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Dear friends,
If you’ve been following the ECC Facebook page, you are already aware of events in the last two weeks, when several European communities have been welcomed into the ECC. We now have groups in Vienna, Belgium, Poland, and Lithuania. And what is so awesome is the number of young adults who love Jesus, who are very serious about their Christian commitment! Bishop +Peter Hickman and several others traveled and met with these communities.

And now, we have one individual from Belgium who is coming to the U.S. for an entire month! Jetty van den Berghe who is a Novice in the Good Shepherd ECC is going to visit ten ECC communities across three states in the southwest U.S during October! She will learn a lot about us, and she will be able to share her experiences and insights about ECC-E (ECC – Europe) as it begins its journey along side us. We have cultural and language differences that will require a lot of work. The Europeans, in general, are much better educated than most Americans as far as having learned two or more languages. Jetty writes and speaks English in addition to her native language of Dutch. For several months, she has been an important presence on the ECC FB page, often bringing us meditations and spiritual insights. She and I have become good friends. She is a musician and will be sharing some of her music with us.

When I wrote my last post about being behind, I had no idea how busy I would be and how much worse it would get haha! It is all good! Even though I am behind, I haven’t been sitting on my behind haha! We have been extremely busy in our ministries here. I am also in my “high season” as far as my work in the court system — in September and October, work really piles up because all the attorneys and judges have returned from their vacations and so court orders have ended up on my desk. I am paddling as hard as I can! I really want to get back to our project of writing regarding mental health emergencies for pastors. I wanted to at least let those of you who follow this blog know what is going on. Most of the activity is on the ECC FB page. And of course, I have my own FB page (under Martha Rogers). We covet your prayers and participation. If you are in southern California, the Phoenix, AZ area, or the Las Cruces, NM area and would like to participate in one of our communities, you can find out about us from the ECC website (http://ecumenical-catholic-communion.org). Things have happened so fast that not all of our communities are listed or linked there, but it is still a good place to start.

My local community website, where homilies, biblical study materials and other resources are available, along with photos and other information can be found at www.stjuniashouse.com. Our “big sister” community ten minutes away, St. Matthew ECC, is also on FB and we have a website as well at http://www.saint-matthew.org.

So we look for you to join us on FB and in one of our communities if one is near you. And, if not, perhaps you could be the one who initiates a group in your own local area. We will do anything we can to help you.

Blessings, M-J+

Dear friends of St. Junia’s House,
I just couldn’t resist telling you that — because I can track traffic through our blog — someone from the Holy See in Rome looked at us. They were apparently seeking information on Norma Jean Coons, the independent catholic (“Roman Catholic Women Priests”) deacon who renounced her ordination a few months ago. Well, I still pray for Norma Jean, wherever she may be these days.

It has been a month since I’ve been able to post anything here. Things have been incredibly busy, but I hope to get back to our series on mental health issues for clergy in the near future. I am in North Carolina as I write this, visiting my 90 and 91 year old parents and other family members.

Many years ago, an aunt of mine died and there were various household items that were made available for any family member to claim who wanted them. There was a small wooden plaque that read “The hurrider I go, the behinder I get” which I took and hung on my wall in my office. At that time, I had 3 business partners and we shared a total of 5 office condo units that were all interconnected, and the plaque truly describe the dilemma of my life.

But some years ago, I began to rethink my priorities. I ended up selling off my office condos except for one small unit of 400 square feet (It was my favorite one) and downsizing my practice. My business partners went their own way and I went mine, and I discharged employees, choosing to practice more simply and in a solo mode. Still, I cannot say that the words of the plaque no longer apply. The various pieces of artwork and the plaque were discarded when I downsized. But I never have forgotten the words. And today, alas, I must report that I have not gotten past “the hurrider I go, the behinder I get”!

We have fallen behind on our series for pastors dealing with emergent or urgent mental health emergencies. Some of our ECC colleagues in Boston and Belgium have already submitted segments for this series. They will require some editing to fit with the requirements of this series, but they will be very worthy additions that will prove useful to clergy and lay spiritual counselors alike. The last month has been more demanding than I expected, but we will get back to adding new segments to this series. And if you wish to contribute, you can contribute either by writing a response to an existing segment or writing a segment for us. If you need to see the plan for this series, go to my website www.stjuniashouse.com and go to the link on the left side of the first page that says “Pastoral,” and it will take you to the series we’ve done thus far. The  first segment which lays out the format that we are attempting to follow, so if you want to write for us, we need for you to read this. Using a consistent format will help us when we get to the stage of publishing our work in a book. It is our hope that by the time of the next ECC Synod in November 2012, we will be at a stage to complete editing and to approach a major publisher.

So, my friends, pray for this endeavor, as I believe we are producing something that will be very useful and unique. And we hope to be able to take into account approaches to these problems from around the world.

Blessings, M-J+

 

This part of the series addresses what to do if it is discovered that someone has been raped or sexually assaulted and what needs to be done immediately. If you ‘google’ ‘rape crisis’ on-line, a list of local rape crisis centers can be accessed. You can also call your local hospital and inquire into outpatient rape crisis services. Or your local county prosecutor’s office should be able to advise you as to available ‘Victim Witness’ programs which provide follow-up counseling services for sexual assault victims, both adults and children. We need input from our brothers and sisters in other countries regarding where people should turn for emergency help in their own jurisdictions.

General Guidelines:

After having a family member murdered, which is considered the single worst traumatic event someone can experience, rape is considered the next most severe stressor contributing to onset of post traumatic stress disorder (PTSD). In many cases, these victims, who are usually adolescent girls or young women, are very frightened. Not uncommonly after suffering stranger assaults, they become housebound and afraid to travel. They become sleepless, anxious,jumpy, suspicious, and may experience intrusive recall of the traumatic event when other events or places reminiscent of the assault remind them of what transpired [Post-traumatic stress disorder, or PTSD].  In such cases, if a pastor or church member can provide immediate emotional support, this problem can be prevented from becoming chronic as it can be debilitating for many years, if not a lifetime. Last year in 2010, in a penalty phase of a serial killer, I saw and heard the testimony of two middle-aged women who had been viciously raped and sadistically abused — but who survived — incidents from the 1960′s or 1970′s. They were like deer in the headlights in the courtroom.

Male rape is probably the single most underreported crime in the U.S. today. Men or adolescent boys who are raped are rarely willing to come forward and report the incident. In my personal experience, most of the male rape victims I’ve seen were overtaken by drugs or alcohol, sometimes unknowingly after encountering their assailants in drinking establishments or while hitchhiking. They too experience serious PTSD.

