In This Lesson
A: Developing and Maintaining Rapport | B: Identifying the Problem | C: Coping
Exploring the Client's Own Attempts at Coping | Encouraging the Development of New Coping Behaviors
Presenting Alternative Coping Behaviors | Following Up |
A: Developing and Maintaining Rapport
(Connecting with Client)
The first step in crisis counseling is connecting with the counselee. This is the A in the "ABCs" of crisis counseling as articulated by Kanel.1
The first encounter that a crisis counselor has with the counselee is magnified compared to traditional psychoanalysis. In traditional psychotherapy the counselee has more time to bond with the counselor. In crisis counseling, it must happen immediately in order for any meaningful dialogue to take place that will begin to alleviate anxiety. James Peterson wrote a wonderful book entitled, "Why Don't We Listen Better?" It is Peterson's contention that in order to connect with the counselee, the counselor has to be more interested in listening than in talking. In the book he offers three stages in balancing the listen/talk session:
- Listen a while.
- Talk until the other person stops hearing.
- Listen until the person calms enough to hear again.2
In crisis counseling, it is crucial that the counselor listen intently and really hear the heart of the counselee. Job's three friends listened to his story but had already decided how to answer him. Their counsel was that Job had obviously done something wrong to garner the wrath of God. This was an obvious case of a failure to communicate. The problem with Job's friends' analysis was that it was just pure speculation. Job was puzzled himself because he did not know of any egregious sin that created his crisis nor did God ever reveal it to him. In BCC, one should never prejudge a counselee.
The Bible teaches that Christians can make judgments about actions, but not to be judgmental toward individuals. Jesus said in the Sermon on the Mount, "And why do you look at the speck in your brother's eye, but do not consider the plank in your own eye?" (Matthew 7:3)
According to Greenstone/Leviton in their book "Elements of Crisis Intervention", "Interveners should make no assumptions about helping the victim find solutions to the problems that precipitated [caused abruptly] the crisis. Management, not resolution, is the intervener's goal, and at best is a short term one."3 Thus, "Crisis Counseling" attempts to return the counselee to a pre-crisis emotional state. If more sessions are needed after the crisis has subsided, the counselor can begin attitudinal and behavioral therapy.
Crisis counseling is not the time for moralizing or brow beating the counselee with Scripture. It is critical that a counselor practicing a BCC modality be in a proper attending position in order to expedite a return to normalcy. In crisis counseling, you may only have one shot at getting it right. The immediate impression the counselor should give the counselee is that they are there to listen more than talk. This first, and maybe only, session is not about impressing the counselee with your counseling skills but to listen, empathize, and expedite a shift back to a pre-crisis mentality.
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B: Identifying the Problem
According to Kanel, the most important step in the "ABC" model of crisis intervention is identifying the problem. Kanel says that determining the presenting problem and its development into a crisis is like climbing a tree. The trunk represents the problem, the branches and leaves represent the client's ability to assess and react to the crisis.4
The most efficient way to be successful in identifying the problem is adopting a proven consistent counseling modality. "Recent research findings suggest that, in fact, counselors may not be prepared. For example, studies of practicing high school counselors have found that up to two-thirds of these professionals believe they could not recognize a student at risk for suicide."5 Shields and Kiser report similar numbers of counselors who cited their inability in handling violent behavior. This is disturbing because these professionals understand that they have a high probability of encountering it.
Dattilio and Freeman6 remind crisis counselors that the primary initial concern is for the safety of the counselor, client, and other innocent bystanders. Identifying the problem in crisis intervention involves taking some precautionary steps to ensure a safe and conducive environment before the counseling can proceed.
These facts should be a wake-up call for the Christian counseling community. Just because we use a Bibilotheraputic [Bible-centered curative] therapy does not insulate us from the potential of becoming a victim of a violent client. The Christian practitioner should present a high standard of excellence to the secular counseling world. Being slothful in this area will put the counselor at great risk of physical and emotional harm if not adequately prepared. BCC should be the gold standard in crisis counseling. It is not only sad but naive and dangerous to go into a crisis intervention without proper training. Yes, God does protect His children, but He also expects us to use our brains and common sense.
