The sound of spiritual care: music interventions in a palliative care setting

The article describes how music has been integrated into spiritual and supportive care for palliative care patients at Brantford General Hospital (Ontario). Numerous case examples illustrate how a song or piece of music can play a vital role in the spiritual dimension of end of life care. The article expands the concept of the "living human document" by positing that a life story has an accompanying soundtrack: a musical memory and sensorial attunement that can be energized when music is offered at the bedside. The writers suggest that music provides an alternate spiritual language for patients whether or not they have a religious affiliation.     

The meaning of prayer: A Christian physician's experience

Christians in health care need a habit of prayer that allows them to express to God the full range of their reactions to daily experience. All of life can become the occasion for prayer when understood as communion or conversation. After brief commentary on this view of prayer, actual prayers are shared, demonstrating one Christian physician's attempts to pray without ceasing.This paper is part of a forthcoming book to be published by Broadman. All personal references in the article are to Dr. Elkins.     

Kathleen Benton and Renzo Pegoraro (ed.): Finding dignity at the end of life: A spiritual reflection on palliative care

Theoretical Medicine and Bioethics -     

"Elicitation hooks": a discourse analysis of chaplain-patient interaction in pastoral and spiritual care

The article considers the communicative role of the hospital chaplain and maps some of the language strategies deployed to facilitate disclosure of the patients' concerns and achieve enhanced spiritual care. These include: i) involvement, ii) politeness and iii) encouraging disclosure or exploring emotion.     

The difficulties assessing spiritual distress in palliative care patients: a qualitative study

This paper reports on a focus group study aimed at exploring the difficulties that palliative care healthcare professionals encounter while assessing the spiritual distress of their patients. Three focus groups were conducted in a hospice (n = 15). Participants were all healthcare professionals working in the hospice in-patient unit. Interviews were taped and later transcribed. The data was analysed through content analysis. Emergent themes included: lack of vocabulary around spiritual issues, personal issues surrounding death and dying, training issues, fear of being unable to resolve spiritual problems, time constraints and difficulty separating spiritual and religious needs. Participants provided a number of recommendations for improving care. This pilot study has generated useful data in relation to how spiritual care of patients might be improved. Despite the abundance of academic publications and policies on spirituality, this area is not integrated well into palliative care.     

Eyes to see and ears to hear: Identifying religious experience in pastoral spiritual guidance

Elizabeth Liebert is Director of The Program in Christian Spirituality at San Francisco Theological Seminary.     

Clinical pastoral education (CPE) on the prairie

While the Clinical Pastoral Education (CPE) method is usually employed in the health care setting and pointed toward the pastoral care of the sick, it can be adapted to the pastoral care and supervision of students doing ministry in the political, economic, and cultural systems of the rural community. In this article, the author, who speaks from thirty years of experience as a CPE supervisor in small towns in eastern South Dakota, describes his approach, an approach that emphasizes immersion in the general systems of struggling communities on the Great Plains. From his experience, he derives ten practical lessons that are applicable to CPE work in the rural context or in any pastoral setting.     

Counselling, careers education and pastoral care: Beyond the National Curriculum

The National Curriculum and other recent educational reforms in the UK have had the effect of compartmentalising children's education into the measurable—usually the academic—and of undervaluing its socio-emotional aspects. A symposium presenting different views of the implications of these reforms is introduced. A plea is made for all professionals involved in education to move from a reductionist view to one which truly enhances the whole child.     

Reciprocal maturities: Spirit and psyche in pastoral counseling and spiritual direction

This article uses a model for integrating spiritual and psychological maturity (Conn, 1989) in theological anthropology to contend that there is a reciprocal relationship not only between spiritual and psychological maturity but also between pastoral counseling and spiritual direction. I review Christian spirituality in terms of maturity in relationship: to self, to others, and to God. Next is an examination of the prevailing attitude in pastoral counseling toward spirituality and spiritual direction. Then Conn's integration is assessed — of spirituality with psychology, of spiritual direction with pastoral counseling — as a combination of spiritual and hermeneutical perspectives on the maturing self.     

Clinical pastoral education and post privacy legislation: an Australian perspective

Recently introduced privacy legislation in Australia has required that professional associations approaching education from the perspective of human cases review their standards and develop new policies and procedures to protect the privacy of individuals. In this article, the author explores the disruption created for Clinical Pastoral Education by the introduction of these privacy laws, demonstrates that it is possible to be loyal to both a commitment to privacy and learning from "living human documents," develop strategies for changing the educational culture, and establish new procedures, strategies, and policy.     

Canadian ethnographic study of sources and definitions of theological reflection in pastoral care and counseling

What are the sources and definitions of theological reflection developed by Canadian practitioners of pastoral care and counseling? This study is part of a larger qualitative research project on theological reflection. This research reviews the literature, describes the ethnographic method, and presents the findings with a sample of 75. Main sources are sacred texts, personal experience, experiences of clients, and traditions of faith group. Definitions are meaning making, discovering the divine and discipleship with recommendations for future research listed.     

The value of observing an autopsy in clergy and pastoral care education

The value of observing an autopsy for clergy and students training to provide pastoral care is that it raises consciousness about death and dying, assists in the participants' healing from loss, provides resources for ministering to the bereaved, builds a network with other professionals responding to death and dying, and evokes viscerally-generated insights into theological questions concerning body and soul, life after death, and concepts of God in relation to death and bereavement.     

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.     

Utilizing hospice for visitation of comatose patients: field education for pastoral care students

This article provides a reflection on how three educational organizations utilized a hospice setting for field experience to provide spiritual care with comatose patients. It outlines how three students, who formed a collegial group, prepared for the experience, completed and documented assigned visits, summarized outcomes, and discussed some implications for ministry with terminally ill comatose patients.     

Toward a theology of maturity in pastoral care

Popular theology has neglected a developmental perspective and has reinforced the concepts of human inadequacy and divine self-sufficiency. This has tended to keep persons in a state of infantile dependency on a super-father-figure God. Pastoral care, with its concern for the person and its commitment to the processes of growing and maturing in the self and in relationships, needs a theological frame of reference which positively reinforces a developing maturity in relation to God, as well as self and others.Formerly Associate Professor of Psychology of Religion and Pastoral Care at Midwestern Baptist Theological Seminary, Dr. Woodruff is Executive Director of the Peninsula Pastoral Counseling Center, Hampton, Virginia.     

Space in the Trinity and in pastoral care

A central feature of the life of the Trinity is contrast without conflict: God is three and God is one. This dynamic has a spatial reference. The Three draw close to each other in the intimacy of love, but they also give each other space to be. This dynamic is a necessary condition for mature relationships on the human level. It is argued that effective pastoral counseling involves both moving in close through empathy and acceptance, and creating appropriate distance through a process that Martin Buber refers to as confirmation. Confirmation involves wrestling with the other person to help her or him actualize her or his God-given moral and spiritual potential.     

The plausibility of spiritual intelligence: spiritual experience,problem solving and neural sites

Australian teachers in Church related schools have begun to use the term ‘spiritual intelligence’ in their educational discourse. Is it accurate to describe spirituality as a form of intelligence? This paper explores whether the notion of spiritual intelligence is plausible. It addresses this firstly by discussing the notion of spiritual experience as a mechanism for problem solving—one of the central themes that underlies the concept of intelligence. Secondly, it examines some of the neural sites of the human brain that have been found to be active in those who apperceive spiritual experience. In light of this discussion, this paper argues that although some concerns prevail in considering spirituality as a form of intelligence, the concept of spiritual intelligence may nonetheless be rendered as plausible.