The majority of children who are sexually assaulted do not disclose it prior to adulthood, and many may never disclose it at all. The worst psychological effects are incurred in such cases of secrecy. In your youth groups, you can do much to make it safe for such a youngster to come forward. See the segment under Child Abuse for further advice about dealing with child victims of sexual assault. It is probably worth asking of any known victim if there were previous incidents s/he has not talked about.

What to Do Urgently:

  • In the case of a child, the police or social services agency can facilitate a forensic interview completed by a professional who has been trained in how to interview young children and to obtain reliable information from them. Please do not attempt to elicit details from a child until after a forensic interview has been completed!  A serious problem in the U.S. is that children may be interviewed repeatedly. If you are a parent, insist that any child interview is audiotaped or videotaped. A properly documented interview will prevent the child from being retraumatized by continued interviews. Do not ever place a child in counseling or therapy to deal with a sexual assault until forensic interviewing is complete as this can actually lead to the defense claiming that details have been suggested to the child.
  • In the U.S. if the assailant was a household member, in the U.S. you would first contact Social Services.  If it was someone outside the family, one would first contact the police. In most cases, the victim will be directed to a hospital Emergency Room for examination.
  • For children who are required to undergo an examination at the ER, preferably a parent or other familiar person should participate and attend with them, providing reassurance and support through the process. Some children may feel embarrassed and humiliated. The supporting adult may also be uneasy. If the parent is emotionally unable to “hold up” through the process, a lay person, deacon, or priest of the same gender as the child who is known by the child can accompany them, but ask the child beforehand who s/he would like to go with him/her to keep him company.
  • The police or social services agency will  facilitate a medical exam including collection of physical evidence, if there is any. Be aware that lack of such evidence does not prove that an assault didn’t occur — fully 50% of child sexual abuse exams result in no physical findings or evidence. Because the genital areas are richly supplied with blood (very vascular), healing is usually rapid, within a few days. In some cases of chronic abuse, there may be physical findings, scarring, and other changes that can be documented, but not in most cases.
  • The parent will be interviewed as to the child’s health history and any observed symptoms.  Sometimes there are pre-existing medical conditions that can make interpretation of forensic evidence in an assault more complex. For example, recent courses of treatment with antibiotics can result in genital and urinary tract problems.  And younger children may be less able to give crucial details about the context of the assault or the time line of events surrounding the incident, so the parent is needed to fill in this information.
  • Suggest that the adult victim go to a local hospital ER and go with him or her. Some of the issues that the adult victim will typically have to address at that time are prophylactic treatment for STD (sexually transmitted disease) or for prevention of pregnancy. A pastor, deacon or lay support person can be of immense help in helping such a victim.
  • Discourage brushing teeth, showering or bathing, or changing clothes, because collection of evidence will be done in the ER and evidence will be lost if such hygiene is carried out. Take a fresh change of clothes to the ER because any clothing worn at the time of an assault will be retained by police.
  • Many victims do not go to police or the ER because they fear being blamed for their assaults. If the situation started out as a date, or if they met the assailant at a bar or party, the encounter may have begun as consensual but turned into a non-consenting situation. In some cases, drugs or alcohol were used and not always knowingly. Such victims may not remember everything that happened and hence are even more reluctant to come forward. Do your best to support the victim to disclose at the earliest possible moment. Delays in reporting will be more problematic, both from an emotional and a legal perspective. I once had a case where a prostitute was raped and we were successful in proving that the incident was not consensual, so while this is more extreme, it demonstrates that such situations can be successfully prosecuted. Many young women are killed in such situations because the assailants believe no one will know or care who the victims.
  • Any ministry that can be offered to young women living on the streets should address these issues of assault.
  • Mentally disabled men or women are very vulnerable to sexual assault by men who encounter them and who recognize their gullibility and naivete. Many of them are repeatedly assaulted sexually by various people. Any ministry offered to mentally challenged adults should address these issues, and teach them how to assert themselves and to avoid potentially compromising situations.
  • Undocumented immigrant females are very vulnerable to rape and sexual assault because the perpetrators assume they will be too intimidated to report what happened, for fear of being deported. It happens at the hands of “coyotes” bringing the victim across the border. Rape or sexual assault in their countries of origin can in some cases help make a case for legal asylum into the U.S.  Some of these victims are gay or lesbian and subject to continued abuse if they return home. In the U.S. sexual assault happens not only in social situations but even in the work place, especially where such individuals are working “under the table.” I once had a case of a young woman raped at work when she was asked to work after hours by the person who had sponsored her to work in the U. S.  You should know that police treat these cases very seriously, and they are not deported. Indeed, they are supported so that they can testify against the assailant.
  • In most U.S. jurisdictions, laws have been passed that prevent the sexual histories of the victims from becoming an issue when these cases are prosecuted. In the old days, the defendant would depict the victim as a whore and create doubt about whether the incident was non-consensual. The most common defense is that the incident was consensual. But this no longer “sells” to juries as it might have in previous generations. Offer respect and lack of judgment about how the victim got into the situation, and help him or her come forward.
  • In many U.S. jurisdictions, pastoral counselors and lay counselors can be trained in rape crisis intervention in their own communities and can serve on hospital rape crisis teams. This is a worthy training and service opportunity and it would be very good if at least one person from every church would go through this process and become the “go to” person in their church.

We solicit input from readers who have dealt with this issue personally; what was helpful and what was problematic when you or a loved one faced this situation? We also solicit input from those from other countries. Help us understand what the procedures are in your own country.

Copyright (C) 2011 Ecumenical Catholic Communion

Dear friends,
I do not know what news access our friends in Asia have but every time I have posted information about ‘house churches,’ I’ve gotten hits from all over the world on this blog. So I think this article that just came out in Time Magazine provides very important perspective on the religious landscape in mainland China. The link for this article is:

http://ti.me/jgvYDE

Blessings and prayers for all our Chinese brothers and sisters who risk being arrested every week by merely attending church.

M-J+

This segment will address adult domestic violence and homicide risk, which is an area in which few pastors or mental health practitioners have had adequate training. While the general principals described here are probably sound cross-culturally, this article does not address how DV risk and interaction with police authorities takes place outside the U.S. We solicit input from our international friends to round out the picture.

Known Triggers to Escalation of Violence
Most homicidal violence occurs in a domestic context rather than done by strangers. There are certain situations in which the risk of DV rises markedly. When drugs or alcohol are involved, behavioral controls are reduced and less predictable.

In domestic homicides, the single biggest trigger seems to be imminent fear of abandonment, e.g. threat of separation, breaking up, or leaving. Instead of grappling with fear or loss, the perpetrator becomes jealous, enraged, retaliatory, and seeks to subjugate the victim. If you are working with a family where DV has been an issue and one party is contemplating separation, make certain that s/he does not disclose his/her plans to depart in a situation where s/he is alone with the partner.

