Category Archives: Social Work

Four Guaranteed Experiences, and One Thing You’ll Never Experience, When You Step Out in Faith to Do God’s Work

We’ve been meeting bi-weekly for some time now. The closer we get to November 4th, the more sense it made to be in closer, more frequent contact. Yes On 1 has been a massive undertaking. The goal is to mobilize pro-life voters to pass a historic amendment to the Tennessee Constitution and bring life back to our state. A wrongly decided state Supreme Court decision in 2000 made Tennessee an abortion destination by interpreting a “fundamental right” to abortion in our state constitution and undoing the most basic legal protections for women and unborn children.

Around the time of one of our meetings, our regional coordinator sent an email reporting on the ways many of our volunteers have experienced personal trials as our campaign is coming down to its final days. He also gave us scriptural encouragement to continue on in our work.

As our enemy sees us giving our all in service to others, attacks are inevitable. Here are 4 guaranteed experiences that are destined to challenge you as you seek to do God’s work.

I am going to operationalize doing “God’s work” as doing “service,” or serving others- individuals, groups, or even entire communities. In our work with the Yes On 1 campaign, my wife and I have served voters who needed to understand the issue Amendment 1 intends to address. We also have striven to serve volunteers who are passionate about creating positive change in Tennessee. Ultimately, we hope our efforts serve vulnerable women and unborn children. Service to others is God’s work.

Fear. There are going to have bouts with fear when you set out to serve others. I see fear often in the eyes of social work students I am serving at Union University, who have never yet had to sit across from vulnerable people and be competent, compassionate helpers. The fear of being misunderstood, being rejected, or being defeated can be paralyzing. But you can’t be (or stay) paralyzed. You can’t stay stuck wondering, “What do I do now?” In a world that needs your connectedness, you can’t afford to be shut down and out of the fight.

Frustration. The work of serving others is rife with frustration. Service is messy, under-appreciated, and not immediately fulfilling. One of the questions we ask job candidates at Youth Villages is, “How do you gauge your personal effectiveness?” One of the reasons this question is so important is, if you are expecting to rely on “warm fuzzies” to get you through the difficult days, it ain’t gonna happen. The paycheck won’t keep you on the job either, because too often long hours serving others ends with too few tangible results. People don’t always follow through on your good ideas. And when they do, it isn’t often enough that you will get the gratitude you deserve. Nobody who serves others long does it for a paycheck or a pat on the back. It takes a long-term view and an inner-confidence that you are making a difference through service.

How is this tracking with you so far? Well, take some time to ponder over the first two of four guaranteed experiences you will face when you do God’s work of serving others. We will have two more guaranteed experiences, and the one thing you are guaranteed to never experience, in the next post.

Advertisements

Reducing Suicide Deaths in Our Communities

Two extremely sad stories in the media caught my attention recently, each of which highlights something that our communities should take very seriously.

Joseph Jennings, via Addicting Info
Joseph Jennings, via Addicting Info
A Kansas teen on an apparent “suicide mission” was gunned down by police on August 23rd. The police were called to help recover the young man, who had been home only 6 hours after a 2-day hospitalization, a result of an overdose attempt. I don’t know the extent of the psychiatric care he received while in the hospital, if any. What stands out is that someone felt he was safe to return to the community, which ended in the young man attempting to take his life again, this time with tragic results due to the police involvement.

Brandon Greene, one of the youths that committed suicide, via The Tennessean
Brandon Greene, one of the youths that committed suicide, via The Tennessean
Closer to home for me is the story of two incarcerated youths who committed suicide in a youth development center in East Tennessee. With only 3 weeks separating the two suicide deaths, systemic issues were apparent, and it was discovered that the understaffed facility was woefully deficient in providing supervision and dispensing medications.

There are common characteristics between the 3 young men in these news stories that placed them at higher risk of committing suicide:

  • Previous suicide attempts
  • Current or recent treatment for mental health problems
  • Social isolation
  • State custody/family disruption

One risk factor that most people do not take into consideration is that people, youths or adults, are more susceptible to suicidal thoughts, attempts, or completion following treatment than they were prior to treatment. In a recent managed care provider meeting I attended, it was stated that there is a 30% increase in suicidal risk following contact with a medical provider, whether inpatient or outpatient. This article highlights increased post-discharge suicide completions occur with 2 weeks of inpatient psychiatric care, the majority of which occur on day 1.

