Crisis Response

Crisis Response

Passed 7/20/15

Reviewed by Rev. Drum

Laura Fuller (Snow)

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 difficult or dangerous situation that needs serious attention (Crisis). 

               A crisis is an emergency.  It’s a situation that is dangerous to the people involved in it, even if that danger is only in their self-perception.  It’s a situation that has the chance to spiral out of control and needs immediate intervention.  In the midst of a crisis, a person can act out of character and not think clearly.  A crisis is usually triggered by something external (Kennedy 386-388).            

Precipitating event:  Precipitating: 1) to hasten the occurrence of; bring about prematurely, hastily, or suddenly (Precipitate).

               A precipitating event is the trigger of a crisis situation.  Understanding what happened as the precipitating event allows a counselor to follow the ‘trail of burned powder’ backwards to see what triggered the crisis and gives a better understanding of what happened or what caused the crisis to occur (Kennedy 388).  The precipitating event is important because it is there we find the circumstances that unbalanced the person in question.

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).

Three categories of emergency situations are Interpersonal, Intrapersonal, and Somatic Complaints (Kennedy 392).   

Interpersonal emergencies are emergencies where a significant player in the situation is someone other than the person in crisis.  This may be a case where someone is irritated by the behavior or actions of someone else, or it might be because of a crisis in a relationship.  An example of this would be a divorce. 

        Intrapersonal emergencies are emergencies where an individual is moved by something internal to themselves such as depression or by something they themselves did or (perhaps more frequently) failed to do.  An example of this might be succumbing to an addiction such as alcoholism and feeling guilty for drinking after you’ve committed to yourself you wouldn’t drink anymore.

Somatic Complaints are the potentially complex physical symptoms a person perceives as triggering an emergency.  Usually they have no medical cause and are unexplained by traditional medical care.  An example of this is the way the body can spiral from depression into pain and fatigue, which exacerbates the depression into a downward spiral.

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 list of possible precipitating events for a crisis is long and varied.  In truth, almost any change in circumstances can cause a person to go into crisis mode.  For that matter, sometimes it is the lack of change that might trigger the crisis (Kennedy 391). 

Divorce: When an individual (or couple) is going through a divorce, there are many possible triggers of crisis.  The feelings of loss, of inadequacy, of betrayal are all enough to cause depression in not only the person getting divorced, but the children, too. 

Marriage: While we think of marriage as the beginning of happiness ever after, the financial strain of a wedding and the loss of autonomy might well trigger a breakdown.  Further, there are a lot of stressors that are sometimes linked to a marriage, such as a move.

Birth of a child: Adding to a family, either through birth or adoption, is a stressful event that has many changes in family structure and routine that could easily precipitate a breakdown.

Death of a loved one: Like divorce, death is the loss of a loved one.  It might be a parent who cared for us or a child we cared for, a spouse or partner, or a friend or more distant relation.  Regardless of the relationship, death can trigger depression as a person tries to figure out how their life will continue with this change.

Military family issues: Military families go through the process of deployment and reunification in cycles.  The process is always stressful for everyone involved.  For the family members left behind, routines change and there is considerable worry for the person who is gone, especially if they are in a war zone.  Even if they are not, suddenly the one remaining behind is for all intents and purposes single for the duration.  The one who is mobilized not only has to deal with the guilt for leaving behind their family and missing important milestones, but has their own concerns related to the campaign to work through.  While reunification is a happy time for the families, it too is not without stress as the family has to learn to function as a whole once more.  The ones left behind have to adjust their routines again for the returning person, while the returning person has to come to terms with all of the changes that have happened in their absence. 

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).

In a time of crisis, an individual’s normal coping mechanisms may be inadequate or inappropriate to deal with the situation.  In fact, this may be what triggers the crisis in the first place.  During a crisis, an individual may become confused (unable to situate themselves in time and place) (Kennedy 394).  They may have trouble focusing or experience pain or other somatic triggers (Kennedy 395-396).