The next biggest triggers to violence seem to be finding out that the partner is involved with a thirty party romantically, or actually coming upon/encountering the partner with a third party unexpectedly. Perhaps this will be perceived as a bit of crass advice by some, but it is important: Don’t do it at home. Advise such parties to be very circumspect if the terminated relationship is still in the throes of anger and has not reached a stage of acceptance and resolution. (And, it should be noted, for some people, this stage is never reached. Particularly, those who have been left may not ever accept that it is over.) In my own experience, while the urge to seek out support in the wake of one’s own stress and loss may be strong, one would do well not to become romantically involved with someone else and to avoid the appearance of involvement until the former relationship has been severed and both parties’ lives have restabilized.

Steps Toward Separation, Termination of Relationship or Possible Marital Reunification

• If living in the U. S., the abused partner who is leaving should seek temporary restraining orders (TRO) from the local family law court; this will legally require the abuser to stay away from the abused partner, and to prevent or stop his/her harassment. If s/he disobeys the Court Order, then s/he is in Contempt of Court and can be arrested. Find out what the procedures are in your particular county jurisdiction. We would appreciate comments by those residing outside the U.S. as to what is appropriate action in your own legal jurisdiction.

• In the U.S., a party can go to court without having a lawyer and there is usually a paralegal on site who will assist in the completion of the Petition. If you or one of your parishioners can go with the person, this may assist him/her, especially if s/he does not speak English or s/he speaks English-as-second-language. Simply go to the Court, ask for the necessary paperwork, which may usually be completed in long-hand and does not have to be typed up in “legalese.” We should also add that lack of legal residency in the U.S. is not a barrier to seeking such court Order to restrain an abusive spouse. The information is not provided to INS. However, we should also note that if a case ends up in criminal prosecution and there is a criminal conviction, this fact could result in denial of citizenship and lead to deportation. Hence, it is important to intervene earlier rather than later to prevent such outcome. We would also appreciate feedback from those who have dealt with this issue from the perspective of not being U.S. citizens.

• Some pastoral care providers, particularly those who hold more conservative theology about male/female relationships, where they believe the marriage must be preserved at all costs, may unwittingly risk safety in the interest of trying to get couples to stay together no matter what. Their goal is to prevent separation while undergoing marital counseling. Such approach can actually be quite dangerous and most mental health experts would advise against this.

• In such situations, it is not uncommon for the abuser who is usually male, to try to co-opt a male pastoral counselor into religious justification for continued control over the spouse. Pastoral counseling that attempts to avoid a separation after domestic violence has already occurred can pose an increased risk. Pastors need to avoid an unwitting collusion with DV perpetrators.

• Marital separation with a goal of maintaining safety should be encouraged rather than “negotiating” with DV perpetrators which allows them to maintain control. The principle is: Their behavioral change must occur first before marital reunification is appropriate. Failure to report such domestic violence to the police in the presumed best spiritual interests rarely leads to a successful outcome. Indeed, at least in the U.S., research indicates that the only intervention that seems to make any difference in the behavior of DV perpetrators is arrest, incarceration, and court controls.

• Do not encourage DV victims to give in and have unauthorized contact with abusive spouses once restraining orders have been put in place. The abuser needs to earn trust through respectfully submitting himself/herself to the imposed legal boundary. His/her lack of respect for the partner is displayed by his/her refusal to honor their boundaries and is symptomatic of a core spiritual problem.

• You should also be aware that domestic violence is not limited to married couples. Indeed, in any cases, DV begins even before couples are living together. They may only be dating. Such young couples need immediate help. The individual who is dating someone who is already paranoid, controlling, and even physically abusive needs to be counseled out of that relationship, because any existing constraints that are present will disappear once s/he feels s/he “owns” him/her.

• DV is also not limited to heterosexual couples. Gay and lesbian couples also have their share of domestic violence episodes. Men who are victims of DV in either heterosexual or homosexual relationships are very often reluctant to come forward, so we need to stay attentive to them. Sometimes they are severely injured or killed, although the majority of DV victims are women. You should also be aware that DV and child abuse may occur in the same families. Even if the children are not directly abused, witnessing parental abuse can also be horribly traumatic and I have seen some children or adolescents commit murder of a parent as a result.

• A rising area of risk of homicide and suicide is in the elderly population where one or both parties may be chronically ill or suffering pain, suffering from the effects of dementia, or an inadequate support system. Pay special attention to these individuals, especially when it becomes apparent that physical altercations have already occurred. Such families are at very high risk for fatal incidents.

If you are working with a DV family or if you  would like to learn more about DV and dealing with its victims and perpetrators, there are some excellent sources on the internet where you can receive training. See, for example, www.dhs.state.OR.US/training/dv/tools.htm or www.dhs.state.OR.US/caf/dv/tools.htm

The State of Oregon has a great website with many articles and tools that will help you understand how to deal with DV, including issues of economic problems for survivors. Some of the articles are more technical and intended for their social workers but most are quite helpful for the pastoral or lay counselor.

What to Do in Urgent Situations

• If you receive an urgent call about an issue involving domestic violence taking place in the home, and you have any doubts as to your immediate safety or that of others and your ability to defuse the situation, call the police and ask for a well-being check at the residence of the family. Handle the contact only by phone until you determine appropriate steps.

Situations in Which Police Intervention Should be Sought

• Find out from the reporting party if there have been prior incidents and whether police have been previously involved in prior incidents. Also find out if the family is currently or if they have previously been under supervision of Social Services. If there has previously been police intervention, this is a situation where you should not attempt to intervene on your own, but you can take preliminary steps to assure safety for all family members.

• If it is alleged that one party has previously threatened to kill, DO NOT take this on.

• If one or both parties is under the influence of alcohol or drugs do not attempt to handle it by yourself.

• Find out if there are weapons in the house such as guns and ammunition. If such items are on the premises, call the police and inform them of the address and locations of weapons.

How to Achieve Cooperation so that Intervention Can Occur

• In general, if you are not known by both parties, outside intervention may be preferable, because the party that does not know you may expect or presume that you will “take sides” in the conflict. Some individuals will tell you to “butt out.”

• Talk by phone with both parties separately if at all possible. If you’ve been invited to participate by one party to assist, let the other person know your intended role. Establish yourself as not taking sides but simply to ensure safety and well-being of everyone.

• If a conflict is going on at the moment, tell them that one party needs to leave temporarily. Do not assign blame in your attempts to separate them. The parties should not be allowed to assign blame to one another as a way of deciding who gets to stay home or who has to leave. Simply say that everyone needs a cooling down period. Move the more cooperative or pliant party.