Furthermore, people incarcerated in jails or prison are at higher risk of suicide than the general population. The APA states in its practice guidelines on suicide that “suicides among youths in juvenile detention and correctional facilities are about four times more frequent… than the suicide rate in the general population.”

Tennessee is taking part in implementing the Zero Suicides initiative through the Tennessee Suicide Prevention Network. This slide from a recent webinar shows the differences between a suicide-safe system and a system that is not suicide safe:

Via Zero Suicides Initiative, click for website.
Via Zero Suicides Initiative, click for website.

I have worked with young people at risk of suicide my entire career. There is always deep psychological pain in these youths, too often the result of adults who were supposed to care for them, but didn’t. Behaviors manifest, the result of depression, low attachment to others, or just poor decision-making, and assumptions then are made on the part of us adults that ultimately does not relieve the pain. Relative to suicide, the worst of these assumptions is that these young people will be safe if they are in a facility, if they see a psychiatrist, if they are on suicide watch. Being isolated from suicidal means may prevent a suicide completion, but it does not alleviate the pain that drives suicidal thoughts or actions.

Only involvement, engagement, and treatment for suicide will be effective in reducing needless deaths in our communities:

  • Parents, teachers, therapists, and anyone responsible for youths in foster care, residential facilities, or detention centers, need to have the awareness and skills to recognize and intervene in potential suicides.
  • Medical, mental health, and correctional facilities need a comprehensive approach, like Zero Suicides, to ensure that suicide risk is consciously addressed, effectively treated, and responsibly monitored after discharge.
  • Caregivers, correctional staff, and mental health professionals in the community need a solid plan following inpatient treatment of immediate suicide risk so they can provide treatment and supervision during the high-risk period following discharge.

Restrictive measures may be a necessary step in preventing suicide in some cases. But what will really save lives is when everyone has a stake in alleviating suicide risk, before, during, and after inpatient or restrictive treatment for suicide.

The Most Effective Way to Prevent Suicide

On World News Tonight’s August 12th, 2014 broadcast, in a conversation with medical correspondent Dr. Jennifer Ashton, it was reported that calls to suicide prevention numbers have shot up substantially since the report of Robin Williams’ suicide. The anchor stated that perhaps Robin’s “greatest gift” is raising awareness so that people who are depressed or suicidal are now asking for help. I would say it is an unintended blessing. Life is the greatest gift.

Addressing suicide is never easy. If you could increase your skills and confidence in suicide prevention, do you think you would be more likely to get involved and save a life from suicide? Here are some practical steps that I have been teaching educators this year as schools have come back into session.

Ask the Question
And the question is, “Are you thinking about committing suicide?” Depending on the developmental level of the person, it may be more appropriate to ask, “Are you thinking about killing yourself?” It is most helpful to address suicide directly, and this can be the most difficult part. But if someone seems depressed, withdrawn, has experienced significant loss or a perceived insurmountable challenge, you might just save that person’s life. If the answer is no, that’s great. If it’s yes, or something other than a definite no, you have the opening you need to start directing that person to life-saving help.

Use the CPR of suicide prevention
The presence of one or more of these risk factors increases the risk of suicide.

Current plan
If a person indicates thoughts of suicide, ask, “Do you have a plan to kill yourself?” The presence of a plan increases risk of a completed suicide. The more detailed the plan, the higher the risk as well. Details to look for are the means of death, the place and time intended for the suicide, use of measures to avoid being discovered or stopped, and belief that the plan would work, not just in taking that person’s life, but also in ending the pain he or she currently feels.

Previous history
Past thoughts or attempts in a person’s lifetime increase the risk of a completed suicide. This includes thoughts of suicide, plans for suicide, rehearsing a plan, aborted or thwarted attempts, and unsuccessful attempts (the plan was carried out but death did not occur). If previous plans or attempts have gone unreported, the risk also increases because no treatment or planning has occurred to reduce suicide risk.

Resources available
Denying access and opportunity when thoughts of suicide are present is one of the most effective ways to prevent suicide. Restricting means and opportunity reduces the lethality of desperate or spontaneous attempts. A support person is more likely to discover, interrupt, and get immediate medical help if needed. For a person who is ambivalent about dying, reducing access to resources will prevent an attempt and allow effective helping to occur.

