Reflections on Lay Counseling as Service Learning

Lay Counseling Service Project

Context and Meaning of the Project:

The Service Learning Project I have chosen is actually something I have been involved with–in an increasing capacity–for quite a while. I do Lay Counseling at The Bridge Community Church network. My clients are women who have survived sexual assault and trauma and have been referred to me by a Pastor, elder, or church member who knows of my experience in this area. I set aside Tuesdays from 2-7 PM to meet with these women, hear their stories, and at times share a piece of my own story. I refer them to further professional counselors or therapists if the need arises. Typically, the church is a busy place on Tuesday afternoons and evenings, with pastors and staff coming and going, small group meetings and impromptu chats taking place in the halls. This is fortunate because at times, my clients need further assistance and the church members are happy to show love, kindness, and support. The lead pastor, small group leader, prison ministry leader and I have had some discussions surrounding how to further help these women and others who are in need of mental and spiritual support. We have also discussed the counseling model I use–based on the scripture found in Philippians, chapter 4–and how to train other Lay Counselors.
I cannot reveal the things my clients and I discuss due to privacy obligations, but many of them have found their voices by being unconditionally accepted and heard. Most of the survivors have never shared their experiences with anyone and have only come to see me because they are in despair. Their lives have taken an unexpected turn and they find themselves questioning everything about faith and the significance of life. Overwhelmingly, they feel unlovable and unloved by people and God due to their suffering. Some have experienced childhood abuses that bring tears to my eyes because they are unable to cry for themselves.
I began Lay Counseling at The Bridge as a restoration of the joy I found following resolution of personal pain and as an outgrowth of the addiction and reconciliation ministry Conquering Addictions (CA for short). Some of the CA curriculum addresses past abuse–including Child Abuse and sexual trauma–and the ways people continue to be influenced by their past.

• We respond out of who we have always believed ourselves to be, out of pain. 
• We tend to mistrust others and put up barriers against potential hurt. But when we build walls to shut out pain, we also shut out the joy of Christ. When we put up barriers against being wounded, we also shut out relationships and the chance to know grace and love.
• Women who have been sexually assaulted typically feel diminished self-worth and so have multiple relationships (or dysfunctional relationships) in search of value and acceptance. They may go through substance abuse and mental distress in various forms.
• By helping them see their inherent worth, dignity, and how much God loves them they find meaning and identity. By encouraging them to give voice to their anger and pain and grief–and ultimately release those things–, they find reconciliation and restoration; they find joy in a Father's love.

When I began this project, I made assumptions that everyone would react similarly, that everyone wanted to be mentally and spiritually sound and whole because they chose to come to me for counsel, but this is not the case.

• Some have been referred due to losses in life and yet they are unable to face truth or work through pain. 
• Some have come as referrals from a case worker at the Division of Family Services (DFS) because they have lost custody of their children, have no insurance, and know I will talk with them free of charge. Much of the time these clients do not want to be in counseling. They discuss all the ways society at large has mistreated them but they never truly look inward at the damage done to them, and the damage they do to others. They refuse to take responsibility for their actions and so do not desire help beyond legal means. I feel sadness that these clients vacate any true hope or healing because they choose to stay in addiction.
• My assumption–that everyone seeing a counselor wants counsel–proved to be untrue. The discrepancy occurred due to my own experiences with counseling...projecting my feelings and experiences and choices onto another. I brought a bias into the counseling room at the beginning of my Lay Counseling ministry, but I have since learned to step back and let ALL my experiences and wisdom provide a lens from which to view the client and the situation.

Experience Interpretation:
 In my Lay Counseling I use academic material from past nursing classes (such as the information I gained in writing a paper on Bipolar Disorder) and combine that with the knowledge I am gaining on community nursing.

