Provision of spiritual and pastoral care facilities in a high-security hospital and their increased use by those of Muslim compared to Christian faith

The relationship between religion and psychiatry remains controversial amongst British psychiatrists. We looked at the provision of spiritual and pastoral care facilities in a high-security hospital and the role of faith chaplains with particular reference to the Muslim minority group. There was a significantly higher uptake of pastoral care services amongst those of Muslim faith compared to Church of England and Roman Catholic Christians. Possible reasons for this are discussed. Resources allocated for the Muslim faith group were limited and heavily dependent on the availability of the Muslim faith chaplain. Our study highlighted the need for clearly defined standards for the provision of spiritual and pastoral care within high-secure psychiatric hospitals, and by implication other NHS psychiatric settings, a re-examination of the role of the faith chaplain in relation to the clinical team, and raised questions about the equitable allocation of resources between various faith groups within the hospital.     

Nursing: Significance for spiritual care

Nurses can be seen to contribute significantly to the spiritual objectives and programs in hospitals and other health agencies under religious auspices. One impressive example is nursing involvement with and cooperation in the pastoral care program at North Carolina Baptist Hospital in Winston-Salem. At this hospital the nurse is both an assistant to and a coworker with the chaplain and functions in many ways as facilitator and supporter in his spiritual mission.     

Providing Pastoral Care for the Elderly in Long Term Care Facilities Without a Chaplain Utilizing Coordinated Congregational Resources

Elderly persons living in long term care facilities are often separated from or have no pastoral care sources. Spiritual care by chaplains was not available in any of the six nursing homes in Wausau, Wisconsin. Twelve Lutheran congregations in the area worked out a plan to provide the necessary pastoral care. The congregations formed a coordinating agency, Greater Wausau Christian Services, Inc. Through the services of one staff person, the director, who enlisted the lay and pastoral resources of the participating congregations, pastoral care was provided. Worship led by the pastors, meaningful visits made by trained and supervised lay people, and the availability of a trained chaplain became a reality for nearly seven hundred residents in the six long term care facilities.     

A national survey of health care administrators' views on the importance of various chaplain roles

A random sample of hospital administrators throughout the United States was surveyed about their views on the importance of eleven chaplain roles and functions. The 494 respondents fell into three categories: (1) directors of pastoral care departments (N = 132); (2) administrators of hospitals that have a pastoral care department (N = 180); and (3) administrators of hospitals that do not have a pastoral care department (N = 182). All three groups considered all eleven roles to be relatively important, although administrators of hospitals that do not have a pastoral care department gave lower ratings, overall. Meeting the emotional needs of patients and relatives were seen as chaplains most important roles, whereas performing religious rituals and conducting religious services were seen as least important by all three groups. In all but a few instances, the level of importance that administrators assigned to the various roles were positively related to their ratings of their own religiousness and spirituality (r's = .11 to .26, p < .05).     

A national survey of hospital directors' views about the importance of various chaplain roles: differences among disciplines and types of hospitals

A national random sample of hospital directors was asked to rate the importance of seven categories of chaplain roles and functions: 246 nursing directors, 267 social services directors, 307 medical directors, and 611 pastoral care directors. All four groups rated end-of-life care, prayer, and emotional support as being between very important and extremely important. Other roles, including consultation, advocacy, community outreach, and religious services and rituals were rated significantly less important. Significant differences were found across disciplines and hospital settings (general, psychiatric, etc.). Medical directors rated most chaplain roles lower than other directors did, and directors in psychiatric hospitals rated all roles, except religious services/rituals, lower than their counterparts in other types of hospitals. The importance that directors accorded to all the chaplain roles examined was also influenced by their own spirituality and religiosity, as well as the religious affiliation of their institution.     

A Jungian Perspective on Therapy at the End of Life

This paper explores the insights of Carl Gustav Jung with respect to pastoral care and counseling. Particular focus is given to a reading of the theorist that raises the possibility for, and challenge of, pastoral psychotherapy at the end of life. Jung's writing offers an important lens for examining a critical challenge of our age–the means by which pastoral caregivers assist persons to live fully and meaningfully even at life's end. The author asserts that the role of the pastoral caregiver is crucial for helping people to bring their own lives to completion. has served as hospice chaplain, parish pastor, and campus minister. Currently, he is a Ph.D. student and CPE supervisor-in-training at Claremont School of Theology and Methodist Hospital of Southern California.     