One of the best illustrations in the Bible of how to identify the precipitating problem is the story of Moses and his father-in-law, Jethro. In Exodus 18 we discover that Moses was in crisis. The Israelites had been miraculously freed from the oppressive hand of Pharaoh. Estimates are that the Israelites numbered between 2-4 million people. The people looked to Moses for counsel. Moses was overworked and stressed. One day Jethro confronted him in Exodus 18:18-21
"Both you and these people who are with you will surely wear yourselves out. For this thing is too much for you; you are not able to perform it by yourself. Listen now to my voice; I will give you counsel and God will be with you: Stand before God for the people, so that you may bring the difficulties to God. And you shall teach them the statutes and laws, and show them the way in which they must walk and the work they must do. Moreover you shall select from all the people able men, such as fear God, men of truth, hating covetousness; and place such over them to be rulers of thousands, rulers of hundreds, rulers of fifties, and rulers of tens."
Jethro was the quintessential [perfect example of a class or quality] crisis counselor. He saw the crisis in which his son-in-law found himself and identified the problem. Moses was in over his head and God used Jethro to intervene and give Moses a workable plan to resolve the crisis.
Sometimes identifying the problem involves help from others. The BCC model has, at its heart, seeking the wisdom of God. This leaves the non-believing counselor at a significant disadvantage. God directs the Christian counselor with the aid of His Word guided by the Holy Spirit with the ability to identify and diffuse any crisis. It may be that God will instruct the counselor to back away. There is nothing in the Bible to suggest that any Christian counselor, pastor, or lay person should or can help everyone who seeks their advice. Knowing your limitations is as important as knowing your abilities.
In crisis counseling it could be a matter of life-or-death. Do not allow pride to push you into enmeshing yourself into a crisis intervention that you have no business in. Remember Jesus' words to His disciples, "Behold I send you out as sheep in the midst of wolves. Therefore be wise as serpents and harmless as doves." (Matthew 10:16)
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(Providing Practical Steps to the Client)
The third step in the "ABC modality" is coping. The counselor has connected with his client on an emotional and personal level. He has successfully identified the presenting problem. At this point, the counseling session can shift into practical steps that the counselee can take to manage the crisis. Kanel divides this step into three areas:
- Exploring the Client's Own Attempts at Coping
Exploring the client's past coping skills is crucial. Each client's coping skills are developed from family environment, education, social pressures, and personality type. Arguably, the wisest man who ever lived, outside of Jesus Christ, was Solomon. In his wisdom book, Proverbs, he gives us insight into human differences. In Proverbs 22:6 he states: "Train up a child in the way he should go, and when he is old he will not depart from it." Some pastors and theologians interpret that verse to mean training up a child in a Christian home guarantees they will always live a Christian lifestyle. Evangelical Christian Psychologist Dr. James Dobson interprets the statement, "in the way he should go" to mean teaching a child according to their specific personality type. Some children respond to a spanking while another may only need a verbal reprimand. A competent counselor will understand that each client has different coping abilities that are shaped by various factors including personality type.
McAdams and Foster state: "For clients in counseling, the developmental benefits of successful crisis recovery have included a heightened awareness of their problems, a renewed belief in their ability to face and overcome their problems, and a revitalization of their trust in the counselor and commitment to the counseling process."7
Encouraging the Development of New Coping Behaviors
This is what motivates most counselors to become counselors. This is the part of the job that gets the juices flowing [slang for "excites" or "instigates"]. The question arises, how does the counselor know if the client is being helped?
"Successful 'recovery' from the experience of a serious mental health crisis is said to occur when crisis survivors become able to manage the debilitating effects of the crisis sufficiently to resume pre-crisis levels of functioning. Recovery is further marked by applying what has been learned from the experience toward personal growth and preventing crises in the future."8 & 9
Peterson reminds the counselor that we must listen very closely to the client and be invited into the moment when we can offer advice. He tells us to stay away from phrases like, "The only thing for you to do in this situation is...' Phrases like that may be interpreted by the client as pushy and arrogant. Rather, include heart talk and say something like, "You know, if I were in your spot, I think I might... Do you think that might work for you?" Most counselors, especially Christian counselors, need to resist the temptation in mandating coping options that they personally believe are right over against what is right for the counselee."10[Back to Top...]
