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.     

In-Home Family Therapy as a Prevention of Foster Care Placement: Clients' Opinions About Therapeutic Services

The purpose of this qualitative study was to explore clients' perceptions of the in-home family therapy services they received. The sample consisted of 20 low-income families who were at risk for having their children placed in foster care, but who had ultimately retained custody of their children. Results indicate that families view in-home family therapy as a useful intervention. They expressed appreciation for the therapists, their availability, and the support offered. Participants also stated that they wished services could have been more frequent and longer-term. Implications for researchers and practitioners are discussed.     

Emotional expressiveness during worship services and life satisfaction: assessing the influence of race and religious affiliation

The purpose of this study is to see if an emotional expressive worship style is associated with life satisfaction. Our study model contains the following core relationships: (1) blacks are more likely than whites to worship in conservative Protestant congregations; (2) members of conservative congregations and blacks will attend church services more often; (3) blacks and conservative Protestants are more likely than either whites or members of other congregations to openly express their emotions during worship services; (4) individuals who express their emotions during church services will be more likely say they worship in a highly cohesive congregation; (5) people who worship in highly cohesive congregations will generalise this sense of connectedness to people outside their place of worship; and (6) those who feel closely connected with all people will experience a greater sense of life satisfaction. Finding from a nationwide survey provide support for each of these relationships.     

Older Mexican Americans and God-mediated control: exploring the influence of Pentecostal/Evangelical affiliation

A growing number of Mexican Americans are leaving the Catholic Church to join Pentecostal and Evangelical congregations. The purpose of this study is to explore the benefits that are associated with joining Pentecostal and Evangelical congregations. A latent variable model is specified that contains the following core relationships: (1) older Mexican Americans who affiliate with Pentecostal/Evangelical congregations will attend worship services more often; (2) older Mexican Americans who attend church more often will receive more spiritual support from their fellow church members; (3) older Mexican Americans who receive more spiritual support will develop a closer relationship with God; and (4) older Mexican Americans who have a close relationship with God will develop a stronger sense of God-mediated control. Findings from a nationwide survey of older Mexican Americans provide support for each of these linkages.     

Micro Practice and Faith-Based Initiatives: The Role of Religious Congregations in the Social Service System

SUMMARY

Religious organizations have provided services for older adults for thousands of years. For the sons and daughters of Abraham, this is Biblically mandated. Charitable Choice and the President's Office of Faith-Based Initiatives is only the most recent effort to bring this informal caregiving system into dialogue with the remainder of the formal social service system in the United States. At this time, religious congregations play a gap-filling role in the community service system. Their services range from informal volunteer-driven approaches to a local need, to large formal service systems. From the first draft of the Older American's Act, nutrition sites have specifically named religious congregations in partners with the service system. Today this system continues to be ready to support at least the seniors in their own congregations.     

Pastoral care for pastors: Toward a church strategy

Areas of stress in the ministry are compared with those in the other professions. After noting the similarities and outlining some of the unique areas of need in the ministerial profession, the author discusses some basic presuppositions about appropriate career support models. The specifics of one such judicatory support system are outlined briefly and are related to the specific needs discussed earlier. A plea is made for greater investment in pastoral care for pastors as a means of supporting effective ministry as well as of meeting the legitimate needs of the pastors.Prior to that time, he worked as a hospital chaplain-supervisor and for fourteen years was Professor of Pastoral Care and Counseling at the St. Paul School of Theology, Kansas City, Missouri.     

Understanding Respite Care Use by Families of Children Receiving Short-Term, In-Home Psychiatric Emergency Services

Respite care is widely believed to be an important support service for families raising a child with a disability. We report the findings of a respite care utilization study conducted within the context of a larger research and demonstration project examining three models of intensive, in-home services for children experiencing psychiatric crises. Respite care, both in-home and out-of-home, was a support service available to families in two of the three study conditions. Overall, 34% of 146 eligible families used in-home and or out-of-home respite care. Utilization was lower than the estimates developed prior to implementation, prompting an inquiry at the end of the first project year designed to maximize use and to gather more information on caregiver and service provider attitudes toward respite care. The inquiry included caregiver and provider focus groups, surveys, and enhanced data collection and analysis. Caregiver interviews indicated that many families did not fully understand what it meant to receive respite care or even that it was available to them. A comparative analysis of respite care users and non-users revealed that respite care users were more likely to have younger children, children who had a greater number of assessed functional impairments, and fewer social supports. Respite care users also reported greater difficulty managing their children's difficult behaviors.     

