or depression, they don’t have the energy or the mental strength to attempt taking their own life. As soon as the crisis begins to improve, and they begin to feel better, suddenly a suicide attempt seems possible, and should be actively monitored for in patients receiving their first treatment for major depression for this reason. (SAVE)

Talking about suicide may give someone the idea.

“A healthy person talking about suicide or being aware of a suicide among friends and family does not put them at a greater risk for attempting suicide” (SAVE). Merely exposing someone to suicide does not increase their risk – however, should a person have other risk factors (depression, emotional crisis, other untreated or uncontrolled psychological disorders) being around someone who attempts suicide may increase their likelihood of an attempt. Discussion, however, especially discussion in the interest of preventing suicide, does not increase suicide risk. (SAVE)

After a person has attempted suicide, it is unlikely he/she will try again.

A previous suicide attempt is actually one of the warning signs for future attempts at suicide. Depending on the care and change in situation that a person receives for their previous suicide attempts, they may simply return to that mental state, and having done so in the past, may choose to try again if they feel the situation warrants it or isn’t getting any better. Also a previous suicide attempt shows that a person is serious about taking their own life, and should be treated very seriously by caregivers. (SAVE)

7.    Discuss why an individual in crisis might seek an ADF clergy person for help and explain whether or not you feel this is an appropriate function for ADF clergy, why or why not? (minimum 200 words)

ADF clergy serve roles in their community that are akin to the roles held by clergypeople in other religions, and our society expects its clergypeople to be trained in dealing with crisis situations. As well, people come to trust their clergymembers as friends, and so seek them out whenever a difficult situation arises. People naturally gravitate towards spiritual and religious help and “may wisely call on the religious faith of those involved to support them during a time of stress” (Kennedy 391). ADF priests provide this kind of religious support through prayer, ritual, divination, and simply by being an impartial ear to hold space for and assist when nothing else seems to be helping.

That said, it is vitally important that ADF clergy – who do not have the training in pastoral care that someone who has been through theological seminary and has a Master’s of Divinity would have – maintain careful boundaries around this type of care and helping. They can provide spiritual guidance, and they can provide emergency resources, often being able to help someone get resources from elsewhere that they didn’t know were available. But they are not licensed therapists or social workers, and thus must maintain very careful guard of what they can and cannot assist with. The most appropriate role of an ADF clergy person is at the point of emergency to provide support in getting a person the correct professional help, and after the point of emergency to provide spiritual and religious assistance processing and dealing with the crisis situation – which might require maintenance over a period of time.

8.    Discuss an example of a crisis situation to which you have responded (this may be a crisis you have personally experienced or an experience in which you tried to help someone else in crisis). Reflect upon your response to the crisis in your example, and explain what you found effective, as well as how you could have improved your response to this situation. (minimum 200 words)

I have a grovemate who is currently coming to me for crisis management, after dealing with (treated) bipolar disorder and anxiety that has been worsening with the onset of graduate school and then a precipitating event with a young man that she has fancied for some time, who did not accurately convey his intentions and ended up hurting her badly.

When she originally called me, she was in a state of such distress that she was having difficulty with basic function. I made a trip to her apartment with crisis numbers in hand, and helped her get something to eat and encouraged her to get a shower and get some of her things in order so that she could adequately deal with her increasingly troubled situation. I did a lot of active listening and a lot of affirmation. Because this is someone I know well, I was able to help her see all the good things she has done for our grove and for our community, as she was feeling like she “couldn’t do anything right”. After spending some time with her, I made sure she felt safe and was not in danger of harming herself and went home. (She has previous experiences with suicidal ideation, and I trust her to have been honest with me about whether we needed to go to an emergency room.)

Over the next few days, I provided peripheral support, encouraging her when her spirits were flagging as she contacted doctors to get her medication adjusted and went in search of a local therapist – something she hasn’t had for some time.

While overall I think I did well in this situation, I would definitely not have been able to provide this kind of effective support to a community member that I did not know well, and did not have years of history of working together with. I also think I would have encouraged her to go to the counseling center at her university immediately (or taken her there myself) rather than trying more mundane coping skills at first. I also would have provided better structure to my support over the interval between when she had her first breakdown and when she finally got in to see a psychiatrist – I’d like to see myself with better boundaries and also more consistent support of someone close to me who was in crisis (say, a check in twice a day, instead of relying on whether I’ve heard from her in a while).

This kind of support is something I do not mind giving to close friends, but that I would be uncomfortable providing to a new member of our community who contacted me. I don’t feel like I have a lot of experience helping community members who are not also close friends – a symptom of my grove being a very close-knit group that is still small enough to all have each other’s phone numbers.

