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Fall 2014 Newsletter

Volume 13, Number 1
Published November 3, 2014

Edited by Chaplain John Ehman, Network Convener

Network members are encouraged to submit articles for upcoming issues.
The Newsletter is published three times a year: Fall, Winter-Spring, and Summer.

 

Table of Contents

  1.     Joint Research Council Created by the APC
  2.     New Handbook: An Invitation to Chaplaincy Research: Entering the Process
  3.     Announcement of the 2015 Conference on Medicine and Religion
  4.     Catholic Health Association Surveys of Executive and Clinician Views on Chaplaincy
  5.     Update: Study of the Effects of Religious Symbols on Brain Function
  6.     Gordon Hilsman's "Five Questions I Wish Research Would Address"
  7.     Follow-up Report Regarding an Irish Study of the Impact of Stillbirths on Chaplains
  8.     Integration Models for Spirituality and Medicine
  9.     New Journal: Health and Social Care Chaplaincy

 

1.     Joint Research Council Created by the APC

The Board of the Association for Professional Chaplains has created a Joint Research Council, to be composed of members of the APC and representatives from major chaplaincy organizations. This Joint Council is designed to provide a forum for collaboration between organizational partners on research advocacy, education, efforts, and literacy which minimizes duplication of effort and maximizes impact. Its three primary goals are to: 1) enhance communication among colleagues with mutual interests and in different organizations about research-related educational opportunities, educational resources, research opportunities; 2) collaborate in advocating for research efforts and research literacy and compare strategies being used to move this agenda forward; and 3) provide a central place to identify and disseminate information about opportunities for chaplaincy-related research. Members of the Council will provide research-related workshops at the APC and other organizations’ annual or regional conferences. Fulfilling these goals will advance the profession towards being a research-informed clinical practice.

ACPE President David Johnson has appointed Lex Tartaglia, DMin, the Senior Associate Dean, School of Allied Health Professions and the Katherine I. Lantz Professor of Patient Counseling at Virginia Commonwealth University as the ACPE representative to the Joint Research Council. Other members of the Council include Daniel H. Grossoehme, DMin (Cincinnati Children’s Hospital Medical Center); George Fitchett, PhD (Rush University Medical Center) and Stephen King, PhD (Seattle Cancer Care Alliance). Representatives from the NACC, NAJC, NAVAC, as well as chaplaincy and spiritual care organizations in Europe, Australia, and the United States, will be invited to participate.

 

2.     New Handbook: An Invitation to Chaplaincy Research: Entering the Process

The HealthCare Chaplaincy Network, with support from the John Templeton Foundation, has published a new handbook: An Invitation to Chaplaincy Research: Entering the Process, edited by Myers, G. E with Roberts, S. (2014). It is available freely as a PDF through the HealthCare Chaplaincy Network's publications page.

This handbook explores how the chaplaincy profession, through research, may establish vital links between chaplain caring practices with the growing expectations that healthcare providers demonstrate the value of their practices. This book is both an invitation and challenge to the profession to contribute to the growth, effectiveness and longevity of chaplaincy by increasing its research literacy and by supporting or participating in research opportunities work of interest to practitioners. [--description from the website]
The fifteen chapters of this book offer personal and practical insights from a full range of leaders in the field that should be of great value to chaplains interested in becoming involved with research or honing research skills. The preface of the text also states: "Readers…will: increase their research literacy, share the personal journeys of chaplains into research, identify strategies for joining research projects, recognize obstacles and solutions related to adding research to the chaplain’s portfolio, learn how to respect patients’ needs while conducting research, and catch a glimpse of the future of chaplaincy research" [n.p.].

The significance of this resource cannot be overstated in the promotion of chaplaincy research, and ACPE centers should raise awareness of its availability among all students. Many of the individual chapters have strong potential for group discussion.

