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Pastoral Care Switzer Exam
McAfee-Pastoral Care
28
Religious Studies
Graduate
02/06/2014

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Term
The Facilitative Conditions of the Helping Relationships
Definition
1. Empathy
2. Respect
3. Concreteness
4. Genuineness
5. Self-Disclosure
6. Confrontation
7. Immediacy
Term
How do we help in a situational crisis? Part 1
Definition
Contact:
1. Establish the relationship.
2. Identify the presenting problem and the precipitating event.
3. Assist catharsis.
4. Build hopeful expectation.
Term
How do we help in a situational crisis? Part 2
Definition
Focus:
5. Explore the present situation.
6. Identify the threat.
Term
How do we help in a situational crisis?
Part 3
Definition
Cope:
7. Inventory problem-solving resources.
8. Assist in decision making.
9. Emphasize relationships with others.
10. Summarize new learning.
Term
Guidelines for ministry in hospital emergencies. (arrival and patient visitation)
Definition
1. Unless we immediately see the family members and/or friends in the ER or the ICU, make way to triage desk/nurses station, identify ourselves, state who the patient is, ask for info, if we can see the patient and where the family is.
2. In the room, tell the ill/injured person we are there, give our name, state that we are the pastor/representative,touch the person appropriately if possible, express concern, give very brief prayer.
--always check before going back to visit
-brief visits, if aggitation is noticed conclude visit with appropriate comment very brief prayer and then inform nurse/doctor
Term
Guidelines for ministry in hospital emergencies. (Family and medical staff)
Definition
1. upon seeing family, express genuine reaction
2. "how are they doing?" (respond with empathy)
3. "tell me what happened."
(chronological order not important)
4. pray (after getting the details) "I would love to pray, but first, tell me what's happened."
--pastors can often be around the patient when the family can't, can provide quick updates to family before the doctor can, help clarify the doctor's words
Term
Views about the stages of dying and reflections on them: Elizabeth Kubler-Ross
Definition
Stages:
1. Shock and denial--Not me.(It can't be true.)
2. Anger-- Why me? (Rage, resentment; envy of those not dying).
3. Bargaining -- It's me, (but if you'll... then I'll..).
4. Depression--It's me. (What's the use?)
5. Acceptance --It's me (and I accept it).
Contributions: made society more aware of dying, presented dying as a process, offered a model of relating to the dying
Reflections: should not take the stages too literally and rigidly
Term
Views about the stages of dying and reflections on them: Hinton
Definition
Depression present throughout, increases during the last two weeks.
Anxiety is present, also increases during the last two weeks.
Denial operating throughout the process in 60% of patients.
Term
Views about the stages of dying and reflections on them: Weisman and Kastenbaum
Definition
-noticed that some patients did not withdraw from daily activities and become inactive but instead initiated new activities and relationships
Term
Views about the stages of dying and reflections on them: Switzer
Definition
"there does seem to be a process of dying, no particular set of stages has been satisfactorily identified, individual variances within the stages if we could identify them"
Term
Needs of dying persons
Definition
1. Expressions of Feelings.
2. The Overcoming of Loneliness
3. That One's Life Has Been Meaningful
4. To Find Meaning in the Present Moment.
5. To Continue to Feel Useful.
6. The Need to Maintain Some Control over One's Life.
7. The Need for Consistent Messages.
8. Spiritual Needs.
9. The Need to Let Go of Life.
Term
How we can help family members of dying persons
Definition
1. assist the family in accepting the reality of the situation
2. assist in facilitating the family's own anticipatory grief (understand reactions of fear, anger, guilt, grief, conflicts, how their reactions affect one another).
3. help the family understand the dying person more fully
(help family members understand how important it is to bring their relationships up to date)
4. play some role in the family's first reactions to the death itself (possibly relief)
Term
Dynamics of Grief:
Definition
1. Anxiety (primarily separation anxiety)
2. Sorrow (an empty space that cannot be filled)
3. Other Feelings: (anger, overt and realistic fears, relief, sense of loss of control, confusion)
Term
Process of Grief:
Definition
1. Numbness and Denial
2. Yearning
3. Disorganization and despair
4. Reorganization of behavior
Term
Guidelines for responding to the threat of suicide:
Definition
1. Be Alert
2. Don't Flinch
3. Be Willing to Ask Questions
4. Always Take Suicidal Language Seriously
5. Be Capable and Willing to Discuss Issues of Faith
6. Be Able to Make a Relatively Accurate Evaluation of Lethality Potential
Term
9 Criteria to Evaluate Lethality Potential (Guideline Number 6)
Definition
1. Age and Sex (Older, male, white most likely)
2. Suicidal Plan(how thought out is the plan)
3. Contemporary external threatening events and situations.
4. Symptoms-voices, addicts, clinically depressed, hopelessness
5. Resources
6. Lifestyle- stability, good relationships, previous attempts
7. Degree of Communication
8. Reactions of significant others
9. medical status
Term
Pastoral Responses to the person who has attempted suicide:
Definition
1. What were you feeling just before you took this action?
2. What were you thinking just before and as you took this action?
3. What did you want to happen?
4. What were your experiences which led you to that point?
5. What seemed to stand in the way of your calling on someone for help right at that time?
6. What were your feelings about various family members and other significant persons?
7. After you had committed the act, did you imagine being rescued? If you did, what do you suppose that meant?
8. How do you feel about being alive right now?
9. What would you like to see happen from this point on?
10. How may I help in this?
Term
The Process of Divorce (stages and points of crisis) Part 1
Definition
Stages
1. The sense on the part of one or both partners that something is wrong with the marriage. Usually no significant action is initiated.
