Spiritual Care Practitioners Research Articles

The Nature of Religious and Spiritual Needs in Palliative Care Patients, Carers, and Families and How They Can Be Addressed from a Specialist Spiritual Care Perspective

This paper is written from the perspective of a specialist religious and spiritual care practitioner who practises in major referral hospitals in Sydney, Australia. In these hospitals, religious care and ward-based spiritual care chaplaincy services are offered in tandem. The perspective offered is based on the author’s knowledge, research, and experience in how people make the necessary religious or spiritual adjustments to their deep view of reality when faced with severe or chronic pain or terminal illness. Religious and/or Spiritual Care (R/SC) are interventions that scaffold people through a process of sense-making which helps them find meaning in their new reality. These R/SC adjustments concern conscious and unconscious beliefs about ultimate meaning, morality, justice, transcendence, and relationships within themselves, and with others and the supernatural. Palliative care practitioners described the importance of spiritual care and integrated spiritual care principles into their biopsychosocial-spiritual model of care in the 1960s. As palliative care practitioners have increasingly clarified their discipline as a distinct discipline in medicine, religious and spiritual care practitioners have struggled to define their place. These concerns merit a fresh evaluation of the religious and spiritual needs of patients, carers, and families of those suffering chronic pain and terminal illness and further clarification of the specialist discipline of religious and spiritual care.

Spiritual Wounds and Injuries (Part 1)

Moral injury (MI) has become a significant area of study and debate with regard to veterans’ mental health and general well-being. Due to the nature and intensity of coalition operations in Iraq and Afghanistan over a prolonged period, MI has become one of the “signature wounds” of these conflicts. Spiritual damage is a critical aspect of the MI paradigm. For some people, exposure to complex and demanding environments and situations creates threats to their spiritual understanding and belief systems. These threats may be expressed through doubt about their beliefs surrounding the concept of an omniscient, omnipotent, omnibenevolent divine creator. Such doubt, uncertainty and distress can negatively affect an individual’s overall mental health and well-being. This article seeks to achieve two objectives. The first is to introduce some of the history, language and concepts regarding MI, in order to enable spiritual care practitioners to participate in this crucial area of veterans’ health and well-being. This participation may include, but is not limited to, definitional research, language analysis, treatment and management. This study also serves as a starting point for a deeper discussion on whether spiritual damage is best described in a MI context, or whether a deeper analysis is needed independent of MI syndrome.

Is Supervised Pastoral Education (SPE) "Substantially Equivalent" to a Recognized Psychotherapy Program in Ontario?

After completing their Supervised Pastoral Education units provided by the Canadian Association for Spiritual Care, two soon-to-be-certified Spiritual Care Practitioners applied to the College of Registered Psychotherapists of Ontario. Both were rejected because their Supervised Pastoral Education program was not deemed to be "substantially equivalent" to a recognized psychotherapy program. This came as a surprise since similarly qualified Canadian Association for Spiritual Care Practitioners in Ontario are also members of the College of Registered Psychotherapists of Ontario through a process called "grandparenting." Using the 10 characteristics of a College of Registered Psychotherapists of Ontario recognized program, this paper examines Canadian Association for Spiritual Care's SPE program in detail, showing how closely it aligns with the College of Registered Psychotherapists of Ontario's description of an equivalent psychotherapy program. I conclude by suggesting the College of Registered Psychotherapists of Ontario should embrace Supervised Pastoral Education as an equivalent program and grant memberships, not just to those grand parented in, but to future Canadian Association for Spiritual Care Practitioners.

\u201cWe are also here\u201d\u2014Spiritual Care Practitioners\u2019 Experiences of the COVID-19 Pandemic: A Qualitative Study from Poland

Although healthcare professionals have become the symbol of risk and sacrifice during the COVID-19 pandemic, spiritual care practitioners (SCP) have also put themselves at great risk while offering their service in hospitals, hospices and other healthcare facilities. This study was designed to explore the lived experiences of SCP during the current health crisis in Poland. Semi-structured interviews were conducted with twenty-four SCP. Nine major themes emerged from the interviews: personal reactions to the pandemic, SCP’s perception of the pandemic, the impact of COVID-19 on the provision of spiritual care, spiritual needs during the pandemic, work-related emotions, the impact of the COVID-19 on religion, the role of spiritual care during the outbreak, the healthcare professionals’ perceptions of SCP and barriers to the provision of spiritual care during the pandemic. The SCP indicated that although the COVID-19 crisis has affected the availability of pastoral, religious and spiritual care, it has amplified the importance of such care and has positively influenced the visibility of SCP in modern healthcare practice. Nonetheless, in such desperate times, SCP are still neglected and should be further recognised and integrated into the healthcare system.