The modern mystic: a spirituality for health care workers

In this essay the author suggests that a deepening of one's spirituality may be the nurture that is required to remain fulfilled when working in the health care professions; and she illustrates this thesis by tracing a young chaplain's deepening spiritual journey in a Clinical Pastoral Education program. As the young aspiring chaplain attempts to minister to Joe, a dying farmer, he embarks on a path that leads to a religious experience. The essay concludes by listing eight criteria or guidelines that may help pastoral caregivers realize that they themselves may be nurtured by meeting the Holy in their caregiving acts.     

Rolling away the stone: post-abortion women in the Christian community

This article seeks to bring to awareness and address the issues of a neglected group of people in need of pastoral care: women who have had an abortion. It offers some commentary regarding what many women experience following an abortion, focuses on the story of a specific woman, and goes on to offer a biblical perspective for a pastoral response to their needs. Responses to the article are offered by a healthcare chaplain and a seminary professor.     

Transcultural hospital pastoral care

Transcultural hospital pastoral care's subjects, the immigrant and the refugee, are described. Differences and similarities are noted. Three difficulties—culture shock, prejudice, and ethnocentrism—are followed by principles of transcultural hospital pastoral care, the significance of hospitalization, and a case history.The Rev. David G. Hawkins, B.A., S.T.M., D. Rel., R.S.W., St. George's Anglican Church in Vancouver, is a chaplain at Vancouver General Hospital.     

Chaplaincy research: a case study

The authors report the pragmatic elements of conducting an empirical chaplaincy research project. The article offers the step-by-step process of implementing, coordinating, and completing a sound quantitative research project. The authors offer a definitive answer to the question, "Can a staff chaplain integrate providing pastoral care and doing a quantitative research project as principle investigator"?     

Faith-to-faith at the bedside: theological and ethical issues in ecumenical clinical chaplaincy.

Chaplains who serve in a clinical context often minister to patients representing a wide variety of faiths. In order to offer the best pastoral care possible, the chaplain should first possess a set of personal theological convictions as a foundation for ministry. Second, he or she needs to be sensitive to the beliefs and practices of the patients. Third, it is vital to develop a relationship of acceptance and trust not only with patients under their care, but also with family members and caregivers as well. At times, situations will arise that are purely religious or theological. In a clinical setting, however, the questions and problems that arise more often are both theological and ethical. It is beneficial for the chaplain to be involved in an ethics committee, where the specifics of each case can be discussed, and staff can offer counsel to patients and their families. This study examines issues that chaplains face at the bedside, such as terminal care, life-prolonging treatments, dementia, persistent vegetative state, and euthanasia-assisted suicide. We will discover that those who are involved in clinical pastoral ministry will be called upon to be a comforter, mediator, educator, ethicist, and counselor.     

PAUSE for assessment: a multi-level long-term care assessment tool

The author of this article noes that as health care improves, paradoxically, long-term care residents become "older and sicker." In response, many facilities now offer a wide range of levels of residential care, from independent living to Hospice care--and all under the same roof. Chaplains in such facilities can play a key part in identifying changes in individual residents' needs over time. Toward this end, the author introduces PAUSE--a one-page questionnaire designed to be completed by the chaplain after a visit with a resident. The items reflect the chaplain's impressions of several key aspects of the resident's well-being from a single interaction. The questionnaire serves several purposes: it documents the fact of a visit; it allows comparison of impressions at different times and by different visitors; and it quickly highlights "red flag" areas of possible concern for interdisciplinary referral, pastoral follow-up, or possible change in level of care. It might also function as a teaching tool for student chaplains.     

Values interpretation: A new model for hospital ministry

The importance of values in clinical settings is a topic of increasing discussion in the medical literature, but the nature of values and the process of interpreting them have received little attention. The hospital chaplain or religious professional is an underused resource in addressing values issues. This paper summarizes the current models of the hospital chaplaincy in historical context, and then develops a new model drawn from the disciplines of pastoral care and clinical medical ethics in order to address problems involving values in clinical settings. The model construes the chaplain as values interpreter who provides both consultation and liaison functions in clinical situations. We present a clinical case to illustrate the role of the values interpreter. We conclude that the religious professional can make an important contribution to both clinical decision making and medical education through such a model.The authors thank Don S. Browning, Ph.D., and Thomas H. Jobe, M.D., for their critical readings of earlier versions of this paper.     

Homelessness

The author, acknowledging the reality of homeless persons in most communities, explores the meanings and dynamics of homelessness, and the need to recognize the variety of participants needing to be recognized in appreciating the complexity of this segment of society. He raises the issue of how pastoral caregivers become involved in providing authentic care to this sub-culture and offers examples from his own experiences as a volunteer chaplain in the Salvation Army Corps.     

