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Going the Distance: Resources for Preventing Burnout and Compassion Fatigue in Caregivers

[The following is a presentation I gave at a conference sponsored by the Center for Faith and Health at Samford University, November 2017.]

Introduction

Burnout and compassion fatigue are known occupational hazards for caregivers.  The causes of these conditions are more complex that mere physical exhaustion.  In this presentation, I suggest three ideas that can provide assistance to caregivers for the prevention of burnout and compassion fatigue: a sense of vocation, sufficient margin, and positive social networks.

I spent much of my career in campus ministry, working as a college chaplain on six different university campuses.  My first such job was in 1990. I would wager that my professional experience is similar to many of yours in several key ways.  Chaplains are typically generalists, not specialists, because we often work with a small staff (or no staff) and limited resources.  Chaplains wear many hats.  In 25 years, I have worn many hats: pastor, preacher, teacher, professor, lecturer, counselor, advisor, mentor, supervisor, manager, administrator, coordinator, event planner, travel agent, cook, caterer, editor, chauffeur, sound technician, stage lighting engineer, web designer, graphic artist, photographer, videographer, historian, accountant, DJ, mechanic, pop culture expert, etc. The skills required to continue this work year after year include a willingness to learn quickly, to change readily, and to grow continually.  But maybe more importantly, the job requires determination, endurance, and grit.  We spend long hours, nights, and weekends, dealing with student crises, emotional meltdowns, financial burdens, family dysfunctions, addictions, mental illnesses, academic struggles, and relationship drama.  And honestly, we don’t get paid that well, yet we still love our work and the people at the center of it.  Caregiving in my field requires 10% intelligence and 90% endurance; a little bit of inspiration, a whole lot of perspiration.

I suspect that this sounds familiar to most caregivers, so I also suspect that it comes as no surprise that among the most common occupational hazards of caregiving are burnout and compassion fatigue.  A survey published in 2014 on the prevalence of depression found that over 14% of professionals working in the social services and health care sector suffered from episodes of major depression, the third worst rate of any of the 55 occupations studied. [1]  Frequent interaction with distressed clients and patients, high levels of stress, and low levels of physical activity were found to correlate with depression rates among professionals.  Rates of burnout and compassion fatigue in the healthcare sector could be as high as 60%, further pointing to the costs associated with caregiving.[2]  Additionally, a 2009 study found that nearly 66 million Americans were providing unpaid care for at least one family member.[3]  The emotional, psychological, and spiritual costs of caregiving represent significant personal and professional challenges to many. In my experience, we pay close attention to the details of caregiving, but far less attention to caring for the caregivers.

Burnout and Compassion Fatigue

The concept of burnout was first identified in the mid 1970s by the German-born Jewish-American psychologist Herbert J. Freudenberger.  He identified burnout as consisting of (1) feelings of overwhelming exhaustion, including physical and/or emotional depletion, (2) interpersonal detachment or cynicism characterized by intense negative feelings toward aspects of one’s job, and (3) a sense of ineffectiveness or lack of achievement and productivity at work.[4]  Compassion fatigue, also know at Secondary Traumatic Stress (STS), is a condition similar to but distinct from burnout.  STS is described as a state of extreme stress, tension, or preoccupation with the suffering of others to a degree that is traumatizing for the caregiver.  The key factor distinguishing STS from burnout is the presence of trauma in those for whom one is providing care, although burnout is frequently a symptom of STS, along with frustration, anger, depression, sleep difficulties, fear, intrusive thoughts, debilitating anxiety, and decreased feelings of compassion and empathy over time.  Caregivers at high risk of STS include those who are regularly involved in emotionally charged or traumatic situations, such as first responders, trauma unit workers, oncology caregivers, hospice nurses, public defense attorneys, and military chaplains.[5]

Some of the research on the prevalence of burnout and STS may shed some light on its causes.  Studies indicate, for example, that in many caregiving professions, young caregivers are at significantly greater risk of burnout than older ones. This seems counter-intuitive, does it not?  Female and unmarried caregivers are also at greater risk than male or married ones, suggesting that a sense of control over one’s life and work plays a role in preventing burnout and STS.[6]  Additionally, caregivers who report being “quite a bit” to “extremely” religious had lower levels of diminished empathy and emotional exhaustion than those who were less religious.[7] 

The key point here is that burnout and STS involve more than mere physical exhaustion. These conditions result from an absence of meaning, the lack of belief that one’s work is important or significant, and a sense of hopelessness in the face of life’s demands.[8]  These conditions are emotional, psychological, and spiritual as much as physiological, and so a holistic approach to their prevention and treatment seems clinically advisable and arguably unavoidable.

I think you agree that solutions to the problems of burnout and STS involve more than mere rest from caregiving, otherwise I would simply recommend that you go somewhere and take a nap!  But that’s not my recommendation, so it seems to me that my task as a presenter is to help provide you with some emotional, psychological, and even theological resources to help you who are caregivers for people in crisis stay in this profession and remain effective over the long-term.