Spiritual Care as Part of an Interprofessional Model for Debriefing on an Oncology Unit.

Health care clinicians who care for seriously ill and dying patients have been known to be at higher risk for burnout and moral distress. When not well supported in their workplace, clinicians may suffer additional adverse outcomes to their overall wellbeing. Self-care is one way to help mitigate these adverse outcomes. The literature has described formalized debriefing not only as a self-care strategy but an intervention to promote healthy team development. The focus of this paper will showcase how social work and spiritual care practitioners in our institution worked collaboratively to support an inpatient oncology unit to address issues related to burnout by providing staff with monthly debriefing sessions intended to enhance self-care and wellness in the workplace.

A Chaplain's View on Religious Delusions (and Other Extraordinary Experiences): Towards a Theological Framework of Understanding.

In this article, the author discusses the question of how to evaluate delusions with religious or spiritual content from a theological perspective. How does a spiritual care practitioner listen to such delusions? The author proposes a theory of meaning that can account for both ordinary and extraordinary experiences and discusses a list of theological criteria in terms of which spiritual care practitioners can understand delusional and other extraordinary experiences and beliefs with spiritual content.

HAVE-H: Five Attitudes for a Narratively Grounded and Embodied Spirituality.

Western cultures are becoming increasingly cognitive. While this trend has produced many advances in science and related fields, it has also resulted in the neglect of human emotions and bodies in many domains. This article argues that spiritual care practitioners can counterbalance this trend through the embodiment of five specific attitudes summarized by the acronym HAVE-H ((a) honoring the origins of perception; (b) acknowledging the inevitability of projection; (c) validating experiential neutrality; (d) embodying a commitment to truth; and (e) holding space for metaphysics/transcendence/time).

Chart Audit of Spiritual Care Documentation: Continuous Quality Improvement.

Eight spiritual care practitioners at an acute care teaching hospital undertook a systematic chart audit of their documentation practices in the patient electronic health record. The purpose was to evaluate their practices using the standards of their professional association and regulatory college. A preliminary "mock audit" was essential for the overall success of the audit. Plans for ongoing chart audits will lead to continuous quality improvement. A limitation was that their manager acted as both improvement coach and performance evaluator.

The board-certified chaplain as member of the transdisciplinary team: An epistemological approach to spiritual care

ABSTRACTTransdisciplinary models of healthcare require specialists in all clinical disciplines including medical, nursing, social work, and spiritual care. Spiritual care is the least understood of these disciplines, often resulting in using unqualified people to provide such care. This may result in spiritual harm for the care recipients and inability for this discipline to provide meaningful contributions to care plan objectives. The failure to utilize qualified spiritual care practitioners is a result of a failure in epistemology. Spirituality, and thus the care of people’s spirits, is a unique domain of knowledge that is subject to its own epistemology and has its own criteria for knowing and validating its specialized domain. Current best practice in the United States and Canada requires the spiritual care specialist on a clinical transdisciplinary care team be a board-certified chaplain who has undergone the proper formation, education, training, and vetting. Whether other countries require board certification or not, the epistemological requirements for adjudicating qualified spiritual care practitioners remains the same. This article spells out what these epistemological requirements are for a spiritual care specialist.

Are the Providers of Spiritual Care in your Hospital Capable? Narrative Review of Professional Accountability in Australia

Although spiritual care practitioners, also variously known as pastoral care workers or chaplains, have had a foundational presence in most Australian hospitals, the discipline has been poorly regulated and does not have national standards of care. This leads to inconsistencies in the way hospital administrators are able to scrutinize the credentials, supervision processes and capability of the Spiritual Care workforce. This paper is a narrative review of the systems ensuring safe practice for the Spiritual Care workforce, focusing on the relationships between professional associations, clinical workforce capability and education in this field of practice in Australia. Substantial gaps and inconsistencies are revealed in the education and training of clinical practitioners, findings which align with variability of practitioner capability and which provide no assurance of quality or accountability. On the basis of these findings, recommendations are provided for relevant stakeholders with a view to improving safety and quality of care consistent with other health care professions and to assure the Australian public that accountability is core to the services provided in their name and under their jurisdiction.