The perspective of evil in understanding and treating child abuse

This paper places the problem of child abuse in the perspective of evil. In so doing it calls into question the amoral assumptions of social science and human services. The current social science paradigm paradoxically dismisses evil as a real factor in the world, despite its concern for indisputably moral issues such as child abuse. The practical advantages of a perspective incorporating evil are several. Among them are a more realistic appreciation of the need for mechanisms of social control in preventing abuse, the role of confession and conversion, and the role of pastoral care as a support system for families.     

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.     

Moving from Principles to Practice: Recommended Policy Changes to Promote Family-Centered Care

This paper emphasizes the value of family-centered care. Discussion highlights family-centered philosophies (e.g., Systems of Care [SOCs]) and practice models (i.e., wraparound) and identifies discrepancies between conceptualizations and actual practice. Data from multiple sources detail issues in fidelity to family-centered values and needs and risks experienced by siblings of children with severe emotional disturbance and their caregivers. This discussion provides a springboard for policy recommendations to strengthen family support programming and enhance family-centered care, from modifying funding streams such that systems extend their reach beyond children with full-blown, diagnosable problems (those meeting standards of "medical necessity), to supporting prevention and early intervention initiatives that address families as targets for intervention. Recommendations include ensuring that communities with SOC funding address the needs of families; broadening Medicaid rules and definitions; expanding the range of reimbursable activities and services; and increasing funding for evaluating family-centered care models and family support programming.     

Focused on the Family? Religious Traditions,Family Discourse,and Pastoral Practice

The relationship between religion and the family has recently reemerged as an important object of sociological inquiry. However, research has largely overlooked the ways in which the family discourse produced by specific religious traditions is connected to family-focused pastoral practices of congregations. Using data from the National Congregations Study, we find that family discourse and pastoral practice are only "loosely coupled" to one another. Ideological differences among mainline Protestant, conservative Protestant, and Roman Catholic congregations do not translate directly into differences in family ministry offerings. These findings help explain why research often finds that religion exercises uniform effects on family life, insofar as most congregations offer a similar package of ministries even though their family discourse is markedly different .     

Healthcare Policy in the United States: A Primer for Medical Family Therapists

As family therapists increasingly practice in healthcare settings, they need to be aware of forthcoming changes in healthcare policy and the impact of these changes on their clinical work and the lives of their clients. In this paper, we provide a primer on healthcare policy for family therapists, which describes current and proposed changes in healthcare that will potentially revolutionize healthcare delivery for families. We describe three key initiatives: (1) Triple Aim; (2) the Accountable Care Organization; and (3) the Patient Centered Medical Home. We conclude with a discussion about future directions and healthcare policies that include families.     

Predictors of Service Utilization Among Youth Diagnosed with Mood Disorders

In this study, I investigated patterns and predictors of service utilization for children with mood disorders. The Behavioral Model for Health Care Utilization was used as an organizing framework for identifying predictors of the number and quality of services utilized. Hierarchical regression was used in secondary data analyses of the Multi-Family Psychoeducational Psychotherapy study (MF-PEP), a randomized controlled trial of 165 children aged 8–12 with mood disorders. The children were using an average of two services, with pharmacotherapy and school services as most frequent. Children with bipolar disorders used significantly more and higher quality services than children with depressive disorders. Parent knowledge of mood disorders, area of residence, and perceived need for treatment were all related to the number of services families were utilizing. Parent knowledge of mood disorders and treatment, child’s age, and mood symptom severity were all predictors of the quality of services being utilized. Findings highlight the impact of non-need factors on service utilization and the potential to decrease disparities caused by these factors. For example, increasing efforts to educate both the general public and individual families coming in for treatment about children’s mental health may improve service utilization patterns in this population.     

