7 Step Emotional/Spiritual First Aid Model
1. “Holy Spirit, come!”
2. Meet basic needs
3. Listen (validate)
4. Normalize
5. Next step (what to expect)
6. Refer
7. Offer prayer
I. Step Number 1 - “Holy Spirit, come!”
A. Say this out loud – it rhymes! Adopt it as a lifestyle. Jesus only did what He saw His Father doing (John 5:19). Think about that - Jesus never responded to need. Neither must we. Get into the habit of stopping to ask God what He is doing before engaging in conversation with anyone.
B. Technically, this phrase is false theology, because Holy Spirit is already present before we arrive, and remains after we leave. We are asking Him to “come” with His manifest presence and direction, and open our eyes to what He is doing.
C. God always takes precedent over any model. He is the ultimate top of any chain of command – follow Him!
II. Meet Basic Needs
A. This step sets crisis response apart from “normal” ministry. It may not apply as much in personal crisis, but don't dismiss it. In the hierarchy of needs, people will usually progress from physical to emotional to spiritual needs.
B. In a disaster situation, we may be encountering people who are in physical or emotional shock, have had nothing to eat or drink, don’t have their medications, are upset because they can’t find their families, have just suffered great loss, etc. Unless God breaks in in an unusual way, they will not be able to engage in spiritual conversation until their basic needs are met.
C. We need to listen to God and to them to find out what their most immediate needs are – physical (water, food, medical attention, place to stay), emotional, mental, or spiritual. Bleeding is an immediate need. Spiritual injury isn’t always apparent. Maybe their most basic need is for you to offer to pray for their migraine – which you couldn't have known about if God hadn't told you, and that immediately shows God's loving concern for them.
D. Introduce yourself, ask their name, and use it. Look at them and assess what they may not have language for. Always protect their dignity.
E. Hysteria breeds hysteria, so if someone is loud and upsetting others, calm them down, or separate them from the others, as possible.
F. Basic needs will change as time elapses from the event. As the phases of disaster recovery unfold, the acute reactions to the crisis subside and more of the emotional and spiritual issues emerge.
III. Listen (validate)
A. Listening goes with Meet Basic Needs because you have to listen to discern what is needed first. Do not underestimate the importance of listening! Validate as you listen and use active listening – good eye contact, body posture, “uh-huh,” etc. Say, “I’m sorry for your loss,” or “I’m sorry to hear that,” or “Oh, how hard!” – or just remain silent while listening with your full attention. People get great healing and stress relief just in feeling heard by being able to tell their story, sometimes over and over again. Verbalizing helps our brains process things. Attuning to the person can actually prevent the person from being traumatized. This quote is from Dr. Karl Lehman about attunement: “...you have successfully received my attunement if you feel seen, heard, and understood, if you feel that I am with you in your experience, and if you feel that I care about you and that I am glad to be with you. ...the very short summary...is that when there is an attunement connection between them, vulnerable individuals, such as children, can temporarily share the neurological, emotional, and spiritual resources of stronger individuals. Now let’s put this together with the above discussion regarding how a painful experience only becomes psychological trauma if the person is not able to successfully process the painful experience. If any person going through a painful experience has safe, strong friends or family who are attuning to him – people who are truly with him in the experience, who are seeing him, hearing him, and understanding him, who are empathizing with him, who genuinely care for him, and who are glad to be with him – he will almost always be able to receive tremendous assistance from their attuned presence, this will almost always enable him to successfully process the painful experience, and he will therefore almost never be traumatized.”
B. Active listening includes paraphrasing and asking questions, but if their story doesn’t make sense, don’t question details, just keep listening – they may have some cognitive impairment. However, be alert for a level of confusion that may need medical attention (not oriented to person, place, time, and event).
C. It may become apparent that what they really need most right then is prayer for the peace of God that passes all understanding (Ph 4:7) or salvation. You do not have to wait for Step #7 to pray. They have no expectation of being touched by God when you pray, so if they feel anything at all, you have a wide open door. Go for it, or continue building relationship, or refer to someone else who has enough time or is more experienced. (Step #1) Usually, there has to be some level of relationship established before people are receptive to spiritual issues. We never know if we’ll see them again so we want to move into spiritual discussion as soon as possible, yet honoring the readiness of the person. They don’t care what you know till they know that you care. (Step#1)
D. People will often use spiritual language to express their distress – think of David’s laments – and cry out, “Why God?” or “How could a good God do this?” or some variation. It is not our job to answer for God, especially if it is a rhetorical question. Just because a question is asked does not mean we have to answer it, especially if it’s in the middle of a disaster event. Instead, deflect it by saying, “I am so sorry this is so hard for you right now,” or ask a question that requires a concrete answer, “Who can I call for you?”
