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Support Team: Case Study

LukeNotes, Fall 2018

Father Richard had just finished six months of residential treatment at Saint Luke Institute. Now it was time for him to assemble his support team. One of the people he asked to serve on it was Mary, a former parishioner who had also worked for him as his secretary.

Mary knew little about the reasons Fr. Richard went to Saint Luke for treatment, but she knew she loved and cared for him, so she agreed to help. He said she must first attend a workshop that would take place at his new parish. There she would learn everything necessary about serving as a support team member. At that time, she would also meet the other members of the support team, as well as Fr. Richard’s Continuing Care therapist from Saint Luke.

The date came, and everyone met in the rectory. During his stay at Saint Luke Institute, clinicians had diagnosed Fr. Richard with bipolar disorder. The Continuing Care therapist explained the symptoms related to this condition. As Mary listened, she realized she had seen many of these signs when Fr. Richard was her pastor and boss.

Every group member felt confident they could help identify Fr. Richard’s moods because of how well they knew him and how often they saw him. This regular contact would enable them to identify when he was showing signs of mania or depression.

They each knew these signs because each had seen them before he went to treatment.

Even with the briefing, however, Mary wondered how she could help. She was not a clinician. Indeed the support team had no clinicians.

The Continuing Care therapist mentioned that the team could help Fr. Richard by telling him what they observed. She explained he had a therapist and a psychiatrist, and these two professionals would monitor his mood and behavior, as well as the effectiveness of his medication.

The group expressed other concerns. Would he now be delivered from all the symptoms they knew so well? If so how? Or would he still have them, and would they have to do something to control them? If so what?

The Continuing Care therapist reassured the support team by reminding them of the Al-Anon principle, “You didn’t cause his problem, you can’t control it, and you can’t cure it.”

The team met at regular intervals, at first monthly and later every 6-8 weeks. Like the others, Mary learned to trust her feelings about Fr. Richard’s moods and behavior.

At times he seemed quiet, at other times more emotional and loud. He was still learning how to differentiate a mood disorder from just ordinary feelings connected to the events of his day. His friends in the group helped him recognize the difference.

Mary learned to trust the other support team members. In phone conversations, they would compare their experiences of Fr. Richard. She also learned to trust the group when they related something different from her own experience, and they did the same with her. Each learned from the other.

In the second year of recovery, Fr. Richard lapsed into old patterns of working long hours in isolation. Sometimes the support team felt frustrated by their inability to get Fr. Richard to take their suggestions or make critical changes.

Mary called the Continuing Care therapist at Saint Luke for advice. She suggested they meet with Fr. Richard as a group along with the vicar for clergy, whom they had met at the re-entry workshop two years’ prior.

At the meeting, everyone described their observations. Fr. Richard admitted he had been constantly working, and at times he couldn’t do much of anything.

He also admitted he had not taken his medications as prescribed. Rather, he took them sporadically, almost as if conducting an experiment to see what the effects would be.

Based on this feedback, the vicar for clergy called Fr. Richard’s therapist and asked for an appointment with the psychiatrist as soon as possible. Within a few weeks, Fr. Richard was back in balance.

Mary and the support team saw that their intervention with Fr. Richard had proven successful. They realized that saying yes to being on a support team meant none of them had to do this all alone. They would have each other as well as assistance from Fr. Richard’s professional helpers.

Rev. Kenneth D. Phillips, TOR, M.S., is a member of the continuing care team at Saint Luke Institute.