The split professional identity of the chaplain as a spiritual caregiver in contemporary Dutch health care: are there implications for the United States?

The professional identity of the chaplain in Dutch health care institutions is in need of a new theoretical underpinning. The continued employment of the "spiritual caregiver," as the professional is called in the Netherlands, may be at stake. In former days, she or he was primarily a religious office holder fulfilling ecclesiastical functions. Against the background of secularization and individualization of religions and worldviews, the spiritual caregiver now turns more and more into an existential counselor, focusing on the search for meaning and life-orientation of all the clients/patients/residents, irrespective of their religion or philosophy of life. This brings along the need for a conceptualization of spiritual care. What is the spiritual caregiver's particular contribution to care and treatment, compared to that of, for instance, psychotherapists and social workers? What are the specific aims, methods, and key images of the profession? This brief communication sketches the specific context in which the Dutch spiritual caregiver has to work and the identity dilemmas he or she faces.     

Crises and spiritual growth

The principal concern of this essay is the spiritual growth which life crises make possible. My assumptions are a) that every crisis can arouse within us a fresh awareness of the transcendent source of and goal for every human life, and b) that precisely in the trauma which every crisis brings, we are given the opportunity to reassess the principles by which we have lived, in the direction of a more encompassing and adequate set of values, informed by a deeper faith. For such reassessment to occur, however, we must be willing to call into question our whole lives, and not just those decisions contributing to the specific crisis now confronting us. I believe that close to the very heart of pastoral work is that enlivening and encouraging pastoral presence which supports change in the face of obstacles and overwhelming anxiety, and which mediates the Giver of Life in a way which makes radical change truly possible. I elaborate upon this conviction in two sections: the first discusses the role of the pastor in crisis intervention and the second advances the claim that exacerbating a sense of crisis for the sake of facilitating peoples' growth in faith is the uniquely pastoral contribution to helping people in crisis.     

Clergy in crisis: when human power isn't enough

The author cites current research and more than a decade of clinical work with hundreds of clergy from a variety of denominations to suggest an approach for empowerment and renewal by addressing the tension between the call to ministry and the need for self-validation. He describes a short-term, multi-counselor, intensive intervention for clergy in crisis and offers two heuristic models designed to facilitate integration of the domains of clinical diagnosis and spiritual discernment.     

The Stress of Adversity,Samadhiand Spiritual Development: science and the psychodynamics of non‐specific experience

While it has been widely observed that the stress of adversity may prompt spiritual/moral growth, for a number of reasons there is little research or theory that explains the basis on which such experience would lead to the emotional maturity and moral sensitivity that characterizes spiritual development. Inquiries are complicated by the fact that the stress of adversity can just as well lead to emotional disintegration. This article advances a model which seeks to clarify the role that adversity plays in promoting spiritual development. Drawing from psychoanalytic theory, neuroscience and yoga psychology, a model is presented which may not only plausibly explain the phenomenon under consideration, but in addition, the role of meditation practice in advancing spiritual/moral growth. Such a practice may be more humane, more reliable and more educationally applicable than any other social or educational policy which would seek to exploit the principles for development elucidated in this model.     

Spiritual Assessment in Genetic Counseling

One hundred and twenty seven full members of the National Society of Genetic Counselors participated in this study exploring current spiritual assessment practices of genetic counselors and reactions to a spiritual assessment tool. While 60% of genetic counselors reported they had performed a spiritual assessment within the past year, fewer than 8.7% of these counselors assessed spirituality in more than half of their sessions. Counselors reporting high perceived relevance of spiritual assessment performed an assessment more frequently than those reporting a low perceived relevance. Barriers to spiritual assessment included lack of time, insufficient skills, and uncertainty regarding the role of spiritual assessment within genetic counseling. Almost two-thirds of counselors expressed that having a spiritual assessment tool would increase their ability to elicit relevant information. These data suggest a need for increased training regarding the methods for and relevance of spiritual assessment in genetic counseling. Recommendations for future directions of research are explored.     

Spiritual Distress and Depression in Bereavement: A Meaning-Oriented Contribution

One key focus of a meaning reconstruction model of bereavement concerns spiritual meanings attributed to the death, whether consoling or troubling. Specifically, previous studies in our research program suggest that religiously inclined violent death survivors are at risk for elevated levels of both bereavement distress and complicated spiritual grief, a crisis of faith following loss that refers to the erosion of the mourner’s relationship to God and/or the religious community. However, more research is needed to understand the convergence of depression and spiritual struggle in the context of violent and natural loss. In this study of a diverse sample of 59 American Christians bereaved less than 5 years, we sought to: (1) determine if individuals bereaved by homicide, suicide or fatal accident differed from those bereaved by natural causes in their levels of depression and spiritual coping; (2) investigate the relation between the latter constructs; and (3) ascertain if cause of death mediates the effect of religious coping on depression. We found that: (a) violently bereaved individuals endorsed more negative religious coping, and (b) depression was associated with greater spiritual struggle, particularly a sense of disrupted relationship with God. Contrary to expectations, positive religious coping was unrelated to post-loss depression, and cause of death did not mediate the relationship between spiritual coping and depressive symptomatology. A clinical case study concludes the article, illustrating the interweaving of spiritual and psychological distress in tragic bereavement, and their implications for a meaning-oriented grief therapy.     

