Member Care: Pearls and the Perils--Introductory Devotional

Named, Known and Called
Dr. Cynthia Eriksson, Fuller School of Psychology, USA

This encouraging devotional, given 19 February, 2009, set the stage for the three lectures that followed at Fuller’s Integration Symposium. Cynthia Eriksson shares her journey as a missionary with mental health training and as a psychologist in missions. Using the interaction of Jesus and Peter in John 21: 15-19, she encourages us to live in the freedom of who we are and the freedom of who we are called to be. Her healing words are especially addressed to those of us in leadership: like Peter our frailties are not so much obstacles as they are a means to experience God’s grace, relationship, and call to lead.

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We think you will hear some very helpful comments by Cynthia as she intertwines her own life experiences with those of Peter’s. Her devotional and the opening remarks to the Symposium are about 37 minutes, and available to download for free in audio and video formats at:

http://www.fuller.edu/academics/school-of-psychology/integration-symposium-2009.aspx

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Reflection and Discussion

1. Summarize Cynthia's main point in one sentence. How does it apply to your life practically?

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2. List two charactersitics of Peter that are similar to your own characteristics. Are these areas we need to change or are they more like weaknesses that we need to live with?

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3. What are you thoughtts on Cynthia's assertion that Peter could still be called to lead in his broken state? How might this apply to your own leadership?

Member Care: Pearls and Perils, Lecture 3

Ethics and Human Rights in Member Care:

Developing Guidelines for Good Practice
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This third lecture at Fuller School of Psychology (February 2009) explored ethical principles for member care workers and sending groups as well as how human rights commitments are foundational for member care work. The goal was to move towards a trans-cultural/conceptual framework for ethics as a way to upgrade the work we do in member care and mission/aid. The emphasis on human rights is a new contribution to the development of the member care field. The lectures are available on line for free in written, audio, and video formats. We have included a few excerpts below from the third lecture to encourage you to download and watch the video.

http://www.fuller.edu/academics/school-of-psychology/integration-symposium-2009.aspx

Shining light on good practice. © 2008 MCA/KOD

Perspectives on Ethics
Member care is a broad field with a wide range of practitioners. As this field continues to grow, it is important to offer guidelines to further clarify and shape good practice. Any guidelines must carefully consider the fact of the field’s international diversity, and blend together the best interests of both service receivers and service providers. They also need to be applicable to member care workers (MCWs) with different types of training and experience. This is a challenging task to undertake, and it is one that must be done in consultation with many others and on an ongoing basis. Trying to differentiate between codes, guidelines, frameworks, and suggestions is just one important aspect of this challenging task.

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Many types of professional ethical codes exist that can relate to the practice of member care. For some practitioners, these codes are essential and are a good “fit.” But one size does not fit all! For example, as a psychologist and as an international affiliate of the American Psychological Association (APA), I abide by the APA’s Ethical Principles of Psychologists and Code of Conduct (2002). But a skilled Nigerian pastor providing trauma training/care in Sudan may not find this code so helpful. Such ethical codes are primarily relevant for the disciplines and countries for which they were intended. Yet many MCWs enter the member care field via a combination of their life experiences and informal training, and are not part of a professional association with a written ethics code. Common sense and one’s moral convictions only go so far. Further, appealing to another country or discipline’s ethical code can result in a rather cumbersome mismatch between the person and the code.
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Guidelines for Good Practice

Stone one reflects the need for a generic set of guidelines for all types MCWs. The specific example given offers 15 basic guidelines for MCWs in the form of commitments. It focuses on the personal characteristics, backgrounds, and relationships needed to practice member care ethically. The underlying commitment is for MCWs to provide the best services possible in the best interests of the people whom they serve. Like all the stones, stone one is intended to be referred to regularly, to be discussed with colleagues, and to be applied in light of the variations in our backgrounds. Further, it requires serious reflection and a serious consideration of the implications for one’s life and work—these are not just “suggestions” but commitments. The “look before you leap” warning in Proverbs 20:25 is instructive here: ‘It is a snare for a person to say rashly, ‘It is holy!’ and after the vows to make inquiry.”

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Stone two focuses on the crucial role of sending groups to responsibly support and manage their staff well, including their international staff, local/national staff, home office staff, and family members of their staff. It also considers the big picture of member care from recruitment through retirement and the commitment to nurture both organizational and staff health. The international model of member care in Doing Member Care Well (2002) refers to sending groups as the “sustainers” of member care. “They demonstrate [their] commitment by the way they invest themselves and their resources, including finances, into staff care. Sending groups aspire to have a comprehensive, culturally relevant, and sustainable approach to member care, including a commitment to organizational development.” (p. 18). Sending groups do well to offer quality services for staff and to expect quality services from staff.