Vocation

The first helpful resource that I would like to discuss is vocation.  An oft-quoted passage from the American Presbyterian writer and theologian Friedrick Beuchner serves as an effective introduction to the concept of vocation:

“Vocation comes from the Latin vocare (to call) and means the work a person is called to by God. There are all different kinds of voices calling you to all different kinds of work, and the problem is to find out which is the voice of God rather than of society, say, or the superego, or self-interest. The kind of work God usually calls you to is the kind of work (a) that you need to do and (b) that the world needs to have done. If you find your work rewarding, you have presumably met requirement (a), but if your work does not benefit others, the chances are you have missed requirement (b). On the other hand, if your work does benefit others, you have probably met requirement (b), but if most of the time you are unhappy with it, the chances are you have not only bypassed (a) but probably aren’t helping your customers much either. The place God calls you to is the place where your deep gladness and the world’s deep hunger meet.”[9]

The concept of vocation is rooted in the claim that you are the happiest and most energized when you are doing the work that bring you joy and meets a genuine need.  [e.g. cigarette sales and cardiology]  No doubt, the world needs caregivers, but if Beuchner is correct, you are not going to last very long at it unless you find some level of gladness in it.  Vocation frees you to think about your work as a calling rather than merely a job.  Your vocation and your job need not be the same thing identically.  St. Paul, the missionary who authored a considerable portion of the New Testament, was a tentmaker by trade, a job that allowed him to pursue his missionary vocation.  A job is meaningful only to the degree that it allows you to pursue your calling, and can be stifling if it does not.  A series of jobs strung together over a lifetime we call a career, and careers typically follow the paths of ambition and upward mobility.[10]  But they need not do so. 

Henri Nouwen and Albert Schweitzer provide two examples of people who forsook the enticements of career for the rewards of vocation. Nouwen was a Dutch-born Catholic Priest who left a successful academic career that included two decades of teaching at prestigious universities such as Notre Dame, Yale, and Harvard.  He left the academy at the age of 53 to live and work with physically and mentally handicapped people in a small community in Richmond Hill, Ontario, Canada. Schweitzer, a German organist, theologian, and medical doctor left behind a brilliant music career in Paris at the age of 30 and became a medical missionary in what is now Gabon, Africa.  During his first 9 months on the continent, he treated thousands of patients and performed hundreds of surgical procedures with the help of his wife, a trained anesthetist, in a hospital that he built on his own out of corrugated iron.

These men left behind prestigious careers to become caregivers.  They traded ambition for vocation.  Their work was not easy and they were not perfect – Nouwen struggled with depression and Schweitzer with exhaustion – but their stories illustrate the powerful pull of a call.  Are you called?  Do you think that you have merely inherited your work by accidental necessity?  Or do you believe that there is a divine providence that organizes our universe by matching others’ necessity with your ability?  Vocation reminds you that you are here for a reason, created for a purpose, and equipped for that purpose.

Margin

I first encountered the concept of margin in a 1995 book by that title, written by the physician Richard A. Swenson. Swenson describes margin as “the space that exists between ourselves and our limits.”[11]  Swenson observes that the stresses of modern life devour margin. Technological progress helps us do things faster, but simultaneously gives us more to do and increases the pace of life. Every space is filled with clutter.  Every moment is filled with noise.  Every dollar is spent, and probably a few more.  We have not a minute to spare.  Our relationships with family and friends weaken, we limp through life physically exhausted, sleep deprived, and emotionally drained.  We lack the time to practice genuine reflection and build true virtue.  So although scientific progress benefits us in many ways, it may also make us less likely to experience lives of meaning and purpose.  As a medical doctor who restructured his own life and practice in order to create margin, Swenson’s prescription for what he calls “overload syndrome” is fairly predictable: work less, earn less, spend less, accumulate less, exercise more, sleep more, rest more, etc. (That actually sounds like vacation to me.)  In other words, we regain margin not by making a few small behavioral changes, but by transforming the way we live entirely.

Good caregiving requires margin, doesn’t it?  We need margin for emergencies, for unexpected or unwelcomed interruptions, for serendipitous opportunities to show kindness, and for timely conversations.  Genuine compassion is difficult to schedule because caregiving is the ministry of interruptions.  Add to that the fact that many of us in this room chose our professions for reasons other than earning potential, so we are particularly subject to the economic pressure to spend more than we earn, and the resulting pressure to work harder and longer in order to earn more.  So in a profession in which margin is sorely needed, the evidence suggests that it is sorely lacking.  We need change, individually, institutionally, and culturally. 

