: To provide the “companioning” model of care and strategies for pastoral trauma care at the immediate, intermediate, and long-term stages.
Victim Care: Issues for Clergy and Faith-Based Counselors
Overview of Victimization – Lesson Two
Access via http://FCPEI.denverda.org/Classroom/LessonTwo.html or Contact Steve Siegel – 720/913-9022
“Strong at the Broken Places” – Named by the Academy of Motion Picture Arts and Sciences as one of the outstanding documentaries of the year in 1999; available from Cambridge Documentary Films for $185; rental $50 per day; add $10 for shipping and handling. 617-484-3993.
Tragedy to Triumph: Hope Gets the Last Word – Finegan & Flannigan
Pages 65 –78 “Spirituality”
Trauma and Recovery – J. Herman
Chapter 10 “Reconnection”
Chapter 11 “Commonality”
(1) Divide the class into four small groups and assign each group one of the scenarios below. Ask them to discuss and then report to the class what they will do at the crisis intervention level and to anticipate what kind of trauma care might be appropriate at the intermediate and long-term care levels.
- The site is your faith community. Two days ago, divorce papers and a restraining order had been delivered to a battering spouse who is a member of your congregation. Today, before services, he followed his wife as she drove to your house of worship. As she got out of her car, he approached her and asked if she would get into his vehicle so they can talk. She did not want to make a scene, so she got in. Your worship service is now over, and he has returned her and driven off. She walks in, obviously bruised and battered.
- The site is your office. A woman in your faith community reveals to you that one of your elderly congregants recently told her that she had been raped a week ago. She says the woman is embarrassed and humiliated, so she has not called the police.
- The site is a hospital emergency waiting area where you have been called because one of your congregants was walking into work when she was struck by a co-worker who was apparently driving intoxicated in the parking lot. She hit her head against the concrete of the parking lot quite hard and may have some broken bones. The doctor has informed the woman’s husband that her head injury was more severe than he had originally thought and that his wife has lapsed into a coma. You are now alone with the distraught husband.
- The site is a vehicular crash on the street just beyond your faith community. The father of one of your congregation’s families had left home early to practice with the choir before service. He was hit broadside by a young man driving quite fast as he turned into the parking lot. You hear the crash and run to the street where you find the father, unconscious and bleeding. An ambulance arrives just about the same time, and an EMT tells you that you must move away so they can treat/transport the wounded man. As they are lifting him into the ambulance, you see the victim’s wife and children approaching the car. They do not realize that the victim is their husband and father.
(2) If you use the documentary, Strong at the Broken Places, divide the class into four groups and ask each group to pay particular attention to one of the four survivors (Marcia, Max, Michael, or Arn) and prepare to report to the rest of the class about the turning points in their lives that helped them reconnect with a positive life course.
Psychological First Aid
Psychological First Aid is a crisis intervention model that focuses on creating and sustaining an environment of 1) safety, 2) calming, 3) connectedness to others, 4) self efficacy/empowerment, and 5) hopefulness. According to the Center for the Study of Traumatic Stress, Psychological First Aid is intended to:
- Help people meet basic needs for food and shelter, and obtain emergency medical attention. Provide repeated, simple and accurate information on how to obtain these. (safety)
- Listen to people who wish to share their stories and emotions and remember there is no wrong or right way to feel. (calming)
- Be friendly and compassionate even if people are being difficult. (calming)
- Provide accurate information about the disaster or trauma and the relief efforts. This will help people to understand the situation. (calming)
- Help people contact friends or loved ones. (connectedness)
- Keep families together. Keep children with parents or other close relatives whenever possible. (connectedness)
- Give practical suggestions that steer people towards helping themselves. (self-efficacy)
- Engage people in meeting their own needs. (self-efficacy)
- Find out the types and locations of government and non-government services and direct people to services that are available. (hopefulness).
Psychological First Aid does not:
- Force people to share their stories with someone, especially very personal details. (can decrease calmness)
- Give simple reassurances like “everything will be okay” or “at least you survived."