... In the parish

Conclusion In the past fifteen years there has been change in the field of pastoral theology. Titles of anniversary books and annual conferences do have a new look. This progress gives hope that pastoral theology in the parish of the next two decades will have grown as much beyond today as today has grown beyond the early fifties. Redefinition of model, clarification of vocation for the whole parish, and a new clericalism are possible. When they come alive, pastoral theology will have kept faith with those who minister; more important, it will have contributed to the relevancy of Christianity for a changed world; most important, it will have kept faith with faith experienced.     

Training Pediatric Psychologists for Perinatal Behavioral Health Services in a Pediatric Hospital

Although pediatric hospitals specialize in providing care to children and adolescents, at The Children’s Hospital of Philadelphia (CHOP), our team has been providing behavioral health services for two unique parent populations—parents with a child in the Newborn Infant Intensive Care Unit and pregnant women carrying fetuses with specific birth defects and receiving prenatal care in the Center for Fetal Diagnosis and Treatment. A new training program was developed to expand the scope of pediatric psychologists’ practice to include perinatal behavioral health services, specifically for these two unique parent populations served at CHOP. The program includes direct service provision for adult mental health concerns, as well as education and support to help families cope with the existing medical conditions. This article describes the training program and its implementation as a model of training for other pediatric hospitals. The roles of psychologists embedded in these units and hospital privileges are discussed.     

Pastoral counselling: an American perspective

While pastoral counselling is a function of pastoral ministry in religious communities, it is also a specialised ministry requiring professional training that extends well beyond a pastoral/ theological education for ministry, as well as beyond the confines of religious communities. This article is an American perspective on Certified Pastoral Counsellors as mental health care providers for individuals, couples, and families, generally on a fee-for-service basis, with many qualifying for reimbursement by private and federal third party payers. It demonstrates that pastoral counselling as practised in the USA is spiritually integrated counselling and psychotherapy, requiring graduate academic and clinical work in these disciplines as well as graduate education in religious studies. It offers an American perspective on this specialised ministry of mental and relational health and discusses its identity and function, methodology, supervision requirements, and the clinical use of religious resources, including a case illustration.     

Stewardship Models of Pastoral Care,Counselling and Supervision: The Commonians Meet Ricoeur at Worship

The common factors debate in psychology and, more recently, marriage and family therapy is slow to erupt in pastoral care and counselling. This article introduces the common factors debate into pastoral science by proposing the Stewardship Models of Pastoral Ministry and Supervision. The model integrates common factors research and pastoral practice using Ricoeur’s “economy of the gift” ethic. The model’s focus is pastoral care, counselling and supervision in congregations, a unique community context in search of an adequate pastoral praxis.     

Race Differences in Congregational Social Service Activity

This article uses data from the 1998 National Congregations Study, a survey of a representative sample of 1,236 religious congregations in the United States, to examine the social service activity of African-American congregations. The first goal is to explore the question of whether African-American religious congregations participate more (or less) than other congregations in social service provision in general. Then, the focus shifts to specific types of social service programs in order to determine if African-American congregations tend to specialize in the provision of certain types of services. The rates at which congregations support nine different types of social service programs are reported, and participation in programs is then subjected to logistic regression analysis. Significant race effects for African-American congregations exist for four types of programs: clothing, substance abuse, tutoring/mentoring, and nonreligious education. These findings, particularly the effect on education and mentoring programs, counter the assertion by Lincoln and Mamiya (1990) that African-American congregations are not doing enough in areas that are critical to African-American youth.     

The Ministry of Care in Twenty-First-Century Protestant Congregations

This article explores the importance of the congregational setting for determining the meaning of pastoral care and counseling in that setting. The congregational setting is brought into dialogue with clinical and teaching settings and with contemporary pastoral care and counseling paradigms. It is proposed that the congregational setting should contribute to the dialogue by providing an understanding of congregations seen in relation to societal change and crisis. Implications for understanding the ministry of care in the congregational setting are drawn.     

Formation for the Whole Church: A New/Old Vision of Theological Education in the 21st Century

This article offers a proposal for a vision of theological education beyond the boundaries of training and teaching for traditional professional ministry roles. Particular attention will be given to the idea of education as formation and the shared role academic institutions have with congregations. Implications for reshaping definitions of student and faculty will be explored.