E. If it is not rhetorical, our best answer is, “I don’t know.” (It’s really okay to say I don’t know.) If appropriate, we can continue by saying, “But what I DO know is…” that God loves them, is with them, they matter to God, etc. Avoid platitudes like it’s God’s will, it’s all for the best, etc.
F. Use discernment if their questioning is rhetorical, needs to be addressed, or is a crisis of faith, in which they are in danger of losing their faith. The amount of time elapsed since the event helps determine which is which.
G. Do not get into arguments or even theological debate, unless specifically directed by Holy Spirit. Do be ready to give an answer to the hope that lies within you (I Pet 3:15). To do that, you must have worked out your offense against God in advance and operate from a place of peace.
H. Be sensitive to cultural and denominational issues.
I. Above all, love well. Love as Jesus loves. He always listens and is always fully present with us (Dt 31:6, Mt 28:20).
J. Ask, “How are you holding up?” – empowers them by implying they are holding up, not falling apart. “How can I help you?” – trust their answer. “How are you doing?” not “feeling” – don’t go there unless it’s intentional. If they are overly anxious/emotional/ disoriented, ask questions that require a concrete answer to help ground them back into cognitive thinking – “Who can I call for you?” or “When is the last time you ate something?”
K. Validate, validate, validate. Validate how hard it is, how you can’t even imagine what they are going through, how anyone experiencing this would feel this way, how frustrating or difficult this is for them, etc. Validate the positive aspects of what they did to keep safe. But always be sure to move them into hope.
L. You don’t have to agree to affirm (psychological alignment).
M. They may need to ventilate – do not take it personally.
N. Do not give false hope or any assurance that isn’t absolutely true. (Don’t say, “It’s okay” when it’s not! Instead of, “I’m sure your child is just fine,” say, “They are working on finding your child.”) Never make promises you can’t keep, or take on responsibility that isn’t yours.
O. Don’t assume anything – ask. If they don’t want to talk, don’t force them, just be available, but do ask if they want company. They may not be traumatized. Or they may be too numb to process. Sitting in silence with them can be powerful. (Step #1) Isolating is different.
P. Sometimes it’s helpful to put things into words for them, giving them language they didn’t have, or give a menu selection (are you feeling this or that - i.e., angry or sad; are you upset because of how they treated you or because of the loss you experienced, etc.). Even if your suggestions don’t fit what they are experiencing, it can be helpful for them to know what they are NOT feeling. Be careful to never tell them how or what they are feeling.
Q. If appropriate, ask things like, “Did you get hurt or see others get hurt? How afraid were you?”
R. This is about them, not you. Do not bring your experiences into it unless specifically relevant, i.e. if you have lost a child and so have they, but NEVER say, “I know just how you feel.”
S. Don’t open up their emotions without returning to the cognitive/positive and helping them move forward.
T. Special gender note: men and women may differ in their definition of active listening, so guys, it’s okay to listen to a guy as a guy - if your grunt and quick nod makes the other guy feel heard, great. But validation usually requires words, and you must resist the urge to fix it. As hard as it may be, the point here is just to let them tell their story, without fixing it. Just be present and listen. Anyone who needs to fix it, male or female, must get their own healing first before ministering in crisis.
IV. Normalize
A. There is a very wide spectrum of what is considered normal response to a crisis situation. Normalization is very important; sometimes the assurance that I’m not going crazy or there's not something wrong with me makes all the difference. Normal vs common vs natural. “That makes sense” is a great response.
B. Post traumatic stress (PTS) is a normal person having a normal reaction to an abnormal event. Post traumatic stress disorder (PTSD) is a pathological version of that survival mechanism. Post Traumatic Growth (PTG) is a newly recognized growth process whereby you come out of a trauma better and stronger than before. (But James already knew it in Chapter 1: 2-4.)
C. Common signs of stress (this is one short list – please research lists online and educate yourself thoroughly)
1. Shock, anxiety, fear, panic, anger, denial, feeling overwhelmed, helpless, numbed out/shut down, outbursts, crying, guilt, depression
2. Poor concentration/memory/judgment, hyper vigilance, eat or sleep or have sex too much or too little, poor hygiene, confusion, flashbacks or intrusive dreams, escaping through drugs/alcohol/thrill seeking, etc.