What Swenson is suggesting, and what I am suggesting, is not unlike what Christian theologians have commended for centuries.  In the Christian classic Celebration of Discipline, Richard Foster notes that “superficiality is the curse of our age.”  By contrast, “the classical disciplines of the spiritual life call us to move beyond surface living into the depths so that we have the capacity to “be the answer to a hollow world.”[12]  Foster’s prescription for the shallow life consists of three sets of practices: the inward disciplines (meditation, prayer, fasting, and study), the outward disciplines (simplicity, solitude, submission, service), and the corporate disciplines (confession, worship, guidance, celebration).  But who has the time, or the discipline, for all of these disciplines?  Just glancing at this list of disciplines makes me tired.  And here is the irony: how many of us seek to reclaim some margin by avoiding the practice of margin-giving disciplines?  We have become very much like the proverbial woodchopper who has little time to sharpen his axe.  We know we could work more efficiently with a short break, but we feel as if we will fall hopelessly behind if we take one.  And so we continue to chop, with decreasing effectiveness, until exhaustion overtakes us, and the blade becomes almost irreparably dull.  All the while the disciplines of religious faith call to us, or more accurately, God calls to us.  “Come to me, all who are weary and heavy burdened, and I will give you rest.”  If we cannot claim the time to respond to that call, to care for our own souls, then we will not likely care well for others for very long.

Positive Social Networks

Let us turn our attention now to the network of people that you need to survive as a caregiver long-term.  In a 2012 book entitled When Our Leaders Do Bad Things, social worker and clinical psychologist Mangal Dipty argues that people fall into three categories in terms of their impact on us. There are positive, negative, and neutral people.  Positive people are those who, on the whole, contribute more to us relationally than they cost us.  Every relationship costs you something, but positive people make a net contribution to your coping resources and your margin.  Negative people, on the other hand, cost more than they contribute.  Neutral people cost about what they contribute, for zero net gain or loss relationally.  Admittedly, you cannot quantify relationships with exact precision, and relationships change such that people who were once positive can become negative and vice versa.  That said, I still find this idea persuasive, that you need a critical mass of positive and neutral people in your life so that you can help negative people.  We cannot and arguably should not spend all of our time with positive people.  Most healthy adults consider helping others an essential part of life, so we should spend some time with negative people.  The key strategy is to balance the negative people with positive to maintain balance.

The problem for us caregivers is that we are particularly at risk of spending much of our time with relationally negative people.  Notice that I am not necessarily talking about the attitude of the people who need care.  Some may have quite positive attitudes, but relationally they likely require more of us than they can give to us.  And if we surround ourselves with mostly negative people most of the time, then we will eventually be of little help to anyone.  Excessive relational negativity can lead to what University of Washington psychologist John Gottman refers to as “negative sentiment override,” a condition in which a relationship becomes conflicted to the degree that even positive messages are interpreted negatively.[13]  When you reach this state, your environment has become toxic and your physiological response to that environment changes biochemically.  Your blood pressure and heart rate increase, your brain’s ability to process information is reduced, hormones trigger your body’s most basic fight or flight instinct, and compassionate care becomes almost impossible.  Emotionally, physically, and spiritually you cannot sustain critical levels of relational negativity.  They have the power to taint your vocation and ruin your career. 

The bottom line is that we need relationships that nourish us.  All caregivers need caregivers.  We are incapable of surviving long-term in these demanding fields without resources that we simply cannot get on our own.  We are fallible and dependent creatures.  Until we admit this, we are in trouble.  When we admit this, then we are free to seek in humility what can save and sustain.  The Christian tradition calls this grace.  And I know that other religious traditions provide comparable resources. The forgiveness and compassion that was hard earned by Christ is offered to us freely, so that we in turn can offer it to others.  Grace is the relational resource that feeds our vocation, giving us the margin to run with endurance the race set before us.

Conclusion

Three years ago I took up trail running.  I have been a runner and cyclist for many years, but with age I have slowed.  So, when the Red Mountain trail system opened just seven minutes from my home here in Birmingham, I found a new hobby.  Trail running requires of me physically what my vocation requires of me spiritually.  Many trail races are longer than marathons (usually 50k or longer) and as a result, trail running is less about raw speed and more about steady progress.  Trail runners must carefully balance nutritional intake with the strategic expenditure of energy for long hours over difficult terrain.  Even the best trail runners walk or fast hike up steep inclines in the mountains.  At mile 30, every runner wants to quit and every runner needs a good reason to keep going, a calling to continue.  Slow and steady wins the race, or at least finishes it.  Strangely enough, trail running energizes me.  A weekend without a few hours on the trail seems empty, almost wasted.  The physical depletion that accompanies a dozen miles in the July heat also includes for me a reconnection with God’s creation, a time for reflection, and a rejuvenation of the soul.  Everyone needs his or her version of a good trail run.

For the surgeon and author Richard Seltzer, it is the library.  And now I’d like to quote a brief excerpt from an essay that appears in Seltzer’s book entitled Letters to a Young Doctor that will conclude and I think captures the heart of my talk today.  The essay that I abridge here is called “Toenails.”

It is the custom of many doctors to withdraw from the practice of medicine every Wednesday afternoon.  Some doctors spend Wednesday afternoon on the golf course.  Others go fishing.  I go to the library where I join that subculture of elderly men and women who gather in the Main Reading Room to read or sleep beneath the world’s newspapers, and thump through magazines and periodicals, educating themselves or just keeping up.

