Chaplain development in Clinical Pastoral Education (CPE) in healthcare settings in England: A mixed methods study.

BACKGROUND: Clinical Pastoral Education (CPE) is the predominant specialised training for healthcare chaplains in several national contexts. CPE is spiritual care education that uses experiential and action-reflection learning methods to train diverse participants. However, CPE is not established for chaplaincy training in England. Currently, chaplaincy education in England lacks standardisation, leading to inequalities in entry into the profession and inconsistent training and career pathways. CPE has the potential to address these issues. We examined changes associated with participating in CPE and participants' perceptions about their learning experience. We sought to evaluate the effectiveness of CPE as a viable chaplaincy education model in healthcare settings in England. METHODS: Convergent mixed methods involved pre-post surveys and focus group sessions to examine the experiences and development of seven chaplains, with diverse experience levels and backgrounds, who participated in the pilot CPE unit in NHS England. We integrated thematic analysis and survey results. RESULTS: We identified four overarching themes: Development pathways, Catalysts for development, Advantages of CPE for chaplaincy education, and Experiences with CPE course structure. Participants developed along various pathways: confidence, reflective practice, emotional intelligence, listening and attending skills, diversity in chaplaincy care, and spiritual assessment. Survey results confirmed several themes, indicating gains in chaplaincy capabilities, emotional intelligence, and counselling self-efficacy. Participants emphasised the advantages and effectiveness of the CPE model. CONCLUSIONS: Quantitative and qualitative findings converged to provide rich evidence that CPE generated personal and professional development, improving chaplaincy practice. General learning pathways moved from personal development, through the interpersonal learning context, and translated into chaplain competency. Participants endorsed CPE, as a robust and effective training model for chaplaincy in the English context, for those entering the profession and experienced chaplains alike. We conceptualised preliminary models for chaplain development and learning pathways in CPE that need validation and refinement by future research.

Maybe God Doesn't Even Like Miracles That Much.

Reflections from a pediatric chaplain on the irregularity of miracles with help from a Victorian author and an atheist-humanist colleague.

The Importance of Training to Manage a Church as a Predictor of Emotional Exhaustion and Ministry Satisfaction.

The study found that pastors who agreed they were trained to manage a church ranked high in ministry satisfaction and low in emotional exhaustion compared to those who disagreed to receiving such training. This work has implications for seminaries, congregations, denominational leaders and clergy themselves to ensure clergy are properly prepared and continue their career journey. This study could be used to modify curricula at seminaries and produce post seminary training and educational information.

Existential Needs in Mental Health - Who Cares? A Mixed Methods Study in Norway.

Mental health care that is open to patients' existential needs requires well-trained professionals who work in teams and use an open conceptualization of spirituality, religion and other meaning-making domains. Using a mixed methods approach, this article explores how professionals (n = 262) in secular Norway perceive obstacles and opportunities in existential care. The results show correlations between age group, personal religiosity, terminology and perceived expertise. Commitment is high, but collaboration with chaplains and team training are neglected.

Exploring Spiritually Integrated Psychotherapy as a Modality: How it is Evolving in the Ontario, Canada Context and the Relevance of Contributions from the Fields of Theology and Spiritual Care.

This paper surveys the current understanding of spiritually integrated psychotherapy (SIP) and connects the historical role of religious training to better understand how SIP is developing as a psychotherapy modality in Ontario, Canada. The paper clarifies how SIP is defined and proposes three levels of practice: spiritually conscious therapy, spiritually informed therapy, and spiritually integrated therapy. As evidence-based and practiced-based literature expands, more consensus is needed in how SIP terminology is used.

An Examination of the Impact of Clergy-Involved Mental Health Activities for Their Congregants on Clergy Life Satisfaction, Happiness, and Perceptions of Having a Life Close to Ideal in the USA.

Clergy play a crucial role in supporting the mental health of their congregants, but the impact on their own well-being is understudied. A review of 2019-2020 data from 636 U.S. religious leaders using generalized estimating equations analysis found that clergy use prayer, preaching, readings on mental health, and referrals to mental health professionals to support congregants' well-being. Future longitudinal studies are needed to understand the needs of diverse clergy groups.