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Foundations for Good Practice--Human Rights Principles

This fifth stone is based on doing what we “know” is morally right to do. It shines light on our inner sense of duty. I believe that it must especially take into account human rights in a way which hitherto has received minimal consideration in the member care field. This includes understanding and protecting the rights of mission/aid staff and the people with whom they work, as described for example in international human rights documents (discussed below).
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However, the primary focus of this stone is not just mission/aid staff. It is rather on the ethical responsibility—ethical imperative—for personal and group duty (often sacrificial duty) on behalf of humanity. It is about the duty and choice to risk one’s own rights and well-being in order to extend member care, broadly speaking, to vulnerable populations. More specifically, it is a principled commitment to improve the quality of life and seek justice for those whose human rights, including religious liberties and freedom of conscience as well as physical safety and economic livelihood, are habitually threatened through neglect, disasters, poverty, discrimination, fear, and persecution.

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Reflection and Discussion

Here is one of the five "Ethics Sensitizers" from the article.
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When is it ethical to deploy workers into risky areas?
Workers who serve in cross-cultural settings are often subject to a variety of extreme stressors. Natural disasters, wars, sudden relocation, imprisonment, sickness, and protracted relationship conflicts are but a few of the examples. The general consensus seems to be that sending groups that deploy their people into potentially adverse situations have an ethical responsibility to do all they can to prepare and support them. This thinking is in line with Principle 7 from the People in Aid Code of Good Practice (2003) which states, "The security, good health and safety of our staff are a prime responsibility of our organization." There are so many locations where the social/political situation is very unstable, where there is the possibility of death or serious physical/emotional injury in the course of helping others, and/or more isolated places where there are few supportive member care resources available. The very places that are the neediest are also often the riskiest.
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Applications
Risk can also be understood as being part of one’s job description, and continuous with the reality that there are always risks in life regardless of one’s location or job. But to what extent should mission/aid workers take risks? Does one help victims of car accidents without having protective barriers that can prevent the transmission of HIV through the victims’ blood? Does one obey an organizational requirement to evacuate from a war zone knowing that there may be far more dire consequences to the nationals/locals that remain without the protective presence of international peacekeepers and providers? How much information about risk does one need to know in advance of an assignment?

Member Care: Pearls and Perils, Lecture 2

Wise Doves and Innocent Serpents?
Promoting Health and Managing Dysfunction in Mission/Aid

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This second lecture at Fuller School of Psychology (February 2009) looked at suggestions for developing healthy organisations and for safeguarding workers in light of personal/systemic dysfunction. Human relationships and organizatinal life are vierwed as being very positive provided that good practices are understood and embraced. The lectures are available on line for free in written, audio, and video formats. We have included a few excerpts below from the second lecture to encourage you to download and watch the video.
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http://www.fuller.edu/academics/school-of-psychology/integration-symposium-2009.aspx

Snakes in suits, doves in snakes. © 2006 MCA/KOD

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Overview of Health and Dysfunction

Most of us have been part of both healthy and dysfunctional work settings. The healthy ones are personally rewarding and we feel we are contributing and growing, and challenged and respected. The dysfunctional ones on the other hand drain us, stealing our time, focus, effectiveness, and even our emotional and physical health. Much of my work in member care is devoted to helping organizations develop healthy practices. Conflict management in particular takes up a lot of time for me and many of us, especially for those in management roles. Research also supports what we all seem to know from painful experience: relational struggles in the mission/aid sectors stress us out (Gish, 1983, Carter, 1999, Fawcett, 2003). Conflicts, even if managed well, do not always lead to personal growth and closer relationships. This is especially the case when dysfunction is involved. Dysfunction disables our people and purposes, but most importantly from a Christian viewpoint, it dishonors God (Rms. 2: 21-24).

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The above assertions may sound good and “balanced” most of the time. But we must also be concerned about the other side of the distortions—downgrading clear dysfunction and referring to obvious deviance as merely being “differences”. This will become apparent usually if skilled, unbiased people will take the time to inquire. Otherwise people back away from what is seen as a complex confusing story with two or more sides, rather than there being a cohesive core of truth that is being distorted/overlooked. So surely we must not make a mountain out of a molehill; yet neither should we make a molehill out of a mountain! The tricky part is trying to discern who has the clear or clearest perception of what constitutes a mountain or a molehill. It is also tricky since most issues are not so black and white. As Proverbs reminds us (16:2, 18:17): All the ways of a person are right in one’s own eyes, but the Lord weighs the motives; and the first to plead one’s case seems just, until one’s neighbor comes and gives input.

