Pain Control and Chaplaincy in Aotearoa New Zealand

This paper summarizes the results of 100 New Zealand health care chaplains with regard to their involvement in issues concerning pain control within the New Zealand health care context. Both quantitative (via survey) and qualitative methods (in-depth interviewing) were utilized. The findings of this study indicated that approximately 52 % of surveyed hospital chaplains had provided some form of pastoral intervention directly to patients and/or their families dealing with issues concerning pain and that approximately 30 % of hospital chaplains had assisted clinical staff with issues concerning pain. NZ chaplaincy personnel involved in pain-related issues utilized a number of pastoral interventions to assist patients, their families and clinical staff. Differences of involvement between professionally stipended hospital chaplains and their volunteer chaplaincy assistants are noted, as are the perspectives of interviewed chaplains about their pastoral interventions with issues relating to pain. Some implications of this study with respect to chaplaincy utility, training and collaboration with clinical staff are noted, as are comparisons with international findings.     

Organ Procurement and Health Care Chaplaincy in Australia

As part of an Australian national project, quantitative data via a survey were retrospectively obtained from 327 Australian health care chaplains (staff and volunteer chaplains) to initially identify chaplaincy participation in various bioethical issues—including organ procurement. Over a third of surveyed staff chaplains (38%) and almost a fifth of volunteer chaplains (19.2%) indicted that they had, in some way, been involved in organ procurement issues with patients and/or their families. Nearly one-fifth of staff chaplains (19%) and 12% of volunteer chaplains had also assisted clinical staff concerning various organ procurement issues. One hundred of the surveyed chaplains volunteered to an interview. Qualitative data were subsequently coded from 42 of the chaplains who had been involved in organ procurement requests. These data were thematically coded using the World Health Organization ‘Pastoral Intervention Codings’ (WHO-PICs). The qualitative data revealed that through a variety of pastoral interventions a number of chaplains (the majority being staff chaplains) were engaged in the critical and sensitive issues of organ procurement. It is argued that while such involvement can help to ensure a holistic and ethically appropriate practice, it is suggested that chaplains could be better utilized not only in the organ procurement process but also for the training of other chaplains and clinicians.     

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.     

Making Sense of Suffering and Death: How Health Care Providers’ Construct Meanings in a Neonatal Intensive Care Unit

Biomedical technology has progressed at a pace that has created a new set of patient care dilemmas. Health care providers in intensive care units where life-sustaining therapies are both initiated and withdrawn encounter clinical scenarios that raise new existential, theological, and moral questions. We hypothesized that there might be broad patterns in how such staff understand these questions and make sense and meaning from their work. Such meaning making might be the key to working with the critically ill and dying while helping to create and sustain a meaningful context for personal living. This article presents themes evident in an in depth analysis of open-text responses to a spiritual and religious questionnaire survey completed by staff in one neonatal intensive care unit. The data reveal the central roles of perceived infant suffering and death in these providers’ work experience and details how they understand the ultimate meaning of the suffering and death. We investigate patterns in how different providers articulate their individual attributes and motivations for working in intensive care. We found a surprising range of religious, spiritual, existential, and other meaning-making systems that underpin how staffs understand their work and how, certain of them, even define their purpose in life as caring for critically ill infants and their families.Wendy Cadge received her Ph.D. in sociology from Princeton University. She is currently an Assistant Professor of Sociology at Bowdoin College and a Robert Wood Johnson Foundation Scholar in Health Policy Research at Harvard University. Her research examines a range of topics related to religion in contemporary American life including religious pluralism, religion & immigration, religion & sexuality, and religion & the arts. Her first book is titled, Heartwood: the First Generation of Theravada Buddhism in America (Chicago: University of Chicago Press, 2005). Dr. Cadge’s current research focuses on the history, presence, and significance of religion and spirituality in American hospitals. Elizabeth A. Catlin is a senior faculty neonatologist at the Massachusetts General Hospital (MGH) in Boston and an Associate Professor of Pediatrics, Harvard Medical School. Dr. Catlin completed general pediatric training at Tufts University School of Medicine, Boston, followed by subspecialty training in neonatal–perinatal medicine at Brown University School of Medicine, Providence, Rhode Island. Dr. Catlin served as Chief of Neonatology at MGH from 1992 to 2004. She completed a Kenneth B. Schwartz Foundation fellowship in Clinical Pastoral Education in 1999. Dr. Catlin has a long-standing interest in spiritual distress, tragic decision-making, suffering, bereavement, and religious components of patient care in neonatal intensive care. Correspondence to Elizabeth A. Catlin, ecatlin@partners.org.     

