Community Mental Health: The Role of Church and Temple by Howard J. Clinebell, Jr., (Ed.)
Howard J. Clinebell, Jr., is retired professor of Pastoral Counseling, School of Theology at Claremont, California. Published by Abingdon Press, New York, Nashville, 1970. Used by permission. This material was prepared for Religion Online by Ted & Winnie Brock.
Chapter 18: A Church-Sponsored Crisis Counseling Service by Donald C. Bushfield
On April 1, 1965, the incoming lines were activated at the Help Line Telephone Clinic in Los Angeles, California. It was the first denominationally sponsored crisis counseling service in the United States to offer help to all areas of human need, caring for the whole man. It is a project of the Los Angeles Baptist City Mission Society, a division of the American Baptist Convention.
Help Line was guided into being through the creative leadership of the Rev. H. Leslie Christie. He was inspired by the pioneering effort of the Life Line Centre in Sydney, Australia, in 1963 at the Central Methodist Mission, led by its superintendent, Dr. Alan Walker. Mr. Christie caught a vision of how the telephone could become the vital link between the masses of troubled people in Los Angeles, and the loving concern of the Christian church with its good news of Godís love and willingness to help. Impressive evidence in this direction was obtained in the summer of 1963 when he led in the training of a battery of telephone counselors. The counselors were being prepared to help those responding to an invitation to discuss their personal needs which was made at the conclusion of a pre-taped telecast of a Billy Graham Southern California Crusade meeting. The response was overwhelming; calls continued coming in until late into the night. This experience convinced Mr. Christie of the potential of such a service. The success of these past three and a half years has vindicated his decision to proceed.
Hopeful of securing a broad ecumenical base of support, the Los Angeles Council of Churches was approached, but the needed funding was unavailable, so it was decided to underwrite the support within the American Baptist structure.
We found that a preparatory period prior to the opening of the service is very strategic. To communicate to your constituency the need, relevancy, and efficacy of such an operation is vital. In most denominations the pastor is the key figure, the one at the local church level who can best determine whether the plan will get a fair reception.
The recruitment of telephone counselors, lay and clergy, also is very important. An open invitation should be made to all who are interested to attend a series of preparatory training sessions. Our policy has been to accept as volunteers only those who have been endorsed by their pastor after they have applied through him. The pastors should be informed of the personal qualities needed to be an effective telephone counselor, such as sensitivity, healthy motivation, concern, stability, cooperativeness, dependability, willingness to learn, and a non-judgmental attitude. They should be accepted into the program on a provisional or probationary basis. This serves at least two purposes. It is a reminder that they remain a member of the team only as long as they continue in the ongoing training program. It also leaves a door open in case a volunteer just does not measure up as an effective counselor after there has been an opportunity to observe and evaluate. We have used the term "enlisted staff," rather than volunteers, a term which might imply that all who apply will be accepted. The final decision as to who was accepted was made by the Director. Another safeguard as to a volunteerís acceptability could be to require the taking of the Minnesota Multi-Phasic Personality Inventory or some other similar test. Yet another could be the requiring of an autobiographical sketch with questions asked to determine how they have responded personally to stressful situations in the past.
To prepare these potential workers, a series of training sessions was scheduled. Meetings were held once a week for eight weeks prior to the beginning of the service. Resource persons from the specialities of social work, law enforcement, communication (the telephone company) , pastoral counseling, alcoholism treatment, and care for the aging were invited to share their insights, answer questions, and make suggestions. In addition, a field trip was taken to the office of the Los Angeles Police Department where special attention was given to their telephone center through which all incoming calls of a crisis nature are routed. These training sessions were helpful in illuminating vital areas in the wide scope of human problems. It was also decided to have, as a minimum, quarterly training conferences and an annual conference which would include staying overnight at a church conference ground in the mountains.
In the meantime, rapport was being established with the various helping organizations in the community. Information was being gathered as to the names, addresses, telephone numbers, services offered, and eligibility requirements of the various agencies. It was then recorded on Rol-o-dex files, to be kept within easy reach of the person handling incoming calls.
Our professional staff consists of a director (supervisor) who oversees the operation, arranges for publicity, schedules the interpretation of our work to individual churches and other groups, and recruits volunteers. He also supervises the professional staff members and participates in case review sessions periodically to keep a sensitive ear tuned to types of cases we have been handling and then notes their disposition and progress.
The supervisor coordinates various phases of the operation. It is he who ferrets out information regarding the new helping agencies that are forming almost every week in our area. He maintains a liaison with them and sees that our information and file system is kept current while doing the major part of the work of referring our clients to the specialized helping agencies. On a weekly basis he confers with the consultant and the chaplain at the case review sessions, both to review recent cases and to preview those coming up.
The staff consultant counsels almost exclusively over the telephone with those clients who have been referred to him by the intake worker. He also plays a vital part in the ongoing training program for the volunteers. He helps them to be more skillful in handling different types of problems, utilizing some of the "idle" time when they are serving but when the phones are not busy. His responsibility also includes the vital "call backs" to people who have previously contacted us, been helped, and referred to a special helping agency. His friendly call of concern for their current progress and needs is received with appreciation.