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Relational Resiliency

When I teach on relationships within the mission/aid sector, I like to distinguish between functional trust and foundational trust. Functional trust is assumed, and needed so that we can work together. It believes a priori, within limits, in the good intentions and reliability of a colleague. It gives others the benefit of the doubt until proven otherwise, so that work-related tasks and mutual interests can be realized. Foundational trust however is much deeper and it is earned. It is developed over both time and over tough times together. Enduring and genuine friendships are based on such trust. Functional and foundational trust can overlap over time, with work-related confidence in a colleague flowing into a growing friendship. Yet it is a real mistake to think that being friendly colleagues in a work context (functional trust) is the same as being true friends (foundational trust) in life. The shift from functional to foundational trust is slow and easily hindered. As Christians, this shift leads to deeper levels of “fellowship” (koininia) as emphasized in New Testament writings (e.g., John’s epistles) and to greater levels of “oneness, unity, community” (yachad) as emphasized in the Old Testament (e.g., Psalms 133).

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"Trust shifts" from the functional to the foundational are healthy. They happen via consistent demonstrations over time that people are seriously and sacrificially committed to each other. This is especially evident during crises which force people to work together closely with mutual dependency. Further, there is the genuine willingness to put someone else's best interests over one's own, with no strings attached. There is the deep sense that people are doing their utmost to respect and understand each other. People communicate regularly, equitably, and empathically. Finally, trust shifts happen when people fulfill their promises. Where foundational trust flows, entrenched conflicts usually do not.

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Essential Resources: Good Governance and Good Management

Healthy people form healthy organizations, and vice versa. One of the greatest challenges of maintaining a healthy organization is to manage conflict and dysfunction well. I have learned the hard way (not simply from the literature!) that people in conflict do not always play fair and that often significant dysfunction (not just differences in opinion or personality) must be addressed. Probably like many of us, I default towards being a helper who stays neutral, preserves unity, increases mutual understanding, arrives at a “win-win” outcome, who helps people agree to disagree and believe the best in each other. This approach is usually sensible of course. However there are times when this approach is inadequate and ill-advised, and confrontation and discipline are required. This is tough love that necessitates verifiable contrition and verifiable change. Otherwise innocent people, now and in the future, get hurt. And justice is not done.

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3. Guidelines for Grievances and Whistle-blowing. Third, I suggest that organizations have clear guidelines for handling grievances and for "whistle-blowing" including non-retaliation commitments to those who confront serious problems in an organization. These guidelines are part of good management practices and are in addition to those for conflict resolution. With regards to grievances, mission/aid organizations should also consider the role of an “ombudsman”, a person who acts as a neutral intermediary to represent and help negotiate the interests of both staff and the organization. As for whistle-blowing, one helpful resource is the Policy on Suspected Misconduct, Dishonesty, Fraud, and Whistle-Blower Protection by the Evangelical Council for Financial Accountability in the USA (see Box 9,). This policy takes into account the legal protection offered by the 2002 Sarbanes Oxley Act in the USA for those who report possible or actual organizational misconduct. It also urges that a variety of safe reporting mechanisms be set up that are understood and used by staff, and includes sample policies for both large and small organizations to adapt for their purposes. Note too that similar legislation to protect whistleblowers was passed in the United Kingdom in 1998, as part of the Public Interest Disclosure Act (http://www.opsi.gov.uk/acts/acts1998/ukpga_19980023_en_1). See also the standards for raising concerns and retaliation at: www.business-ethics.org/newsdetail.asp?newsid=88. Mission/aid workers, whether they are employees, volunteers, or independent contractors, need to be aware of their rights/status under the law. Organizations are responsible to explain these laws to their members and to abide by them.

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Reflection and Discussion

Here are three of the ten "Health Promoters" that are included in the article.

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1. Healthy organizations have clear policies/procedures that are understood, recognized, and reviewed. Clear ethical values/commitments are also indicators of health. Yet even still there can be a mess when healthy practices are not followed and dysfunction exists. What do you think?

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2. What behaviors in your experience would you consider to be dysfunctional? Examples: manipulation, lying, stealing, ignoring, ridiculing, discrediting, withholding information, blaming/shaming, scapegoating, demoting, dismissing, etc. Note that organizational and personal health can be described in opposite terms of how dysfunction is described (e.g., honesty vs. lying, affirming vs. discrediting). How can focusing on healthy practices be more constructive than focusing on the negative?

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3. Have you had to confront “poisoned water”? If so, what were the outcomes? What helped? What did you learn? Have you ever felt like you and/or your colleagues were being harassed and “sifted like wheat” by a malignant force that seemed far greater than yourself (e.g., Luke 22:31)? If so, what did you learn?