If you know when suicidal thoughts or plans are present in someone’s life, and you have an idea of a person’s level of suicide risk, you will be able to support a friend or loved one who desperately needs your help. When your loved one knows you truly care, you will be trusted to provide help they otherwise would not seek out for themselves. And that is the most effective way to prevent suicide.

Call the National Suicide Prevention Hotline if you need help.image
To learn more about helping people who are vulnerable to suicide, download the A Friend Asks app from the Jason Foundation.

Short Guide For Churches: Responding to Individuals in Crisis

Importance of Responding to Crisis

Crisis situations typically drive individuals or families to the pastor’s door requesting counsel outside of normal church functions and interactions. As such, it is important for pastors to assess crisis situations in order to provide the most effective help. Defined simply, a crisis is “a perception or experiencing of an event or situation as an intolerable difficulty that exceeds the person’s current resources and coping mechanisms,” (James, 2008). It is a turning point with the potential for great danger or great opportunity for the one experiencing the crisis (Wright, 1985).

It is not only congregants and their families that rely on the ministry to help them in times of crisis. According to research posted on the EssentialChurch twitter feed, “26% of the church dropouts surveyed indicated that their church acted as a support network during a time of personal crisis.” (EssentialChurch, 2011). Because so many people seek help through pastors as an initial step in times of crisis, and because crisis presents both danger and opportunity, it is extremely important that the pastor provide help that is caring, effective, and within the scope of his duties, skills, and qualifications. Anything less could leave the individual confused and disillusioned concerning the ability of the church to help them in times of need.

What is Crisis?

Crisis theory states that an individual may face developmental, situational, or existential crises throughout his lifetime (James, 2008). Developmental crises are those that accompany life events such as birth, death, starting school, marriage, having an “empty nest”, and aging. Situational crises seem to arise unexpectedly and may include accidents, job loss, disease, familial strife, or any number of other unexpected events that create extraordinary stress. Existential crises are those that involve identity, purpose, spiritual or moral beliefs, and other internal conflicts of meaning. Often these types of crises overlap. For example, a mother may feel she has lost her purpose in life once her youngest child finally leaves home. A husband may question God’s existence after losing his wife in a car accident. The ministry has the ability to impact people who experience any of these three types of crises through spiritual and practical guidance, as well as care and fellowship.

An individual also may be in a state of crisis that is either acute or chronic in nature (James, 2008). In terms of assessing crisis, a pastor is among the most qualified to determine acute or chronic crisis, as he usually has the opportunity to see and know the counselee outside of the office and in several different contexts. A person that presents for counseling that normally is happy, fulfilled, rational in his behavior, and orderly in his thoughts and judgment, is likely facing a specific, acute crisis. This particular counselee should be able to recover quickly from the initial crisis and begin to cope using his usual coping skills and resources with limited guidance. A person that presents for counseling by the pastor that is usually depressed or irritable, irrational in his actions, and lacking in sound judgment on a normal basis is likely in a state of chronic crisis, and may require extensive support to overcome a crisis event. Recognizing the acute or chronic nature of the crisis is key to providing help that is effective and within the scope of the duties and abilities of the pastor.

What Can A Pastor Do To Help?

Pastors can provide much help to individuals in acute crisis of all kinds. First, people who come to a spiritual leader for such help expect that the Bible and biblical methods will be used to alleviate the crisis. This is advantageous, as we know that there is no greater source of help and healing for those suffering emotionally and spiritually. Second, in the early stages of dealing with crisis, very practical help and direction is needed, from providing material needs, to giving direction in practical tasks that will help ease stress and worry. This can easily be provided by the pastor, or delegated to another minister or layperson following the initial session. Third, as people in crisis generally are in need of greater social and practical supports, the church itself becomes one of the pastor’s most powerful therapeutic tools. It is very likely that your church already provides a ministry that would make a direct impact on the situation, or that particular families in the church can be sources of practical and emotional support to extend the counselee’s network.

If a pastor recognizes that a person is in chronic crisis that is exacerbated by complicated grief, trauma, mental illness, substance abuse, or other stressors, it may be necessary to refer out to an appropriate service provider to address these issues while continuing to offer all of the benefits of pastoral care, spiritual guidance, and practical help. Therapists, psychologists, psychiatrists, social workers, attorneys, and financial advisors provide specialized services to address social, legal, psychological, and biological factors that contribute to crisis.