9.     Discuss how the skills required of ADF clergy in ritual, especially those which involve mitigating chaos and generating order, might relate to those necessary for appropriately responding to an emergency situation (minimum 100 words).

ADF Clergy are skilled at rituals that create order from chaos – a skill that is desperately needed in a crisis situation. In a crisis, “the basic human balance is disturbed and individuals are thereby rendered vulnerable” and “in an instant… balance [can collapse] and disorganization takes place”(Kennedy 398). If, by their actions as a priest, an ADF clergyperson can help a person feel that their equilibrium has been restored, at least on a religious or spiritual level, that person may be able to go forward into the rest of the situation. Their ability to manipulate the tides of chaos into creating order, to provide a voice of calm and ordered reason, and to be generally stable and unswerving in the face of crisis can be inspiring to a person in a crisis situation, and may be the best strength of an ADF priest in the face of a difficult crisis. Forming and reforming the cosmic order is a steadying, grounding force that each ADF priest ought to have at their disposal for use in critical situations.

10.Compile and submit a list of mainstream resources providing crisis services available in your locality. Additionally, explore your locality for a hotline number to access emergency services and discuss the results of your search. (Please provide the following information for each resource listed a) name of resource b) contact information c) how to make a referral d) hours of operation e) specific service[s] provided by the resource). (no minimum word count)

The National Crisis Text Line – https://www.crisistextline.org – is an invaluable resource for any person going through any form of crisis situation. Trained staff is available 24/7 simply through a mobile phone, where they are available to listen and provide de-escalation techniques to assist with a person in crisis. To access this service, simply text HOME to 741741 from anywhere within the United States. This hotline is applicable to pretty much all of the categories below, and rather than repeat it over and over, I am putting it up front since it is explicitly designed for people in crises of any situation or type.

As well, the City of Houston maintains a Crisis Intervention Hotline at http://crisishotline.org or via phone at 832-416-1177 or via app at CIH Resource Guide. This resource is designed to assist persons in crisis as they de-escalate a difficult situation and begin to approach it with clarity. It is staffed by volunteers through the Houston Service program, and is available 24/7. These resources are trained volunteers, and so are primarily most useful for emergencies and not for long term care.

The United Way of Greater Houston provides the 2-1-1 Helpline 24/7 to assist people in crisis who need help finding resources. This is designed to be a complement to the citywide 9-1-1 program, only for help with basic care and human needs. While not specific to a crisis, I had no idea that this number even existed, and I am very glad to have it to use in the future to refer to in the community.

Suicidal thoughts

(no suicide specific resources found – use the national suicide hotline provided below, or one of the above listed crisis hotlines)

National Suicide Prevention Lifeline
https://suicidepreventionlifeline.org/
1-800-273-8255
24/7 free and confidential support for people in distress, and for prevention of suicide

Mental illness

NeuroPsychiatric Center
https://hcpc.uth.edu/pages/public-mentalhealth/
A 24-Hour Psychiatric Hospital – crisis evaluation and treatment
1504 Ben Taub Loop, Houston, TX 77030
(713) 970-7070

The Mental Health Authority of Harris County
“Persons with severe mental illness and substance use disorders should be able to live in homes of their own, develop relationships, work, and remain out of hospitals and criminal justice facilities.”
http://www.mhmraharris.org/
Crisis Hotline – 24 hours / 7 days
(713) 970-7000
1-866-970-4770

Outpatient services are provided from 7:30-3:00 Monday-Friday on a first come, first served basis. No referral needed.

• Northwest Community Service Center, 3737 Dacoma, 77092
• Northeast Community Service Center, 7200 North Loop East Freeway, 77028
• Southwest Community Service Center, 9401 Southwest Freeway, 3rd Floor, 77074
• Southeast Community Service Center, 5901 Long Drive, 77087

Substance abuse (addiction)

The Mental Health Authority of Harris County
“Persons with severe mental illness and substance use disorders should be able to live in homes of their own, develop relationships, work, and remain out of hospitals and criminal justice facilities.”
http://www.mhmraharris.org/
Crisis Hotline – 24 hours / 7 days
(713) 970-7000
1-866-970-4770

Outpatient services are provided from 7:30-3:00 Monday-Friday on a first come, first served basis. No referral needed.

