Improving access to palliative care clinical pastoral education.

Palliative care is interprofessional care for seriously ill people. Many clergy, religious leaders, and hospice and palliative care chaplains of color and minority religious backgrounds desire clinical palliative care education. This manuscript presents findings from a three-year quality improvement project which included the development of a palliative care specialty ACPE: The Standard for Spiritual Care and Education (ACPE) accredited program at an academic medical center. The program was designed to improve spiritual care provision in palliative care at the institution and to facilitate the participation of clergy and spiritual leaders of color and minority religious groups. Forty-six students participated in 53 400-h clinical pastoral education units. Strategies from medical education literature were employed to address obstacles to CPE participation including a racially and religiously diverse CPE advisory group, financial assistance, flexible learning (e.g. hybrid, asynchronous), and clinical placement agreements at places of employment. Upon completion of the program students provided written feedback, participated in a structured exit interview and completed a survey. Data were reviewed for common themes and results report student perceptions about the strategies utilized.

Implementing Spiritual Care in the Pediatric Complex Care Clinic.

A project integrated a Clinical Pastoral Education Fellow into a clinic designed to treat children with medical complexity (CMC). The integration of a chaplain into the care team fulfilled the goal of increasing accessibility to spiritual care through a quality improvement project and seemed to positively affect patients and the interdisciplinary team itself. These efforts demonstrate the need for research to better understand the relationship between spiritual screenings, interventions, and outcomes for CMC patients.

Recognizing and Managing Performance Anxiety in First-Year Supervised Pastoral Education (SPE) Students: Description, Causes and Remedies.

Describes the nature of performance anxiety that can appear in students doing their first clinical placement in Supervised Pastoral Education1 in the Canadian Association of Spiritual Care. Explores origins of performance anxiety drawing on research, the Diagnostic and statistical manual of mental disorders-5, theology of Paul Tillich and supervisory experiences of authors. Examines Canadian contextual factors like COVID-19, culture and multi-faith. Offers ways students might manage anxiety with help from supervisors and peers.

Is Supervised Pastoral Education (SPE) "Substantially Equivalent" to a Recognized Psychotherapy Program in Ontario?

After completing their Supervised Pastoral Education units provided by the Canadian Association for Spiritual Care, two soon-to-be-certified Spiritual Care Practitioners applied to the College of Registered Psychotherapists of Ontario. Both were rejected because their Supervised Pastoral Education program was not deemed to be "substantially equivalent" to a recognized psychotherapy program. This came as a surprise since similarly qualified Canadian Association for Spiritual Care Practitioners in Ontario are also members of the College of Registered Psychotherapists of Ontario through a process called "grandparenting." Using the 10 characteristics of a College of Registered Psychotherapists of Ontario recognized program, this paper examines Canadian Association for Spiritual Care's SPE program in detail, showing how closely it aligns with the College of Registered Psychotherapists of Ontario's description of an equivalent psychotherapy program. I conclude by suggesting the College of Registered Psychotherapists of Ontario should embrace Supervised Pastoral Education as an equivalent program and grant memberships, not just to those grand parented in, but to future Canadian Association for Spiritual Care Practitioners.

Toward an Integrative Model of Psychospiritual Therapy: Bringing Spirituality and Psychotherapy Together.

As a supervisor-educator for the Canadian Association of Spiritual Care, my primary task is to help developing spiritual care providers and psychospiritual therapists learn how to use psychotherapy within the field of spiritual care. The purpose of this essay is to share a psychospiritual model that I teach my students that helps them see how psychospiritual therapy is a form of spiritual practice that helps their clients experience healing from the sacred.

Embedding Critical Reflection in Training for Spiritual Care Supervision and Practice: The Experience of a Specific Student Group.

This article explores student experiences of a subject called Supervision in Spiritual Care Using Critical Reflection in postgraduate study in Australia for spiritual carers and ministers of religion. Their online dialogue identified how students used critical reflection in practice, and what they saw as the benefits and challenges in their learning. This affirms the value of a critically reflective approach to spiritual care and how this can be used in supervision and in practice.

What's the Point of Clinical Pastoral Education and Pastoral Counselling Education? Political, Developmental, and Professional Considerations.