Executive Leadership Development of Corporate Healthcare Leaders: Integrating Spirituality into the Framework.

A faith-based healthcare system implemented a Leadership as Wholeness formation program, including a spiritual formation curriculum described here. The spiritual formation curriculum intends to connect leaders with their purpose and identity to ensure mission stability in the organizational culture, now and in the future. More research must be done to understand how, or even if, these types of programs make a meaningful difference in organizational mission initiatives and workforce stability.

Self-described religious and spiritual identities of patients receiving gender-affirming surgeries: Implications for chaplaincy practice.

Studies of the U.S. population in general and transgender and gender diverse (TGD) communities specifically suggest that religion and spirituality (R/S) can function in both positive and negative ways, including on health outcomes. Patients recovering from gender-affirming surgeries were asked by chaplains, during the course of spiritual care visits, to describe their R/S identities in their own words. Seventy-five responses were included in the study and were coded. Six themes and 10 sub-themes were identified. The themes were (1) centeredness in self; (2) transcendent belief system; (3) non-religious belief systems; (4) importance of prayer; (5) R/S identity and practice as fixed and consistent; and (6) R/S identity and practice as flexible, contextual, and transforming. The findings broadly reflected national data about R/S belonging, including trends related to the growing share of the population that identifies as atheist, agnostic, or spiritual but not religious; ambivalent relationships with R/S communities due to transphobia; and R/S beliefs and practices as supportive. Implications for chaplaincy practice are discussed, including the need for chaplains to understand both demographic trends and the intersections of R/S and transphobia.

Pediatric chaplains iterative process to address religious & spiritual struggle: a qualitative study.

The growing body of literature on religious and spiritual (R/S) struggles consistently highlights its association with various health outcomes in Pediatrics. Chaplains or spiritual care providers, as members of interdisciplinary teams, frequently offer spiritual care to patients and families grappling with R/S struggles. However, there is a paucity of literature demonstrating how chaplains address R/S struggle in their practice. This study aimed to construct a theory describing the process by which pediatric chaplains conceptualize and address it. Employing a constructivist Grounded Theory study design, we sought to comprehend the approaches pediatric chaplains utilize in addressing R/S struggles. Following a semi-structured interview guide, we interviewed twelve Board Certified or Board Certification-eligible chaplains. Findings reveal that chaplains use an iterative three-phase process to address R/S struggles. Thirteen categories emerged, which were further organized into four major themes: Assessing, Processing, Intervening, and Navigating Limitations. A model depicting this iterative process was constructed.

Chaplain interventions and outcomes in outpatient settings: a scoping review.

As chaplaincy is increasingly practiced in outpatient settings, further understanding is needed of what it entails and is accomplishing within this unique context. This scoping review summarizes 42 articles that describe the types of spiritual care interventions and programs offered by chaplains in outpatient settings, and their outcomes. Findings support that chaplaincy is practiced in outpatient settings, especially in palliative care, oncology, and primary care. Interventions are delivered by chaplains as the sole interventionist, and by interdisciplinary teams with chaplain participants. Results show that outpatient chaplain interventions are feasible and acceptable, with positive psychological and spiritual outcomes. More studies with consistent outcome measurements, and structured chaplain interventions are needed to draw further conclusions about the effectiveness of outpatient chaplain interventions.

Spiritual assessment models for palliative care chaplains: a narrative review.

Palliative care chaplains conduct spiritual assessments for those within their care. This narrative review examined the literature concerning existing spiritual assessment models developed or designated for palliative care chaplain use. The literature review was performed using four databases, including a hand search of references due to the variability of keywords used within the spiritual care literature. Five spiritual assessment models were identified. The analysis of the models focused on three areas: (1) Foundational basis, (2) Spiritual needs, and (3) Structural frameworks. Published spiritual assessment models for palliative care chaplain use are variable in how each one was formed, how each tool describes and structures spiritual care needs, and how the models are implemented within their respective contexts. The PC-7 advances the field, especially through its mixed methods approach. Future validation and reliability research is needed as well as investigations concerning which models are taught by chaplain educators and used by palliative care chaplains.