Perceptions of Chaplains’ Value and Impact Within Hospital Care Teams

Many scholars have written about the role of spirituality in health care. One mechanism for incorporating spirituality into the care of patients is to integrate clinically trained chaplains into hospital care teams. We examined in a mixed-methods fashion, the effects of this type of integrated care team within a teaching hospital setting. The quality and impact of chaplain involvement were studied from patient and physician-in-training perspectives, using data from more than 200 patients and physicians in training. Findings clearly show that clinically trained chaplains can contribute meaningful expertise and real value to the quality and comprehensiveness of patient and physician experiences.     

Contemplation and compassion: the heart of a Franciscan spirituality of clinical pastoral supervision

After five years of supervising CPE modules in two different hospitals in South Africa, a chaplain supervisor reflects on how his Franciscan spirituality had impacted his supervisory ministry. He describes how he was able to narrow the impact to two defining Franciscan qualities: contemplation and compassion. This article explores the relationship between spirituality and clinical pastoral supervision. Then the Franciscan dimension of contemplation and compassion of Franciscan spirituality are considered. Finally some contours of a Franciscan spirituality of clinical pastoral supervision are described.     

Chaplaincy and Mental Health Care in Aotearoa New Zealand: An Exploratory Study

This paper summarizes an initial exploratory study undertaken to consider the ministry of New Zealand chaplaincy personnel working within the mental health care context. This qualitative research (a first among New Zealand mental health care chaplains) was not concerned with specific health care institutions per se, but solely about the perspectives of chaplains concerning their professional contribution and issues they experienced when trying to provide pastoral care to patients, families, and clinical staff involved in mental health care. Data from a single focus group indicated that chaplains were fulfilling various WHO-ICD-10AM pastoral interventions as a part of a multidisciplinary and holistic approach to mental health care; however, given a number of frustrations identified by participants, which either impeded or thwarted their professional role as chaplains, a number of improvements were subsequently identified in order to develop the efficiency and effectiveness of chaplaincy and thus maximize the benefits of pastoral care to patients, families, and clinical staff. Some implications of this exploratory study relating to mental health care chaplaincy, ecclesiastical organizations, health care institutions, and government responsibilities and the need for further research are noted.     

Referrals to chaplains: The role of religion and spirituality in healthcare settings

Given the increasing importance of understanding how healthcare workers interact with the principal person designated to meet patients’ spiritual needs— the chaplain— the current study provides an inter-disciplinary perspective of the role of chaplains (and spirituality) in patients’ emotional, physical, and spiritual health. The study surveyed a randomly selected national sample of hospital directors in four disciplines: medicine (n?=?278), nursing (n?=?230), social services (n?=?229), and pastoral care (n?=?470). Participants rated the importance of referring patients to chaplains for four different areas: pain/depression, anxiety/anger, treatment issues, and loss/death/meaning. Results revealed significant differences in referral patterns for type of hospital, professional discipline, the hospital's religious affiliation, and self-reported spirituality. Results are discussed in relation to historical views of spirituality and religion within the different disciplines.     

Inner Night and Inner Light: A Quaker Model of Pastoral Care for the Mentally Ill

The same theological principles that motivated Quakers in institutional reform work continue to influence uniquely Quaker approaches to pastoral care for the mentally ill today. This unity of psychological and spiritual care, inspired by George Fox, was first apparent in the work of the Religious Society of Friends asylum reforms in the nineteenth century. These principles matured during the early twentieth century as they entered into dialogue with Jung and Jungian psychology and continue to inspire Quaker pastoral care models today. This paper will examine how theological concepts affect the way Friends approach mental health care, historically and in contemporary times.     

Prison pastoral care: The seer as a new paradigm

The purpose of this essay is twofold: to review two existing paradigms (the Priest and the Prophet) of pastoral care with prisoners; to propose a new paradigm (the Seer). The prison chaplain has been traditionally identified as a priest or a prophet. The change of pastoral setting from parish to prison is a drastic one that requires a paradigm shift. Incarceration is understood in terms of liminality which is a transitional period of a life re-ordering. To those in liminality, the Seer as a divine visionary of hope comes to reawaken a sense of God's presence and aims at renewing of covenant faith.This article is an edited version of an address presented by the author to the Chaplains of Tennessee Department of Corrections at their annual meeting in January 1990.