Persistence in seminary and in ministry

A follow-up study of 672 seminary students from 14 seminaries who took the Theological School Inventory in 1962 and 574 from 10 seminaries who took it in 1973 investigated factors involved in persistence in seminary and in ministry. Among those found were definiteness of decision, interest in parish ministry, a supportive spouse, unambivalent resolution of the authority problem, good role models in father and ministers. Motivations included redemptive outreach, pastoral care, Christian insight and scholarship, the encouragement of other people and a sense of effectiveness in ministry.Dr. Cardwell is Assistant Professor of Psychology and Counseling at Christian Theological Seminary, 1000 W. 42nd St., Indianapolis, Indiana 46208. This study was the basis for her Ph.D. dissertation, Indiana University, June, 1978. TSI data for the 1973 subjects were made available by Richard A. Hunt, Ph.D., Professor of Psychology, Southern Methodist University, and Director of Ministry Inventories, P.O. Box 8265, Dallas, Texas 75205. TSI data for the 1962 subjects were coded and made available by Edgar W. Mills. Ph.D., presently visiting Associate Professor of Sociology, University of Texas, San Antonio, formerly Director, Ministry Studies Board. Special credit is due the 16 seminaries who cooperated by furnishing follow-up data.     

Psychiatry and religion circa 1978: Analysis of a decade,part I

Prior tensions between science and religion have dissolved and coalesced into new alliances based on ideology and philosophy. This general cultural pattern is reflected in the realignment of interests and interactions between psychiatry and religion. There are increasing numbers of mental health professionals with devout religious commitments and involvement in religiously oriented mental health activities; while clergy have developed new organizational structures to reflect many diverse mental health interests, including pastoral counseling, community mental health chaplains, hospital chaplains, and expanded parish ministries. Clinical and research literature has continued to rapidly proliferate, while a unique genre of pastoral care and counseling literature has emerged. A decade ago there was hope for an amicable alliance between specialists in psychiatry and in religion. That irenic quest has shifted into overlapping goals and roles, with tensions between those engaged in universalistic norms and those seeking to develop particularistic norms.Dr. Pattison is Professor of Psychiatry and Human Behavior, Social Science, Social Ecology; Acting Chairman, Department of Psychiatry and Human Behavior, University of California, Irvine; Deputy Director, Training, Consultation, Education Division, Orange County Department of Mental Health. His address is UCI Medical Center, 101 So. The City Dr., Orange, Ca. 92668. Part II of this article will be published inPastoral Psychology, Volume 27, No. 2.     

An Overview of Primary Care Family Psychology

This paper describes the application of family psychology to the primary care setting—in service, education and training, and scholarship. Primary care family psychology integrates family systems with biopsychosocial theory, yielding an approach that is uniquely suited to the generalist demands of primary care. This approach attends especially to the effects of relationships on health and healthcare, using the family as a potential resource to the patient just as the healthcare team is a resource to the clinician. Training opportunities in primary care family psychology are growing. The University of Rochester School of Medicine and Dentistry fellowship is described as an example, with core primary care family psychology training in four different clinical sites: Family Medicine, Internal Medicine, Pediatrics, and Obstetrics/Gynecology. Susan H. McDaniel is Professor of Psychiatry & Family Medicine, Director of Family Programs & the Wynne Center for Family Research in Psychiatry, and Associate Chair of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York. Dr McDaniel also directs the Primary Care Family Psychology Fellowship. Picter LeRoux is Associate Professor of Psychiatry & Pediatrics, and Director of the Family Therapy Training Program in Psychiatry, University of Rochester School Medicine and Dentistry, Rochester, New York. Dr. LeRoux also heads the Pediatric Track of the Primary Care Family Psychology Fellowship.     

Voices outside the camp: Some significant nonpastoral books in 1979–80

A review article of recent books in disciplines related to pastoral care which may increase the effectiveness of the pastor's care and counseling ministries. Books selected challenge prevailing assumptions, offer new ways to perceive the pastoral task, and provide new and significant information. Books are reviewed from personality and psychotherapy, family history, theory and therapy, studies of violence and victimization, psychology and theology, and general ministry theory.Dr. Hunter is Associate Professor of Pastoral Theology and Book Review Editor ofPastoral Psychology. His address is: Candler School of Theology, Emory University, Atlanta, Georgia 30322.     