• Handle your initial contacts by phone. Ask both parties if they will temporarily leave the residence. Then assist at least one of them to vacate. Help each of them find someone where they can spend the afternoon or evening, to cool down.

• Is there someone that they both trust to work with them? If possible, ask both of them.

• When one party is temporarily relocated, instruct the friends or neighbors with whom s/he is staying not to assign blame or “take sides” in the conflict.

• Tell the parents that children need to be temporarily moved to a neighbor’s house, friend, or church member’s home for their own safety and so they do not witness a parental dispute. I have been involved in several cases where children witnessed the murder of a parent, so it is critical to secure their safety and to make sure they are not witnesses to arguments, disputes, or worse.

• If you are dealing with the elderly or a disabled or mentally handicapped person, where a partner or perhaps a care provider or adult son or daughter has become abusive or neglectful, this is a situation that requires Social Services intervention. And there should be frequent and continued checks on their well-being. This is as necessary as what you would do in the case of a child.

We solicit responses to this article from those of you from different cultural perspectives or those living in other countries. How would these situations be handled in your locale? We also solicit responses from anyone who has been involved in or dealt with DV, either professionally or personally. What was most helpful in your case? What was done that was less helpful or even harmful?

Copyright © @2011. Ecumenical Catholic Communion

This segment focuses heavily on prevention of abuse and neglect for the most vulnerable populations, building awareness of risk factors by church members, developing support systems within the church. Some attention is also given to preventing abuse within the church itself.

The pastoral counselor is in a position to be the eyes and ears for the little child who has no ability to report things that are wrong or neglectful. The church can be a resource for prevention of child abuse problems. Starting with pregnant girls or women, offer any support you can to help them not keep their pregnancies a secret, which often leads to infant abandonment or infanticide. Make a policy of Safe Haven in your ministry, consistent with laws in your own state or country.

With pregnant women or girls who are using drugs and alcohol, immediate intervention is required to prevent the unborn child from suffering brain damage or other birth deformities. The single biggest cause of mental retardation in the U.S. is fetal alcohol syndrome, which can occur with a single usage of alcohol, often before the woman is even aware that she is already pregnant. Such women need immediate education and help to cease any drug and alcohol use for the protection of the unborn.

With poor pregnant women lacking in adequate nutrition or prenatal care, the risk for problems is much higher for their infants. For women who continue to smoke tobacco during pregnancy, the risk for low birth weight, premature birth, or other problems is also increased. There are women in your church who have been very successful mothers who can provide immeasurable preventive help and support to pregnant women and  young mothers, and thereby helping to extend your capabilities for spiritual care and guidance as their good shepherd.  In the Aramaic, “good shepherd” means “skilled shepherd,” so we are called upon to develop the skill base to help our flock.

There is also a high risk of severe injury or fatalities in babies in the first year of life due to shaken baby syndrome. First-time parents are unaccustomed to the loss of sleep and the constant demands and may lack frustration tolerance or the skills to deal with a crying infant. Sometimes babies cry for no apparent reason. The time frame of 3-6 months is an especially vulnerable time for shaken baby syndrome, which may leave a child permanently brain damaged or worse.

If the mothers are living with young men with no past experience in caring for infants, such as a first-time father, or a boy friend who is not the father of the child, and they are relying on them for child care during work hours, the risk for abuse is high. Such young parents should be offered help and support by older, wiser parents in your congregation who are spiritually mature. This is especially needed where young parents do not have supportive extended families who can help with child care and offer them occasional respite from the stress.

Single parents – usually the mothers – may be under stress from their multiple and unrelenting responsibilities.  Support groups in the church for such parents can go a long way toward helping young parents learn needed skills, find someone to listen, to trade babysitting, learning practical and spiritual parenting. Those young parents whose own parental role models were not the best can be inspired by additional, more positive role models to whom they can look up. It is the child under age 5 who is at greatest risk for neglect or abuse where s/he is “under the radar” and goes undetected because s/he is unable to complain effectively. Most child deaths or permanent injuries from abuse and neglect are in this age group.

Child sexual abuse can occur at any age, but it is more common in school-age children and adolescents. Most perpetrators are someone known to the family, if not an actual household member or extended family member. But there are predators who seek out victims beyond the family. Be aware of who comes and goes in your group because predators have been known to seek out church settings where they may quickly gain trust of congregants. People in a parish should be taught to use common sense in how quickly or frequently they allow people even within the church to have unmonitored access to their children.

Within the church, there are some people who seek leaderships roles whose social skills are limited. They may sincerely wish to serve children and may not have ever consciously had any intention of abusing a child, but who become molesters. They are often more childlike or immature, relating to children more as their peers than as adults. Churches should routinely have two or more adults working together – preferably a male/female team, a married couple if possible – to share responsibilities for working with children’s or adolescents’ groups. No church worker, lay or ministerial, should be spending time with an individual child apart from a group or joint family activities. For a church worker to take an individual child to the movies, to a theme park, or to sleep in the same bed or tent with him/her on overnight trips reflects a loss of boundaries.

The best criterion for selecting good workers with children in the church is the adult who has well-established adult/peer relationships with persons of both genders. A person who is most comfortable around children and less comfortable with and/or deriving few of his/her own needs with other adults is at risk for becoming too emotionally involved with children. Such individuals seem to be more at risk for drifting into molestation. Ask the prospective children’s Sunday School teacher or youth leader, “Who is your best friend?”…”Who are your closest friends?” …”Across your lifetime, what is the best relationship you have ever had with anyone?”…”How much of your time do you like to spend with children?” Look at their social and recreational activities and ascertain whether they are adult-centered or child-centered: for the single person who is not yet a parent, they should already be adult-centered.

