A Case Study Using The Discipline with a Clinical Team

SUMMARY

Health care delivery in hospitals and clinics promotes an interdisciplinary team approach. This article presents the use of The Discipline though the involvements of the chaplain as part of the Infectious Disease team as together they addressed the inherent spirituality of one HIV/AIDS patient. This narrative recounts the unfolding events of the patient's life and describes the use of The Discipline during a very difficult time period for the patient and the staff. The experience can serve as a model for other health care teams who must manage difficult, deteriorating patients.     

Experience with Clinical Pastoral Education in the Context of The Discipline

SUMMARY

This article relates the experience of integrating The Discipline into the process and curriculum of an ACPE accredited clinical pastoral education (CPE) program involving residents and single unit students. It describes supervisor and student concerns as well as the conclusions they reached concerning the integration of The Discipline into The CPE process.     

An Adaptation of The Discipline in a Clinical Pastoral Education Program

SUMMARY

The author describes his perspective on providing pastoral care to hospital patients, his search for new ways to understand that ministry, his first contact with The Discipline, and his adaptation of it to the clinical and educational programs at his center. He discusses the need to help clinical pastoral education students to operationalize their ministry and to learn how to identify outcomes that are meaningful to health care decision makers.     

First Steps: Approaching The Discipline Based,Outcome Oriented Ministry Model

SUMMARY

This article describes how a new staff chaplain is approaching and applying a discipline based, outcome oriented ministry model. He describes his move from being a lone, geriatric chaplain in a long term care facility to becoming a member of a team of staff chaplains in a teaching hospital who have disciplined themselves to an outcome oriented ministry model. The writer gives his perspective on The Discipline, and denotes ways in which his ministry has been impacted. Though the author has been involved with this process for only six months, both he and those in his care are experiencing some of the benefits of making tangible contributions and developing measurable outcomes in ministry.     

Clinical Pastoral Education for Laity

Medical science, with its high technology, has had a major impact on today's hopitalized patient. Not only has the length of stay been shortened dramatically but the level of illness is much more intense. Both of these foactors have influenced the role pastoral care plays as a member of the health care. Carefully selected and trained laity can help meet the expanding pastoral care needs of hospitalized patients. This article describes a program designed exclusively for laity, which equips these volunteers through a clinical process similar to that of Clinical Pastoral Education (CPR). The authors contend that any program designed to prepare laity for passtoral care must include the clinical component. Their experience with 38 laity who have completed the program described in this article has led them to the conclusion that such a process inspires a dynamic growth in faith as laity claim their rightful authority in pastoral care.     

How Has Health Care Reform Affected Professional Chaplaincy Programs and How Are Department Directors Responding?

SUMMARY

No published studies were identified that describe the impact of health care reform on professional chaplaincy departments in hospital settings. Results from a random sample (N = 370) of department directors indicate that 45 percent report no budgetary consequences, 27 percent have experienced budgetary cutbacks, and 17 percent describe departmental growth. The cutbacks most often involve the loss of staff chaplain positions. Directors also describe past and future strategies for resisting downsizing trends.     

Evaluation of a Chaplain Residency Program and Its Partnership with an In-Patient Palliative Care Team

In 2009 a Consensus Conference of experts in the field of spiritual care and palliative care recommended the inclusion of Board-certified professional chaplains with at least 1,600 hours of clinical pastoral education as members of palliative care teams. This study evaluates a clinical pastoral education residency program’s effectiveness in preparing persons to provide spiritual care for those with serious illness and in increasing the palliative care team members’ understanding of the chaplain as part of the palliative care team. Results showed chaplain residents felt the program prepared them to provide care for those with serious illness. It also showed that chaplain residents and palliative care team members view spirituality as an integral part of palliative care and see the chaplain as the team member to lead that effort. Suggested program improvements include longer palliative care orientation period, more shadowing with palliative care team members, and improved communication between palliative care and the chaplain residents.     

Health Care Reform: Analysis of Narrative Responses from Directors of Pastoral Care Departments

SUMMARY

This paper is a narrative analysis of comments written by hospital pastoral care department directors in response to the questionnaire item that asked them to write about their experience with health care reform and to make suggestions as to what the profession could do about it. Three central themes included: (1) the importance of and need for administrative support of the department, (2) the importance of departmental visibility within the institution, and (3) the challenges of embracing change. Two secondary themes were the admonishing of peer department directors concerning inadequate performance and the ministry to hospital staff during reform efforts.     

Economic Rationalism and the Cost Efficiency of Hospital Chaplaincy: An Australian Study

SUMMARY

Health care reform is also occurring in Australia and effects hospital chaplaincy programs. “Economic rationalism” is the philosophic foundation of this effort and its contrast with the values inherit in hospital chaplaincy are highlighted. Selected research results from the Australian system are described and the authors offer a perspective on the cost efficiency of hospital chaplaincy.     