Inpatient cognitive therapy: Detours,potholes, and roadblocks along the routes of progress

Developing innovative treatment approaches for psychiatric inpatient settings is an emerging area of interest. This paper delineates the detours and circuitous paths treatment with difficult patients often takes. Differences between typical outpatient and inpatient care are described and the obstacles to cognitive therapy that inpatients present are discussed. The role of case conceptualization is emphasized as a way to promote increased effectiveness. Finally, methods for maximizing therapeutic opportunities with inpatients are suggested.Robert D. Friedberg, Ph.D. is a staff psychologist on the Cognitive Therapy Unit at Mesa Vista Hospital and is an adjunct faculty member at the California School of Professional Psychology.Raymond A. Fidaleo, M.D. is the Clinical Director of the Cognitive Therapy Unit at Mesa Vista Hospital. He is also the Medical Director of the Cognitive Therapy Institute as well as an Associate Professor of Psychiatry at the University of California-San Diego School of Medicine. Dr. Fidaleo engages in private practice in San Diego, CA.Michele M. Mikules, M.A. is a predoctoral psychology intern with the United States Navy at Balboa Hospital, San Diego, CA.     

Chaplain–Physician Consultancy: When Chaplains and Doctors Meet in the Clinical Context

This paper summarizes the perspectives of 327 Australian health care chaplains concerning their interaction with physicians within the clinical context. In general terms the findings indicated that nearly 90% of chaplains believed that it was part of their professional role to consult with physicians regarding patient/family issues. Differences of involvement between volunteer and staff chaplains, Catholic and Protestant, male and female chaplains and the type of chaplaincy training are noted, as are the perspectives of chaplaincy informants regarding their role in relation to physicians. Some implications of this study with respect to chaplaincy utility and training are noted.     

Importance of School Health Education An Interview with Dean Joyce Hopp

Joyce W. Hopp is Dean of the School of Allied Health Professions at Lorna Linda University. Program development in response to market demands is her forté Dr. Hopp is also a Professor of Health Promotion and Education in the School of Public Health at Loma Linda University, a position she has held for 30 years.

Dr. Hopp began her career in healthcare as a nurse. Her primary interest is health education in Seventh-day Adventist educational institutions. The interview addresses her educational progression to a Ph.D., her experience in training healthcare professionals, and her philosophy of Christian education. Also included are her suggestions for future research in Christian health education.     

Ministers’ Perceptions of Depression: A Model to Understand and Improve Care

While depression is a significant worldwide health problem, fewer than half of individuals seek care. Faith-based communities may play an important role in improving the knowledge of and linkage to depression care. Focus groups of Caucasian and African-American clergy were conducted to explore these issues. Using a grounded theory approach five themes emerged, including explanatory models of depression, barriers and facilitators to care, and recommendations for involving religious communities. A model of depression care pathways was constructed that integrates secular and spiritual approaches. The findings highlight the need for targeted interventions to build trust between clergy and mental health professionals. Teresa L. Kramer, Ph.D., is Chief Psychologist and Associate Professor of Psychiatry in the College of Medicine, University of Arkansas for Medical Sciences in Little Rock. She has conducted research in child, adolescent and adult mental health assessment, outcomes, and quality of care. Her current research on adolescent depression is funded through a Research Career Development Award from the National Institute of Mental Health. She is currently developing faith-based programs to educate ministers and their congregations about depression-related illness. Dean Blevins, Ph.D., teaches in the Department of Psychiatry, College of Medicine, at the university and is associated with the Center for Mental Health & Outcomes Research, Central Arkansas Veterans Healthcare System, and the South Central Mental Illness, Research, and Clinical Center in Little Rock. Terri L. Miller, Ph.D., also teaches in the Department of Psychiatry. Martha Phillips, Ph.D., is at the Department of Human Services in Little Rock. Vanessa Davis and Billy Burris are employed at the Division of Behavioral Health Services, also in Little Rock.     

Correctional Services and Prison Chaplaincy in Australia: An Exploratory Study

This paper summarizes an exploratory study undertaken to consider the work of Australian chaplaincy personnel ministering to prisoners within correctional facilities. This qualitative research was not concerned with specific correctional institutions per se, but predominantly about the perspectives of chaplains concerning their professional contribution and issues they experienced while trying to provide pastoral care to prisoners. Data from a single-focus group indicated that prison chaplains were striving to fulfill religious and spiritual duties according to national and international standards for the treatment of prisoners. Given various frustrations identified by participants, that 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 prisoners. Implications of this exploratory study relate not only to prison chaplaincy but also to ecclesiastical organizations, correctional facilities, governments and the need of support for further research to be conducted.     

Spiritual direction and pastoral counseling

The thesis is that spiritual direction is a form of pastoral counseling-indeed, the core from which all other forms of pastoral counseling radiate, since all pastoral counseling aims ultimately to help others to ground their lives in God. The major elements of spiritual direction are described in an attempt to justify the thesis.Dr. Barry is Associate Professor of Pastoral Theology at Weston School of Theology and a staff member of the Center for Religious Development, both in Cambridge, Massachusetts. He is a priest of the Roman Catholic Church.     