What to Do:

  • The most effective responses are made by church communities who already have designated people in place who have thought through in advance what the church can realistically offer, and who are also aware of community resources to which they can turn. If there are professionals in the church community with expertise, use them as consultants to develop your standard operating procedures. It may be appropriate to develop a standing committee to help develop procedures and to identify needed agencies and their addresses and phone numbers.
  • Churches can advertise their willingness to help families in their own church bulletins and with leaflet handouts. Such leaflets can provide how to get appointments, how to ask for help, and perhaps a list of local agencies or resources.  Such written sources should include a statement about confidentiality in some situations such as Rite of Reconciliation, but obligation to report abuse, neglect, or risk of harm in other situations.
  • In all situations, make a judgment about the current risk of harm. For example, if a parent confesses to abuse years ago and there are no minors currently in the home, then risk would be viewed as low. If a parent confesses to ongoing and current domestic violence or child abuse, part of penance will be to develop a viable plan of safety and putting resources in place for both continued accountability and support.
  • If an issue of possible abuse or neglect has been raised by a child brought to you by a parent, try to talk with the child without the parent in the room. Depending on the age of the child, ask as few “leading questions” as possible. “I understand something happened that you did not like (that hurt you, that scared you). Can you tell me what happened?”…”Tell me more about that.”…”And then what happened next?”
  • If you have access to the child or a non-abusing parent or guardian, ascertain whether the parent is capable of protecting the child from the abusing individual. Some parents are themselves too threatened by the other parent to be able to keep him/her safe. In some cases, suggest to such parent that arrangements be made for the child to stay temporarily with a responsible extended family member, neighbor, or other church member while the issue is sorted out. If there are other children, they too should be removed.
  • In making a report of abuse where you’ve taken these preventive steps, inform CPS or police of what you’ve already done and where the child(ren) are currently located.
  • If both parents appear to be involved in neglect or abuse, or neither appears to be cooperative in or capable of developing a safety plan, then report directly to Child Protective Services or the child abuse hotline in your county. Inform them of your failed efforts, as this will get the case more attention than it might otherwise draw.
  • Neglect or failing to meet the necessary needs of a child often falls under the radar of awareness especially with children age five and below. Where young children or babies are left alone or unsupervised, are not adequately fed, or lack needed medical care, then the parent has neglected the child. Do everything you can to enlist the help of others to stand in the gap to help the parent fulfill his/her responsibilities. Check on their status frequently, if possible, in person and in the home. Either you or a trusted person in the church can observe the child or children and the condition of the home. Is there adequate food in the house? Are conditions adequate for the safety of a young child? Is there evidence of reasonable organization and attending to daily chores? What about sanitary conditions? Are there any problems that need immediate resolution? (Utilities turned off, lack of running water, lack of suitable food for the child(ren). Obviously, in any family with young children or babies, there is a certain degree of chaos that is inherent where children take precedence over chores. A single mom with five children under age ten shouldn’t be held to the same standard as a mom with a responsible partner and only one child.
  • If another child in the church reports to you that a young peer is being abused, encourage the reporting child to tell the peer to come forward and to bring him/her to speak with you. If you then can identify a responsible non-abusing parent, ask the child to allow you to bring in the parent to help in making decisions about what to do. A child who is reluctant to directly share such information with a parent will usually be relieved that you are willing to help.
  • Make a report in the state/jurisdiction where abuse was alleged to have occurred.  Be prepared, if at all possible, to give the following information: Name of child, date of birth, gender, race, present home address or location of the child, and any siblings plus their ages. Name, address, and phone of the child’s school or preschool. Name, date of birth, gender, race, home address or location; home, cell or work phone numbers of the parent(s), and any similar information known about the alleged perpetrator if s/he is not a family member. Be prepared to tell the agency what the child said happened (if child made a statement), or your observations of any bruises or injuries, whether a physician was seen, and what the adult(s) said.
  • It is not your place to investigate the validity of an abuse allegation before reporting. If you are a mandated reporter in your state, and any priest, deacon, or minister working with families is, then you are required to report. However, you can add your own impressions and concerns at the time you report.
  • In working with families where abuse is alleged, be careful to leave the doors open with all family members, not rushing to judgment, so that you can be an agent of healing.
  • If you feel that the parent may not be able to protect the child and the parent has not allowed the child to be temporarily moved from a risky situation, this information should be relayed to the authorities when you make a report.
  • If the perpetrator was not a member of the child’s immediate family, the reporting authority should be the police (U.S. procedure, check your own legal authorities if you reside in another country.) If the perpetrator was a parent or other member of the child’s household, the Social Services Agency (which goes by different names in different U.S. locales, e.g. Public Social Services, Children’s Services, etc.). If a hotline is available, call the hotline and they will make a determination of where the information should go.
  • Prevention of escalating violence/homicide: If you determine that an adolescent, particularly a male, is being abused chronically by a parent figure, precautions should be taken to prevent future violence toward the parent. Sometimes the child will complain of unpredictable behavior on the part of the parent, such as intoxication or abuse toward the other parent or siblings. The abuse may not necessarily appear to be extreme, e.g. resulting in need for medical care, and often, it has not been reported to authorities. It may not be so severe as simply unrelenting. Some adolescents may complain of extreme control and denial of age-appropriate levels of freedom where you may need to make a judgment about how far out-of-bounds this seems to be. Is the mother also under similar constraints? Typically, boys have reached a level of physical size and maturity where they begin to feel capable of challenging the abusive parent, most often the father or stepfather. Girls often enlist the help of a boy friend. Usually, the choice of weapon is a gun. They often disclose to one or more peers about his/their plans, and may enlist one or more peers to assist them in some way. Experience and research have shown that from the time such a youngster first voices the desire to kill a parent, it is likely to be carried out within two or three weeks. Always take such threats with the utmost seriousness. Do everything you can to temporarily remove the adolescent from the situation. If there has been a specific threat, inform the police of the intended victim, and allow authorities to inform such person of their risk. The minor needs to be taken into another family at least temporarily, but you need to go through the appropriate legal channels in your community.
  • Teach adolescent groups that it is never appropriate for them to keep information confidential if a peer has talked about committing suicide or killing a family member. The same teaching and same window of time pertains to adolescents who threaten school violence. Very often, only peers have been told and typically they never disclose to a responsible adult until it is too late. They may report that they felt the youth was joking. Or they feel that they are “ratting out” their friend, when, in reality, they may be saving two lives – that of the friend being saved from a lifetime of incarceration as well as the intended victim being spared injury or death.

Local Phone Numbers for Reporting Abuse

Abuse must be reported within the state in which it occurs. When seeking to report abuse, remember these points:

1.    Not every state has a reporting hotline.

2.    Not every hotline is 24-hour accessible.

3.    If the state does have a hotline, it may only be accessible within that state. You can call information and ask for the number for reporting child abuse in your local county or township.

4.    Should you need to report in another state or the particular state does not have a hotline, you may need to contact the out-of-state reporting number of the specific county in which abuse occurred. The Childhelp USA National Child Abuse Hotline can provide these numbers for you:

http://www.childhelpusa.org/child/report.htm#co

Assisting Families Where Reports of Child Abuse Have Been Made

Part of the spiritual growth process of working through abusive behaviors may involve reconciliation and reparations both with God and the aggrieved parties. Where such acts must come to the attention of authorities, as a part of the legal disclosure process, the minister/priest may be able to facilitate the person’s participation in needed therapeutic or parenting programs that will assist him/her in regaining control of his/her behavior. Try to frame the necessity of your making a legal report as an opportunity to obtain help and support.