How brave, how reliable they are!  So unbroken is their attendance that, were one of them to be missing, it would arouse the direst suspicions of others.  And of me.  For I have, furtively at first, then with increasing recklessness, begun to love them.  Either out of loyalty to certain beloved articles of clothing, or from scantiness of wardrobe, they wear the same things every day.  For the first year, this is how I identified them.  Old Stovepipe, Mrs. Fringes, Neckerchief, Galoshes – that sort of thing.

Neckerchief is my favorite. He is a man well into his eighties with the kind of pink face that even in July looks as though it has just been brought in out of the cold. A single drop of watery discharge, like a crystal bead, hands at the tip of his nose. His gait is stiff-legged, with tin, quick, shuffling steps accompanied by rather wild arm swinging in what seems an effort to gain momentum or maintain balance.  One day, as I held the door to the Men’s Room for him, he pointed to his knees and announced, by way of explanation for his slowness: “The Hinges is rusty.”  From that day, Neckerchief and I were friends.  I learned that he lives alone in a rooming house eight blocks away, that he lives on his Social Security check, that his wife died a long time ago, and the he has no children.

One day I watched as Neckerchief , having raided the magazine rack, journeyed back to his seat. As he passed, I saw that his usually placid expression was replaced by the look of someone in pain. Each step was a fresh onslaught of it. His lower lip was caught between his teeth. His forehead had been cut and stitched into lines of endurance. He was hissing. I waited for him to take his seat, which he did with a gasp of relief, then went up to him. “The Hinges,” I whispered. “Nope. The toes.” “What’s wrong with your toes?” “The toenails is too long. I can’t get at ‘em. I’m walkin’ on ‘em.”.

I left the library and went to my office. “I need the toenail cutters. I’ll bring them back tomorrow,” I said to my nurse. Neckerchief was right where I had left him. “Come down to the Men’s Room,” I said. “I want to cut your toenails.” I showed him my toenail clippers, the heavy-duty kind that you grip with the palm, and with jaws that could bite through bone. One of the handles is a rasp. I gave him a ten-minute head start, then followed him downstairs to the Men’s Room. “Sit here.” I pointed to one of the booths. He sat on the toilet. I knelt and began to take off his shoes. “Don’t untie ‘em,” he said. “I just slide ‘em on and off.” The two pairs of socks were another story, having to be peeled off. The underpair snagged on the toenails. Neckerchief winced. “How do you get these things on?” I asked. “A mess, ain’t they? I hope I don’t stink too bad for you.”

The nail of each big toe was the horn of a goat. Thick as a thumb and curved, it projected down over the tip of the toe to the underside. With each step, the nail would scrape painfully against the ground and be pressed into his flesh. There was dried blood on each big toe.  It took and hour to do each big toe. The nails were too thick even for my nail cutters. They had to be chewed away little by little, then flattened out with the rasp. Now and then a fragment of nail would fly up, striking me in the face. The other eight toes were easy. Now and then, the door opened. Someone came and went to the row of urinals. Twice, someone occupied the booth next to ours. They’ll just have to wonder, I thought.

I wet some toilet papers with warm water and soap, washed each toe, dried him off, and put his shoes and socks back on. He stood up and took a few steps, like someone who is testing the fit of a new pair of shoes. “How is it?” “It don’t hurt,” he said, and gave me a smile that I shall keep in my safety-deposit box at the bank until the day I die. “That’s a Cadillac of a toe job,” said Neckerchief. “How much do I owe ya?” “On the house,” I said.

The next week I did Stovepipe. He was an easy case. Then, Mrs. Fringes, who was a special problem. I had to do her in the Ladies’ Room, which tied up the place for half an hour. A lot of people opened the door, took one look, and left in a hurry. I never go to the library on Wednesday afternoon without my nail clippers in my briefcase. You just never know.

[1] Lawson Wulsin, Toni Alterman, et al, “Prevalance Rates for Depression by Industry,” Journal of Social Psychiatry and Psychiatric Epidemiology (2014): 49:1805-1821.

[2] Bernie Monegain, “Burnout Rampant in Healthcare,” Healthcare IT News (April 30, 2013) online at http://www.healthcareitnews.com/news/burnout-rampant-healthcare.  Accessed July 31, 2015.

[3] Lauren G. Collins and Kristine Swartz, “Caregiver Care,” American Family Physician (June 1, 2011): 83 (11): 1309-1317.

[4] H. J. Freudenberger, “Staff Burnout,” Journal of Social Issues (1974) 30:159-165.

[5] L. R. Simpson and D. S. Starkey (2006), “Secondary traumatic stress, compassion fatigue, and counselor spirituality: Implications for counselors working with trauma.” Retrieved July 2015, from http://www.counseling.org/resources/library/Selected%20Topics/Crisis/Simpson.htm.

[6] L.L. Emanuel, F.D. Ferris, C.F. von Gunten, and J. Von Roenn eds. Education in Palliative and End-of-life Care for Oncology (Module 15: Cancer Doctors and Burnout). Chicago, IL: The EPEC Project, 2005.  Retrieved July 2015, from http://www.medscape.org/viewarticle/754366.

