Introduction to Crisis Response CRTC 501 Module 1...Introduction to Crisis Response 5 Light University Online 4. Trauma is like Death a. Both trauma and death are places of darkness

Introduction to Crisis Response 1

Light University Online

Introduction to Crisis Response

CRTC 501

Module 1



Module One

Table of Contents

Trauma & Crisis Care: Why We Serve Diane Langberg, Ph.D. ................................................................................................................................................. 3

Crisis Response: An Overview of Emergency Mental Health & Chaplaincy Jennifer Cisney, M.A., Tom Webb, M.Div., & Jim Nelms, B.A. ...................................................................... 9

Crisis Theory and Assessment Jennifer Cisney, M.A. & Joshua Straub, Ph.D. .................................................................................................. 13

INTRODUCTION TO CRISIS

COUNSELING



Description The very nature of trauma is that it is difficult to see and speak about. This course will discuss the foundation of crisis work and the cost involved.

Learning Objectives:

1. To understand the unique ways in which crisis can affect the people whom it touches.

2. To better understand your calling and your role in God’s plan of

resurrection for those who have suffered.

Trauma & Crisis Care: Why We Serve

VIDEO

Diane Langberg, Ph.D



Introduction A trauma is both externally and internally staggering. Because the things that crisis workers see and experience are so terrible to comprehend, many people push their experiences from their conscious mind. The problem with this natural reaction is that in order to heal from trauma, it must be exposed and discussed. The unspeakable must be described and remembered.

Concepts 1. Push/Pull Complex

a. A conflict arises when trauma victims and crisis workers are torn between the need to forget and the need to speak. b. This is a recurring dialectic that can affect not only those who have endured trauma, but those who must listen to them speak about it. c. Healing cannot occur until that which one most wants to forget is remembered.

2. Crisis is a Calling

a. Crisis workers have been called in the name of Jesus Christ to enter into the most atrocious situations. b. This calling is a way to follow the example of Jesus who also interceded for those in need and darkness.

3. Isaiah 61: 1,2

a. The people of God are crisis workers for this world. b. God’s people, in order to follow Jesus, must walk into poverty, brokenness, and despair without promise of material or immediate reward.



4. Trauma is like Death a. Both trauma and death are places of darkness and powerlessness. b. The taint of trauma is carried with people who work with it into their daily lives. c. In order to truly help others, we must learn how to help ourselves.

5. Philippians 3

a. Paul encourages the church to value knowing Christ over any worldly success. b. The degree to which we know Christ directly corresponds to the degree to which we are able to work amongst trauma.

c. Without beginning from a place of worship, we will not be able to face the traumatized without being met with panic and despair rather than with forgiveness and tolerance. d. If you want to walk well with those that are suffering, you must begin on your knees.

6. Free in Order to Free Others

a. In order to share the truths that Christ offers to those suffering, you must have felt those truths work through you. b. To reach out to people in dark places with light, you must not have any dark places of fear within yourself. c. To free others without being free will harden and destroy you.



7. The Resurrection of Lazarus a. Just like with Lazarus, God has called humans to help him with the resurrection of others. b. He has called us to use our gifts, experience, and training to do the work that will allow him to bring resurrection and light.

c. Being good at our work is imperative, but understanding that the power behind it is not ours is the key to humility.

8. The Least of Those

a. When you care for or witness suffering in others, you are caring for Our Lord. b. Bearing the burdens of others can be disruptive and risky, but God is always there to bear your burdens. c. There is no part of any tragedy that you will encounter that Jesus has not faced and carried; none of us must face tragedy alone.

9. Isaiah 45:3

a. When you partner with God to resurrect others, you will undoubtedly be resurrected. b. Parts of yourself that held darkness will be exposed and healed and you will yearn to seek Him.



Conclusion The ability to work with the traumatized is a unique and important one, but you must never forget that you are merely a servant called to do the work of God. Crisis is a calling and an honor placed on you by God to work with him to bring resurrection to the suffering in this world.