• Northwest Community Service Center, 3737 Dacoma, 77092
• Northeast Community Service Center, 7200 North Loop East Freeway, 77028
• Southwest Community Service Center, 9401 Southwest Freeway, 3rd Floor, 77074
• Southeast Community Service Center, 5901 Long Drive, 77087

Bay Area Recovery Center
Inpatient and Outpatient rehabilitation, substance abuse counseling, hotline. Serves men, women, and adolescents.
http://www.bayarearecovery.com/
713-999-0116
281-853-8715

IntoAction Recovery Centers – Drug and Alcohol Rehab in Houston TX
Inpatient and Outpatient rehabilitation, substance abuse counseling for adult men only
https://www.intoactionrecovery.com/
844-694-3576

Financial issues

Gulf Coast Community Services Association (GCCSA)
“The Gulf Coast Community Services Association, Inc. engages partners and forges strategic alliances to educate, equip and empower individuals and families in their pursuit of economic independence.”
https://www.gccsa.org/
713-393-4700
9320 Kirby Drive, Houston TX 77054
info@gccsa.org or fill out form at: https://www.gccsa.org/contact/

No referral information given.

 

Homelessness (lack of shelter, food, clothing, other basic needs)

Bay Area Homeless Services
http://bahs-shelter.org/
281-837-1654 (24/7 staffed hotline)
3406 Wisconsin St., Baytown TX 77520

New clients accepted 9am-4pm 7 days a week. Emergency Shelter Services, Employment Services, Speaker Services.

No domestic violence support.

Coalition for the Homeless of Houston/Harris County
http://www.homelesshouston.org/
Printable street guides to shelters and homeless services

Suspected abuse of the individual’s child(ren)

Texas Department of Family and Protective Services
https://www.dfps.state.tx.us/contact_us/report_abuse.asp
1-800-252-5400
https://www.txabusehotline.org

24/7 monitoring and response of child, elder, or disabled abuse. To make a referral, call the hotline or fill out a form on the webpage and get a response within 24 hours.

Criminal victimization (victims of theft, sexual assault, domestic violence)

9-1-1
24/7 emergency police and responder line

281-332-2426 – Webster Police Non-emergency Line
832-395-1777 – (Bay Area) Houston Police Non-emergency Line
713-726-7126 – Houston Police Non-emergency Line

RAINN – Rape, Abuse, and Incest National Network
https://www.rainn.org
1-800-656-HOPE (4673) 24/7 assistance
Live chat available 24/7

National Domestic Violence Hotline
http://www.thehotline.org
1-800-799-7233 24/7 assistance
Online chat available 24/7

Houston Area Women’s Shelter
https://hawc.org
24/7 crisis counseling and hotlines

• Domestic Violence – 713-528-2121 or 1-800-256-0551
• Sexual Assault – 713-528-7273 or 1-800-526-0661

Because of the possibility of being tracked, the HAWC does not publish hours or locations of their facilities, and requested that I not do so in order to continue to protect the women and children who are escaping dangerous situations.

Grief (resulting from death, terminal illness, divorce or other loss)

Bo’s Place
“Bo’s Place exists to offer support and community to those who have experienced the death of a loved one. A non-profit, free-of-charge bereavement center, Bo’s Place offers multiple grief support services for adults, children and families, and provides education and resources for those who assist people in grief.”
https://www.bosplace.org/en/what-we-do/
10050 Buffalo Speedway, Houston TX 77054
713-942-8339

8:30am-5:30pm Mon-Thurs
8:30am-4:30pm Fri

No referral needed.

Grief Recovery Center – Mental Health and Counseling Services
https://griefrecoveryhouston.com/
2040 North Loop West, Suite 300, Houston TX 77018
832-413-2410

Traditional therapy office with several counselors, operating on various schedules, that specializes in grief and recovery. No referral needed, but works on a standard medical insurance reimbursement program.

Works Consulted

Caruso, Kevin. “Suicide Warning Signs.” Suicide.Org, 2011. Web. <http://www.suicide.org/suicide-warning-signs.html&gt;.

“Crisis.” Merriam-Webster.com. Merriam-Webster, n.d. Web. 18 Oct. 2017.

“Crisis Intervention.” Encyclopedia of Mental Disorders. Advame, Inc., 2011. Web. < http://www.minddisorders.com/Br-Del/Crisis-intervention.html&gt;.

Kennedy, Eugene, and Sara Charles. On Becoming A Counselor, Revised Edition: A Basic Guide for Nonprofessional Counselors and Other Helpers. Crossroad Classic, 2001. Print.

Milne, Aileen. Teach Yourself Counseling. McGraw-Hill/Contemporary Books, 1999. Print.

“Precipitate.” Merriam-Webster.com. Merriam-Webster, n.d. Web. 18 Oct. 2017.

–. SAVE. Web. 21 Feb 2017. <https://save.org/about-suicide/faqs/&gt;.