• I am learning to look at the whole picture of the community and how the client fits into the community. 
• As I continue to be mentored by other professional counselors, I am able to see a larger scope for my gifts and ways they can be a blessing–or ways they can be abused and become harmful. For instance, I have become versed in all levels of confidentiality and privacy, not only for clients and their family members but also for other counselors. Some therapists do not want my clients to know they have given me advice while others welcome the sharing of information. My clients sign a form which states our conversations are confidential unless I feel they are going to bring harm to themselves or others, or if I feel their mental health problems need further consultation from a professional (either a therapist or pastor). I stay within a specific realm for my counseling and the clients and church staff understand this, so I have referred people to trusted therapists. The form also explicitly states I am an RN, not yet a Mental Health Nurse Practitioner and so am a Lay Counselor. 
• Learning how to "step back" and only give the personal information that will help a client is another aspect of respecting privacy and the client/counselor relationship. It is also another aspect of community mental health (MH) nursing. Ways to provide personal information and the amounts to share change depending on the setting: a seminar, a support group, a therapy group, or private counseling session.

Community Culture and Needs:
The mental health needs of a community are reflected more in a seminar or support group or through an organizational survey. When setting up a Lay Counseling service at the church, we looked at the needs presented through the CA group, through the needs of the county MH Board, at the needs of the people who contacted the leadership staff of The Bridge, and met with a group of therapists who were willing to answer questions we had.

• Part of community mental health nursing is coming up with both "upstream" and "downstream" solutions to issues. As one of the founding members of the county MH Board I saw ways to provide primary, secondary, and tertiary interventions. 
• Examples of primary interventions are mental self-care, abuse prevention, education on addictions and how to prevent the problem, compassion fatigue, and parenting classes. 
• The church is working on secondary and tertiary interventions through small groups (Cells) and CA. 
• A community's culture affects the mental health of its citizens, for good and ill. In a rural setting, many times women who are abused and sexually assaulted are bound by secrecy. Families are loathe to disclose problems and abuses within their circles. Appearances are extremely important in small towns, where relationships are extensive and social prestige or position are part of everyday life and identity. Learning of these extended relationships with the rural community assists the counselor and nurse to provide the best culturally sound care. 

Understanding small town culture and experiencing it:
Small towns many times are viewed from the outside as the epitome of American Life–with fewer problems and ills plaguing them than plaguing a city. Small towns are also seen as intellectually lacking and the citizens as less competent or educated; both of the premises are lacking in depth. Small towns are a microcosm of the city with health and illness, intelligence and ignorance.

• The differences in small town and city culture are often due to a lack of resources within the smaller community, not due to a lack of intellect or interest. MH resources have dwindled in the past few years, especially in rural areas, along with many other resources such as employment, food service and industry.
• Believing culture and diversity are only found in ethnic groups or diverse racial groups is a fallacy. By refusing to see the cultural diversity of small, rural communities we refuse creative solutions to their healthcare.
• As I work with women who have been assaulted I have seen similarities and differences in their culture and familial experiences. Rich or poor, well-known or obscure, they all come from families where they felt powerless and helpless. According to well-known therapist and author, Dan Allender: 
• "We were helpless to turn our families into places of warm, nourishing relationships.
• We had not true power to stop the abuse itself from happening; our abuser made sure that avenues of escape were blocked.
• We were and still are helpless to end the relentless pain our our soul" (Allender, 2008, p. 91, workbook).

The service I provide in mental health counseling is extremely rewarding. I have been with women as they broke the chains of silence, as they poured forth the poison of anger and resentment brought on by the shame of abuse and rape, and as they found the healing of the Great Healer. One young woman was so changed by the newfound grace God gave her, she literally went from darkness to light. She glowed, she shined, she was transformed so much so that at times people didn't recognize her. She was able to laugh and cry and share. She sees a meaning to her suffering and is now sharing her story...THE story...of how God has changed her life.

In my next blog I hope to expound on the mission of my university (Regis): "How ought we to live?" and discuss how it compares with the mission of The Bridge Community Church network. I will also analyze my actions in comparison with others' and what I discover weekly about myself when I meet with clients.

Reference:

Allender, D. B. (2008). The Wounded heart: Hope for victims of childhood sexual abuse. 

Colorado Springs, CO: NavPress.

Allender, D. B., & Lee-Thorp, K. (2008, revised). The Wounded heart: hope for adult victims of childhood sexual abuse, a companion workbook. Colorado Springs, CO: NavPress.