Ideally, crisis intervention progresses through several phases. First, I would assess what had happened and what was the precipitating event.  I would consider what the individual’s responses to the various things that happened had been.  I would then look for one of the common patterns we find in various crisis situations and see if I could detect a pattern to their reaction.  Perhaps most importantly, I would determine if the person was at risk or experiencing something beyond my capabilities or if they just needed the sort of support I can provide.  If I think there is even a chance they require assistance I am not able to provide, I would encourage them to seek it or take them to the hospital myself (Crisis Intervention).

Some of the things to be aware of as a point of intervention are your own limits, and also being aware of when someone is not reacting in a healthy way so that you can make additional referrals.  As someone who is not professionally trained as a counselor, it is imperative that when we see someone struggling in a way that professional help could address, we do what we can to get them the help they need.

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).

Withdrawing from family and friends.  This symptom is so common in today’s world and so easy to miss.  So often people get absorbed into their routines and don’t notice when someone slowly fades out of their lives.  This can include losing interest in things they’d once done with other people, or forgetting things like birthdays.  When a person does this, they are withdrawing and creating distance between themselves and those who care about them, the people who would normally be their support network. 

Abusing drugs or alcohol.  Abusing drugs and alcohol might be an attempt at self-medicating for depression.  It might also be a sign that a person does not like how they see themselves without the substance use.  Sometimes this is also because they feel the need to appear more social than they feel. 

               Changes in sleeping and eating habits.  Like withdrawing, someone would have to be very close to a person to notice this change and therefore it might go unnoticed by most counselors unless and until it causes changes in physical appearance or mood or something more easily observed and yet this is a very common sign of depression.  This change can go in either direction, meaning that people might eat more or less than before, or sleep more or less.

               Feelings of hopelessness.  When a person feels trapped, or as if there is no way out of a situation, they may seek to end their life instead of continue to face the situation.  This sense of powerlessness is different than the sadness we all face at times when we don’t like the hand we’re dealt in life.  When it goes on over a period of time, it is quite possibly a symptom of a more serious depression.

               Acting impulsively or recklessly.  When someone has given up caring about life, they may act impulsively or reckless without taking care of themselves, those around them, or their things.  They may be disassociated from the long term consequences of their actions or unable to consider the risks they are taking or putting others in.

Response:  In each of these cases, the first and perhaps most difficult step is to identify the behavior for what it is.  If someone is withdrawing, or if the symptoms are such that they’re not obvious or shared, this can be even more difficult.  Even with symptoms that are obvious, it can be difficult to tease out what is a sign of something serious and what is simply part of someone’s personality.  Regardless, my response would be to assure that they are not in danger at the moment and to encourage them to seek professional counseling.  I would be sure to direct them to a suicide prevention hotline, and if they already had a counselor, encourage them to call and schedule an appointment as soon as possible.  It is important to neither over react nor underreact to the situation, but rather to listen to them, let them know they aren’t alone, and make sure that they are capable in their current frame of mind to take care of themselves.  This isn’t to say that as a priest, the spiritual counseling you can provide is not important, but if they are seriously at risk of suicide, it should be in addition to professional help, not taking its place (Caruso).

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)

1. People who talk about suicide won't really do it.

If someone is talking about suicide, then there is a chance they will do it.  A good chance.  The thought is present for them, and they are clearly considering it.  Talking about suicide is a way for a person to prepare themselves and those around them for what they are considering.  If someone is talking about it, they are reaching out for help.  It is critical to act at this time, at the very least directing them to a suicide prevention hotline and encouraging them to seek counseling with a trained professional (SAVE).

2. Anyone who tries to kill himself/herself must be crazy.

It was once a common belief that suicide was the product of a broken mind, but current understandings of suicide are much more nuanced.  Depression is an illness, one that must be treated and one that has long term negative impacts.  Assigning this illness a stigmatized label like crazy is a disservice to the person suffering.  Further, current research shows physiological changes in people suffering from depression, showing it is most certainly not all in their head (SAVE).