- Tell people what they should be feeling, thinking or doing now or how they should have acted earlier.(decreases self-efficacy)
- Tell people why they have suffered by giving reasons about their personal behaviors or beliefs. (decreases self-efficacy)
- Make promises that may not be kept.
- Criticize existing services or relief activities in front of people in need of these services.
Faith leaders, faith-based counselors, victim advocates, and disaster and emergency responders work with people in the throes of personal disaster. They function in the role of advocating for victims, providing crisis intervention and psychological first-aid. Some are faith-based; some are secular-based. But all have the well-being of the victim foremost in their minds.
The goal of effective trauma care is not to “treat” or “dispense answers.” The goal is to walk with the victim as a trusted companion.i “Companioning” differs from “treating” in the following ways:
- Companioning is about honoring the heart and sole; it is not focused on the intellect.
- Companioning is about curiosity; it is not about expertise.
- Companioning is about learning from others; it is not about teaching them.
- Companioning is about being still; it is not about frantic movement forward.
- Companioning is about discovering the gifts of sacred silence; it is not about filling every moment with words.
- Companioning is about listening with the heart; it is not about analyzing with the head.
- Companioning is about bearing witness to the struggles of others; it is not about directing those struggles.
- Companioning is about being present to another’s pain; it is not about taking away the pain.
- Companioning is about respecting disorder and confusion; it is not about imposing order and logic.
- Companioning is about going into the wilderness of the soul with another human being; it is not about being responsible for finding the way out.
Models for companioning or helping are never clean cut, but for the sake of organization, this unit will be divided into three sections: (1) Immediate Care/ Crisis Intervention, (2) Intermediate Care, and (3) Long-Term Care.
Immediate Care/Crisis Intervention
In the late 1980’s, Bard and Sangrey applied what was known about crisis reaction to victims of crime and defined crisis as “a specific set of temporary circumstances that result in a state of upset and disequilibrium, characterized by an individual’s inability to cope with a particular situation using customary methods of problem-solving.”ii They identified three stages of crisis reaction: Impact, Recoil, and Reorganization.
Today, after many more years of research, most would agree that intense emotional reaction to traumatic events is not indicative of pathology but is a natural reaction to abnormal events. Not every traumatized person wants or needs professional help. Some are resilient enough to be able to handle it themselves, and many more will rely on their own family and community networks for support. Crisis interventionists are urged to tread lightly so as not to disrupt these natural healing and supportive networks in the interest of rescuing the individual.iii
A commonly-recognized model of crisis intervention, proposed by the National Organization of Victim Assistance (NOVA), includes three components: 1) Safety and Security; 2) Ventilation and Validation; 3) Preparation and Prediction.
Other than emergency professionals, faith leaders are the only profession that society acknowledges as having the right to immediate access to persons in distress. Faith leaders are granted access to victims and their families in hospital emergency departments and at funeral homes. Unlike other professionals, they are expected to visit members of their faith communities in their homes.
As noted above, the immediate needs of traumatized victims are safety and security. Nothing will help a victim until he or she knows that the threat of personal harm has passed. This may mean helping a victim move away from a dangerous crime scene, calling “911” for emergency services, offering the victim a cup of water or a blanket, or making a telephone call to a loved one. It is not a one-size-fits-all strategy. Simply try to get the victim what he or she wants. Faith leaders and pastoral counselors should not assume decision-making authority unless the victim is unable to do so.
Beyond the immediate crisis, provision of safety can mean referral or transportation to a domestic violence shelter or a rape crisis center. When the crime has been committed in the home, whether by an intimate or a stranger, the victim may prefer to spend the night, or several nights, in a hotel or other place that is safe. As these strategies help the victim restore the sense of physical safety, they also begin to enhance emotional safety.
Once physical safety is assured, giving choices and honoring those choices may be the next step to restoring empowerment. Faith leaders and pastoral counselors are in an excellent position to provide emotional and psychological safety of victims. They represent authority and status. Their very presence represents a restoration of control in the midst of chaos. Whether perceived as a direct representative of God or as a person with authority, or both, faith leaders can help a traumatized person feel that a safe, parental-type person is now standing with them in their suffering and will use their authority to make things better.