For example, in many cases of more minor incidents, Social Services will place a parent under an “informal supervision” program, where they are required to attend counseling, e.g. domestic violence classes, therapy, substance abuse classes or AA/NA, participation in Parents Anonymous or similar organizations, parenting classes. This is especially true if a responsible person in the church has offered support and oversight.

Obviously, it depends somewhat on the “luck of the draw” of county personnel as to whether your family will get the help they need. Ask the family to sign a release of information so that you can maintain communication with the social worker – if someone is serving as an advocate for the family who is trying to work with the county, they are more likely to pay attention to their needs. The squeaky wheel always gets the grease. This kind of consistent follow-up can be carried out by a Deacon or other dedicated lay member of your congregation. It also helps to keep the system honest and accountable.

If a child is removed from the home, church members can come forward and be screened to serve as visitation monitors, thus helping the family to maintain more frequent contact with the minor. Social workers’ loads are so heavy that visitation could be limited to an hour a week or less, so the parent/child bonding can be substantially damaged, especially with babies and very young children. Another important role that church members may play is to become qualified as foster care providers, so that children can remain with people they already know who will try to facilitate family reunification where appropriate.

Copyright(c) 2011 Ecumenical Catholic Communion

 

 

This segment will address several aspects of unintended pregnancy including abortion, unwanted pregnancy, adoption, guardianship, child custody and visitation, and newborns’ Safe Haven.

General Overview

About 85% of women engaging in unprotected sex will become pregnant within a year. It is estimated that 77% of births to women over age 40 and 86% of births to teenagers are the result of unintended pregnancies. In a recent report in U.S.A. today (5/19/11), in nearly every state, about 65% to 75% of unintended pregnancies were considered mistimed and 25% to 35% unwanted, according to the Guttmacher Institute, which studies reproductive issues.

There are millions of unplanned pregnancies in this country every year and some unknown percentage of them would better be classified as “unwanted.” It is not the “bad girls” who are more likely to become pregnant: Among young girls who are having their first sexual experiences, becoming pregnant is very common within the first four instances of intercourse. Hence, many young girls are caught “off guard” and become pregnant very quickly upon initiation of sexual intercourse and before they have given any serious consideration to use of birth control.  Use of birth control requires acknowledging to one’s self that you intend to have sex, and in some religious groups, this is so forbidden that denial or guilt can prevent her from avoiding pregnancy. Of course, the risk for sexually transmitted diseases (STD) is also higher with unprotected sex.

Many resources are available for assisting young women with these issues. If you go online and type in “unwanted pregnancy” or “unplanned pregnancy,” many resources will be listed, ranging from groups who support women to have their babies and keep them and raise them, or to give them up for adoption to others who provide counseling to this end, or those providing counseling prior to abortion services. The catch is that many of these services are offered by groups who have some unspoken agenda or theological premise that influences what is offered. Sometimes this is not immediately apparent, but in other cases, such services are “up front” in their views. Some who are quite militant are not helpful and may even create harm. Unplanned pregnancy is an issue that is fraught with emotional and spiritual implications and fall-out. It is not an inconsiderable problem given that an estimated 43% of American women make the decision to abort at least once prior to age 45. There is a consensus in research in the field that at least 10-20% of women who have had an abortion are subject to serious negative emotional complications. With over 1.3 million abortions performed yearly in the U.S., using the more conservative 10% figure would result in 130,000 new cases of women experiencing abortion-related psychological problems each year. This is not an inconsiderable public health issue.

They may suffer from anxiety, depression, sleep disturbances, substance abuse, increased risk of suicide and problematic parenting. This is not to say that those who elect to give birth are immune to these same problems. It is not my intention here to review these positions or to take a stance in the abortion or right to life debates. The pastor can best assist if s/he is “up front” on his/her views of these problems and how s/he approaches them from a spiritual perspective. Additionally, we all have to consider the possibility that there are situations we face as pastors that should be referred elsewhere, if there is a conflict with what is sought and what we feel that we can morally/ethically offer.

I will comment, however, from the standpoint of a psychologist who over the years has seen girls and women who resolved the issue reasonably well, or who continued to be wounded with the various consequences. There are painful consequences for the woman who chooses to give birth and give up her child which are often not recognized. In previous generations, adoptions were invariably “closed,” and only in recent years have legal procedures been developed in some states that would allow adult adoptees to unseal adoption records and find their biological parents. This allows for the possibility of better emotional outcomes. Unfortunately, I have also evaluated many women who abandoned, abused, or killed their children.

Raising a child as a single parent is an alternative that for many is the best route and this no longer engenders as much disapproval and loss of support from others as it used to do. In the past, there was much social rejection and denigration for such mothers, and many were reluctant to seek the support of a church community, fearing further disapproval. In some cases, their own families rejected them and did not provide much help or support. These women and their children need to be embraced in our faith communities.

There is no perfect solution in this situation: It is not usually a “…they lived happily ever after” scenario. There will be pain and suffering no matter what resolution is sought. The young woman or the older woman who has an unexpected pregnancy is not well-served with any advice that does not allow full exploration of all her options. Nor should it be implied that undesirable and possibly painful consequences will be avoided by one particular choice. There is no way to unring the bell and avoid all difficulty and pain.

The choice at this point is only which alternative will you choose to live with thereafter? Forgiveness for unwise choices should be at the forefront of pastoral counseling and support to keep all options open for the young parent to make the best decision possible. Wherever possible, the young father should be included in this counseling process. Understanding the spiritual implications for the choices to be made by the young person should be a focus for prayerful intervention on the part of family members, friends, and pastors.