The Discipline for Doing Spiritual Care: Variations on a Theme

SUMMARY

This article describes the writer's introduction to The Discipline and his decision to utilize selected aspects of it in direct care and in an educational milieu. The first section describes adaptation of the Profile (Concepts of Holy, Meaning, Hope, and Community) in the writer's work with addicted persons on a Recovery Center. The second section presents the employment of this Profile as a way to introduce CPE interns to the art of pastoral assessment.     

To Pray or Not to Pray: Considering Gender and Religious Concordance in Praying with the Ill

Analysis of Covariance was conducted on quantitative data collected by chaplains from January 2005 to December 2008. Data from 82 Catholic, Jewish, and Protestant chaplains, consisting of 53 CPE students and 29 professional chaplains were used in this study. Overall, chaplains exhibited a statistically significant higher rate of prayer with patients from their own religion (religious concordance) than they did with patients of different religions (religious discordance). There was also an interaction of chaplain religion and religious concordance wherein Protestant chaplains were 50% more likely to pray with Protestant patients than with patients of other religions, and Catholic chaplains were 20% more likely to pray with Catholic patients than with other patients. Chaplains were also significantly more likely to pray with patients of their own gender (gender concordance) than with patients of the other gender (gender discordance).     

Playing Well with Others: The Discipline in a Pediatric Hospital

SUMMARY

This article contains a personal reflection on the way it feels, in fact and in theory, to move from a chaplaincy position in a clinical setting, to one where clinical chaplaincy is relatively new. The article presents the ways a clinically trained chaplain can introduce herself to a new setting, and how she must continually reevaluate her approach.     

Using The Discipline for Integrative Ministry Formation

SUMMARY

One United Methodist Annual Conference has begun a program of ministry formation education for probationary, first-appointment ministers in conjunction with Emory Clergy Care, Atlanta. This program uses an adaptation of The Discipline as an integral part of their ongoing formation education. Participants have learned the basics of planned pastoral care delivery, family and congregational systems thinking and self-supervision. Using The Discipline, they have been effectively adapting it to their local church settings and ministries.     

The Chaplain as Faithful Companion: A Response to King's Case Study

This article is a response to a case study describing the spiritual care provided over an 18-month period by an experienced professional chaplain at a prominent cancer center to a woman undergoing stem cell transplantation following therapy for relapsed leukemia. The author, a professional chaplain at another cancer center, reviews the spiritual assessment, interventions, and outcomes presented by the attending chaplain. The author's comments are organized about the chaplain's characterization of the seven parts of the patient's spiritual profile: courage, meaning, psychological issues, courage and growth in facing spiritual/religious struggle, rituals, community, and authority. The purpose of the response is to engage those inside and outside the discipline of health care chaplaincy in a conversation about the specific aspects of providing spiritual care in health care settings.     

A Case Study of Jerry: Emphasizing Team Communication Through Use of The Discipline

An Ideal Intervention Paper was initiated in 2005 to consolidate the learnings of clinical pastoral education students. As papers from students, practitioners, and educators were collected over a period of seven years, it became evident that a knowledge base comprised of this work would expedite the professionalization of clinical chaplaincy via provision of second opinions in difficult cases, education of administrators and the public about the nature of chaplaincy work, and baseline data for effectiveness research—to include replication of effective interventions toward designation of evidence based spiritual care best practices. An online 395-sample knowledge base hosted by the Association for Clinical Pastoral Education Research Network was amassed, nearly 40 percent of which is the work of experienced practitioners and educators. A pilot effectiveness study of samples failed to produce meaningful results. As an interim measure a content analysis has provided tentative effectiveness ratings until further research can be done.     

Introduction

No abstract available for this article.     

The Dance with The Discipline

The author became acquainted with The Discipline only recently and this article describes two pastoral visits in which The Discipline provides guidance for interactive presence. Thus this material represents how the author seeks to grasp and integrate it into her clinical practice in a short time.     

Chaplains and Access to Medical Records

This study was initiated by a Pastoral Care Department of a large academic medical center in order to establish hospital chaplaincy policies and procedures. Four basic questions were asked about professional hospital chaplains and record keeping. The results of the survey show that the standard of practice is that chaplains access the medical record, enter notes in the record, have access to the electronic medical record, and that no special credentialing beyond Clinical Pastoral Education (CPE) is required for chaplains to have this access.     

“Chaplains for Wellbeing” in Primary Care: A Qualitative Investigation of Their Perceived Impact for Patients’ Health and Wellbeing

The growing importance of professional chaplains in patient-centered care has raised questions about education for professional chaplaincy. One recommendation is that the curricula of Clinical Pastoral Education (CPE) residency programs make use of the chaplaincy certification competencies. To determine the adoption of this recommendation, we surveyed CPE supervisors from 26 recently re-accredited, stipended CPE residency programs. We found the curricula of 38% of these programs had substantive engagement with the certification competencies, 38% only introduced students to the competences, and 23% of the programs made no mention of them. The majority of the supervisors (59%) felt engagement with the competencies should be required while 15% were opposed to such a requirement. Greater engagement with chaplaincy certification competencies is one of several approaches to improvements in chaplaincy education that should be considered to ensure that chaplains have the training needed to function effectively in a complex and changing healthcare environment.