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

Sometimes all it takes to stop someone is knowing that there is someone who cares, sees, or notices them and what they are going through.  A person makes the choice to commit suicide because they are in pain and don’t see another way out.  Helping them see other ways, showing them other coping mechanisms for the pain, and supporting them are all things that can prevent suicide even if someone seems determined to do it (SAVE).

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

Once the crisis improves, the risk may lessen, but it isn’t over.  The plan has been hatched, the idea planted that suicide is an option, and it’s one that doesn’t go away.  Lesser bouts of depression may show up as evidence that things aren’t really any better and may trigger suicidal thoughts even when someone seems over the initial crisis.  This can happen months or even years later.  If someone has experienced suicidal thoughts, they should continue treatment until the professional believes they have developed sufficient coping mechanisms to deal with the situations in question.

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)

There are many reasons why someone in crisis might seek an ADF priest for help.  The most obvious of these is that they want support from someone who they feel has a connection to the spiritual realms.  Often in a crisis, we as humans turn to our god(s) or ancestors for advice and help.  Faith and spirituality are recognized as important factors in emotional stability and psychological well-being (Kennedy 390-391).  In times of crisis, having the support of a person’s faith community can be an important part of their healing, and as a leader of the religious community, an ADF priest might be the most visible person available.  This is especially true since many pagan clergy have no training in crisis management and clergy in other faith paths may not only not understand pagans but consider our religious beliefs as part of the problem!

That said, an ADF priest is not a trained psychologist, social worker, or counselor.  It is important to understand that in severe crisis when a person is in danger, that our best role is finding them professional help.  We can later provide them support in more spiritual ways, such as working with them to create a ritual or prayer or helping them feel connected and supported as they work through the crisis.  That is our appropriate role.  

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)

There are been a number of times in my life I have found myself in crisis or dealing with a crisis for others.  One of the things that became apparent to me when I reflected on my experiences with crisis (both personal and in other capacities) is that they are rarely single instances.  Rather, they tend to be more of a series of events, each building off the last, until someone or something is stressed more than they can support and lose their ability to cope.

One time I have had to deal with crisis was when (now ex-) husband’s unit was mobilized to active duty in Iraq.  This was a change that caused crisis for myself as well as for a number of people in my support network.  One of the benefits of the whole unit being mobilized together was that while we were all going through a crisis situation and each of us was experiencing it different, because there were a number of us going through it together we at least did not feel the loneliness that is so commonly a part of the process.  One of the problems that arose as part of the mobilization was a problem with paperwork.  Orders were not issued correctly, which caused a delay in pay for several families.

My response to this was multi-faceted.   First, I should note that part of the reason I was responding to this crisis is because I was the unit’s Ombudsman and point of contact for family members with the chain of command.  My first step was to determine exactly where the problem had originated, by working with the chain of command to correct the paperwork issue.  My next step was to work with the families affected to be sure they had the resources they needed until the paperwork was fixed.  This included getting them in touch with the Red Cross for emergency assistance, writing letters of support to the local Catholic diocese so they would release emergency funds, and working with other families within the unit to help get them what they needed in the meantime.  At the same time, I was also referring them to food banks, and working with the various USO/VFW/Legion organizations to see if they would help (they all did). 

Looking back, there are a few things I would do differently.  First, I would try and be more prepared for such an occurrence.  I had to spend a lot of time making the connections during the crisis.  It would have been better if I had known ahead of time who to call for what and what documentation would be needed.  The faster you can help in a crisis, the better the person feels.  Second, I would have delegated more.   This particular crisis wasn’t something that had to be kept confidential.  I would have spread the burden of calling around a bit more in the hopes of getting faster responses and instead acted as the coordinator, making sure everything got done.  Third, I would have spent more time encouraging the families to reach out for themselves.  They were more upset, but perhaps if I had let them make at least some of the calls on their own, they would have felt more in control of the situation.