Sensitive and compassionate death notification is another form of providing a sense of emotional and spiritual safety following a homicide or suicide. When a death notification is to be delivered, the clergy who shares the task with the law enforcement officer or physician brings a spiritual perspective to the tragic moment by his or her presence, even if the word “God” is not mentioned. Some families want prayer; others don’t.
Faith leaders, along with funeral directors, are perceived as caretakers of the body following a death. No matter how assured the survivors feel that their loved one’s soul or spirit has gone to God, they remain strongly attached to the body. Faith leaders and pastoral counselors can work with hospitals, medical professionals, and funeral directors to see that the family’s wishes regarding the preparing and viewing of the body, and other matters are honored. Faith leaders also are viewed as keepers of rituals. These rituals can begin to restore meaning in the aftermath of a tragedy. This includes special prayers and religious rituals, death rites, and guidance through the funeral and burial.
Components of Crisis Intervention
Many crisis intervention strategies involve two major components
1) Ventilate and Validate
2) Prepare and Predict
1) Ventilate and Validate:
The “Ventilate and Validate” component of crisis intervention refers to providing victims with the opportunity to talk about what happened to them – when or if they choose. Trauma specialist, Marlene Young states:
“Because of the role of dissociation at the time of the experience, many people who have been traumatized may remember only fragments of the experience and those fragments are associated with immediate recall of sensations, images, and affect. They are not encoded into narratives or language. Therapeutically, helping such a person find words can help them begin to deal with the terror, moving it from a sensation to a concrete experience that can be tackled. When the emotional response can be tolerated, then words can come. When the problem is known and can be named, it becomes less terrifying.”iv
At this early and vulnerable time, answering open-ended questions may be impossible. Specific, closed-ended questions, however, can help a victim to begin to talk about their experience and feelings:
“When did this happen?”
“Where were you when it happened?”
“Who were you with?”
“What do you remember seeing, hearing, smelling, touching, or tasting as the time?”
“What did you do?”v
From the conversation these questions generate, other follow-up questions may facilitate a victim’s recall. The questioner should always speak in a controlled and calming voice, and keep facial expressions or follow-up questions supportive. Natural emotional reaction is fine, but the questioner should not over-react. Some victim reactions may seem to be uncharacteristic, explosive, expressive and urgent, threatening, remorseful and guilt-laden, sad and tearful, or even self-destructive. It is tempting to “cut off” or discourage these intense reactions. In addition, some of the language may not harmonize with a spiritually-oriented crisis responder. However, at this stage, all of these reactions should be acknowledged and validated unless actual physical harm to oneself or others is attempted.
Here are a few important things to remember when providing crisis intervention:
- Listening and agreeing are not the same. You are called to listen, not to agree or disagree.
- Because of the nature of certain crimes and various cultural taboos about touching, particularly between the sexes, physical touching may not be appropriate. Never touch a victim until permission has been granted.
2) Prepare and Predict
“Predict and Prepare” in crisis intervention refers to the action of giving victims information that will help them anticipate and, thereby, emotionally and logistically prepare for what is to come. Crisis responders can help normalize a victim’s reactions by assuring him or her that they are having normal reactions to an abnormal situation. Depending on the victim’s frame of mind, they may be given a list of common trauma reactions, as long as they are not told that they should expect these reactions. In other words, it should be presented as descriptive, not predictive. Some may not experience any of them. But for those who do, it is helpful to know that they are normal.
This course includes a unit on the Criminal Justice System which may be instructive in helping a victim to anticipate the role of the justice system. At the crisis intervention stage, the next step in the process needs to be explained to the victim, for example;
- An investigator will ask the victim to describe exactly what happened so the law enforcement agency can apprehend the offender and, if the case goes to trial, so the prosecutor will have the evidence they need to prosecute. Especially in cases of rape, domestic violence, and child abuse, medical evidence must be collected. Crime scene photos and photos of injuries are usually taken.