Member Care: Pearls and Perils, Lecture 1

Staying Healthy in Difficult Places:

Member Care for Mission/Aid Workers

This first lecture at Fuller School of Psychology (February 2009) looked at historical milestones in member care, listening to our global voices, and future directions for this field. The lectures are available on line for free in written, audio, and video formats. We have included a few excerpts below from the first lecture to help encourage you to download and watch the video.

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http://www.fuller.edu/academics/school-of-psychology/integration-symposium-2009.aspx

A Somali woman at the gate of the UNHCR compound prior to
registration and admission to a refugee camp in Dadaab, Kenya, October 2008.
© Manoocher Deghati/IRIN. Used by permission. http://www.irinnews.org

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Historical Milestones

Opportunity, danger, duty, hell. Life can be as difficult as it can be wonderful. And helping those whose life is even more difficult than our own can be very difficult indeed! There is so much misery that requires the interventions of the faith-based, government, and civil society sectors (e.g., natural and human made disasters, poverty, HIV-AIDS, malaria/diarrheic disease, and internecine war, to name a few). For the mission/aid community, helping can often involve staying sane—and alive—in unstable, insane places. It is not that mission/aid work always deals with life-threatening experiences, of course. Rather it is just that helping to relieve the “maims and moans” of creation takes its toll. Mission/aid workers, like the people they are helping, have some special challenges and needs indeed.

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Over the last 20 years, a special ministry within the Christian mission/aid sector, really a movement, has developed around the world that is called member care. At the core of member care is a commitment to provide ongoing, supportive resources to further develop mission/aid personnel. Currently there are an estimated 458,000 full-time “foreign missionaries” and over 11.8 million national Christian workers from all denominations (Barrett, Johnson, and Crossing, 2008). These figures do not reflect the number of Christians involved in the overlapping area of humanitarian aid, nor do they reflect the unknown number of “tentmakers” or Christians who intentionally work in different countries while also sharing their faith. Sending organizations and churches, colleagues and friends, specialist providers, and also locals who are befriended are key sources of such care.

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The member care ministry and movement did not develop easily. It was often through crises, mistakes, and failure that we began to realize that Christian workers needed quality support in order to help them in their challenging tasks. One of the first books written to help with this need was written by Marjorie Collins in 1974, providing many ideas for how churches and friends could better support mission personnel (Who Cares About the Missionary?). Previously in 1970 Joseph Stringham, a psychiatrist and missionary working in South Asia published two landmark articles in Evangelical Missions Quarterly on the mental health of missionaries. Stringham identified a number of external and internal challenges including culture shock, being disillusioned with others, children, medical care, etc. (external) and resentment, sexual issues, marital struggles, dishonesty, guilt, spirituality, trauma/deprivation in earlier life, motivation etc. (internal).

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Listening to our Global Voices
Expendable Humanitarian Workers, Africa, Viola Mukasa. I’m a humanitarian worker living in a location in Africa that is in prime need of help/missions. I’ve experienced many types of stress as I have worked in various mission programs. The most sustained tension that I have experienced has been related to the urgency and the amount of work to be done in a potentially explosive social and political environment. The challenge here is not only to produce expected results quickly, under tense and sometimes risky circumstances. The challenge is also to deal with the constant worry about the security and health of those within my immediate world and where I, my family, and friends fall within that world.
(Excerpts from chapter 27 Doing Member Care Well 2002)

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Grave Consequences. India, Dr. Manoj. The recent deaths of many young missionaries in different parts of the country have been very shocking. More so, because the causes of the deaths are malaria, enteric fever and other common treatable and preventable causes. Today when medical science has advanced so much, it is sad that these young budding lives have been lost through what could have been ignorance, neglect, or delayed/improper treatment….As a health professional, I would recommend that every missionary sent to the field, especially to the remote areas, be given a proper training in basic health and be oriented to the health realities of their locations, in addition to other areas of preparation.

(Missionary Upholders Trust, Care and Serve Bulletin, March 2004; excerpts p.3)

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Research on Mission Workers, Dorothy Gish, 1983 Sample of 547 field missionaries in several countries and with several organizations, Stressors (reported by 40%+ to be moderate to great):
· Confronting one another when necessary
· Crossing language and cultural boundaries
· Time and effort maintaining donor contact
· Amount of work
· Work priorities

(Journal of Psychology and Theology, reprinted in Helping Missionaries Grow (1988)

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Future Directions

The need for old/new treasures [directions and resources] must also take into account the significant shifts in demographics among the world’s 2.1 billion “affiliated Christians,” especially the growing majority of Christians in/from the Global South and the proportional decline in Christians in/from the global North (Johnson and Kim, 2006). These treasures must also support the efforts to resolutely and responsibly deal with the world’s greatest problems, including the need to eradicate poverty (e.g., the 910 million urban slum dwellers), provide universal education, promote gender equality, combat HIV/AIDS, foster environmental sustainability, etc. (United Nations Millennium Development Goals http://www.un.org/millenniumgoals). Here are 12 such treasures...