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).

One of the main aspects of ADF ritual is how we bring order to chaos.  In recreating the cosmos and establishing the sacred center, we are essentially taking the actions needed to move the universe from chaos to order.  When someone is in the midst of a crisis, they are usually feeling overwhelmed by things being out of control, or chaotic.  When an individual experiences a precipitating event, they are often experiencing a collapse of order, of their world devolving into chaos (Kennedy 398).  If we consider the purpose of sacrifice as feeding the cosmos and regenerating life (Thomas) then by encouraging someone to make offerings, either physical or of their experience, we are giving them something to do in their time of crisis that will possibly be a helpful tool for them in visualizing themselves as part of something larger and giving them the tools and the knowledge to once again find their inner balance.

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)

First, I would like to note that I do not currently live in the community for which I am submitting this list, but rather, I will be moving there in August.  However, it seemed like a good use of my time to go ahead and compile this list for my new home, since that is where I will be practicing for the foreseeable future.

Caldwell, OH is a small town in rural Southeastern Ohio.  It is the county seat of Noble County, Ohio, which is one of the Appalachian counties.  Located approximately halfway between Zanesville and Marietta on Interstate 77, Caldwell is a town of approximately 2500 people.  Currently experiencing an economic boom from the fracking industry, there is a huge disparity in wages in the county.  Additionally, the influx of temporary workers has driven up the cost of some basic needs such as housing and the rental market is highly skewed with rents significantly higher than the surrounding areas (and indeed, higher than even the closest metropolitan area, Columbus.)  The location means that there are very few services available compared to in an urban setting.  Further, the resources available tend to be less specialized, with a reliance on regional or national services.  The only 24-hour local emergency number is for the Sherriff’s office.  The strategy that is used in our county is to let the Sherriff’s office handle all emergency calls than then decide where to route them (ie send a car, call an ambulance, or refer to another agency during normal business hours

Noble County Sherriff’s Office: Phone:  (740) 732-5631

1. suicidal thoughts

(a)    Six Counties, Inc

(b)   1-800-344-5818 or (740) 454-9766.  1-800-432-4142 FREE TDD

(c)    Referral: call during business hours to make a referral, except in cases of emergency, then call the hotline or 911.

(d)   24 hours a day

(e)    Services:

Outpatient Counseling (individual, group, family, and marital)

Diagnostic Assessment and Psychological Testing

Psychiatric Evaluation and Medication Management

Partial Hospitalization

Management Consultation

Crisis Intervention and Crisis Stabilization

Community Psychiatric Supportive Treatment (child, adolescent, adult, and elders)

Intensive Outpatient Program

Peer Support Services

2. mental illness

(a)    Six Counties, Inc

(b)   1-800-344-5818 or (740) 454-9766.  1-800-432-4142 FREE TDD

(c)    Call during business hours to make a referral.

(d)   8:30-4:30

(e)     

Outpatient Counseling (individual, group, family, and marital)

Diagnostic Assessment and Psychological Testing

Psychiatric Evaluation and Medication Management

Partial Hospitalization

Management Consultation

Crisis Intervention and Crisis Stabilization

Community Psychiatric Supportive Treatment (child, adolescent, adult, and elders)

Managed Care Services

Consumer-Operated Social Drop-In Program

Intensive Outpatient Program

Peer Support Services

3. substance abuse (addiction)

a)      Morgan and Noble Counties Reentry Taskforce

b)     (740) 373-3745

c)      Call during normal business hours

d)     8-4

e)     Referrals to various services

a)      Alcoholics Anonymous Newark (about an hour away)

b)     (740)345-7060

c)      Call during normal business hours

d)     8-5

e)     Referrals to meetings.