- Following a homicide (and some suicides) the body must go to the Medical Examiner’s Office for autopsy before it is taken to a funeral home. Again, this is required to collect medical evidence of how the death occurred. Some survivors want to view their loved one at the Medical Examiner’s office rather than waiting for funeral home viewing. Most Medical Examiner’s Departments now allow this; however, it is important for someone from that department or a support person to view the body first and describe to survivors what they will see. They should be offered the opportunity again to decide whether to view once they have this information.
- It is important for many victims to know if and when an alleged offender is apprehended and placed in custody. The faith leader or pastoral counselor may be able to serve as an intermediary between the law enforcement agency and the victim in letting them know when this occurs. At this point, victims should also be informed that, under the concept of “innocent until proven guilty,” most offenders are released on bail or bond unless the court finds that they may attempt to flee or may further endanger the victim or the public.
Community Crisis Response
Following community disasters, a number of national crisis response teams stand ready to deploy to locations to provide crisis intervention assistance. Particularly since 9/11 many states and communities also have crisis response teams. Faith leaders and pastoral counselors participating in these efforts are required to undergo special training and should not simply “show up” at a community disaster and expect to help. It is helpful to investigate crisis intervention models to decide which model suits a particular style and community profile.
Crisis Response Models include:
CISD teams - Critical Incident Stress Debriefing Teams affiliated with the International Critical Incident Stress Foundation founded by Jeffery Mitchell. CISD is only used with homogenous groups of people who work on a disaster together.
NOVA Crisis Response Teams - National Organization for Victim Assistance crisis response teams consist of service professionals from all over the country, typically including mental health specialists, victim advocates, public safety professionals, and members of the clergy, among others.
Red Cross disaster mental health teams - Mental health services help people affected by disaster by providing crisis intervention, mental health screening and assessment, emotional care and support, referrals, advocacy, mediation, consultation, psychosocial education and psychological triage. The Red Cross requires a mental health license to participate in their program.
Intermediate crisis care is initiated approximately forty-eight hours after the victimizing act and may extend up to several weeks. After the immediate medical response has been completed, initial law investigation interviews have concluded and, in cases of homicide, the funeral has taken place, the greater emotional and spiritual aspects of victimization can surface. For some victims, the intensity of emotional reactions steadily declines; for others the passage of time allows it to deepen and broaden. Through this process, faith leaders and pastoral counselors can become the “backbone” of companioning victims, particularly if the relationship has already been established, if the victim trusts his or her spiritual caregiver, and if the spiritual companion has been trained in trauma reaction and care.
Faith leaders and pastoral counselors will want to reach out to their own faith community members who have experienced criminal victimization rather than waiting for the victims to approach them. A victim simply may not feel like initiating a phone call, may be overwhelmed with the details and procedures of processing their victimization, and may need someone in a caring position to initiate contact with them. It is very easy to resort to isolation in the aftermath of victimization to attempt to ameliorate guilt, shame, hurt, and pain. The empathy and assistance spiritual leaders can offer can be an important element in successful recovery.
Victims can experience such despair in the aftermath of violence that they may imagine ending their lives.vi Victims often feel a sense of relief when the faith leader or pastoral counselor asks whether they ever have such thoughts. If they do have such thoughts, have been close to someone who committed suicide, and have a plan and the means to carry it out, the spiritual companion needs to consult with medical or mental health professionals. Consultation is necessary because few faith leaders and pastoral counselors are trained to assess suicide ideation. If suicidal issues are involved, these must be addressed before any further helping strategies are used.
Another important strategy is to inquire about the extent to which victims are re-experiencing memories through nightmares, panic or anxiety attacks, or flashbacks. Insomnia can be a symptom of PTSD, depression, or both. If victims are not able to manage these intrusive symptoms of trauma, they should be referred to mental health professionals with expertise in trauma intervention.
Absent disabling traumatic stress, faith leaders and pastoral counselors may be able to teach victims effective breathing exercises and other relaxation techniques to help regain a sense of equilibrium and control. These techniques can relax muscles, lower blood pressure and pulse rate and help to manage a panic attack.