[7] K.M. Kash, J.C. Holland, W. Breitbart, et al. “Stress and Burnout in Oncology,” Oncology (2000) 14:1621-1633.

[8] A. M. Pines, “Burnout: An Existential Perspective” in W. Schaufeli, C. Maslach, and T. Marek, eds. Professional Burnout: Recent Developments in Theory and Research. Washington, DC: Taylor and Francis, 1993.

[9] Friedrick Beuchner, Wishful Thinking: A Theological ABC, Harper & Row, 1973, page 95.

[10] Brian J. Mahan, Forgetting Ourselves on Purpose: Vocation and the Ethics of Ambition, San Francisco, CA: Jossey-Bass, 2002, pages 9-14.

[11] Richard A. Swenson, Margin: Restoring Emotional, Physical, Financial and Time Reserves to Overloaded Lives, Navpress, 1995. A newer edition of this book was published in 2004.

[12] Richard J. Foster, Celebration of Discipline: The Path to Spiritual Growth, San Francisco: Harper Collins, 1978.

[13] John Gottman, The Seven Principles for Making Marriage Work, New York: Three Rivers Press, 1999, page 21.

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A Common Sense Dress Code for College Students

As a college instructor, parent, and campus minister for over 20 years, I’ve seen it all when it comes to the clothes students wear, or the lack thereof. I’m not particularly conservative or legalistic when it comes to dress, but I do think that some common sense is needed for the best interest of students, and to respect the learning communities of which they are a part. I am not attempting to destroy individuality; I firmly believe that one can dress both appropriately and creatively. I’m no fashionista, so my suggestions aren’t intended to make you the most stylish person around.  I’m not a shopping diva, so I can’t point you to the best sales, but I can tell you that it doesn’t take an enormous budget to dress reasonably.  And reasonability is my goal here, to avoid unnecessary and attention-seeking extremes.

Of course, this isn’t the most theological post I’ll ever write. I do intend this somewhat tongue-and-cheek. But still, there are some serious faith implications for how we think and feel about clothing. Jesus taught, “Don’t worry about your life, what you will eat; or about your body, what you will wear. Life is more than food, and the body more than clothes. Consider the lilies of the field. They do not labor or spin. Yet I tell you, not even Solomon in all his splendor was dressed like one of these.” In other words, you can surely spend too much and worry too much about these matters. In that light, here are a few common-sense suggestions for dressing in a sensible, simple, and considerate manner.

  1. Get dressed. Seriously. Wear actual clothes intended for public viewing. I get it that you were up late studying, but nobody wants to see what you slept in. Respect the people around you enough to look at least somewhat presentable in class.
  2. Dress according to the season. When in doubt, check the weather app on your phone. If it’s 30 degrees, avoid shorts and flip-flops. You look silly trying to look tough through your hypothermia.
  3. Wear clothes that fit. A blinding flash of the obvious I know. But you’d be surprised … actually, no, you aren’t surprised at how poor a judge people tend to be about what fits and what doesn’t. Here’s a hint – if it takes more than about 2 seconds to slip it on, it’s probably too tight. If you could fit another human being into it with you, it’s probably too big. The extremes look ridiculous to at least half of the population. You aren’t looking for that kind of attention, are you?
  4. Wear clothes that appropriately cover everything that ought to be covered. Remember that cameras are now ubiquitous, so think about that when you head out the door. Your clothes say something about you.  What are you saying with your short shorts, low cut tops, muscle shirts, skin tights skirts, or leggings?
  5. Don’t wear clothes intended for a specific activity unless you’re engaged in that activity, or on your way to or from that activity. Let me be more specific. Yoga pants are for yoga. Gym shorts are for the gym. Hiking pants are for hiking. That makes sense, yes?
  6. Wear clothes that go together. Please, I beg of you, no shorts with snow boots. No jeans with a tuxedo. No running shoes with a dress. No dark calf socks with athletic attire. These may seem trendy to you at the moment, but trust me, you’ll be embarrassed one day.
  7. Avoid clothes obviously intended to draw attention to you. Whether you realize it or not, vulgar tee shirts, extreme colors, and stripes with plaids are all screaming to those around you, “Hey, look at me!!” Is that really what you want to scream?
  8. Ladies, always wear pants. Always. Tights are not pants. Leggings are not pants. Yoga pants only count as pants if you’re at yoga (see #5). If you aren’t sure whether you have on pants, go put on some pants.
  9. Gentlemen, no tanks. Nobody wants to see your deodorant coated armpit hair, no matter how large your biceps are. If you are a weight-lifting athlete, I grant you a once per day exemption to this rule, if and only if you are in the gym. After that, put on a tee shirt.
  10. When you stop growing, buy fewer items of higher quality. This is just a practical tip. When you’re growing a couple of inches a year, you do what you have to do to get by. When you stop growing, start building a reasonably better wardrobe. Most people wear about 20% of what’s in their closet. Only buy items you like better than the 20% of stuff you currently wear. Buy less but get higher quality. You’ll like it better, it’ll last longer, and you’ll save money in the long run.
  11. Clean out your closet every year and give away what you haven’t worn. The principle here is simplicity. There is no sense owning what you don’t need. It takes up limited closet space, makes your other clothes wrinkled, and makes it more difficult to find the clothes you want to wear.
  12. A summary principle – your clothes say something about you. What do you want to say? What are you actually saying? Do these two questions have the same answer?
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Meeting with Students: Four Kinds of Conversations