Further Consideration 1. How does healing occur? 2. How are those who have faced trauma like the dead? 3. Where does Paul instruct us to begin our work with victims? 4. Why did Jesus ask for help when he raised Lazarus from the dead?



Additional Reading

Counseling Survivors of Sexual Abuse by Diane Langberg Counseling Pastor’s Wives by Diane Langberg Feeling Good, Feeling Bad by Diane Langberg



Description This panel discussion will define and illustrate the concept of how emergency mental health helps us to fulfill our role in the Church and how we can, like Christ, help those who have suffered.


1. Understand how God’s people can work together to help others in crisis situations.

2. Acknowledge that mental health professionals, pastors, and peers all

have important roles in emergency mental health.

Crisis Response: An Overview of

Emergency Mental Health & Chaplaincy

VIDEO

Jennifer Cisney, M.A., Tom Webb, M.Div., & Jim Nelms, B.A.



Introduction Crisis can be big or small and it can affect many or just a few. God has called us to help those who are suffering and this extends easily to crisis response. If employed correctly, the church and Christians can be a powerful tool for helping victims of trauma.

Definitions

1. Psychological First Aid- the immediate action that must be taken with victims of trauma in order to prepare them for healing down the road; a temporary intervention 2. Emergency Mental Health- the responsibility of all Christians to show God’s love to one another in a time of dire need, including both physical and spiritual care.

Concepts 1. Anyone can be an Interventionist

a. You might not get to choose your role, you might just be there in the face of someone who has faced trauma and is looking to you for stability. b. Contrary to popular belief in the Church, special training is required to help people who have suffered a critical incident but anyone can help with the practical matters of mental health. c. People are affected by trauma physically, cognitively, and emotionally. d. Our first goals should reside around getting the victim’s needs met--- save the philosophical discussions for later.

2. Crisis Comes in All Sizes

a. Psychological first aid and crisis intervention can be in huge groups or one-on-one b. Whether applied to one ambulance driver or a group of disaster workers, the model works.



c. Both peers and mental health professionals have important roles in crisis response.

3. The Roles We Play in Crisis

a. Pastors- uniquely recognized as an ambassador of God and brings calm and relief to terrible situations b. Mental Health Professionals- background and knowledge of symptoms and warning signs are important for future referral c. Peers- most critical understanding of the personalities and tendencies of the victim d. Everyone plays the same role in initial crisis response. e. We must all try not to fall back on our previous training when participating in psychological first aid; there will be a time for pastoral care and psychotherapy later. f. The church has a perfect opportunity to do what the government cannot effectively do in times of tragedy; we already have a support system set-up.

4. Teamwork

a. In a team of interventionists, it is important for members to balance each other out and be accountable to the mission of the team. b. One of the most difficult things you might have to do is to tell another team member that it is not a good time for them to go to a crisis situation.



c. One of the most therapeutic things you can do with someone in crisis is to pray with them or pray for them; any member of the team can pray. d. The synergy found in the church is incredibly important for the returning team; to feel that support is invaluable.

Conclusion Crisis response is a difficult task that every Christian is called by God to partake in. Everyone will have different roles that are important to help victims return to a normal life. Training is important for peers, mental health professionals, and pastors to help them understand the crisis response model. The church can work as a team, as the Body of Christ to do good work for the victims of crisis.

Further Consideration 1. When would it be a bad time for a trained interventionist to NOT participate in psychological first aid? 2. How do the specific roles of pastors, mental health professionals, and peers complement one another? 3. What is an example of something that EVERY Christian can do to aid victims of crisis?



Description This course will discuss the roots of crisis response, the controversy that has arisen around it, and why it works. We will also emphasize the importance of assessment and identify some red flag symptoms to watch out for throughout the assessment process


1. Develop a deeper understanding of the research supporting Critical Incident Stress Management.

2. Appreciate the importance of assessment.

3. Understand common pitfalls in assessment and some red-flags to look

out for.