What's the Point of Spiritual Care? A Narrative Response.

This article assumes spiritual care is relevant for all people, regardless of their faith affiliation. Building on the author's work in narrative spirituality, the discussion demonstrates how spiritual care practitioners can engage clients in their lived narratives, with Narrative Empowerment being the end goal. Several therapeutic practices are thus revealed, as well as three traits by which a client's Narrative Empowerment can be described and assessed.

Understanding, assessing, and intervening in the spiritual nature of medical events: theological and theoretical perspectives

ABSTRACTThat professional spiritual care practitioners are required to work in and communicate in secular healthcare is an increasing reality in this profession. However, the theological nature of spiritual care practitioners’ work does not always lend itself to easy translation into terms standard to healthcare. This is in part due to healthcare’s universal dependence on empirical science to determine its norms of care. Spiritual care practitioners therefore need to find ways to describe and justify their practices for other healthcare professionals. This article seeks to do precisely this by articulating a philosophical theory about the spiritual nature of medical events. This article furthermore develops a clinical tool for assessing a client’s progress in integrating the event into the fabric of their life. The result is there is now a way forward for understanding spiritual care practitioners’ theological work in secular contexts.

Spiritual Care in a Social Media Landscape.

Given that social media extends both connection and suffering that occurs in physical spaces into digital spaces, issues of connection and suffering are increasingly integrated across people's online and in-person lives. Spiritual care in a new media landscape necessitates spiritual care practitioners who are invested in listening to, exploring, and ministering to people's social media experiences, both their joys and their laments.

Incorporating living from the heart into medical education

Medical training poses many challenges to trainees' wellbeing. To address the impact of learning in a high turnover, high volume, acute care setting in the General Internal Medicine Clinical Teaching Unit, the Chief Medical Resident, in this personal account, shares how she and the Spiritual Care Practitioner united to form an innovative partnership. The introduction of the skills of spiritual care practitioners, generally referred to patients and families, to support medical students and residents resulted in the co-development and co-implementation of a unique, reflective, one-hour session. The objective was to create a protected space and time to discuss the impact of training and clinical experiences on medical trainees' wellbeing, in the context of “living from the heart”.

Spiritual care as a secular profession: politics, theory, and practice

ABSTRACTSpiritual care is a greatly misunderstood profession, both conceptually and practically. This misunderstanding was most recently demonstrated in the decision in the Canadian province of Saskatchewan to eliminate all public funds to spiritual care in public healthcare on the grounds of state impartiality with regard to religion. In contrast, this article argues that spiritual care is a secular practice which utilizes religious forms of knowledge to assist the aims of secular state-funded healthcare. Drawing upon such theorists as Jürgen Habermas, Charles Taylor, Paul Ricoeur, and Graham Ward, the article demonstrates that spirituality is the concept employed by secular healthcare to make sense of religious and metaphysical phenomena. As a healthcare profession uniquely suited to address religious and metaphysical concerns using the concept ‘spirituality’, spiritual care practitioners are thus shown to be an integral part of the secular healthcare team.

Frames for the Future: Developing Continuing Education & Professional Development Programs for Spiritual Care Practitioners: A Perspective from Victoria, Australia.

This article examines the educational issues in ongoing professional education for spiritual care practitioners. A meta-evaluation of registration and evaluation data over four years (between 2013 and 2016) of one such monthly program conducted by Spiritual Health Victoria (Australia) will be examined. Recommendations are made to support healthcare managers and spiritual care educators in designing and developing continuing education programs for spiritual care practitioners in a variety of other professional health and care contexts.