The chaplain is assigned those cases that have been referred to the staff consultant because of the depth of the problem, and it has been determined by the consultant that a face-to-face visit from the chaplain is needed. The supervisor obtains consent for a visit by the chaplain, and the appointment is set up. The chaplainís schedule is usually filled up two or three days in advance. However, occasionally the urgency of a particular problem -- e.g., case manifesting signs of a high suicide potential -- may necessitate the juggling of his schedule. We feel that having a chaplain available for face-to-face home visits is vital for our organization, since it was founded in the spirit of One who incarnated Himself to minister to human needs. The chaplain seeks to be the clientís friend helping him to clarify the causes of his problem, to focus on some constructive alternatives of action, and to be aware of the helping resources available. A brief report is made on each visit and is kept with the original intake sheet.
Two secretaries give a portion of their time for filing, typing, and other miscellaneous tasks.
The public is informed of our services in a variety of ways. We run ads in both metropolitan newspapers on alternate days. Also, we buy space in suburban papers. Free public service time is granted to us by eleven AM and FM radio stations. Occasionally we have been interviewed on radio and television, and special newspaper articles have featured our ministry. In addition, brochures and small business-size cards have been used and distributed by churches and other groups.
As has been noted, Life Line was the first church-sponsored comprehensive crisis counseling center in the world; Help Line was the first in the United States as far as we have been able to determine. At present, The United Methodist Church is establishing some centers like this. Some individual churches and religious groups presently offer services to people who have special problems such as alcoholism, suicide, unwanted pregnancies, narcotic addiction, juvenile delinquency, blindness, old age, illness, and so on.
A good way for a church to proceed in starting such a service is to examine the needs of the community. A survey could be helpful. A committee of concerned and responsible persons could serve to stimulate interest in the membership. A study would help determine the manpower and funds needed. It would be well to project realistic needs for a five-year period to avoid a cutback later because of insufficient funds. The securing of a skilled, competent professional staff is a vital part in the forming operation also. The church willing to give to such a venture the time, effort, and expense required will be repaid manyfold by the knowledge that many people have been helped to better, happier and more purposeful lives.
Like any new venture, we encountered problems and have profited from wrestling with them. Among these has been a difficulty in maintaining an adequate number of competent volunteers. Also, we had a struggle finding an effective training program that would meet the particular needs of all the volunteers with their varying degrees of skill. Again, the churchesí interest seems to lag at times in spite of our sending out periodic progress reports and occasional case summary illustrations. Also, we have had some difficulty in setting down designated areas of responsibility in our "clinical process" within the professional staff, while also trying to have some degree of flexibility in special instances. Some of our volunteers have difficulty operating as members of a team and have caused problems by encouraging some clients to become dependent on them.
Vital to an effective service is a skillful professional staff who work well together. They need to be able to function not only within their own sphere of responsibility, but also to "double" in training the volunteer staff. A maximum of "live" coverage of the telephone should be provided during the week with the electronic recording "secretary" used only when staff members are not available. Another necessity is adequate advertising placed strategically to reach the largest number of people. An added benefit would be to get permission to have the service listed in the front of the local telephone directory with the other recognized emergency agencies, such as police, fire, and ambulance services. Also mandatory is a good working relationship with the other community helping agencies; the referral list must be constantly revised and updated. An effective training program is a requisite, and included should be appropriate recognition and awards given periodically to remind volunteers of their importance and your appreciation. Our training program has inspired several of our volunteers to enroll in college classes in human behavior, suicide preventive seminars, and pastoral counseling courses. Case review sessions scheduled at least weekly are necessary for the professional staff. Records need to be kept and the inactive cases periodically shifted to prevent the files from becoming too cumbersome.
It is imperative to stress the need for the wholehearted backing of your constituency before you begin. We have found it very difficult to make up later what we did not get at the outset in interest and support. It is important to set goals high enough to challenge, yet realistic enough to be accomplished. There should be an understanding with the volunteers that they will have to meet certain standards of involvement in the training program to maintain their active status. Included as a part of these standards should be the serving of a minimum number of hours on the line during a set period, attending a certain minimum number of training conferences a year, and complying with requests to come in for special individual conferences relative to problem areas. We have found that volunteers tend to lose their interest in the program more quickly by idleness than by being overly busy answering calls. To help them avoid boredom, we try to arrange for them to have something useful to do when not on the phone, such as stuffing envelopes or typing records.
It is best to determine and explain to all involved the "clinical approach" to be used. Our method is to have all incoming calls handled by the volunteers; the more serious ones are referred to the staff consultant, and those whom he feels could profit from a home visit are turned over to the supervisor, who arranges an appointment for a visit from the chaplain. This approach avoids confusion, but flexibility even here is necessary, since overlapping in certain cases will be unavoidable. Another lesson that will be learned as one proceeds is what is the appropriate time and method of referral and when it is best to continue in a supportive role until the client is able to accept a referral and not misinterpret it as rejection.
It is hoped that some readers will be encouraged to initiate the formation of a crisis counseling service in their communities. They will find the challenge exciting, the experience rewarding, and the accomplishments fulfilling. God speed you on your way!
For additional reading
National Institute of Mental Health. Manpower: Utilization of Non-Professional Crisis Workers, by Samuel M. Heilig. Planning Emergency Treatment Services for Comprehensive Community Mental Health Centers, 1967.
Pretzel, Paul W. "The Volunteer Clinical Worker at the Suicide Prevention Center." Los Angeles: Suicide Prevention Center, 1968 (mimeographed)
Rioch, Margaret; Elkes, Charmian; and Flint, Arden. Pilot Project in Training of Mental Health Counselors. U.S. Department of Health, Education and Welfare, Public Health Service Publication #1254.
Verah, Chad. The Samaritans. London: Constable, 1965.
Walker, Alan. As Close as the Telephone. Nashville: Abingdon Press, 1967.