Recently, one of our interns asked me how I provide pastoral care for students. This week I had two separate discussions with faculty members who asked about the kinds of meetings that I have with students. With these conversations in mind, I’ve tried to think more carefully about the kinds of interactions I have with students and what strategies and outcomes may be appropriate for each. Generally speaking, here are four types of conversations I regularly have with students and my strategies and goals for each:

1. Crisis Intervention. Regularly I am in conversation with a student who has suffered a significant loss, experienced a major tragedy, or is faced with the prospect of a crisis (perceived or real). Typically such a student is overwhelmed, has no experience with major trauma, and may be immobilized by the shock of the situation. In these cases, the ministry of presence is important, a listening ear invaluable, and only a few carefully selected words appropriate. Somethings students barely remember these meetings or feel embarrassed that they broke down in my office. Follow-up after the initial meeting is almost always necessary to be sure students are getting the support they need and to reassure them that their feelings are natural and my support unwavering. Instances where a student is a danger to self or others, immediate intervention in mandatory and in these instances alone, pastoral confidentiality is suspended to protect lives.

2. Pastoral Care. Often students not yet in crisis begin to feel significant levels of stress, grief, pain, confusion, depression or anxiety that begins to interfere with their ability to function, to grow spiritually, or to enjoy a reasonably level of happiness and enjoyment in life. Such students are often genuinely seeking advice, some action steps they can take to improve their life situation. Of course sometimes students just want some attention, someone to listen, and to know someone cares. In these cases, I try to determine what the student wants and needs and whether the student’s condition is episodic or chronic (some psychological training helps here). Sometimes a single meeting that concludes with me praying for a student is all that is needed. Often I sense that students need longer term assistance from a counselor and I make referrals. I help students frame the issues they face biblically and theologically, and hopefully set them up for some success in counseling when that is needed.

3. Theological counsel. Sometimes students just have questions about life and faith. What does the Bible say about a particular topic? What should I believe about a particular theological, social or political issue? What is God’s will for my life? How do I handle this complex relationship or family situation? Through the years, this has been the most common type of conversation that I have with students. Here I find that students genuinely want answers. I usually resist the urge to give them my answers, but instead try to give them resources so that they can read, think, pray, study, contemplate, and make decisions on their own. I obviously have strongly held convictions about matters of faith and I will advocate for those, but only to the degree that I am not acting manipulatively, recognizing that I am in a power relationship with most students so coercion would be easy.

4. Supervision and Mentoring. We have approximately 30 student workers in our office so personnel supervision is an ongoing responsibility. I have to correct, encourage, compliment, and sometimes fire student employees. Business training is helpful here since people are not necessarily born with managerial skills, but a general rule of thumb is practice open and honest communication and give timely feedback. For some students, I serve in more of a mentor role, either because they ask or because the nature of their work with my office requires it. I generally try to keep the number of students I mentor to 2-3 at most. This takes more time, more insight, more regular meetings, and a long-term investment that will likely include all types of conversations, including crisis intervention, pastoral care, and theological counsel. These relationships also tends to yield the most student growth over time. And these are students who tend to stay in touch after graduation.

Of course, some conversations are hybrids and involve multiple strategies and hopeful outcomes. Some yield remarkable fruit and benefit students in transformative ways. But of course, some go nowhere and seem to accomplish nothing, and that can be frustrating. I try to remember that my job is to plant seeds. Seeds take a long time to grow and their growth may take place haltingly, beneath the surface, and only in season, imperceptible to superficial observation. Such is campus ministry. Such is the Kingdom of God.

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Visiting Campus: Some Advice for Parents of Freshmen

After move-in day, you head home and hopefully get 2-3 weeks of separation from your student before he or she comes home or you go back to visit. These weeks are crucial for students to make connections and establish habits that will sustain them in the months that follow. A premature visit can disrupt that process, but a well-timed visit to campus a few weeks into the semester can help both parents and students reconnect as a family, catch up on each other’s lives, and evaluate how the college experience is affecting all involved. So if you haven’t seen your student for a few weeks and you’re planning a visit for Parents Weekend, here are a few things to keep in mind.