 

3.     Announcement of the 2015 Conference on Medicine and Religion

The 4th Annual Conference on Medicine and Religion will be held March 6-8, 2015 in Cambridge, MA, on the topic of Spiritual Dimensions of Illness and Healing. It is sponsored by the Program on Medicine and Religion (University of Chicago), the Initiative on Health, Religion and Spirituality (Harvard University), the Institute for Spirituality and Health (Texas Medical Center), the Albert Gnaegi Center for Health Care Ethics (Saint Louis University), and the Trent Center for Bioethics, Humanities, and History of Medicine, and Initiative on Theology, Medicine, and Culture (Duke University); and is supported by a grant form the John Templeton Foundation. Keynote speaker Arthur Kleinman, MD, PhD (Harvard University) and plenary speakers Margaret Mohrmann, MD, PhD (University of Virginia); Saul Berman, JD (Yeshiva University); and Ahsan M. Arozullah, MD, MPH (Astellas Pharma and Darul Qasim) will address the conference theme:

Contemporary western culture divides care of the soul from care of the body, apportioning the former to religious communities and the latter to medicine. The division of spiritual and material care of the human person has allowed us to meet many clinical needs efficiently, but it has also wrought unwanted outcomes, including increased mechanization of care and isolation in the experiences of illness and dying. Remedying this situation will require reengaging some critical questions: In what sense is illness a spiritual and/or religious experience? How should particular spiritual and religious needs of patients be addressed and by whom? What is at stake and what is experienced, spiritually, among those who care for patients? How may the powerful social and intellectual forces that continue to dehumanize the patient experience and the practices of health care be overcome? What do religious traditions teach us about these questions?

The 4th Annual Conference on Medicine and Religion invites students, health care practitioners, scholars, and religious leaders to take up these questions and their implications for contemporary medicine, and to do so with reference to religious traditions and practices, particularly those of Judaism, Christianity, and Islam. [--excerpted from the conference's call for abstracts]
For more information, see the conference's website, www.medicineandreligion.com, which also includes links to videos and audio recordings from past conferences.

 

4.     Catholic Health Association Surveys of Executives' and Clinicians' Views on Chaplaincy

David A. Lichter, DMin, Executive Director of the National Association of Catholic Chaplains (www.nacc.org) has penned a brief report, "CHA chaplaincy surveys offer key insights" in the September-October 2014 issue of Health Progress (vol. 95, no. 5, pp. 57-59). National surveys of Catholic health care executives and clinical staff were conducted in 2012, using the database of the Catholic Health Association (CHA) of the United States, to understand their views of chaplains and spiritual care services. Among the findings: health care executives ranked "the purpose and value of spiritual care and professional chaplaincy" as follows:

  1. Providing patient and family support
  2. Demonstrating Catholic identity/mission
  3. Treating the whole person
  4. Providing staff support [p. 57]
Comparatively, the most frequent responses from clinical staff regarding the "purpose and value of spiritual care and professional chaplaincy" were:
  1. Patient and family support
  2. Essential for treatment of the whole person
  3. Support staff
  4. Important (with little clarification) [p. 58]
Also, while "executives want to know how chaplains’ services contribute to patient satisfaction and how they support and educate staff on their role in spiritual care," [c]linicians want to know more about the specific roles and responsibilities, training and credentialing of chaplains" [p. 59].

The article is available freely online from the journal. Health Progress often features articles that incorporate research.

 

5.     Update: Study of the Effects of Religious Symbols on Brain Function

Our Spring 2010 Newsletter reported research planned by Network member Kyle Johnson (Visiting Professor at Jarvis Christian College, Hawkins, TX) into the neuropsychology/neuropsychiatry of religion, using Functional Magnetic Resonance Imaging (fMRI) of the brain during observation of a series of religious and non-religious symbols. That study evolved into a collaboration with other researchers at the University of Pennsylvania, Thomas Jefferson University, Sun Yat-Sen University, University of Toledo, and Texas State University; and it has now been published:

Johnson, K. D., Rao, H., Wintering, N., Dhillon, N., Hu, S., Zhu, S., Korczykowski, M., Johnson, K. and Newberg, A. "Pilot study of the effect of religious symbols on brain function: association with measures of religiosity." Spirituality in Clinical Practice 1, no. 2 (June 2014): 82-98. [(Abstract:) Religious symbols are used throughout the world to evoke specific meaning in adherents. However, it is unclear if the impact of symbols is based upon their meaning or the inherent effect of the visual symbols on the brain. There has never been a study that has assessed the impact of religious symbols, of both positive and negative emotional content, on the brain. In addition, it would also be important to correlate the neurophysiological effect of various religious symbols to specific measures of a person's perspective on religion. Using functional magnetic resonance imaging to study 20 healthy subjects from different religious backgrounds, we found that neural activation in the primary visual cortex was significantly suppressed in response to religious negative symbols compared with neutral and nonreligious negative symbols. No such deactivation was observed for religious positive symbols. Subjects' scores on the Quest scale, an index of religious and spiritual orientation and belief, correlated significantly with activity in the primary visual cortex for negative symbols, but not for positive symbols. In addition, scores on the Beliefs About God Assessment Form (BAGAF), that measures the adaptability of a person's religious beliefs, correlated significantly with activity in the amygdala and insula when observing religious symbols. These findings suggest an early stage visual mechanism underlying the interaction between processing of visual religious symbols and both spiritual quest and adaptive religious beliefs. In addition, the emotional nature of a person's beliefs appears to interact with the emotional perceptions of different symbols.]
Of special interest may be the specific symbols used in the study [p. 84] and the various highlighted brain scan images [pp. 89, 93, and 95].

Chaplain Johnson has previously published "A neuropastoral care and counseling assessment of glossolalia: a theosocial cognitive study" in the Journal of Health Care Chaplaincy [vol. 16, nos. 3-4 (2010): 161-171].

 

6.     Gordon Hilsman's "Five Questions I Wish Research Would Address"

Gordon J. Hilsman, DMin, continues our regular series by which key members of the Network are asked, "What are five questions that you wish research would address?" --suggesting practical issues for study that could be valuable for the ACPE and/or chaplains in general. This is the sort of generative thinking that often takes place informally at chaplaincy gatherings but seldom reaches a wider audience.

Dr. Hilsman's is retired from Franciscan Health System (Tacoma, WA) and is currently Interim Supervisor at Massachusetts General Hospital. Among his work is an investigation of Self-Assessed Spiritual Skill Changes Reported by CPE Residents and Interns, which he presented in a workshop to the 2012 national ACPE conference. The research was also published that year in vol. 32 of Reflective Practice: "Beyond virtue: the growth of spiritual skills during initial pastoral education." He also developed the very helpful research-based enumerations of Spiritual Patient Needs, Chaplain Functions, and Outcomes for Study and 21 specific categories of patients' needs, expressed in patients' own words, presented at the 2006 national ACPE conference (but note that his email address listed on those earlier documents has changed to ghilsman@gmail.com). He is currently exploring the use of chaplains' medical record documentation by other disciplines.

  1. How many interdisciplinary team members actually read chaplains' chart notes or ever seek them for insight into their patients?
  2. Could narrative chart notes improve the readability and usefulness of chaplains' chart notes for interdisciplinary staff members?
  3. What are certified chaplains' attitudes towards patients with potential drinking problems, or toward people at any stage of addiction?
  4. What are the common elements, if any, in the spiritual development stories of certified chaplains?
  5. What are certified chaplains' hoped for outcomes of pastoral conversations with people dealing with estrangement, resentments, discouragement, or acute fear?

 

7.     Follow-up Report Regarding an Irish Study of the Impact of Stillbirths on Chaplains

Following up on a report in our Winter 2013 Newsletter: Daniel Nuzum, Healthcare Chaplain at Cork University Hospital and Marymount University Hospice (Ireland) has co-authored research on "The provision of spiritual and pastoral care following stillbirth in Ireland: a mixed methods study, published (online first) in BMJ Palliative and Supportive Care (2014) and also presented the findings at the September 9-12, 2014 International Palliative Care Congress in Montreal. The study has received significant media attention in Ireland (e.g., Irish Medical Times, Independent (Dublin), and the Irish Examiner. Nuzum participates in the Pregnancy Loss Research Group in the Department of Obstetrics and Gynecology at University College Cork and summarizes the project on that website, noting there that this is the "first research study into the impact of stillbirth on healthcare chaplains who care for bereaved parents following the death of a baby." Among the findings of this study that involved 85% of maternity hospitals in Ireland:

  • Healthcare chaplains experience considerable impact and challenge to their personal faith and belief as they provide care to grieving parents.
  • There is widespread diversity in practice and training of healthcare chaplains in Ireland, when it comes to the provision of spiritual and pastoral care following stillbirth.
  • The provision of specialised spiritual care by chaplains who are not professionally trained and accredited potentially impacts the quality and depth of care to parents.
This study highlights that it is time to acknowledge the human and professional impact of stillbirth on healthcare chaplains. It reveals a very human insight into the personal burden of stillbirth. It also highlights awareness on the part of healthcare chaplains of what bereaved parents experience when faced with this tragedy. Some key recommendations from this study:
  • Recognition of the personal impact and emotional burden of stillbirth is an important step towards fostering a more supportive professional environment for healthcare chaplains.
  • The provision of specialist training in perinatal bereavement care for all healthcare chaplains.
Our study revealed the considerable personal and professional impact of stillbirth on chaplains that, without training and support, could have serious consequences for their well-being. The depth of emotion experienced and expressed by our study participants highlights the demanding nature of this ministry and the importance of adequate training and support to enable them to carry out their role. Due to the diversity of practice among healthcare chaplains, we would recommend a standardised approach so that all bereaved parents receive a consistently high level of care and support following the death of their baby. [--from the University College Cork College of Medicine and Health web page]
For more information, see BMJ Palliative and Supportive Care [--page may load slowly], or contact danielnuzum@me.com. Reverend Nuzum is a Board Certified Chaplain currently completing a second advanced unit of CPE at St. Luke's Home Education Education Centre, Cork, Ireland.

 

8.     Integration Models for Spirituality and Medicine

Michael J. Balboni and John R. Peteet from the Dana-Farber Cancer Institute (Boston, MA) and Christina M. Puchalski from the George Washington Institute for Spirituality and Health (Washington, DC), each known as a leader in research, tackle questions about the integration of spirituality/religion and medicine for palliative care clinicians in a new Journal of Religion and Health article: "The Relationship between Medicine, Spirituality and Religion: Three Models for Integration" [vol. 53, no. 5 (October 2014): 1586-1598]. Chaplains are mentioned throughout. These authors present three complementary models for integration: a generalist-specialist model of whole-person care (pp. 1587-1591), by which clinicians would act in the role of spiritual care generalist for the holistic care of patients while utilizing resources for specialist spiritual care by chaplains/clergy or others specially trained in this area; an existential functioning model (pp. 1591-1593), by which clinicians would give attention to the processes of emotional, existential, and spiritual dynamics of patients' distress; and an open pluralism model (pp. 1593-1596), by which clinicians would intentionally consider the spiritual/cultural contexts and traditions of patients as part of the patient-caretaker relationship.

They sum up in a brief Discussion section:

The generalist–specialist model is a necessary practical step to organize spiritual care as part of whole-person care in the current culture of medicine and to integrate trained chaplains as equal members of the healthcare team. An existential functioning model supports the relational aspects of care highlighted by the generalist–specialist model, while offering clinicians a framework for going more deeply when there is the time, structure, and clear need for doing so (e.g., in psychiatry). And an open pluralist model, while it entails serious practical challenges, provides a way to think constructively about the limits of therapeutic neutrality in the care of individual patients and about the central problem of differing value commitments. [p. 1597]
The authors state in their conclusion that "[c]linicians need to work with trained spiritual care professionals such as chaplains, spiritual directors, pastoral counselors, clergy, and culturally based healers in the care of the whole person --body, mind, and spirit" [p. 1597], though noting at the outset that clincians may find themselves in positions where "there are not enough trained chaplains to treat…spiritual distress" [p. 1586]. Research per se stays in the background for this article, but for chaplains conducting research the integration models here essentially set frames for collaboration with clinicians on research regarding spirituality in the provider-patient relationship and understanding and addressing spiritual distress. Chaplains may also be especially interested in the conceptualizations of the various tables listing Spiritual Concerns or Diagnoses [p. 1590]; Domains of Existential Functioning and the Healthy Self [p. 1592]; Emotional, Existential and Spiritual Distress in Depression [p. 1592]; and Spiritual and Non-Spiritual Plausibility Structures Governing the Socialization Processes and Institutions of Medicine [p. 1594].