3. Trembling, weakness, dizziness, nausea, fatigue, headache, rapid heart rate, high blood pressure, diarrhea or constipation, sweats/chills, aches/pain, mood swings (some need medical attention)
4. Feeling abandoned by God, hard to pray, can’t remember Scripture, no sense of purpose, apathy toward righteousness, loss of joy, hopelessness
D. Some of these signs can also indicate serious medical problems so when in doubt, seek help.
E. There is a natural “dumbing down” that happens (acute cognitive impairment), typically 4 school years less. The implication for children is they can lose achievements in speech or potty training, etc. This website has charts on helping children of all ages after disasters (scroll down) -
F. Survivor’s guilt is an irrational yet common feeling of guilt over surviving or being less injured than someone else.
V. Next step (what to expect)
A. Educate them on self care, going from the physical to emotional to spiritual. Self care is not self indulgence or self centeredness. Ask questions, like how are you sleeping? How's your appetite? Give practical instructions on how they can care for themselves such as do breathing and relaxation exercises, get extra sleep, eat healthy, drink water, avoid sugar, alcohol, caffeine, and junk food, be good to yourself, exercise, get support from family, friends, church, etc.
B. Anticipate and normalize what they might expect next. Educate freely. Give them a heads up on what common signs of stress are, or the stages of grief, or what they may experience later on. Give them permission to let down, but encourage safe and healthy choices. You may need to compassionately explain that things will never go back to normal, but with time, they will develop a new normal.
C. Empowering them to make small decisions restores a much needed sense of control. Conventional wisdom dictates that people in grief should wait before making major decisions, but sometimes in a disaster they need to pretty quickly decide whether to rebuild or move. In the acute stage, help them to develop a plan for the next 24/48 hours. For those who are disoriented or confused, a practical way to show the love of Jesus is by helping them to figure out what’s next. Offer strength for them to lean into, but don't make decisions for them.
- This is a good place to bring in spiritual issues. There are two very good segues. Educate them that they need good support during this time and ask what kind of a support structure do they have – family, friends, church, do they pray, are they comfortable turning to God, etc. Or let them know that it's normal for spiritual issues to come up, and they can expect to deal with them at some point, even wrestling with the “How can a good God allow this?” question. You can ask if that has come up for them yet, or actually share the Gospel with them by saying that when it does come up it's important to remember that God is good and proved it by sending His Son to die...etc. You might ask if they have any religious or spiritual needs at this time. Empower them in their search for meaning - “My hope for you is that you would find meaning/find God/know you are not alone in the midst of this crisis. How can I help you do that?” or “Where do you think God was in this?” Your own testimony of God’s help in crisis is important, but don’t focus on your story, focus on God.
E. As crisis ministers, our next step is to intentionally bring the Kingdom. Repeat Step #1, and use “The Divine Exchange” (see below) – help them gather up their loss, grief, or pain, give it to Jesus, and receive comfort, peace, and healing in exchange.
F. We know it is counterproductive to argue with or pressure an unreceptive person. However, there may be occasions when we must warn them that if they refuse to repent and believe in Jesus, their “next step”, what they can expect when they die, is hell. As crisis ministers, we cannot shrink back from proclaiming the whole Gospel. That includes not only forgiveness and mercy, but the necessity of repentance for salvation (Acts 2:38). Jesus is not just Savior, but Lord, and we are to give Him our lives, not just receive Him as some kind of fire insurance or add-on into our lives. He is also our Bridegroom, King and Judge, even as the Apostle's Creed states, “He will come again to judge the living and the dead.” Judgment is coming, but remember, there is a difference between corporate and individual judgment. We must be sensitive to Holy Spirit’s leading for the right timing, words, and combination of boldness and compassion.
VI. Refer (as needed)
A. Assess whether or not a referral needs to be made. If someone is going to harm themselves or others, you must report it! In a disaster situation, if professional psychiatric/medical attention or governmental assistance is needed (finding family members, etc), your leadership will make necessary arrangements, which will be different in every disaster.
B. In crisis, people may have passing thoughts about wishing they were dead. Hopelessness is common in crisis and can lead to suicide ideation. Ask if they are suicidal – “Are you thinking of killing yourself?” They may say no. But if they are suicidal, have a plan, and the means to carry it out, immediate intervention is necessary! Never “call their bluff.” When in doubt, refer.
C. Be willing to be their advocate. But it’s not our job to fix or take responsibility for someone.
D. In a disaster, it may be appropriate at this point to suggest they move to a designated ministry area, if available. If they just got saved, you may refer them to a local church or your own discipleship team, depending on the situation.
VII. Offer prayer
A. Even if you have already prayed with them, prayer is a great way to bring closure to the conversation. Or it might just open everything up…