What do we learn from the professional field of Crisis Intervention, or Critical Incident Stress Management (CISM) that especially informs the work of pregnancy crisis intervention (PCI)?
Society’s attempt to understand human crises and construct models of intervention is a recent development within the broader field of psychology and counseling. In 1944, Gerald Caplan and Erich Lindemann were the first to analyze the dynamics of human crisis and publish a model of intervention. Ever since, the field of crisis intervention has grown apace.
In my research, I examined many books on crisis intervention. They begin with theory—understanding the human experience of crisis and introducing current approaches to crisis intervention. The rest is application. Each chapter focuses on a sub-specialty within crisis intervention. These typically include substance abuse, intimate partner violence, sexual assault, child sexual assault, suicide ideation, emergency response in the workplace/schools, military reentry, disaster response and more.
I have yet to find a book on CISM that deals with crisis intervention related to pregnancy. I wrote Pregnancy Crisis Intervention in part, to put us on the map professionally as well as to help us grow professionally.
I also reviewed textbooks endorsed by the National Abortion Federation which are used to train people in abortion. After all, the abortion business exists as a crisis intervention service. It’s important for us to understand how they train in terms of counseling women in a pregnancy-related crisis prior to abortion.
The first big takeaway from this research is affirmative in nature. All crisis intervention organizations started as a grassroots movement using volunteers. You may be confident that, in the main, our PHO movement is maturing along the same trend lines as all other crisis intervention movements. We are as professional if not more so, than any other crisis intervention efforts. And that includes the use of volunteers.
The longstanding (8th edition) textbook, Crisis Intervention Strategies, reports,
“To really understand the evolution of crisis intervention, though, is to understand that several social movements have been critical to its development, and these did not start fully formed as “crisis intervention” groups by any means. Three of the major movements that helped shaped crisis intervention into an emerging specialty were Alcoholics Anonymous (AA), Vietnam veterans, and the women’s movement of the 1970s. Although their commissioned intentions and objectives had little to do with the advancement of crisis intervention as a clinical specialty.”
Grassroots efforts always start with volunteers, then with experience, move to “trained volunteers.” From the same textbook:
“Contrary to the popular misconception that paid veteran crisis workers descend on a large-scale disaster like smokejumpers into a forest fire, most crisis intervention in the United States is done by volunteers. . . . Volunteerism is often the key to getting the fledgling crisis agency rolling. The use of trained volunteers as crisis workers has been a recognized component of many crisis centers and agencies for years.”
In other words, it is accepted practice within the field of crisis counseling for much of the work, including the main work of counseling, to be done by volunteers.
Further, it is accepted practice within the field of CISM to receive specialized, in-house training, and thereafter be referred to as “counselors.” This is common in drug/alcohol addiction, divorce recovery, military reentry, suicide prevention, and so on. Conversely, it is not true that crisis interventions services are worried that the word “counselor” opens them up to attack. “Counselor” is not a professional term within the field of crisis intervention the way “doctor” is within medicine. It means only that you have been trained and authorized by the agency to provide counseling in the field of crisis intervention that the agency exists to provide.
Further, as a crisis intervention movement matures, it does not outgrow the use of volunteers, or rely solely on licensed professionals as counselors. As George Everly writes in Assisting Individuals in Crisis, “Both mental health clinicians and peer support personnel may perform crisis intervention and CISM services . . . but specialized training is essential for both groups.”
This is the path we are on. As the Charlotte Lozier Institute reports,
Pregnancy centers rely upon a high percentage of community-based volunteers to operate and provide client care on many levels. Nine in 10 people involved at pregnancy centers are volunteers engaged in client consultation and education, reception, fund raising, center upkeep, and accounting. In addition, licensed medical professionals from a variety of disciplines volunteer to fill needed roles with their expertise to improve the health of individuals and families in their community.
Volunteers who interact with clients are required to complete specialized training at centers and/or at the national level. e training focuses on integrity and quality of care, where honesty, compassion, and empathy towards clients are paramount.” (A Half Century of Hope: 1968-2018, Pregnancy Center Service Report, 3rd Edition)
You can be confident that you are a professional organization within the field of CISM if you use volunteers (and staff emerging from volunteers). Call them whatever you want, but train them well in pregnancy crisis intervention. As research, experience and resources develop, help your team identify themselves as specialists within the field of crisis intervention.