Crisis Theory and Assessment

VIDEO

Jennifer Cisney, M.A. & Joshua Straub,

Ph.D.



Introduction The history of Critical Incident Stress Management is longer than you might imagine. Over time, CISM, or the Mitchell Model, has become, based on extensive research, an accepted standard of care. Controversy over its effectiveness has arisen in recent years, but no opposing research is conclusive. Assessment is an important part of crisis response and can be rather tricky for clinicians and the laity alike. Luckily, there are specific red-flag symptoms that can be identified to help a responder decide if a victim needs further care.

Definitions

1. Multi-component system- illustrates the broadness of what CISM covers, from pre-incident preparedness to post-incident psychotherapy referral.

Concepts 1. The Roots of Modern Crisis Response a. Military Psychiatry has employed crisis response since before World WarI. b. During WWI, responders were placed on the front lines to aid the military. c. The Mitchell model was created based on this research. d. The H.E.R.D. model was also developed based on wartime results. 2. Critical Incident Stress Management

a. CISM is the standard of care on which our training is based. b. CISM was developed originally for emergency service workers who chronically experienced higher rates of divorce, alcoholism, and Post-Traumatic Stress Disorder.

c. As this model has become more commonly used in schools and churches, controversy over its effectiveness has arisen.



3. Does Debriefing Work? a. The Cochrane Review is a study that opposes debriefing; it illustrates a hospital setting in which trauma patients were debriefed one-on-one by a nurse.

b. Debriefing without sticking to a set model is not only dangerous but irresponsible. c. The kind of debriefing that was done in the Cochrane review was not adherent to the CISM model.

4. National Volunteer Organizations Active in Disaster Consensus Points

a. Early Psychological Intervention is valued. b. EPI is a multi-component system to meet the needs of those impacted. c. Specialized training in EPI is necessary. d. EPI is one point on a continuum of psychological care. This spectrum ranges from pre-incident preparedness to post-incident psychotherapy, when needed. e. Cooperation, communication, coordination, and collaboration are essential to the delivery of DPI.

5. Assessment

a. Eighty-percent of Americans will be exposed to a traumatic even in their lifetime; nine-percent will develop PTSD. b. Between forty to fifty-percent of crisis responders will experience severe psychological distress. c. Every individual is different when it comes to the impact of crisis. Assuming that someone is in crisis when they are not can dangerously affect their innate resiliency.



6. What makes up a crisis response? a. Psychological homeostasis is disrupted. b. Usual coping mechanisms have failed. c. There is evidence of significant distress, impairment, or dysfunction.

7. Red Flag Symptoms

a. Behavioral- major differences in behavior post-incident; out of character, atypical behavior with negative results

i. self-medication with alcohol or drugs ii. obsession with work iii. risky, even violent, tendencies

b. Physical- outside of the normal physical symptoms of acute stress; when in doubt, refer

i. chest pain ii. loss of consciousness iii. irregular or internal bleeding

c. Emotional- the person can no longer function on their previous level; emotions are debilitating

i. vegetative depression ii. hopelessness iii. panic attack iv. phobic avoidance

d. Spiritual- the person’s faith is turned upside down, it is very normal to feel that their world has been rocked

Conclusion CISM is a valuable tool that many authorities, including the National VOAD, agree works best for trauma survivors. Assessment is an integral part of CISM. In order to properly assess victims, you must be aware of certain red flags. The nature of a multi-component system is that it is not a one-shot deal. Trauma takes time to process and the church is an incredible vestige of support for victims and responders alike.



Further Consideration 1. Why is the Cochrane Review inconclusive? 2. How do the National VOAD’s consensus points support CISM? 3. Why is it important to connect victims to resources in their area, even if they seem resilient immediately after the trauma takes place?

Additional Reading CISM: Grief Following Trauma by Kevin Ellers, Nancy Rikli, and H. Norman Wright

Documents

Introduction to Crisis Response CRTC 501 Module 1...Introduction to Crisis Response 5 Light University Online 4. Trauma is like Death a. Both trauma and death are places of darkness