- Presenting Alternative Coping Behaviors
The third element to introduce in the coping stage is alternative coping methods. Kanel11 is a firm believer that clients should have a chance to exhaust any and all coping ideas before they are introduced to unfamiliar ones. Kanel11 lists several alternative coping methods.
- Support groups and 12-step groups.
- Long-term therapy, marital therapy, and family therapy.
- Shelters and other organizations.
- Medical and legal referrals.
- Bibliotherapy, Journaling, and Reel Therapy.
- Other behavioral activities such as expressing feelings and needs to others, setting boundaries, physical exercise, visiting family and friends, and recreation.
The more the client is open to alternative coping strategies, the better the chances are for significant change. "Behavioral goals must be both concrete and realistic. Rather than setting a goal of spending more time with friends, for example, a person might decide to contact at least two friends in the next week and try to spend time with at least one of them." Benner12 then goes on to say that these goals must also be realistic.
Kollar13 asserts: SFPC [Solution-Focused Pastoral Counseling] gives the counselor nine assumptions that will aid in helping the counselee with coping skills.
- God is already active in the counselee's life.
- Complex problems do not demand complex solutions.
- Finding exceptions helps create solutions.
- The counselee is always changing.
- The counselee is the expert and defines the goals.
- Solutions are co-created.
- The counselee is not the problem, the problem is.
- The counseling relationship is positional.
- The counselor's focus is on solutions.
The ability of the counselor to offer effective coping skills is directly tied to how they perceive the counselee.
- Following Up
The final stage of coping is the follow-up process. The effort put into connecting with the client, identifying the problem, and teaching coping skills does not end the counselee/counselor relationship. In crisis counseling, not following up is not an option. Part of the follow-up process is called "reinvestment".
"At the reinvestment phase of crisis recovery, active counselor support and guidance are pivotal factors in determining whether or not client survivors, who have overcome their fears and mustered the strength to reinvest in their counseling relationship, will be able to do so effectively."15
In the BCC model, this would be called "discipleship". During the initial stage of crisis counseling the adrenaline is flowing, emotional bonds are made, and the rush to find solutions is intense. After the client and counselor have separated and the crisis has subsided, the tendency of both participants is to emotionally and mentally detach. Part of that detachment is good. But there comes a time for both parties to reinvest in the process in order to implement accountability and to track progress.
Crisis counseling is one of the most demanding disciplines in the counseling arena. Events are compressed, emotions are spiked, and decision-making is cloudy at best. The crisis counselor is hurled into to the center of the storm and must discover the key to expedite calm. Neil Anderson sees counseling as Spiritual Warfare. He believes that emotional and intellectual health can only be achieved through overcoming the powers of darkness by having a personal relationship with Jesus Christ.
In his ground-breaking book, "The Bondage Breaker", he offers his Seven Steps to Freedom. Anderson strongly believes that mental problems are the direct result of spiritual forces of good and evil battling it out for the control of our minds and body.
"Don't think Satan is no longer interested in manipulating your mind in order to accomplish his purposes. Satan's perpetual aim is to infiltrate your thoughts with his thoughts and to promote his lie in the face of God's truth. He knows if he can control your thoughts, he can control your life."15
Anderson has put his finger on the major difference between secular counseling and BCC. Backus/Chapian also understands the significance and reality of spiritual forces working behind the scenes. They name these maladaptive behaviors misbeliefs:
"Misbeliefs generally appear as truth to the person repeating them to himself. They might even seem to be true to an untrained counselor. That is partly because they often do contain some shreds of truth, and partly because the sufferer has never examined or questioned these erroneous assumptions. But, please understand, the misbeliefs we tell ourselves are directly from the pit of hell. They are hand engraved and delivered by the devil himself. He is very cleaver in dishing out misbeliefs. He doesn't want to risk being discovered so he always appears as if the lie he is telling is true."16
Crisis counseling from a Christian worldview understands the source of all human conflict. The Apostle Paul said it best, "For we do not wrestle against flesh and blood, but against principalities, against powers, against the rulers of the darkness of this age, against spiritual hosts of wickedness in the heavenly places." (Ephesians 6:12).