2. Usually one spouse finds the situation intolerable, may consider divorce, may discuss his or her feelings with someone.
Crisis (during the first 2 stages)
1. Making the Decision about divorce. Challenge to one's self-concept, additional tension in relationship with spouse.
Term
The Process of Divorce (stages and points of crisis) Part 2
Definition
Stages
3. Any efforts made toward reconciliation fail and the decision to divorce becomes clear. Both spouses are now aware of the process of the decision.
4. Initiation of legal proceedings and self-doubt, questioning, numerous other strong feelings.
Crisis during these 2 stages
2. Clear cut decision for divorce. Beginning of legal proceedings. Usually involves separation.
Term
The Process of Divorce (stages and points of crisis) Part 3
Definition
Stages
5. Gaining the final decree.
6. Readjustment to being single again.
Crisis during the final 2 stages
3. Post-divorce adjustment. Grief reaction with its several stages.
Term
Limitations regarding referral
Definition
We are limited by:
1. who we are as persons.
2. by our training and our experience
3. by our time
Term
When to Refer (15 guidelines) 1-5
Definition
1. We simply don't understand what is going on with the other person, why the person feels or behaves as they do, even after talking to them.
2. We recognize that the person is psychotic or has a tenacious depression.
3. The person is suicidal or is making serious threats against someone else.
4. We suspect that the person may have some physical disorder,may need a physical examination, and/or may need medication.
5. A person is dependent on alcohol or some other chemical substance, including prescription drugs.
Term
When to Refer (15 guidelines) 6-10
Definition
6. It has seemed as this were a person appropriate to work with, but after a while we realize that no change is taking place;we're beginning to feel frustrated and we don't know what else to do.
7. We begin to be anxious too frequently with the person, consciously anxious or feeling ourselves usually being uptight.
8. We find ourselves beginning to shut the person out emotionally.
9. We feel unconsciously afraid because the person appears to be dangerous to us.
10. We feel angry at the person and aren't clear as to the reason.
Term
When to Refer (15 guidelines) 11-15
Definition
11. We are sexually attracted to the person to the degree that our attention to him/her as a distressed human being is consistently disrupted and our helping responses are compromised. 12. We want to take care of everything for the person and are not really helping the person to begin to be responsible for him/herself. 13. We want to guard our relationship with the person and not let anyone else participate in significant helping with her or him. 14. The situation is primarily a family problem and the family pattern of interaction is complex. 15. We begin to see that, even if over a period of time we may be qualified to help, to do so effectively with this person or this family or in this type of situation means too much of our time and energy in the light of our other important responsibilities.
Term
Signs of psychosis
Definition
1. delusions (usually of extreme suspicion, persecution, grandiosity, or references to the body (I am Queen Elizabeth, have no body))
2. Hallucinations:seeing, hearing, smelling, or feeling things that are apparent to no one else.
3. fairly extreme withdrawal
4. not speaking at all
5. uncharacteristic hyperactivity and inability to sleep
6. saying outrageous and uncharacteristic things
7. breakdown of usual rational thinking process
8. loss of control, impulsive actions
9. talking without usual ability to logically connect with previous statements
10. flood of words with no structure, interrupting oneself and saying something else entirely
Term
Signs of Clinical Depression:
Definition
1. A rapid increase or decrease in appetite or weight
2. excessive or insufficient sleep
3. low energy level, tiredness, easily fatigued
4. psychomotor agitation and/or retardation
5. loss of interest and pleasure in usual activities
6. feelings of self-reproach and extreme guilt
7. decreased ability to think or concentrate
8. recurrent thoughts of death or suicide
Term
Barriers to Referral
Definition
1. living in a rural area/small town with few, if any, psychotherapeutic professionals (know of resources that are close by and relatively easy to access, have connections already set up)
2. when we ourselves do not want to refer (talk to our own counselor about what need of ours is causing us to not want to refer, and refer the client to someone else!)
3. When the person doesn't want to talk to anyone else (be firm in commitment to them as a pastor or friend but insist that you cannot help them but can refer them to someone who can help them).
Term
Two of the most important things any clergyperson can do upon coming to a new parish
Definition
1. find out what persons in the congregation are members of the helping professions, whether they are in independent practice or related to an agency, institution or program; get to know them personally and what their expertise is
2. discover as many as possible of the other community resources; get to know personally as many helping professionals as possible, visit agencies, make appointments to meet directors
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