Centering prayer’s effects on psycho-spiritual outcomes: a pilot outcome study

Centering prayer is a spiritual and religious form of meditation grounded in the history of Christian contemplative prayer. Despite its popularity, empirical research investigating centering prayer’s effects on psycho-spiritual outcomes is relative sparse. This pilot outcome study explored the effect of a centering prayer workshop on participants’ (N?=?9) depression, anxiety, stress, spiritual transcendence, religious crisis, faith development, and mindfulness. Several significant changes were noted over the course of the six-week study, including decreased anxiety and stress, and increased faith development and mindfulness. Interestingly, we noted that participants likely also experienced a spiritual or religious struggle that follows the established spiritual development paradigm called the Dark Night of the Soul. The study did not include a control group, and so did not account for effects related to history, maturation, or regression to the mean. Nevertheless, the initial results prove promising to develop more sophisticated research programmes that replicate the study’s findings.     

The Experience of Crisis in Families of Individuals with Autism Spectrum Disorder Across the Lifespan

It is well-established that parents of individuals with autism spectrum disorder (ASD) experience significant stress in their caregiving role, and research findings indicate that chronic stressors can act as a precipitant to crisis. In the present study, we examined the experience of crisis in families of individuals with ASD from early childhood to adulthood. One hundred and fifty-seven comments provided by family members in response to an online survey were coded using grounded theory methods. We explored three components of crisis drawn from the comments: antecedents (precipitating events and the context of crisis), behaviors (the nature of crisis), and consequences (outcomes and reactions to crisis). Similarities and differences in the crisis experiences among varying age groups are discussed, as well as implications for practice and future research.     

Spiritual and religious experiences of adolescent psychiatric inpatients versus healthy peers

One hundred twenty-two adolescent psychiatric inpatients with depressive disorders and 80 healthy peers were administered the INSPIRIT, a measure of core spiritual experiences. Healthy adolescents reported a greater frequency of spiritual experiences and a more positive impact of such experiences on their belief in God than did their inpatient peers. Adolescent inpatients reported higher frequencies of experiencing angels, demons, God or guiding spirits; feeling unity with the earth and other living things; and with near death or life after death as compared to healthy peers. Overall, females reported higher frequency of spiritual experiences and higher impact of the experience on their belief in God than did males. It was concluded that the INSPIRIT is a feasible spiritual assessment tool for adolescent populations and may be used by chaplains as a means for guiding clinical conversations with adolescents.     

Beliefs and values as possible correlates of ethical awareness in business

The relationship between retailing students' beliefs and values about life and their reactions to and perceptions of ethical dilemmas in retailing settings was investigated. One hundred and two male and female college students majoring in retailing were asked to complete the Beliefs and Values Questionnaire (BVQ) and to indicate their agreement with a variety of actions taken in retailing situations. Participants were also asked to indicate the extent to which the scenarios presented were representative of ethical problems or issues. With a few exceptions, results of this exploratory study did not support the contention that beliefs and values, as a measure of ethical orientation, are related to one's perception of retailing scenarios as either ethical or unethical. Discussion focuses on the need for more rigorous, systematic research to identify the correlates of ethical or unethical behavior and also the need for more direct investigation of the link between ethical decision making and students' ethical orientation. It is argued that such research is necessary as a prerequisite to ethics education.The author expresses gratitude to the College for Human Development at Syracuse University for initial funding for this project.     

Spirituality and the Events of September 11: A Preliminary Study

Personal crises have been associated with spiritual growth. Sparked by the global response to the crisis of September 11, 2001, the authors examined the relationship of spirituality and the September 11 tragedy using a sample of convenience from a college student population. This preliminary study used an experimental design to examine various effects of the world crisis events of September 11 on components of individual spirituality. Spirituality was conceptualized using a 4‐component model, Significant differences between the experimental and control groups were found on the Transcendence subscale. Taking into consideration the different kinds of tragedies, the authors present implications for counseling and suggest directions for future research.     

The early resumption of employment by mothers: Implications for parent-infant interaction

Home observations of mother-father-infant interaction and mother-infant interaction were contrasted in middle-class families in which the mother was employed or a full-time caregiver. First-born infants and their parents were observed at 3 months. The results indicate that when mother, father, and infant were together parents in the single wage-earner families provided more tactile stimulation to their babies; fathers in single wage-earner families tended to interact more with their infants than did mothers, while in dual wage-earner families mothers tended to interact more than fathers; and fathers in single wage-earner families exceeded fathers in dual wage-earner families in interactions with their infants. By contrast, mothers in the two groups showed very little difference in their interactions with their babies. No significant differences were found for maternal behavior in the three-person observation, and a single behavior differentiated between the groups in the mother-baby observation, with homemaker mothers more often making visual contact with their babies. The implications of these findings are discussed, both with respect to further research, and with regards to the development of children of employed mothers.     

