Effective Referrals/Brief Therapy/Pastoral Diagnosis

1. Effective Referrals/Brief Therapy/Pastoral Diagnosis Broadening our Repertoire of Caring Resources in Parish Ministry Fr. Stephen Hrycyniak

2. Effective Referral? • Extending your existing relationship to help find another resource • For a referral to “take” requires the person to believe that you value the resource • Allowing oneself to be referred involves trust • Known resources are better than unknown • Be careful of dual-role relationships

3. Change and Complexity • In the past, one psychiatrist could serve as consultant, counselor, and write scripts • Seldom possible in current managed care environment • Need to create as wide a wellness network as possible • Need to be sensitive to funding issues • Medication & brief therapy preferred

4. Brief Solution-Focused Therapy • is a type of talking therapy that focuses on what clients want to achieve through therapy rather than on the problem(s) that made them seek help. The approach does not focus on the past, but instead, focuses on the present and future. The therapist/counselor uses respectful curiosity to invite the client to envision their preferred future and then therapist and client start attending to any moves towards it whether these are small increments or large changes. To support this, questions are asked about the client’s story, strengths and resources, and about exceptions to the problem. Some clergy are trained in this method of therapy/pastoral care

5. Understanding Pastoral Diagnosis • Existential Dilemmas • Developmental Dilemmas • Personality Formation Issues • Wounded Self—Psychosis • Conflicted Self—Neuroses • Disorders of Mood and Affect—Bi-Polar • Crises of Meaning

6. Obvious Reason to Refer • When we feel over our head • Tranference issues—placed on pedestal, romantic entanglements, hostility • Issues arising from within the priest—romantic feelings, unfinished business • Double-noticing—the importance of awareness regarding the dynamics of the pastoral exchange & interiorly

7. When other healing modalities are required • Genetic, biological, chemical, or neurological needs are in the forefront • Inpatient hospital care to detox due to severe addiction • Psychosis or serious suicidal potential • When persons are a danger to themselves or others • Need to understand mandated reporting

8. Concurrent Treatment and Pastoral Support • Movement toward interdisciplinary team modalities of comprehensive care • For example, a psychiatrist may help manage a parishioner medically, a therapist may help with intensive talk therapy, and the priest provides sacramental and spiritual support or even brief talk therapy, if properly trained • Need for continuing education of clergy in human development, sexuality, and supportive counseling modalities

9. Guidelines for Effective Referrals • Plant the seed early • Gather information • Discern the appropriate resource • Create a wellness network • Collaborate with parish nurses • Investigate community-based resources • Access the AAPC referral directory • www.aapc.org/directoryindex.cfm