Spiritual practices, such as prayer, can help victims cope with flashbacks and sudden anxiety. Roman Catholics may find it comforting to say the prayers of the rosary. Those with strong liturgical traditions may recite daily prayers that have been comforting to them communally or individually. Meditating on the Psalms in Hebrew scripture can be a powerful resource for expressing a range of feelings. Religious texts set to music may help victims let go of anxiety and access other feelings. Daily devotional readings available through denominational traditions are helpful to some.
Victims can explore and reflect upon the effect of their spiritual and religious practices more effectively if they trust their faith leader or pastoral counselor not to impose religious and spiritual practices and interpretations upon them. Victims who have grown up in faith communities where they were told what to believe and how to practice their faith may cast the faith leader in the role of God’s spokesperson. This role should be resisted. The goal is for a victim to construct religious meaning and spiritual practices that are personally relevant.
In exploring the use of spiritual or religious practices, spiritual companions and victims must evaluate together whether such practices are effective in lowering anxiety and alleviating the numbness and emotional disengagement resulting from violence. If not, referral is the next step.
Some victims continue to experience traumatic stress reactions long-term. For those suffering severe trauma, or numerous complicating aspects of trauma, its resolution is never final; recovery is never complete. It is impossible to forget what happened. Even in the best of circumstances, most victims mourn the old self that trauma destroyed and must begin to develop a new self, a new normal, which incorporates the traumatic experience into it.vii
This aspect of trauma care makes it important to avoid words like “recovery,” “healing,” “getting over it,” and “closure” because they place unrealistic expectations on victims that they cannot achieve. Time does not “heal all wounds.” Wounds do get better, but the deeper the wound, the greater the scar. In Jewish mourning practice, the clothing of the mourners are torn as they “sit Shiva” for several days following the burial of their loved one. After that, the patch is sewn back on the garment to represent the fact that, while life goes on, it is never the same. Hitting an old wound or a scar still produces pain, even though it may not be as severe as an open wound.
Following are some common negative behavioral changes that can be addressed in long-term care:
- Becoming over-controlling and rigid out of a need to control the environment or others;
- Regression to traits or life patterns central to previous life stages;
- Faulty management of tension or stress;
- Inability to retain or initiate relationships;
- Avoidance or withdrawal from new challenges.
Spiritual reconstruction also is a common need of victims that can be accomplished only with significant time and effort. Too many faith leaders are eager to offer a quick fix or answer for deep spiritual dilemmas that can be resolved with spiritual integrity only over time.
Victims of violence return over and over again to the question of why. “Why did violence happen to me?” “Why this suffering?” For many victims, the “why” questions have more to do with feeling powerless and not being able to prevent what happened than with actually seeking a definitive answer to the question.viii Victims may attribute the cause of violence to many circumstantial aspects of their experience, tending to blame themselves rather than feeling powerless. For example, a woman may blame herself for being “in the wrong place at the wrong time” when a stranger assaulted her. A date rape victim may feel that she was at fault for “going too far” with sexual intimacy before she said “no.” All too often, family and friends reinforce these messages as a way of assigning blame and imagining that they would have handled the situation differently. This unrealistic self-blame should be explored by spiritual leaders as they gently guide the victim to be more realistic about her ability to thwart the determination of the offender.
Unfortunately, some religious beliefs and faith communities reinforce self blame. Whereas guilt involves assuming responsibility for actions that one identifies as wrong, shame is an overall feeling that one is a bad or unworthy person. Shame is one of the emotional reactions to violenceix that comes with the dehumanizing dynamics of violence, an experience in which the victim’s basic dignity as a human being is violated.x
Perpetrators of violence do not recognize their victims as unique, worthy of respect. With such deep disregard and dehumanization comes shame: the internal sense of being “less than human.” How victims make sense of such shame depends to a great extent upon the immediate support they receive and their past religious and spiritual experiences.