Spiritual advisors and old age psychiatry in the United Kingdom

This survey investigates the role and views of NHS spiritual advisors across the United Kingdom on the provision of pastoral care for elderly people with mental health needs. The College of Health Care Chaplains provided a database, and questionnaires were sent to 405 registered NHS chaplains/spiritual advisors. The response rate was 59%. Quantitative and qualitative analyses were carried out. Spiritual advisors describe their working patterns and understanding of their roles within the modern NHS, and their observations of the level of NHS staff awareness of the importance of spiritual issues in the mental health care of older adults. They provide insights into possible negative and positive perceptions of their roles at a service level, and contribute suggestions of topics relevant to shared education between pastoral care and clinical services. This survey further highlights ethical and operational dimensions at the point of integration of the work of spiritual advisors and multidisciplinary teams.     

A Christian for the Christians, a Muslim for the Muslims? Reflections on a Protestant View of Pastoral Care for all Religions

Whereas in the first half of the 20th century, proclamationwas the focal point of pastoral care in Germany, the 1970s witnessedan embracing of the American pastoral care movement. From thenon, pastoral care was increasingly understood as accompanyingpatients whilst adopting the spiritual dimension. Nowadays,Christian chaplains are encountering an increasing number ofpatients from different religious communities. Various modelshave been proposed to help Protestant chaplains find an authenticform of pastoral care suitable for all religions. Until a clearposition is assumed with regard to Christianity's demands ofabsolutism, however, none of these approaches can be satisfactory.     

Psychiatry and religion circa 1978: Analysis of a decade,part II

Prior tensions between science and religion have dissolved and coalesced into new alliances based on ideology and philosophy. This general cultural pattern is reflected in the realignment of interests and interactions between paychiatry and religion. There are increasing numbers of mental health professionals with devout religious commitments and involvement in religiously oriented mental health activities; while clergy have developed new organizational structures to reflect many diverse mental health interests, including pastoral counseling, community mental health chaplains, hospitals chaplains, and expanded parish ministries. Clinical and research literature has continued to rapidly proliferate, while a unique genre of pastoral care and counseling literature has emerged. A decade ago there was hope for an amicable alliance between specialists in psychiatry and in religion. That irenic quest has shifted into overlapping goals and roles, with tensions between those engaged in universalistic norms and those seeking to develop particularistic norms.Dr. Pattison is Director of Training, Orange County Department of Mental Health and Professor and Acting Chairman of the Department of Psychiatry and Human Behavior, University of California Irvine Medical Center, 101 City Drive South, Orange, California 92668. Part I of his article appeared in the Fall, 1978 issue ofPastoral Psychology.     

Forgiveness and recidivism

The teaching of Jesus on limitless forgiveness is a difficult one with which to reckon, especially when an offense is repeated again and again (recidivism), sometimes by the same offender. This article finds in the gospel of Matthew (Matt. 18:15–17) and Paul's letters to the Corinthians (I Cor 5:2–11 and II Cor 2:5–8) a model of forgiveness that is assertive, confrontative and direct in style, pastoral in application and reconciling in spirit.Dr. Donnelly (Ph.D. Claremont Graduate School) is an Associate Professor of Theology and Spirituality at St. John's University, New York, and a Visiting Lecturer at Princeton Theological Seminary, Princeton, New Jersey. She has published over a dozen articles on the subject of forgiveness and reconciliation as well as two books:Learning to Forgive (Macmillan 1979; Abingdon, 1982) andPutting Forgiveness into Practice (Argus, 1982).     

Health Care Chaplains and their Role on Institutional Ethics Committees: An Australia Study

This paper presents the results of the largest Australian pastoral study concerning the perceptions of health care chaplains about their involvement on hospital research ethics committees (also known in some contexts as institutional ethics committees). Survey results from over 300 Australian health care chaplains indicated that nearly 90% of chaplains believed there was merit in chaplains serving on hospital research ethics committees, yet only a minority (22.7%) had ever participated on such committees. Data from in-depth interviews is also presented exploring the reasons for the lack of participation and the varying opinions regarding the role, appropriateness, and value of chaplains on ethics committees. Some implications of this study with respect to chaplaincy, hospital research ethics committees, health care institutions, ecclesiastical institutions, and government responsibilities are discussed.     

Today's women and depression

The author suggests that women in our society are more vulnerable to depression than ever before. A brief review of four psychoanalytical approaches to treatment and the religious care of the depressed woman are presented. The Book of Ruth is used as a case study of a woman's reactive depression.Her special interest and concentration are in the field of women's mental health. She has recently completed an Associate in Ministtry Degree from Southern Baptist Theological Seminary. Mrs. Bailey provides supervision for graduate students from Southern Seminary as well as Kent School of Social Work and University of Louisville Medical School. She is actively interested in pastoral care.