Sign up today for weekly email updates of each post and get a free family vision casting form.

When Should an Outside Referral Be Made?

When deciding to make a referral, a pastor must consider his limitations in the areas of time, training, and qualifications (Wright, 1985). Is there time among all the other responsibilities of being a pastor to help this person effectively? What background and specialized training is required to help this person? Is a specific license or qualification required to provide the service that this person needs? If there are doubts on any of these points, and there is a substantial risk of harm to the individual or others around them, then an obligation exists for the pastor to refer the counselee to an appropriate professional.

Many professionals in the community practice Christian values and show respect for their client’s spiritual and doctrinal beliefs. Develop partnerships with these kinds of professionals so that you are not taking a “shot in the dark” with your congregants and their families when specialized help is needed.

The primary responsibility of the ministry is “for the perfecting of the saints, for the work of the ministry, for the edifying of the body of Christ,” (Eph. 4:12). The members of the Body of Christ will benefit and grow through crisis when a pastor can assess a crisis accurately; provide attentive care through prayer, the Word, spiritual care, practical counsel, and the church; recognize the limits of his time, skills, and qualifications; and build partnerships with professionals that allow him to make confident referrals for care.

See my Resource page for additional information on effective helping.

References
EssentialChurch. (2011, January 12). 26% of the church dropouts surveyed indicated that their church acted as a support network during a time of personal crisis. Message posted to http://twitter.com/#!/EssentialChurch

James, R.K. (2008). Crisis intervention strategies, 6th edition. Belmont, CA: Thompson Brooks/Cole

Wright, H.N. (1985). Crisis counseling: Helping people in crisis and stress. San Bernadino, CA: Here’s Life Publishers

The Importance of Personal Values in Helping Others

Personal beliefs provide the Foundation and the Fuel for Helping- the Why and the How.

Helping is universal language that flows out of values and moral beliefs. The very word “believe” means more than to just give mental assent to a notion- it means to act on that which is believed.

My personal beliefs have definitely been the foundation from which I have sprang into my professional and volunteer helping roles. I believe life is sacred and has inherent value granted by God. So I have spent my professional life helping preserve life and improve the quality of life for children and families ravaged by abuse, mental illness, and constant crises. I work on a voluntary basis to help see that unborn life and mothers have common-sense protections and options. For those that decry people that care more for unborn babies than children in difficult living situations- they aren’t talking about me. My belief that God has a preference for life hopefully has influenced everything I’ve done and definitely has brought me into the helping work I have done and continue to do.

20131215-052503.jpg

One of the biggest contributions that a helper’s values, morals, and beliefs have on helping others is the way they sustain the helper. Your values create the anchor that holds you firmly in place while others drift. Dr. Janet Furness, one of my professors and a former director of the Master of Social Work program at Union University, taught me some unforgettable lessons on the impact of Christian spirituality on leading and helping:

  • Strength is drawn from the Holy Spirit and poured back into your helping persona.
  • You are able to provide a non-anxious presence in the middle of turmoil.
  • You are able to know and show the next steps that should be taken.
  • If you have nothing of value to offer, how can you add value to others? Do your values and moral beliefs add to your life and sustain you in times of need? If they don’t, I would ask a) do you really believe the values you claim to believe? And If so, b) Are you truly living out the values you claim to espouse?

    Not everyone you help will have the same moral values and beliefs that you do. And that is ok. When you start on common ground concerning what will help that person, and you believe you can provide what is needed in order to help, with genuine desire to be helpful, you will likely add value to that person’s life by your actions. As values-driven helpers, we have to understand that we are filling a specific, narrow role in the lives of those we help. Stand strong on your values. Also stand on your belief that people can act in their own best interest and make necessary changes to do so.

    “You’re No Help”: When Not Helping is Helpful

    Personal credibility is the currency of trust, and genuine trust is crucial to effective helping.

    Boundaries are really hard to maintain when you’re supposed to be helpful. Helpers are usually good-hearted and more than willing to do anything they can to provide assistance. The fact is, personal, professional, physical, and all kinds of other -al boundaries have to be maintained and need to be respected. We set ourselves up for success or failure with the boundaries we keep.