When victims draw upon psychological and spiritual strategies that calm and center them, feelings of shame may begin to diminish. For example, an adult victim of sexual violence was able to learn to recognize feelings of shame associated with her body and sexuality and to identify when she was most likely to experience such feelings. She and her counselor explored many spiritual practices, like the use of massage with a massage therapist with whom she could share her feelings. She also discovered prayer centered yoga as beneficial. Using such practices, she was able, over time, to release the sense of shame that was part of her experience of sexual violence.
While spiritual practices and beliefs have the power to help heal shame, they can also be misused in ways that deepen shame. An essential task of pastoral counseling with victims of violence is to discuss whether their religious and spiritual histories have the potential to exacerbate shame. This history will come to light in the early stages of pastoral counseling when counselors and victims explore what religious and spiritual practices help them feel safe and calm. For example, a victim who was sexually abused by a priest may experience his Catholic upbringing as deeply shameful. Over time, however, he may be able to separate valuable aspects of his faith from his shaming experiences, and establish or re-establish a sense of connectedness with God.
Another response to violence is anger, which can be directed at self and/or others, including God. Anger toward self can arise out of shame and also out of blaming oneself for not having control over what happened. Anger, unlike shame, can be healthy, in that ultimately, it can lead to a search for justice. Anger becomes unhealthy when it is the only response to violence and it disconnects victims from others, from God, and even from themselves.
Especially for male victims, anger can fuel thoughts and feelings of vengeance and can mask feelings associated with vulnerability, like fear, sadness, and abandonment. The worst consequence of anger is that the victim’s anger over his powerlessness in the midst of violence becomes an intense need to have power over others in their interpersonal and familial relationships.xi Whereas men may be more likely to continue the pattern of violence by overpowering others, women with histories of violence may be more likely to continue to be victimized in their intimate relationships.
If the intense and compelling dynamics of anger can, over time, be managed through healthy coping strategies, victims can gain access to feelings often masked by anger, notably feelings associated with grief. Grieving the losses incurred by violence is a major task in the long-term process of coming to terms with violence.xii
Faith leaders, through worship service planning, can help victims, in the midst of grieving their myriad of losses, to draw upon their religious traditions. Religious symbols and rituals can empower victims to express the depth of their sadness, anger, or despair. For example, the Psalms of Lament and the Book of Lamentation can allow victims to express profound sorrow, rage, and despair in the presence of God and the community of faith, a presence that can be deeply comforting.xiii The songs of lament may be used by communities of faith at particular religious festivals or seasons, allowing victims to re-experience their losses alongside the stories of loss recounted from sacred texts. For example, a victim observing Christian traditions during Holy Week may remember the sense of betrayal that was part of her experience, and identify with Jesus, who was also betrayed.
It is important for faith leaders and pastoral counselors not to provide easy answers or to argue with the theological understanding victims may formulate. They need to empathize with victims by stepping into their shoes and imagining who God is for them. For example, some victims of family violence report that their faith leader told them that God wants them to stay in their violent relationships, that violence is the cross they must bear, and that if they bear this cross long enough, then their partners will change. It is tragic when the faith community provides this message as an “answer” rather than being sensitively attentive to their needs.
With appropriate support and the passage of time, many positive personal transformations can take place. Among them are:
- Redefinition of life goals;
- Increased flexibility in coping strategies;
- Increased tolerance of personal differences with others;
- Development of new understandings of spiritual or religious issues;
- Increased ability to communicate emotional responses and to express situational reactions;
- Replacement of helplessness and isolation with empowerment and reconnection.
Victim Impact Statement
As a result of legislative advocacy by many crime victims over the last two decades, victims now have the opportunity to offer a statement (Victim Impact Statement) during the sentencing phase of criminal court proceedings. Traditionally, the offender and those speaking on the offender’s behalf have had the right to speak to the court about why a lenient sentence or probation would be in their best interest. Now, victims also have the right to speak about the impact the crime had on their lives and the lives of their loved ones. These opportunities can be very cathartic, empowering, healing, and difficult. A willingness to accompany victims to court when they present these statements offers faith-based companions the opportunity to support victims and their families in a powerful way.