Numinous Physiology: A Theological Reflection on Angels, Trauma and Spirituality

In conversation with trauma specialist Bessel van der Kolk, this paper poses three questions for a theology of spiritual care. What does current thinking in trauma studies say about trauma and the human person? What does current thinking about trauma mean for the way we understand spirit and spirituality? What does this mean for the way spiritual care practitioners offer spiritual care to people living with trauma-related disorders? Taking seriously the advances in neuroscience that Van der Kolk applies to trauma studies, the paper proposes that spiritual care must understand spirit as a physiological reality and therefore welcome the whole human organism into the spiritual care space with kenotic humility. The conclusions of the paper are situated within the context of the theological conversation that follows the work of Friedrich Schleiermacher. It provides a critique of the recent definition of spirituality reported by Christina Puchalski, et al. [2014. “Improving the Spiritual Dimension of Whole Person Care: Reaching National and International Consensus.” Journal of Palliative Medicine 17(6): 642–56].

Walking the Labyrinth: Considering Mental Health Consumer Experience, Meaning Making, and the Illumination of the Sacred in a Forensic Mental Health Setting.

The purpose of this study is to explore the unique meaning and experience associated with walking a unicursal seven circuit outdoor Chartress Labyrinth and 11 circuit indoor Chartress Labyrinth for persons residing at a forensic mental health care facility. Over the past several decades labyrinths have enjoyed something of a renaissance and are often utilized by spiritual care practitioners and health care clinicians in order to support reflection, stress reduction, and the exploration of personal wellness in a sacred setting. Labyrinths are used in many settings including places of worship, hospitals, long-term care facilities, and parks. While labyrinths are becoming more prevalent, an understanding of their impact, particularly in the mental health context, is limited. This qualitative study supports a novel investigation of the meaning associated with participation in walking a labyrinth for persons residing at a forensic mental health care facility. The study design is a qualitative methodology involving transcribed interviews with 12 individuals resident at the Southwest Centre for Forensic Mental Health Care who participated in the 'Walking the Labyrinth' program as facilitated by spiritual care staff. A standardized interview protocol was utilized and the collected data was coded for themes. Several methods were employed to establish trustworthiness including triangulation by analyst and by theory/perspective. Member checking was also utilized in order to further validate the themes. Recommendations related to potential health care applications for labyrinths are identified. These include a focus upon the linkage between mental health care planning and labyrinth participation.

Evidence-based spiritual care

As spiritual care has increasingly been considered an integral component of a healthcare treatment plan, spiritual care practitioners have been encouraged to adopt an evidence-based orientation, just as evidence-based practice is encouraged in every other aspect of healthcare. Though the notion of 'evidence-based spiritual care' is still developing, increasingly research is conducted in order to provide an evidence base to the practice of spiritual care. This article reviews spirituality and spiritual care literature from June 2010 to December 2011 that employ empirical research methods. The majority of patient-focused studies concentrate on oncology and palliative care patients. In the review period, studies of care giver perceptions and experience came from multiple disciplines, including medicine, nursing, and chaplaincy. A discrepancy exists between the provision of spiritual care and the theoretical commitment of practitioners to offer such care. Practitioners continue to view spiritual care as part of their role to a greater extent than they provide it. This is often attributed to the absence of consensus in the field regarding the definition of spirituality, a lack of clarity of disciplinary role, and inadequate education for nurses and doctors about spiritual care. Research has further indicated that care givers' explorations of their own spirituality correlate with the provision of spiritual care. Although historically spiritual care has been most integrated into the care of palliative and oncology patients, researchers are developing and testing spiritual care assessment tools with other medical populations. In addition, they are evaluating these tools in diverse religious, cultural and national contexts. Conceptual analysis combined with empirical study of care giver understandings of spiritual care will assist in developing clarity and consensus about the definition of spirituality and spiritual care. Investigation and conceptualization of interdisciplinary roles and provision of spiritual care is needed for optimizing collaborative care. More knowledge is needed about how to effectively teach spiritual care.

Integrating Spiritual Care within Palliative Care: An Overview of Nine Demonstration Projects

Spiritual care is an essential domain of quality palliative care as determined by the National Consensus Project for Quality Palliative Care (NCP, 2009) and the National Quality Forum (NQF). Studies have consistently indicated the desire of patients with serious illness and end-of-life concerns to have spirituality included in their care. While there is an emerging scholarly body of literature to support the inclusion of spiritual care as part of a biopsychosocial-spiritual approach to health care, palliative care programs lack empirical guidance needed to effectively integrate best spiritual care practices.