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Treasure 3. Relief/Aid Workers—Psychosocial support is increasingly being recognized as a necessary and ethical organizational resource for workers in Complex Humanitarian Emergencies (CHEs). This support includes briefing, stress management, debriefing, and practical help for relief workers as well as equipping them with trauma/healing skills to help survivors (e.g., see the account in Randy Miller’s interview with a World Vision relief worker, “Staying Sane and Healthy in an Insane Job” (1998) and the many accounts in Sharing the Front Lines and the Back Hills, edited by Yael Danieli, 2001). Many disaster scenarios provide opportunities to interact with and help UPGs, leading to ongoing joint programs in community development. It is especially important to consider the reality of “neglected emergencies”—the ones that get overlooked due their chronic, seemingly unsolvable problems and overall lower profile— including “fragile states affected by ongoing conflict, poverty, corruption, and weak infrastructure (Gray, 2008, Moeller, 2008). One timely resource is the radio program and materials created to help survivors and caregivers in both natural and human-made disasters (http://www.seasonsofcaring.org/). See also two publications in particular from the International Federation of the Red Cross and Red Crescent Societies: Managing Stress in the Field (2001) www.ifrc.org/publicat/catalog/autogen/4773.asp and Psychological Support: Best Practices (2001) www.ifrc.org/publicat/catalog/autogen/4516.asp.

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Treasure 6. Special Support for A4 Workers—There is an increasing number of Christian workers from the A4 Regions. A4 senders/workers desire to provide develop quality member care approaches that fit their own sending groups, personnel, and cultures. Their experience in member care is also relevant for those from other sending nations (e.g., see the article on the India organization, Missionary Upholder’s Trust (Ethne-Member Care Update 11/08; www.ethne.net/membercare/updates). Quality care is also emphasized in a special listing of “15 Commitments of Member Care Workers”, developed with consideration for diversity in MCW backgrounds (Upgrading Member Care, Evangelical Missions Quarterly, 07/06). The commitment to quality care for A4 workers is also clearly stated in these excerpts from the Declaration by the Philippine Missionary Care Congress of October 2005...

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Reflection and Discussion

1. List a couple items that strike you as being especially relevant for member care: in its history, current status, or future direction.

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Comment on any of the above paragraphs in light of the concluding paragraph in this lecture/article (below):

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Love. Above all, the core of E2MC [Ethne to Ethne Member Care--that is, the vission and strategy to promote member care by and for all people groups] involves the trans-ethnê, New Testament practice of fervently loving one another—like encouraging one another each day; bearing one another’s burdens; and forgiving one another from the heart. By this all people will know that we are His disciples (John 13:35). The Great Commission and the Great Commandment are inseparable. Our love is the final apologetic. It is the ultimate measure of the effectiveness of our member care.

Member Care: Pearls and Perils

Good news.

The materials from the member care lectures at Fuller School of Psychology in February 2009 are now available on-line for free.

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The overall topic was:

The Pearls and the Perils:

Practicing Psychology in Mission/Aid Settings.

http://www.fuller.edu/academics/school-of-psychology/integration-symposium-2009.aspx

These materials include the articles, audio, and video for the three lectures. Please share this info with your colleagues and networks. The three lectures:
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1. Staying Healthy in Difficult Places

Historical milestones in member care, listening to our global voices, and future directions for this field.

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2. Promoting Health and Managing Dysfunction

Suggestions for developing healthy organizations and safeguarding workers/senders in light of dysfunction.

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3. Developing Guidelines for Good Practice

Ethical principles and human rights commitments to upgrade the work in member care and mission/aid.

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Opening prayer for the Symposium,

by Dr. Winston Gooden, Dean of the School of Psychology:

“God we thank you for the call on our lives. We thank you for the many places to which we are sent. We thank you for the sensitivity of those who care for us on this journey that we take. And now tonight as we come to hear, to learn, to study, to be inspired, we pray that your Spirit will hover over us. That you would strengthen our speaker, that you would open our minds, that you would fill us with your rich wisdom so we might be prepared to do your work. We pray this in the name of Him who was sent by You to be our Savior. Amen.”