  1. Talk to your student briefly before the visit to discuss in advance what time you’ll spend together, what functions you’ll attend together or separately, where you’ll sit for the football game, where you might go to church on Sunday, and other such plans. Communication in advance will help you all manage your expectations for the weekend. Except in dire circumstances, never pop in for a visit unannounced.
  2. Don’t expect to spend every waking hour with your student when you visit campus. Your son or daughter now has a life that doesn’t often include you. Friends, studies, rituals, habits, organizations, and responsibilities now occupy his or her time. Those things don’t cease just because you’re visiting. On our first visit to campus to see my son, he dropped by our tailgate for a few minutes, crammed his stomach full of food, and then returned to game-day festivities with his friends after about 30 minutes. We saw him later in the day, and some the next, but he went right on with his life, which showed me that he’d adjusted well to college.
  3. Avoid the temptation to read too much into your student’s response to seeing you. Some students may be tearful and others rather placid. Their emotional reaction to your visit may be more a factor of how much sleep they’ve gotten than their excitement or aversion to seeing you. And here’s a hint: your student is probably ALWAYS sleep deprived, so take their reactions with a grain of salt.
  4. Look around at your student’s life. Take a mental snap-shot of what you see. What are your student’s friends like? Is the car running well and in decent shape? Is his/her room functionally organized? Of course it is reasonable to begin to form some preliminary evaluations, but keep your observations to yourself for now. Parent’s Weekend should probably be a time for celebration more than correction.
  5. Pick your battles. As you see your student’s life on campus, you will inevitably find some things you are pleased with and some things that bother you. Don’t micromanage, but you should express concern where it is warranted. When my wife first visited our son’s dorm room, she was appalled by the smell. I was more concerned with my son’s sleep habits. Although different things felt important to each of us, we had to be careful that we didn’t nit-pick. As you talk with your student about college life, try to focus on the things that really matter.
  6. Ask the right questions. We parents tend to ask our students general questions like, “How’s the semester going?” or “Are you doing well in your math class?” Such questions tend to elicit monosyllabic responses. Instead, ask specific questions that are easier to answer and yield more information, such as “What is your favorite thing about campus?” or “Who is your favorite professor and why?” or “What is the most difficult part of being a college student?” I have a talkative child and two quiet children and these questions have tended to work better for them all at any age.
  7. Relax and have fun. Go into the weekend with a light-hearted attitude expecting to have fun. You may be worried or anxious about how your student is adjusting and that is normal. Express confidence in how they are doing, be encouraging, take them to eat at their favorite restaurant, and maybe give them a little extra spending money. This is a weekend for things that lighten the mood and lift the spirits. A bit of preparation and forethought can help it be so.
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Things Parents Should Know About College

Note: The following is an abbreviated version of a talk I will give to parents of rising college freshmen at Shades Mountain Baptist on July 31st, 2014. Special thanks to Arliss Dickerson, a long-time campus minister at Arkansas State, who originally blogged on this topic and I got the idea and title from him. I compiled my content from a variety of sources, including campus ministers, student affairs professionals, and academic research, but the opinions expressed here are my own and not necessarily those of my colleagues.