    I attended a training on suicide prevention in which the participants were polled on their attitudes toward suicide. One of the questions was, on a 1-10 scale, how far would you go to prevent a person from committing suicide? A number of people rated their willingness much lower than a 10 (everything possible to prevent suicide). I answered 10. During the discussion I clarified my answer- as a father, I would do absolutely anything to keep my son from killing himself. As a professional, while the extent of my role may not allow me to spend the night supervising a client who is suicidal, I would go to the farthest extent within my role to prevent a suicide. That might mean spending hours seeking a hospital bed, assisting with a safety sweep, or signing an involuntary commitment. The frustration for helpers is, even when you are doing all you can do within your given role, you may be perceived as unhelpful by not doing more. But doing more than you should, in the end, will not be helpful. And then your credibility and long-term ability to be of service is compromised.

    Not helping in a given situation is not a judgment on what the other person needs- it is a judgment on whether or not you are able to provide what they need in your particular role.

    Finding common ground and returning to that common ground often throughout the process of helping should help you maintain the level of trust needed for effective helping while building respect for your boundaries:

  • Establish limits of what you can provide early and reference those limits when confusion about your role arises.
  • Establish goals and focus on how decisions made during the helping process impact those goals. When there is unclear whether or not your actions or recommendations are helpful, refer back to how you are helping to reach those goals.
  • Establish the roles of other parties involved and what they are reasonably able to do. When someone feels you aren’t taking responsibility because you are staying within your boundaries, reference the roles that other supports (personal and professional) are able and willing to take, and do all you can to make sure those supports are clear about how they will be involved in helping.
  • The majority of people in need that you find yourself trying to help are not malicious in their intent if they say you aren’t being helpful.
    Usually it is frustration, fear, or trauma doing the talking. There are always a minority of people who are simply unwilling to be involved in helping themselves and want to put all of the burden of their situation on someone else. Remember that helping is about adding value to a person, not being that person or doing the work that they should do for themselves. Never feel bad about your good-faith contributions and remember that people must choose if they truly want your help. Feel confident that you have done all you can do and know that you can’t do it all for everyone.

    Being Helpful: Three Decision-making Frames That Impact Credibility

    credit Microsoft OfficeA line of credit no bank can offer…

    Every time we help someone in need, it should be a chance to build credibility. Helping is a growth opportunity for both parties.

    I last wrote about when helping isn’t helpful and how the best efforts put forward to help others won’t work if those efforts are based on the perceptions of the helper. The quote above is from that post. In this post, let’s talk about three frames or mindsets that will help our hinder our credibility in serving others.

    Personal credibility is the currency of trust, and genuine trust is crucial to effective helping.

    Here are the frames:

    • Prudence- “Count the cost” way of making decisions that takes into account personal limitations and external barriers that could sabotage your efforts to help. Maintaining credibility means avoiding decisions based on good intentions with low ability to actually help. With a prudence mindset, you can heed the axiom of “under promise, over deliver.” People love to get more than they bargained for out of a helping relationship. Prudence also helps us helpers maintain boundaries that do not get us into ethical issues and make promises we cannot keep.
    • Pride- Pride can cause one to over-inflate or undercut his ability to follow through, which is usually due to an individual’s perception of his abilities (competence). The worst kind of pride is the kind that causes a person to think that they can “get away” with underperforming or neglecting duty (“better to seek forgiveness than permission”) which is an overvaluation of others’ good will. It will run out. Confidence erodes quickly. Pride is the voice that says, “He/She should just be glad I’m here to help out.” And that line of thinking is poison to any efforts at helping.
    • Pie-in-the-sky- This view takes the road that is paved with good intentions all the time. It is the “If you build it, they will come” approach. There is a huge risk of underestimating the effort and the costs of helping with this frame. “If I just try hard enough, belief long enough, it will happen,” in spite of what is missing for success. People in need, need a solid plan, not pie in the sky. We owe it to people to be realistic and to model realism for them at times when they are grasping for hope. Empty hope is worse than offering no hope at all.

    Whether you’re a parent, professional, friend or simple good samaritan, working to build your credibility with those you strive to help is is a crucial process that will make or break your efforts.

    So where do you find yourself falling within the three frames? What is the one thing you can do to build up your credibility with the people you routinely try to help?

    Copyright (c) 2013 Glen Gaugh

    image credit Microsoft Office