Modern psychology, which has its roots in eighteenth-century rationalism, denies, or at best disputes, the supernatural realm. The man who is considered the father of modern psychology, Sigmund Freud, believed that when a person died they returned to an inorganic state of calm. Freud was an Agnostic at best, and an Atheist at worst. This is not to say that everyone who is a psychologist or psychiatrist is an unbeliever. But it is a fact that many of the early thinkers in the field were not people of faith in God.
In this lesson, I have cited and given recognition to several of the prominent minds in the psychological world. I believe that these great minds and pioneers in the field have given Christian counselors some important insights into understanding the human psyche. However, I also maintain that counseling from a Christian worldview will limit or eliminate much of psychological theory when it contradicts the clear teachings of Scripture.
As stated earlier, the Bible is not a book on psychology but it does give us insight into human behavior. I do not subscribe to a non-integrative approach of Adams and others who do not see value in the psychological sciences. BCC is unashamedly committed to maintaining the Word of God as its primary praxis [practice]. I believe we would, however, be disingenuous to ignore totally the contributions of those from the scientific community. Just as the Bible is not a book on engineering, every law of engineering originates from the Master Engineer, Creator God. The debate concerning integration will continue. Godly men and women will continue to disagree to the relevance of the psychological sciences to Christian Counseling.
I believes God can use anything He desires to accomplish His will. He used a donkey to speak to a man (cf. Numbers 22:28-30). Not everything we need to function in this world is found directly in the Bible. We are not told how to drive a car or bake a cake. But that does not mean a Christian should refuse to drive a car or eat cake. The Apostle Paul was a Hellenistic [Greek-influenced] Jew. He wrote to the Corinthian church, which was steeped in Greek philosophy and culture,"to the weak I became as weak, that I might win the weak. I have become all things to all men that I might by all means save some." (1 Corinthians 9:22) When it comes to helping those in crisis, I believe we should use all available means (methods) to get the job done!
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1 Kanel, Kristi. A Guide to Crisis Intervention. Belmont, CA: Thomson Brooks/Cole. 2007.
2 Peterson, James, (2007). Why Don't We Listen Better?. by James C. Peterson.
3 Greenstone, L., & Leviton, C., Sharon. (1993). Elements of Crisis Intervention. Belmont, CA: Brooks/Cole Publishing.
4 Kanel, Kristi. A Guide to Crisis Intervention. Belmont, CA: Thomson Brooks/Cole. 2007.
5 King, K. A., Price, J. H., Telljohann, S. K., & Wahl, J. (2000). "How confident do high school counselors feel in recognizing students at risk for suicide?" American Journal of Health Behavior
6 Dattilio, E M., & Freeman, A. (2000). "Cognitive behavioral strategies in crisis intervention" (2nd ed.). New York: Guilford Press.
7 Adams, J.E. (1986). How to Help People Change. Grand Rapids, MI: Zondervan Publishing House.
8 Hendricks, J. E., McKean, J., & Hendricks, C. G. (2003). "Crisis intervention: Contemporary issues for on-site interveners". Springfield, IL: Charles C Thomas.
9 Kanel, Kristi. A Guide to Crisis Intervention. Belmont, CA: Thomson Brooks/Cole. 2007.
10 Peterson, James, (2007). Why Don't We Listen Better?. by James C. Peterson.
11 Kanel, Kristi. A Guide to Crisis Intervention. Belmont, CA: Thomson Brooks/Cole. 2007.
12 Benner, David, G. (2007). Strategic Pastoral Counseling. Grand Rapids, MI: Bakker Academic.
13 Kollar, Charles, A. (1997). Solution-Focused Pastoral Counseling. Grand Rapids, MI: Zondervan.
14 Foster, V. A., & McAdams, C. R. (1999). "The impact of client suicide in counselor training: Implications for counselor education and supervision". Counselor Education and Supervision, 39, 22-33.
15 Anderson, N.T. (2000). The Bondage Breaker. Eugene, OR: Harvest House Publishers.
16 Backus, William & Chapian, Marie. (2000). Telling Yourself the Truth. Minneapolis, MN: Bethany House Publishers.