Victim Impact Panels
Victims in many communities also have the opportunity to participate in Victim Impact Panels. These panels are composed of victims who tell their stories before audiences of criminal offenders who are ordered to attend a Panel as a stipulation of their sentence. Sharing their stories with others gives victims the opportunity to prevent crime and promote community justice and empathy for victims. Also, by speaking in public about their experience, they feel connected to a power larger than themselves.xiv
One of the indications that a victim of a disaster is on the road to recovery is when they assign a meaning to their experience. Many survivors of crime develop a “survivor mission” by re-engaging in the world utilizing their experience to help others. They transform the meaning of their tragedy by making it the basis for social action. They seek commonality with others who have experienced similar tragedies, finding that the normalization of experiences is empowering as they determine strategies together to make the world a safer place.
Community education is a constructive tool that helps victims, their loved ones and communities.
Development of Referral Resources
Connecting victims of crime with the resources specifically designed to help them is a crucial aspect of ethical pastoral care. Create opportunities to develop trust and collaboration between yourself and members of your local domestic violence program or shelter, your local rape crisis program, law enforcement victim assistance providers, as well as other groups that advocate for victims of crime.
iHerman, J. (1992). Trauma and Recovery. New York: Basic Books; Wolfelt, A. (1998). Companioning vs. treatment. The Forum Newsletter. Association of Death Education and Counseling, 24. (pp 4-6).
iiBard, M. & Sangrey, D. (1986). The crime victim’s book (2nd ed.). New York: Brunner/Mazel.
iiiGist, R. & Devilly, G.J. (2002). Post-trauma debriefing: The road too
frequently traveled. Lancet, 360, 741-742; Gist, R., & Lubin, B. (Eds.).
(1999). Response to Disaster: Psycholosocial, Community, and
Ecological Approaches. Philadelphia: Brunner/Mazel; McNally, R.J.,
Bryant, R.A., & Ehlers, A. (2003). Does early psychological intervention
promote recovery from posttraumatic stress?” Psychological Science in the
Public Interest, 4,4, 45-79.
ivYoung, M. (2002). Community Crisis Response Team Training Manual: Third Edition. Washington, D.C.: National Organization For Victim Assistance. (pp. 2-36).
vIbid. (p. 4-8).
viPretzell, P. W. (1990). Suicide (Ethical Issues); Suicide (Pastoral Care); Suicide
Prevention. In Hunter, Rodney (Ed.), Dictionary of Pastoral Care and Counseling (pp. 1233-1235). Nashville, TN: Abingdon.
viiHerman, J. (1992). Trauma and Recovery. New York: Basic Books.
viiiMeans, Jeffrey J. (2000). Chapter 7. Trauma and evil: Healing the wounded soul. Minneapolis, MN: Fortress.
ixRamsay, N. (1991). Sexual abuse and shame: The travail of recovery. In Maxine Glaz & Jeanne S. Moessner (Eds.), Women in travail and transition: A new pastoral care (pp. 109 - 125). Nashville, TN: Abingdon; Means, J. (2000). Chapter 7. Trauma and evil: Healing the wounded soul. Minneapolis, MN: Fortress.
xCooper-White, Pamela. (1995). The cry of Tamar: Violence against women and the church’s response. Minneapolis, MN: Fortress.
xiPoling, J.N. (1991). Chapter 4. The abuse of power: A theological problem. Nashville, Abingdon; Poling, J. N. Chapter 6. Understanding male violence: Pastoral care issues. St Louis, MO: Chalice Press.
xiiMeans, Jeffrey J. (2000). Chapter 7. Trauma and evil: Healing the wounded soul. Minneapolis, MN: Fortress.
xiii19 Billman, K. & Migliore, D. L. (1999). Rachel’s cry: Prayer of lament and rebirth of hope. Cleveland, OH: United Church Press.
xivMercer, D. (Winter 1999). Victim impact panels: A healing opportunity for victims of drunk driving crashes. MADDVOCATE, 8-9.