 

9.     New Journal: Health and Social Care Chaplaincy

Last year the (British) Journal of Health Care Chaplaincy and the Scottish Journal of Healthcare Chaplaincy combined to form Health and Social Care Chaplaincy. It is the official journal of the College of Health Care Chaplains and the Scottish Association of Chaplains in Healthcare, and while it is not focused specifically on research it does contain research reports and research-informed articles. For example:

Foskett, J. "Is there evidence-based confirmation of the value of pastoral and spiritual care? An invitation to a conversation." Health and Social Care Chaplaincy 1, no. 1 (2013): 83-90. [(From the abstract:) This article begins as a response to Julian Raffay’s exploration of spiritual assessment and care based upon the assessment tool HOPE…. It draws upon experience and research in spirituality and religion in the South West of the UK, comparing it with other research and publications. It recounts how research by and amongst mental health service users, professionals and religious leaders reveals important aspects of spiritual and religious care for people with mental health problems. Recent publications confirm the importance of user-led research and practice for their spiritual care and wellbeing. It is an invitation to join this conversation.]

Gubi, P. M. and Smart, H. "Motivational factors in mental health chaplains: practitioners’ perspectives." Health and Social Care Chaplaincy 1, no. 2 (2013): 149-164. [(Abstract:) The role of Mental Health (MH) Chaplains in the UK is unclear. Their motivation to undertake and sustain them in the work is under-researched. The aim of this research is to explore what motivates people into MH Chaplaincy, and what motivates them to remain. For this research, eight MH Chaplains were interviewed to explore what brought them into MH Chaplaincy and what motivates them to remain in it. The data were analysed using interpretative phenomenological analysis (IPA). Three major themes emerged: Contextual; Early motivation; Sustaining Motivation. The data revealed significant factors that motivate MH Chaplains to undertake the work, and factors that sustain them in the work. Implications for recruitment, training, supervision, appraisal and professionalization are explored.]

Howard, N., Snowden, A., Telfer, I. and Waller, R. "Recognizing and meeting the spiritual needs of hospital inpatients." Health and Social Care Chaplaincy 1, no. 1 (2013): 35-48. [(Abstract:) The aim of this project is to improve understanding of the spiritual needs of inpatients and to establish how well these are recognized and met. Interviews were carried out with 13 patients, who had seen a chaplain, to ascertain their spiritual needs. Nursing staff were interviewed about their perception of patients’ spiritual needs, and the referring chaplain’s written account of the intervention was obtained. The study examined and found that there was variable agreement between patients’ and nurses’ ratings of spiritual needs, which may suggest nurses do not always recognize the need for specialist spiritual care referral. Conversely there was substantial agreement between patient and chaplain reported outcomes of chaplaincy intervention (κ=0.77; 95% CI, 0.495 – 1.047), suggesting that chaplains met personally relevant spiritual needs. The results of this research suggest that spiritual needs are important to patients, regardless of religious affiliation, and that chaplains meet these needs. However, staff are not necessarily good at recognizing the need for specialist referral.]

Koenig, H. G. and Al Zaben, F. N. "Depression in the medically ill: evidence for the important role of chaplains in medical settings." Health and Social Care Chaplaincy 1, no. 2 (2013): 137-148. [(Abstract:) Health professionals often underestimate the power that religious faith plays in the healing of the whole person (emotional, social, and psychological), especially when that person becomes physically ill. This article examines the role of religion in coping with stress and medical illness, reviews new research on the relationship between religious involvement and mental health, and explores how religious psychotherapy can speed the treatment of depression and other emotional conditions. A growing research base is now beginning to document the wide prevalence of spiritual and religious needs of patients in health care settings, the importance that addressing those needs plays in the patient’s mental and physical health, and the key role that chaplains play in this regard (as the only health professionals who are trained to address these areas). That research base includes studies from the United Kingdom. We are now developing and testing new psychotherapeutic methods at Duke University for therapists, including chaplains, that will provide tools to address the emotional and religious needs of Christian, Muslim, Buddhist, Jewish, and Hindu patients with medical illness.]

See the journal's Archives page.

 

 


If you have suggestions about the form and/or content of the site, e-mail Chaplain John Ehman (Network Convener) at john.ehman@uphs.upenn.edu .
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