Cultivating Christians: North American family cultures and religious identity formation

North American Christian families face many challenges as they try to live faithfully in an intercultural, multi-religious, secularising world, particularly with regard to the formation of religious identity in children. Answering the question of how children become Christian is more complicated today than it was for previous generations because adults cannot assume that the Christian vestiges of a civil religion will be sufficient to help children embrace a robust sense of themselves as God’s beloved and called people in a divinely created world. Thus, this essay explores what social science research and theological reflection might offer religious leaders as frameworks and tools for encouraging family cultures that cultivate young Christians, focusing particularly on strategies for sharing religious language, communicating beliefs and values, modelling spiritual practices, encountering symbolic images, and participating in congregational life.     

The experience of spirituality in the psycho-social adaptation of cancer survivors

This article presents the results of a retrospective, phenomenological study of the experience of spirituality in the psychosocial adaptation of cancer survivors. The experience of illness for the participants in the study is one which promotes greater personal and spiritual growth. The study demonstrates that illness provokes personal growth and transformation in the individual. While making use of pre-existing coping resources, the person with cancer reevaluates and restructures her or his life, integrating new values, priorities, and perspectives which lead the patient to invest her or his life in something meaningful and beneficial to others.     

自我—他人危机决策信息加工过程的差异:来自眼动的证据

本研究采用iView X-RED眼动仪,分两个实验来考察自我-他人危机决策的信息加工过程的差异。实验一采用单因素实验设计探讨自我-他人危机决策的信息加工过程,结果表明：为自我决策组的平均阅读时间、平均注视时间、平均注视次数、平均凝视时间、平均回视次数都显著高于为他人决策组。实验二采用2（任务框架：积极,消极）x2（决策者角色：为自我、为他人）混合实验设计,结果表明：在积极框架下,为自我决策组平均阅读时间、平均注视时间、平均注视次数、平均凝视时间、平均回视次数显著高于为他人决策组;在消极框架下,两个组没有显著差异。总体表现为,自我-他人危机决策的信息加工过程存在差异,且受任务框架的影响。     

Generation to Generation: Passing on Religious and Spiritual Beliefs and Practices

Many families face difficulties in maintaining healthy relationships. Past research has identified that religious and/or spiritual beliefs and practices can enhance family well-being. Research has also shown that religious and/or beliefs and practices can shape the aging process. Yet there exists little information on the methods through which religious and/or spiritual beliefs are passed on to future generations. This study utilized Eriksonian conceptual ideas, and grounded theory methods to conduct interviews with 13 older adults on the process through which religious and/or spiritual beliefs are passed on to children and grandchildren. Ideas are discussed for practitioners based on study findings.     

CREATED CO-CREATOR AND THE PRACTICE OF MEDICINE

Abstract There is a crisis of interpretation experienced by those making critical‐care decisions and creating health‐care policies and by the patients and families who make life‐and‐death decisions. For example, at both the beginning and end of life, new technologies are changing the way we define life and death. We can prolong life or hasten death in ways that we could not earlier have imagined. This crisis of interpretation demands new ways of thinking and doing. My task is to explicate how the created co‐creator can be used as a springboard to help link theological concepts with feminist concerns about two issues: interpreting the culture and practice of medicine in a new way, and explicating the ambiguity of decision making when considering issues of life and death.     

Ethics and public health emergencies: encouraging responsibility

The three primary ethical challenges in preparing for public health emergencies - addressing questions of rationing, restrictions and responsibilities - all entail confronting uncertainty. But the third, considering whether people and institutions will live up to their responsibilities in a crisis, is perhaps the hardest to predict and therefore plan for. The quintessential example of a responsibility during a public health emergency is that of health care professionals' obligation to continue caring for patients during epidemics. Historically, this 'duty to treat' has sometimes gone unrecognized or ignored, but it has also famously been adhered to, including during the recent SARS epidemic. And non-crisis examples of health professionals working in the face of personal risk are very common. The duty to treat should be circumscribed by several considerations, including the levels or risk and benefit at issue, the degree of public reliance on health professional action, and the nature of the individual health professional's acceptance of greater than usual risk. Examining the professional duty to treat and the legitimate questions it raises can provide insight into other actors' responsibilities. Public health ethics as well as professional ethics can help frame answers to some key questions: How strong are ethical responsibilities during crises? To whom do they apply? Should they be more explicit - and hence more circumscribed - or less explicit and hence largely aspirational? And how can public health policies encourage responsible actions?