a)      National Drug Abuse Hotlines

b)     800-662-4357

c)      24 hours a day

a)      Noble Behavioral Health Choices

b)     (740) 732-5988

c)      Normal business hours

d)     8-4

e)     alcohol and other drug treatment, relapse prevention

4. financial issues

a)      Consumer Credit Counseling Service of the Mid-Ohio Valley, INC. (Based in Parkersburg, WV about an hour away)

b)     (304) 485-3141

c)      Call during business hours

d)     8-5

e)     •Homebuyer Workshops- prepare individuals for homeownership; includes information on home loans, credit reports, and the closing process. Certificates of completion are issued to participants of Homebuyer seminars to help them qualify for loan programs. •Reverse Mortgage- enables homeowners, 62 and older, tap the equity in their home; counseling and certificate •Default Counseling & Foreclosure Prevention- As a H.U.D. certified counseling agency, CCCS assists people experiencing difficulty making their house payments. CCCS works with individual and lender for possible outcomes: forbearance, deferment, refinance/rewrites, workouts/repayment plans. •Workshops and Seminars- a variety of housing related topics are offered to all segments of the community •Financial Counseling- professional, confidential financial counseling which stresses money management so clients can meet current obligations while saving •Debt Management Program- assists clients experiencing problems to become debt-free •Financial Management Program- helps seniors and disabled people remain independent •SSI Representative Payee Program- The Social Security Administration recognizes CCCS as a Representative Payee; responsible for using SSI benefits on behalf of the recipient for his/her personal care and wellbeing.

f)       Costs for Receiving Services- fee and/or donation for services based on the ability of individual to pay. No one is refused because they cannot pay.

5. homelessness (lack of shelter, food, clothing, other basic needs)

There is no homeless shelter in Noble County.  While there are some places that will assist with rent/mortgage payments, there are no local services available within the county for those already homeless.  This is not unusual in a rural county, as the kin-network is usually available to assist with locals.  While this doesn’t address the issue of those who have shelter only at the help of their extended network, it makes it all but impossible to actually track homeless numbers in counties like Noble.   Most of those who find themselves without shelter in a rural county are not locals.  They still are somewhat invisible as they tend to sleep in tents in state parks, and so blend into the environment.

Should there be an issue of homelessness, at this point my best bet would be to refer them to either:

a)      Salvation Army Zanesville

b)     (740) 452-8350

a)      St. Vincent Haven -Newark, OH

b)     740-670-0822

6. suspected abuse of the individual's child(ren)

a)      Noble County Department of Job and Family Services

b)     (740) 732-2392 or (800) 905-2732 (toll free)

c)      8-5

d)     Normal business hours.  If outside of normal ours, call Sherriff.

e)     Reports of abuse and neglect.  Provide the following information:

·        The names of all individuals in the home

·        Ages and/or dates of birth of individuals involved

·        Addresses and phone numbers of the family being reported

·        Current issues/reasons for calling

·        Current physical location of the individuals involved

·        Hazards/dangers from persons or in the home, if known

·        Any other known pertinent information

7. criminal victimization (victims of theft, sexual assault, domestic violence)

Criminal concerns would go to the Sherriff’s office

8. grief (resulting from death, terminal illness, divorce or other loss)

There are no grief counselors in Noble County.  Nor is there a hospital.  Should the need for grief counseling arise, I would refer to Six Counties to find someone who could work with the community member.