What to Do:

  • If every ministry or church made it explicitly known and publicized that they would gladly receive any newborn whose mother wanted to give him/her up without being identified, many babies would be saved in this country.[1] In many states, laws have paved the way for parents who want to anonymously give up an infant within three days of birth to do so without being legally prosecuted for abandonment.
  • Legal guardianship of the newborn by a relative should be considered in the case of women with mental retardation, major mental disorder or continuing substance abuse problems and/or past history of unreliable parenting with previous births. If the mother cannot cooperate with such advance planning by the family to guarantee the child’s safety and stability, then legal consultation, and consultation with Social Services or referral to the Juvenile Dependency Court should be considered by responsible family members. As a pastor, try to work with all of the parties to form a bridge to resolution. You should have an attorney resource for consultation and it is a good idea to know where Social Services offices are in your neighborhood.
  • In such cases, adoption by reliable and willing family members should be considered, with the impact on their future relationships carefully considered: Is the young mother capable of maintaining such relationships without interfering with the adoptive parents’ role and the needs of the child? Or a temporary or permanent guardianship should also be an option. Ask the young mother which of her family members she feels she could work with most successfully.
  • It is suggested that where adoption outside the family is being considered, that “private adoptions” be avoided where there has been no proper investigation of the prospective parents. Adoption agencies which have worked with varying levels of “open adoption” may provide the young woman greater freedom to consider adoption as a possibility – where she may meet the prospective adoptive parents and they may agree to some degree of continuing relationship with one another and the child, dependent on their preferences. It is a good idea for the pastor to become familiar with adoption agencies in his/her own community.
  • Younger single women who choose to keep their children will need much help in assuming the parental role – the pastor can help her assess realistically what her family and personal resources are and what else she needs. Older women in the church who are already parents can provide important support, mentoring, and respite babysitting from time to time. Often they can also provide material support such as used baby cribs, clothes, toys, or can assist in going to thrift shops to find these items at reasonable cost.
  • Younger parents who are not living together as a couple will need to sit down and work out an understanding of shared responsibilities and/or visitation rights of the non-custodial parent. I have seen many of these cases end up in family law courts, where the parents did not actually know each other very well. They came into conflict and at that point could not work it out between them. This situation of needless acrimony could be prevented by sitting down with a pastor and extended family members and together looking at what is in the best interests of the child. Ask the mother if the father and his family can be invited for discussion. Or if you are dealing with the young father, help him to invite cooperation.
  • It is nearly always in the best interests of such a child to know both of his/her parents. There may be a few cases in which this is not true, but you can help the new parent(s) to realistically weigh these issues: A parent being of a different culture or race, a different socioeconomic status, or a different religion should not preclude cooperation. On the other hand, chronic substance abuse or a pattern of criminality, or a pattern of irresponsibility with other children of his/hers requires setting conditions that preserve the well-being of the child. Such parents may require supervision or help by a responsible extended family member.
  • In the court system, once paternity is established or acknowledged, custody and visitation issues are treated essentially the same as though the couple had been legally married.  In the current legal climate, in most states, grandparents can also gain visitation rights. If these issues can be worked out and agreed upon at the beginning, the child will have greater security, and the families will be more cooperative in the long run. Don’t wait for conflict to erupt: address these issues as early as possible. Build on the good feelings that most families have when a child is first born: this is the time to forge future relationships. Meet them at the hospital!
  • For young women who opt for abortion, this decision should be made as early as possible, but should not be rushed or entered into without intensive counseling. No one should be encouraging or influencing the young parent(s) to make such a decision under social pressure, to “save face,” to avoid embarrassment, to keep their families from knowing, or based solely on practical considerations. There are more emotional complications for younger women who have abortions, often because they are in denial and wait so late that they have second trimester abortions.
  • There are also many more baby abandonments and baby homicides in this age group as well. If you encounter a situation where a girl has hidden the pregnancy from others until very late, she requires immediate attention and intervention. Do not leave her to initiate help: Go with her to tell her relatives or to obtain any needed resources.
  • There is also evidence that one factor associated with greater emotional complications after abortion is that the decision was tied up with experiences of domestic violence. Violence with the partner has been found to be systematically related to the choice to abort – perhaps because the woman does not believe that co-parenting with the partner is feasible. She may view it as one more hold that he has over her. So, this combination of unplanned pregnancy and domestic violence could be a salient factor responsible for declines in mental health in these women. Anything you can do as a pastor to tactfully inquire and then to address any potential issues of marital violence and their options for coping with this problem may diminish the likelihood of feeling they must abort. Such women fear being tied to an abusive partner, being further abused, or exposing a child to domestic violence or potential child abuse.

Copyright reserved (c) 2011, Ecumenical Catholic Communion


[1] Please check on the status of newborn “Safe Haven” laws in your state. Check the wording of your state statute, as some require that the child be brought to a hospital, police station, or fire station, so a church location may be intermediary where the parent is assisted to take the infant to a legally recognized location.

General guidelines:

Breaking of bad news is best done by someone who already knows the person and who has some instinct and intuition as to how s/he copes with difficult situations. It is best if it is done by someone who will have a continuing relationship because this is rarely a “one shot” event. People generally are resistive to learning that they are dying or someone important to them may be dying or has already passed away. This is particularly true when a death has occurred suddenly, unexpectedly, or violently as in suicide or homicide. We as care providers and pastors may fear causing the person more pain and “doing it wrong,” so this task is often stressful for the bearer of bad news. But most errors can be corrected and doing nothing cannot be corrected. There are many uncertainties for everyone in many of these situations. It is better to say you don’t have answers when you don’t – this is not the time to avoid and bluff or to give him/her glittering spiritual generalities or platitudes to smooth things over.

What to do:

  • When breaking bad news, sit down unless it is not possible to do so. Remove physical barriers in the way and turn off TV’s or radios.
  • Seat yourself a comfortable distance for discussing personal matters. In American cultures, 20-36 inches is appropriate, but you may need to modify this depending on your relationship with the person and their cultural background.
  • If you and the person can be comfortable with it, brief touching at some point in the conversation – a hand on the shoulder or on the arm – is appropriate and helpful.
  • You must handle short silences – don’t fill it in with words – silence most often occurs when feelings are intense. Acknowledge strong emotions – yours or the other person’s. For yourself, it is better to describe your feelings and contain them rather than displaying them.
  • Find out what the other person already knows or suspects about the situation, be it their own or a relative’s. “What’s your take on what has been happening?” “Did you think it was serious when –?” “Have you been worried about yourself (other person)?”
  • Find out what the person WANTS to know. “If this turns out to be really serious, are you the kind of person who likes to know exactly what is going on?” If s/he expresses not wanting to know details, this hesitation should be honored. You can say, “That’s fine. If you change your mind or want to ask more questions later on, you can let me know at any time.”
  • Give information in small chunks. Most patients retain no more than half of the information they are given. When talking about serious conditions or situations, the loss of recalled information can be even greater. Stop and check whether what you have already said was understood or recalled. “The minute you said, ‘cancer,’ my brain cut off and I just couldn’t remember a thing after that.”
  • The warning shot. If there seems to be a big gap between their understanding of what is going on and the actual reality of the situation, then give them a warning shot that things are more serious than they appear. “Well, the situation does appear to be more serious than that.” Then gradually introduce the more serious points, waiting for his/her response at each step. Keep your sentences short.
  • If a medical condition is involved, consider meeting with the person along with their physician to form a support bridge, and to allow the physician, who is used to delivering bad news, to deal with the technicalities. You are there as his/her support system, and to help plan any needed follow-up actions to be taken, or to make a plan to enlist relatives or others in the church to help.
  • Frequently check what s/he is getting. “Am I making sense?” “Do you follow what I am saying right now?” “This must be a bit overwhelming [bewildering, shocking], but do you get the general idea?” Repeat important points.
  • Give only information that seems needed at the moment, or information that is asked for. They may not be ready to hear that their lifespan is only weeks or months, or that paralysis can be expected to set in, or that their sister may not ever be able to live independently again.
  • Help them figure out what their own goals and priorities are under the circumstances and how to hook up with needed resources. “What do you think would be most helpful to you right now?” Take it a step at a time, a day at a time, rather than anticipating too far ahead of what is immediately necessary.
  • Often people are too stunned to think of questions they may have at the moment. Meet with them again. In case of bad news regarding a death, be sure that people are in place to lend support and to take care of details that the bereaved person may not be able to deal with immediately.
  • Offer prayer and anointing for healing of body, mind, and spirit, if this seems appropriate to the situation.
  • If the person is very distraught or not sleeping, contact the family physician. S/he may benefit from short-term medication. It is best not to “borrow” medications from others that may not be suitable! If at all possible, make sure that someone is staying with the person overnight.
  • Check on the person the following day. And then as often as seems helpful thereafter, but also taking care to encourage his or her usual support systems to kick in.

