Setting:
A community counselling service operated by the Freedom Christian Community Church.
Client:
- Spiro, a 24 year old, who lives alone in the community. He was diagnosed with schizophrenia in his late teens. Spiro is an “on again, off again” member of the Freedom Christian Community Church.
Protagonist:
- Thea, a social work graduate, who has been employed by the Freedom Christian Community Fellowship to act as a coordinator, trainer and professional influence in the church’s volunteer-based counselling service.
Stakeholders:
- Pastor Koffken: Pastor of the Freedom Christian Community Fellowship for more than 10 years; he “grew” the church from a tiny assembly of 10 people to a thriving social and spiritual hub.
- Arthur P Wilkes: Church elder and lay counsellor.
- Jonathon: Specialised mental health nurse from the Adult Mental Health outreach service; Spiro’s caseworker.
- Mick: Rehabilitation counsellor, working with Spiro to enhance his independent living skills, employment options and social support, etc.
Thea stared at the phone and groaned. She had just spent more than 45 minutes in a long and heated discussion with Jonathon, who seemed like a good guy but… well, he could get very passionate about his work.
Things were not going according to plan. For years, Thea had worked for a few hours each week as a volunteer in her church’s counselling service while she completed her degree. She had felt that the church, and the counselling service, could make a real difference in the local community- a place which was, in her experience, both materially and spiritually impoverished (though she knew “significantly behind the norm in all significant socio-economic indicators” was a more acceptable way of phrasing it). She should know- she grew up there.
For this reason she had identified funding sources, prepared submissions, and sought the support of the church board so that the counselling service could be properly funded with a professional coordinator and housed in a shopfront in a local mall. It was with a mix of pride and trepidation that she then accepted the position she now held… it seemed like the culmination of a long term dream that her professional, personal and spiritual values could come together to really make a difference.
This made Jonathon’s call all the more difficult. Jonathon identified himself as Spiro’s caseworker. Thea knew Spiro as a troubled and brooding young man who attended her youth group. He would attend diligently for months, and participate enthusiastically in church activities and services- then disappear from the face of the earth, only to resurface a month or so later. As far as Thea could recall, this pattern was established over a couple of years.
Now she knew why. Jonathon had informed her that Spiro had schizophrenia, and, during his worst times, Spiro was unable to function in the mainstream community. He was prone to intrusive delusions and crippling paranoia, and, when he was unwell, he would usually sit alone in his tiny unit staring at the walls until a neighbour or family member arranged for him to be admitted to hospital. Over the last few years, his “episodes”, hospitalisation and treatment had fallen into a predictable cycle.
In hospital, Spiro was responsive and insightful. The hospital staff would assist him in understanding his illness and maintaining compliance with treatment (both medication and regular psychotherapy). Balanced, settled, and strong, Spiro would be discharged from hospital.
Within a few weeks Spiro would resume his friendships, supported employment, and social activities. The central pillar of his social world was the church community. Once he returned to church (looking well and coping well), he would start attending counselling with the service, seeing the same counsellor- Arthur Wilkes- each time.
Thea remembered Arthur as a likeable, sociable gent in his 60s who was one of the members of the church board who supported her submission for funding for the counselling service and who personally encouraged her to apply for the coordinator’s position.
According to Jonathon, Arthur would, with disturbing predictability, counsel and support Spiro to go off his medication. With faith, support, and the grace of God, Arthur maintained, Spiro could overcome his illness and find a way of living free from psychoactive drugs and psychiatrists. Spiro, feeling strong and confident, would invariably follow Arthur’s advice.
After a few weeks of “success”, celebrated and encouraged by Arthur and other members of the church, Spiro would start to become unwell. Neither Arthur nor anyone else would see Spiro in the long, lonely days in his empty room, as his mental health deteriorated and his illness asserted itself.
This was when Jonathon would be called to pick up the pieces, to assess Spiro, take him to hospital, and start the cycle again.
Only this time, things hadn’t taken the same course. Spiro, after release from hospital (and in a seemingly lucid and rational state), had made a suicide attempt. He was in hospital again and Jonathon was refusing to support any discharge plans until Thea could guarantee that she would prevent any further contact between Arthur and Spiro. Furthermore, Jonathon was threatening to contact the counselling service’s funding bodies and report that the service was ineffective (at best) and downright dangerous (at worst).
Thea had also spoken to Mick, a rehabilitation counsellor who assisted Spiro with day-to-day living skills. Mick had found Spiro unconscious after a massive overdose and called an ambulance. Mick was tearful and distressed, blaming himself because Spiro appeared to be in great mental health the day before the suicide attempt. Mick had always praised the role that the church played in Spiro’s life, seeing it as an anchoring social system which provided personal care and a strong sense of belonging.
Thea had also spoken with Pastor Koffken. The Pastor could acknowledge her concerns about Arthur’s counselling strategies, but reminded Thea that
- The approach was consistent with the teaching of the church- faith and hope were central beliefs and Spiro could overcome his illness with God’s help;
- She had been employed by the church because she shared their vision for the service; and
- Arthur was a church elder who had helped develop the counselling service and who was now the head of its management committee- he had a right to direct the style of service it offered.
Thea looked down at her hands and groaned again (louder this time, and with a deeper sense of dread). She felt like she didn’t know what she believed anymore. Pastor Koffken and Arthur were arriving in 15 minutes for a discussion about the service. What would she tell them?