  1. College is worth it. In purely economic terms, college is a good investment. Even with escalating tuition costs, high unemployment among recent college grads, and falling wages, a college degree today is still worth over $1 million in additional earnings through age 65 (an average ROI of 14-15%). In terms of emotional growth, psychologists suggest that the two greatest times of change in a person’s life are (1) birth to age one, and (2) the first year of college. In educational terms, students who want to learn will learn, and most students still want to learn, although not all. (Rebekah Nathan has an interesting book on this subject).
  1. College is difficult. This seems obvious, I know, but somehow many freshmen seem surprised when they take their first tests and get back their first papers and their grades are lower than they expected. Professors assign more work and expect better work. The most successful students attend class almost always, take good notes by hand (not on laptops), ask good questions in class, meet their professors outside of class, and generally take the educational aspect of college life very seriously.
  1. The most common mistake students make … parking tickets! There are many places where students can make mistakes, some serious and some trivial. Never fear the statistically improbable. Chances are, your students aren’t going to make the most serious kinds of mistakes. The most common mistake is parking. Parking is extremely limited on most campuses. Parking tickets are usually really expensive and the folks who give tickets are typically highly skilled, vigilant employees!
  1. Generally speaking, faculty culture is averse to traditional Christian belief. This is increasingly true at state universities, and even true at some private Christian colleges. Students who write papers or give speeches in support of traditional Christian beliefs and values should be prepared for disagreement from classmates and faculty members. This is not to discourage students from addressing such topics with courage and conviction, only to encourage them to do so with great care, intelligence, and humility. Many faculty members have spent years interacting with arrogant students who hold Christian beliefs but have not applied intellectual rigor to those beliefs.
  1. Almost all campuses have spiritual growth opportunities available to students. Students aren’t merely preparing for a career, they are seeking a vocation. This is best done in Christian community. Fortunately, with the exception of a very few colleges, freedom of religion is alive and well on campus. Campus ministries and college friendly churches abound, particularly in the south. Learn about them and communicate your expectation your students find a place to connect spiritually. Students who nurture their spiritual lives while in college tend to be more settled emotionally and less likely to be overwhelmed academically. (See research from HERI on this subject). The sad reality is that nearly 80% of students who grow up regularly attending church, abandon all connection to the church while in college. I can assure you that this drop out rate isn’t for lack of resources.
  1. Alcohol is a serious problem on most college campuses. Alcohol has powerful symbolic meaning for most college students. Students associate alcohol use with freedom, adulthood, community, and belonging. And they make these associations long before they take their first drink. American culture and the billions spent on marketing represent incredibly powerful forces that shape perceptions about the role alcohol plays in the transition from childhood to adulthood. The most serious problems on most college campuses, from academic failure to the growing problem of sexual assault, have strong correlations with alcohol use. You should know that if your children pledge a fraternity or sorority, you may be unwittingly supporting a culture of alcohol abuse. Of all the conversations you should have with your sons and daughters before they start college, the alcohol conversation is a must!
  1. Let your children handle their own business. Have you heard of helicopter parenting? Once upon a time, parents dropped their children off at college and left them alone until Christmas break, sink or swim. College is so expensive now that parents can’t afford for their students to fail, and so parents hover. Resist the temptation! Problems with roommates? Refer them to Residence Life. Struggles in a class? Refer them to the professor, a campus tutoring service (most are free), or the academic success center. Teach them to solve their own problems, manage their own social lives, and take care of their own business. Don’t give them all the answers. Let them make mistakes. Give them space to think and act for themselves. Intervene only after they’ve done everything possible to solve a problem and the issue is still debilitating them or you in some way.
  1. The first three weeks of school can determine a student’s college career. Talk to your students about starting off on the right foot, setting the right priorities, making the right plans, and finding the right connections (a church, a campus ministry, a campus organization). Start off with good habits of sleep, diet, exercise, worship, etc. If your students go away to college, make sure they do NOT come home during the first three weeks of school. Students who get involved in a campus organization do better in school, are happier, less likely to transfer, and more likely to graduate.
  1. Universities are businesses. Learn the business. Schools care about you, but they also care about their own bottom line. Financial aid, course loads, textbook sales, residence life, campus dining, etc. are all complicated, all specific to a particular campus, all streams of revenue for universities, and are all EXPENSIVE. Not every college is worth what it charges. Some degrees are worth more than others. Even though students change majors 3-4 times on average, an extra year of college (“the victory lap”) is usually not worth the money (it decreases ROI). Without intervening in your student’s business, learn to navigate your particular university’s academic culture and business climate. Work the system, avoid debt whenever possible, save money, expect your son/daughter to have a job, and communicate your family’s financial realities with your student.
  1. A good college experience is not terribly complicated or difficult. One study suggests that a good college experience is as simple as finding 2-3 good friends and building 1-2 strong faculty/staff relationships (which includes campus ministers and college pastors). If your students go to class, prioritize academics, work intentionally to connect during the first three weeks, and keep the faith, they are highly likely to do well. I pray they do!

[Special thanks to Lauren Taylor, Janna Pennington, Paige Acker, Kyle Bailey, and Laura Breedlove for their particular contribution to the content of this talk/blog post.]

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How College Works – Faculty Connections are Key

Recently, the president of Samford University, Dr. Andrew Westmoreland, offered the following succinct summary of a book entitled How College Works, by Dan Champion and Christopher Takacs: According to their research, “A great college experience is built on relationships with two or three friends and meaningful encounters with one or two faculty members.  Everything else, according to Champion, pales by comparison.” Here are the book’s major recommendations for improving the learning environments at colleges, as summarized by Dr. Westmoreland:

1.  Deploy the best teachers for maximum impact.  He says that it is okay–even preferable–for good teachers to teach large classes because it improves the chance that all students will encounter good teachers, hopefully in their first semester. It is a mistake to offer small sections of first- and second-year courses, taught by bad teachers. The bad teachers should teach upper level courses where they will do less damage.

2.  Use space to help people meet. In an interesting observation, Champion says that long halls in residence halls with shared bathrooms offer the greatest chance that new students will develop friends. Apartment-style housing is not friendly toward friend development.  Spaces on campus should prompt “hanging out.”

3.  Use strategic scheduling to improve the odds for learning. The best teachers and courses should be placed in the best time slots. Champion calls for active management of scheduling by deans and department chairs.

4.  Help motivated students find each other. His suggestions here apply primarily to extra-curricular organizations, but he also offers the observation that an invitation to dinner at a faculty home is perhaps the greatest single factor in promoting long-lasting student satisfaction.

5.  Focus especially on students’ early careers. He offers nothing surprising on this subject to long-time observers of new student orientation, but he affirms a strong effort to achieve a positive welcome to the campus for all students. Also, learn their preferred names and call them by their names.

6.  Use the arithmetic of engagement. The arithmetic needs to be focused on connecting those few, key relationships.

I would like to add a personal comment with regard to number 4 above. This past spring, my staff implemented a Home Group program at Samford University. The idea is that groups of 10-12 students meet weekly in the home of a faculty or staff member to share a meal, Bible study, prayers, spiritual conversation, etc. The kickoff was tremendous with remarkable student participation and faculty support. This fall we anticipate nearly 30 groups hosted by Samford employees. We got the idea from a campus ministry at Pepperdine University, and would love for others to steal it too and report back about how it works.

Do you remember visiting the home of a faculty member during your university years? How did the experience shape your college experience?

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