Further clarity is needed regarding the uniqueness of spiritual care and psycho-spiritual therapy. In this article, this uniqueness is described as the relative spiritual health of spiritual health professionals. Drawing upon political philosophy, spiritual development theories, and studies in spiritual health, three traits of spiritual health are revealed that spiritual health professionals need to function effectively in their work environments. The article ends with four recommendations for both clinical pastoral education and pastoral counselling education.

Significant Change in the North American Spiritual Care Education and Psychotherapy Movement.

ACPE: The Standard for Spiritual Care and Education (previously Association for Clinical Pastoral Education) has received the membership of the American Association of Pastoral Counselors (AAPC) into an integrated organization. This integration may mark the beginning of an organizational trend.

Training Community Clergy in Serious Illness: Balancing Faith and Medicine.

Community-based clergy are highly engaged in helping seriously ill patients address spiritual concerns at the end of life (EOL). While they desire EOL training, no data exist in guiding how to conceptualize a clergy-training program. The objective of this study was used to identify best practices in an EOL training program for community clergy. As part of the National Clergy Project on End-of-Life Care, the project conducted key informant interviews and focus groups with active clergy in five US states (California, Illinois, Massachusetts, New York, and Texas). A diverse purposive sample of 35 active clergy representing pre-identified racial, educational, theological, and denominational categories hypothesized to be associated with more intensive utilization of medical care at the EOL. We assessed suggested curriculum structure and content for clergy EOL training through interviews and focus groups for the purpose of qualitative analysis. Thematic analysis identified key themes around curriculum structure, curriculum content, and issues of tension. Curriculum structure included ideas for targeting clergy as well as lay congregational leaders and found that clergy were open to combining resources from both religious and health-based institutions. Curriculum content included clergy desires for educational topics such as increasing their medical literacy and reviewing pastoral counseling approaches. Finally, clergy identified challenging barriers to EOL training needing to be openly discussed, including difficulties in collaborating with medical teams, surrounding issues of trust, the role of miracles, and caution of prognostication. Future EOL training is desired and needed for community-based clergy. In partnering together, religious-medical training programs should consider curricula sensitive toward structure, desired content, and perceived clergy tensions.

Spiritual Nursing Care Education An Integrated Strategy for Teaching Students.

The failure of nursing schools to integrate spiritual nursing care education into the curriculum has contributed to a lack in nurses' spiritual care ability. Developing, integrating, and testing a Spiritual Care Nursing Education strategy in an Associates of Science nursing program significantly increased the perceived spiritual care competence of student nurses. Utilizing a faculty team to develop learning activities to address critical spiritual care attributes offers a method to integrate spiritual nursing care content throughout the curriculum in ASN and BSN programs.

Preparation for Pastoral Counseling and Spiritual Care: Strengthening Pastoral "Felt Knowledge" and Empathy through the Appreciation and Use of Contemporary Films.

Contemporary film offers something unique in the preparation and practice of pastoral counselors and spiritual caregivers by expanding both "felt knowledge" and strengthening empathic responses to care seekers. By experiencing well-chosen films, pastoral counselors and other spiritual caregivers will be better prepared to work with relevant feelings in various caregiving contexts, and clients will gain many rewards, as both their healing and growth will be enhanced. This will be especially true when pastoral and spiritual caregivers are working in areas of need where they have limited personal or professional experience.

Spiritual Care Education and Rural Systems in Swan River.

The provision of spiritual care, and the training of spiritual care providers, must be embedded within the larger systems (economic, social, generational, and environmental) and communities within which clients reside. This study analyzes the results of a systems approach to CPE training that focused on the rural context of Swan River, Manitoba. It addresses the need for new approaches to contextualizing CPE training and for understanding the uniqueness of rural contexts in particular.

The Haircut.

The article describes my experience - and the lessons learned - with a terminally ill patient in 1977 as a clinical pastoral education chaplain intern.

An Integrative Professional Theory and Practice Paper: Personal Reflections from the Journey through Clinical Pastoral Education.