This segment was developed based on a book by Robert Buckman (1992) which I highly recommend entitled How to break bad news: A guide for health care professionals. Baltimore: The Johns Hopkins University Press.

Copyright is reserved on the above material(c) 2011, Ecumenical Catholic Communion

The title above reflects a plan for a new series for this blog. On a weekly basis, I will briefly capsule a particular issue that may come to the attention of pastoral counselors, priests and deacons, as well as others in the Christian community involved in peer counseling, leading support or self-help groups of various kinds, or in other ongoing ministry. Together, I hope that we can share our experiences on the topic at hand.

Five years ago, I wrote a first draft of a “Primer” with 20 or so segments which was intended to overview common problems that come to the attention of deacons, pastors, and volunteer workers in the church engaging in counseling in emergent or urgent situations. It has taken me this long to get back to this project.

It is my hope to write new segments – or invite others to write new segments — and to rewrite those completed five years ago and to obtain and include feedback from others who have experience with these various problem situations, with an eventual goal of publication. There are no available books that cover these issues in a hands on and practical way while also providing an overview of the topic. Please note that I do not have expertise in all of these areas. I look forward to being taught by those who work with some of them every day.

If you want to volunteer to author a segment, please contact me! The segment should be succinct, no more than 2-4 pages. It should include some general orientation to the area of concern, general guidelines, and then a list of practical advice of “what to do” [or not do]. References, or links to relevant resources should be included. How would you advise a pastor facing the problem who does not have your background? If you author a segment or provide helpful feedback to an existing segment, I will acknowledge you on this website and credit you in any future publication. You can make a difference for future church workers by contributing to this process! If you are a volunteer leader, a pastor or deacon, or someone who has actually lived through the particular experience being discussed, YOU can provide important insights!

Whenever possible, information about preventive education and care should be integrated into the discussion. Dedicated and caring church leaders will often be in a position to encourage prevention of illness, injury, neglect, and abuse among their people. Being Christ to others in the world requires attention to the whole person. It is with this premise that we begin. I have been a licensed psychologist for the past 35 years, with specialties in clinical, forensic, and neuropsychology and I aspire to use specialty knowledge and experience from my practice to enhance the work of the church.

I will open this column with a piece on “breaking bad news” to people. Please provide your experiences, insights and feedback! You can play an important part in improving and rewriting this segment. We have several hospice or hospital chaplains within the ECC as well as others from other ministry settings and perhaps they can offer us all some words of wisdom on this topic. Those who serve as chaplains in disaster situations or with police or fire departments may also have some additional perspectives.

Below is a list of topics that I originally compiled plus some additional topics that I recently added. If you have suggestions for other topics, please let me know. And if you want a topic addressed sooner rather than later, please write! These do not have to be done in the order they are listed. If there is a need right now, let’s do it!

Abortion/infant adoption/unwanted pregnancy/newborns‟ Safe Haven
Adolescent parents
Adoption of older children
AIDS/HIV, care of persons afflicted
Alcohol or drug withdrawal
Attention deficit /hyperactivity disorder /use of cognitive functioning enhancing medications
Bad news, disclosure of
Bipolar disorder
Bullying in school settings / risk of violence
Child abuse/neglect /prevention
Codependent relationships
Compulsive or “addictive” behavior patterns:
Gambling
Internet chat and on-line pornography
Overspending/indebtedness
Shoplifting
Drug and alcohol abuse
Compulsive sexuality / “addiction”
Hoarding / “packrat” behavior
Consultants /resources in the community for pastors
CPE or continuing education resources for pastors
Death in the family
Dementia, onset, how to recognize
Dementia, caring for family members
Depression and suicidality
Disability, applying for social security disability
Divorce, remarriage, and “blended” families
Domestic violence/homicide risk
Foster care
Gay/lesbian/transgender „coming out‟
Grandparents or other extended family assuming primary care of children
Homeless ministries
Homicide survivors
Hospital visitation of parishioners, guide to facility expectations / security / clearance
Hospital visitation of parishioners, guide for visits
Immigrants, stress, adjustment
Intellectual disability [mental retardation] in adults / care provider issues
Jail/ Prison inmates / family members in jail/prison
Jail/ Prison inmates / guide to facility expectations / security / clearance
Juvenile arrests
Juvenile dependency / child protective services
Medical illness (acute)
Medical illness/disability (chronic)
Heart disease/stroke
Diabetes
Arthritis
Renal disease
Cancer
Head-injured, living with
Spinal cord injuries / Quadriplegic
Amputees
Mental illness onset – bipolar, schizophrenia, psychosis
Multi-generational households
Nursing care at home / hospice
Nursing care in a facility
Pastoral professional associations
Prescription drug abuse
Psychopathic personality / criminal behavior and its effects on family
Rape, date rape, or other sexual assault
School violence / bullying
Self-help vs. professional help, choices
Sexual abuse / risk of / prevention, in family, community, church groups
Sexual abuse victims, adults, in the church
Sexual abuse victims, children and adolescents
Special education, parents seeking for their child
Spiritual direction or mentoring vs. “therapy”, choices
Suicide risk
Suicide survivors
Tough love, for adolescents, unemancipated adults
Unemployment
War veterans / PTSD
Work place violence, risk of

Copyright is reserved on the above material(c) 2011, Ecumenical Catholic Communion