Crisis Case Management

Nature of Crisis

The A&E Network series, Intervention, documents Alex’s struggle with alcohol in series 17, episode 7, produced by Seeley (2017). Alex’s mom, Patti, is a world-class fiddle player. Alex did not know his biological father until his teenage years. When Alex turned five, his mother married Alex’s stepfather. Alex never felt he could live up to his stepfather’s high expectations. Eventually, Patti and Alex’s stepfather divorced. The estranged relationship with his stepfather left Alex feeling worthless and abandoned. Alex turned to his fiddle to find acceptance and worth, but he felt that he could never live up to his mother’s musical talent. Now in his twenties, Alex turned to alcohol to cope with his emotional pain. Alex’s addiction to alcohol has left him without a career, and his friends and family are about to give up. Alex could soon lose everything. Patti had always loved Alex, her only son, and cannot stand the thought of losing Alex to alcohol. Although Patti does not often attend church, she considers herself a Christian and came to me as her counselor to help her through her crisis with Alex. According to Liberty University (n.d.-a), the type of crisis Patti faces is primarily an interpersonal crisis between her and Alex; however, Patti’s constant enabling of Alex highlights the existential crisis that Patti is encountering as she struggles with her own inner conflicts with identity.

The Complete Guide to Crisis & Trauma Counseling: What to Do and Say When It Matters Most!, Rev. Ed.

Alleviating the Crisis

Several important pastoral counseling strategies need implemented to assist Patti in alleviating the crisis. H. Norman Wright (2011) identifies eight steps of crisis intervention. First, when Patti reaches out for help, a prompt response is important, and the response should include some basic intervention procedures such as listening to Patti’s story, which increases understanding and builds trust. The second step is to help Patti act. To address the overwhelming nature of the situation, the counselor could take a directive role and encourage Patti to brainstorm some alternative ways of handling the situation. Third, the counselor needs to restore balance by normalizing her responses. For example, the counselor can communicate that it is common for parents to enable children during times of crisis due to fear. The next step is for the counselor to provide realistic hope. At this point, the counselor can explain that professionally facilitated intervention, followed by inpatient rehabilitation, has led many people to overcome addictions. Fifth, the counselor needs to clarify the expectations of counseling and identify other mature individuals within the church community to support Patti through the crisis. The sixth step is for the counselor, over time, to help Patti face the problem of enabling through active listening. Once the problem is recognized, the counselor can then help Patti set goals and act to decrease the enabling. Seventh, the counselor can now begin helping Patti recognize that her self-worth is tied to her identity as a mom, which feeds her enabling. At this point, Patti may be open to finding her value and worth in Christ, rather than in Alex’s success or failure. Finally, the counselor needs to clarify that, although she is not responsible for Alex’s choices, she can take responsibility by addressing issues that are within her control (pp. 161-185).

Teaching Coping Skills

Several coping strategies are available for Patti to assist her in dealing with the crisis. First, Liberty University (n.d.-b) suggests deploying stress management tools such as relaxation response training, health initiatives including nutritional techniques and physical exercise, and time management. Second, Although Alex is still alive, Patti feels as if she is grieving the loss of her son. Accordingly, Wright (2011) suggests daily journaling to express the emotions and challenges of grief (pp. 115-116). Third, Wright notes the importance of Scripture and prayer to comfort Patti in her time of crisis (pp. 415-427). Fourth, Liberty University (n.d.-c) explains that an intervention is often necessary with people struggling with addictions. Patti can take steps toward working with a professional to facilitate a message of love to Alex through an intervention. Fifth, Wright recommends that a person in crisis expand “his or her social support system as soon as possible” (p. 174). In Patti’s situation, participation in a crisis small group ministry at church or an Al-Anon family group that share a similar experience may also assist in coping. Finally, Wright explains that crisis counseling is not therapy (p. 150). However, if Patti struggles with ongoing anxiety, depression, or other severe emotional challenges, W. Brad Johnson and William Johnson (2014) suggest that a referral to a cognitive behavioral therapist may help Patti cope (pp. 23-24).

Developing Resiliency

Although difficult to recognize at the time, crisis provide opportunities for personal growth. Wright (2011) explains that individuals develop resiliency when they find new meaning in their crisis rather than maintain stagnant beliefs, develop a survivor rather than victim mentality, and taking control of decisions rather than allowing circumstances to dictate choices (pp. 224-225). It is difficult to imagine finding new meaning through crisis outside of a perspective in Christ. James points out that challenges do have meaning; they test one’s faith, produce perseverance, which in turn, lead to maturity (James 1:2-4, New American Standard Bible). Furthermore, it is natural for people to find their value in worth in just about anything but God: career, money, children, spouses, friends. During times of crisis, something of value is lost, and Christians can find their completeness in Christ rather than the person or item lost (Colossians 2:10, New American Standard Bible). Helping Patti redefine suffering and find her identity in Christ, rather than Alex, will exponentially increase resiliency. 

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References

• Johnson, W. B., & Johnson, W. L. (2014). The minister’s guide to psychological disorders and treatments. New York, NY: Routledge.
• Liberty University. (n.d.-a). Introduction to crisis counseling [Video presentation].
• Liberty University (n.d.-b). Models of crisis counseling [Video presentation].
• Liberty University (n.d.-c). Substance abuse & crisis Care [Video presentation].
• Seeley, K. (Director). (2017). Alex. In G. R. Benz, M. Branton, J. L. Weaver, L. Fleury, and J. Wagman’s, Intervention. New York, NY: A&E Network. Available from https://www.aetv.com/shows/intervention/season-17/episode-7.
• Wright, H. N. (2011). The complete guide to crisis & trauma counseling: What to do and say when it matters most. Minneapolis, MN: Bethany House.