Other numbers (for assistance, not in an emergency):

Food: 

·        WIC (740) 732-4958

·        Noble County Department of Job and Family Services (740) 732-2392 or (800) 905-2732 (toll free)

Housing: Noble County Housing Authority 740-439-6651 (Located in Cambridge, OH)

Heating: Tri-County Emergency HEAP 740-732-2388

Child Support: Noble County Department of Jobs and Family Services (740) 732-2392 or (800) 905-2732 (toll free)

Childcare: Childcare Connection 800-628-8534

Credit Concerns:

·        National Foundation for Credit Counseling (referral) 800-388-2227

·        Credit Reporting Bureaus:

o   Equifax: 800-685-1111

o   Experian:888-397-3742

o   TransUnion 800-916-8800 (Credit Disputes)

Health Care:

Hospitals (None in the County)

Genesis-Bethesda PH:(740) 454-4000

Genesis- Good Samaritan PH: (740) 454-5000

SEORMC PH: (740) 439-3561

Marietta Memorial PH: (740) 374-1400

Selby General PH: (740) 373-0582

Medical & Health Services

United Ambulance

PH: (740) 732-5651

Emergency Assistance: Salvation Army in Zanesville (740) 452-8350

Hotlines

24 Hour Cocaine Hotline 800-992-9239

AIDS National Hotline 800-342-2437

AIDS Treatment Information Services 800-448-0440

Al-Anon/Alateen Hotline 800-344-2666

Alcohol Abuse 800-234-1253; 800-274-2042; 800-222-0469

Centers for Disease Control AIDS Info 800-342-2437

Child Abuse Hotline 800-422-4453

Cocaine Help Line 800-262-2463

Dental Information ODH/Bureau of Oral Health Services 614-466-4180

Domestic Violence hotline 800-799-7233

Eating Disorders Ctr 888-236-1188

Family Violence Hotline 800-313-1310

Gambling Problems 800-589-9966

Hopeline 800-784-2433

Marijuana Anonymous 800-766-6779

Medicaid 800-324-8680 Fed 800-686-1516 State

Medicare 800-686-1578

Mental Health Info Source 800-447-4474

National AIDS Hotline 800-342-2437

National Child Abuse Hotline 800-422-4453

National Domestic Violence Hotline 800-799-7233

National Drug Abuse Hotlines 800-662-4357

National Institute of Mental Health 888-269-4389

National Missing & Exploited Children 800-843-5678

National Suicide Prevention Lifeline 800-273-8255

Ohio Benefits Bank 800-648-1176

Ohio Housing Locator http://www.ohiohousinglocator.org

Ohio Senior Health Program (Medicare) 800-686-1578

Prescription Hope 877-296-HOPE (4673)

Project Woman – domestic violence crisis line 800-634-9893

Rape Abuse Incest National Network 800-656-4673

Runaway Hotline 800-621-4000

Self-Injury Hotline 800-366-8288

Sexual Assault Hotline 800-656-4673

Smoking And Health Information 800-232-1311

Stop it now! (Sexual Abuse) 888-773-8368

Substance Abuse and Mental Health Services Referral Information (National) 800-662-4357

Substance Abuse Treatment 800-662-4357

Suicide & Crisis Hotline 800-999-9999

Suicide Prevention Lifeline -National 800-784-2433

Veterans Affairs (Department of) 800-827-1000

Works Cited

Caruso, Kevin. Suicide Warning Signs. n.d. Website. 16 May 2015. <http://www.suicide.org/suicide-warning-signs.html>.

Crisis. n.d. web. 17 May 2015. <http://www.merriam-webster.com/dictionary/crisis>.

Crisis Intervention. n.d. web. 17 May 2015. <http://www.minddisorders.com/Br-Del/Crisis-intervention.html>.

Kennedy, Eugene and Sara Charles. On Becoming a Counselor: A Basic Guide for Nonprofessional Counselors and Other Helpers. New York: The Crossroad Publishing Company, 2001. Print.

Precipitate. n.d. web. 17 May 2015. <http://dictionary.reference.com/browse/precipitating>.

SAVE. Common Misconceptions. n.d. web. 12 June 2015. <http://www.save.org/index.cfm?fuseaction=home.viewPage&page_id=705EC833-E77D-2519-FA362EDFA62268C7>.

Thomas, Kirk. The Nature of Sacrifice. n.d. web. 18 May 2015. <https://www.adf.org/articles/cosmology/nature-of-sacrifice.html>.