CPE is an experience-based approach to learning spiritual care which combines clinical care with qualified supervision, in-class education and group reflection (CASC--http://www.spiritualcare.ca/). Through didactic seminars, group presentations and personal reading there is opportunity for the student to acquire, apply and integrate relevant theoretical information into their practice. Written for my CPE Specialist application, this paper describes how, through the course of advanced CPE education, I learn to utilize and integrate theory into my clinical work. Beginning with three strands--authenticity, listening and storytelling--I then discuss how the behavioural sciences and theology inform my practice. Focusing on empathy, I speak of the application of disclosure, the use of counter-transference as a diagnostic tool, and the place of therapeutic termination. Group theory, family systems theory, theological reflection, liturgical ministry, and multi-faith practices are considered.

The Evolution of Research Paradigms in Pastoral/Spiritual Care, Counseling, and Education.

This partially autobiographical article is presented as a chapter in the narrative of the evolution of research methodology in the social sciences and the impact that evolution has had on pastoral/spiritual care research as the author has experienced and observed it during the latter part of the 20th century and the early years of the 21st century.

The Effects of CPE on Primary Relationships--Is It Worth Exploring?

Clinical Pastoral Education (CPE) can be a life transforming experience for students, but does it also transform students' primary relationships? An online survey of past CPE students at Royal Perth Hospital, Western Australia, found that--overall--CPE had a positive effect on primary relations in key areas, in particular communication, intimacy and spirituality. Recent relationships were more negatively affected. Some relationships did not survive CPE. Structural and pedagogical implications require further research.

'You are here': locating 'spirituality' on the map of the current medical world.

PURPOSE OF REVIEW: Clinical works at the intersection of 'spirituality, religion, theology and medicine' are studied to identify various aspects of what constitutes spirituality, what contributes to spiritual health and how to provide spiritual-healers for our current health-care system. RECENT FINDINGS: Spiritual care in the current medical world can be classed grossly into two departments: complementary and alternative medicine, considered as proxy variable for spirituality, and physician-initiated clinical Chaplaincy, informed by theology. The large body of research on 'self' as a therapeutic tool, though, falls into subtle categories: phenomenological studies, empathy, embodied care, and mindfulness-based therapies. Development in the field of 'spiritual medicine' has focused on spirituality-related curricula. SUMMARY: As mindfulness-based meditation programs help build deep listening skills needed to stay aware of the 'self', Clinical Pastoral Education trains the chaplain to transcend the 'self' to provide embodied care. Clinical chaplaincy is the destination for health-care professionals as well as theological/religious scholars who have patients' spiritual health as their primary focus. Medical education curricula that train students in chaplain's model of transpersonal-mindfulness/empathy founded on neuro-physiological principles would help them gain skills in embodied care. Such education would seamlessly integrate evidence-based clinical practice and spiritual-theological concepts.

Teaching health care providers to provide spiritual care: a pilot study.

BACKGROUND: Health care providers' lack of education on spiritual care is a significant barrier to the integration of spiritual care into health care services. OBJECTIVE: The study objective was to describe the training program, Clinical Pastoral Education for Healthcare Providers (CPE-HP) and evaluate its impact on providers' spiritual care skills. METHODS: Fifty CPE-HP participants completed self-report surveys at baseline and posttraining measuring frequency of and confidence in providing religious/spiritual (R/S) care. Four domains were assessed: (1) ability and (2) frequency of R/S care provision; (3) comfort using religious language; and (4) confidence in providing R/S care. RESULTS: At baseline, participants rated their ability to provide R/S care and comfort with religious language as "fair." In the previous two weeks, they reported approximately two R/S patient conversations, initiated R/S conversations less than twice, and prayed with patients less than once. Posttraining participants' reported ability to provide spiritual care increased by 33% (p<0.001). Their comfort using religious language improved by 29% (p<0.001), and frequency of R/S care increased 75% (p<0.001). Participants reported having 61% more (p<0.001) R/S conversations and more frequent prayer with patients (95% increase; p<0.001). Confidence in providing spiritual care improved by 36% overall, by 20% (p<0.001) with religiously concordant patients, and by 43% (p<0.001) with religiously discordant patients. CONCLUSIONS: This study suggests that CPE-HP is an effective approach for training health care providers in spiritual care. Dissemination of this training may improve integration of spiritual care into health care, thereby strengthening comprehensive patient-centered care.