Mapping spiritual care in small and critical access hospitals in a faith-based US Health system.

Little is known about spiritual care in small hospitals and critical access hospitals (CAHs), essential sources of health care in rural areas of the US. Using interview-administered surveys with spiritual care providers, we examined spiritual care services in 19 facilities, including seven small hospitals, nine CAHs, and three freestanding emergency departments, in one religiously-owned healthcare system. We identified four groups of facilities based on intensity/frequency of chaplain availability. A central finding was the variation in spiritual care services provided in these diverse facilities. Of the 16 hospitals in the sample, 11 of them (69%) offered spiritual care from professional chaplains at least three days per week. Support for staff was an important priority in all the facilities. Needs identified include virtual training and support for the spiritual care providers in these settings. Future research should replicate this study in a representative sample of hospitals that serve the rural US population.

A Letter to My Friend and Chaplain Colleague Imam Sohaib Sultan, Zichrono Livracha (of Blessed Memory).

I am a Jewish chaplain and I felt moved to write this letter to my esteemed colleague Imam Sohaib Sultan, of blessed memory. Sohaib and I each experienced our first unit of Clinical Pastoral Education together as part of the same cohort in the summer of 2008. Sohaib died tragically in 2021. Here, I reflect on how we might respond to the current Israel-Hamas War.

Moral Injury Post-COVID-19: More Than Military? A Theological Perspective.

The author of this article considers moral distress theologically, as a potential shattering of core sustaining belief systems, hope, securities, self-identities, and organizing principles of one's existence. Shattering of individual moral expectations can occur in both medical and military moral injury.

Chaplaincy and outpatient cancer care in a faith-based health system: lessons learned when imbedding two full time chaplain positions in a cancer institute with a faith-based heritage.

There is interest in chaplains devoted to outpatient cancer care, informed by a growing body of research as well as recommendations of accreditors. Simultaneously, a growing share of U.S. healthcare is faith-based and possesses a foundational interest in religious/spiritual (R/S) care due to institutional culture. In that milieu, few articles describe how religious organizational cultures influence the creation and implementation of FTEs intended to meet the evidence-based recommendations of accreditors. This is a lacuna, given that board certified chaplains are measured on their ability to integrate spiritual care into the life and service of their institutions. In response, this article describes the creation and implementation of two chaplain positions devoted to a group of outpatient cancer clinics in a large Catholic healthcare system. This includes lessons learned when navigating R/S aspects of organizational cultures while implementing and executing chaplain practice to meet accreditor recommendations.

A mixed-method evaluation of implementation determinants for chaplain intervention in a hospital setting.

Healthcare chaplains address broad social and emotional dimensions of care within a pluralistic religious landscape. Although the development and evaluation of chaplaincy interventions has advanced the field, little research has investigated factors influencing the implementation of new chaplain interventions. In this mixed-method study, we examined attitudes about evidence-based interventions held by chaplain residents (n = 39) at the outset of an ACPE-accredited residency program in the southeast United States. We also used semi-structured interviews (n = 9) to examine residents' attitudes, beliefs, and decision-making processes after they trained in the delivery of a novel manualized intervention, Compassion-Centered Spiritual Health (CCSH). Most residents reported favorable attitudes toward manualized approaches prior to training. Interviews revealed complex decision-making processes and highlighted personal motivations and challenges to learning and implementing CCSH. Implementation science can reveal factors related to motivation, intention, and training that may be optimized to improve the implementation of healthcare chaplaincy interventions.

Chaplaincy and spiritual care in Australian ambulance services: an exploratory cross-sectional study.

Ambulance staff wellbeing programs aim to support the bio-psycho-social and sometimes spiritual needs of paramedics. While evidence demonstrates strong connections between spirituality and/or religion to wellbeing outcomes, little is known about spiritual care in ambulance services or its impact. The aim of this study was to investigate paramedics' perspectives on the role and value of Australian ambulance chaplains. A cross-sectional online study of registered paramedics in Australia was conducted between November and December 2022. Analysis of the 150 responses identified that paramedics viewed the chaplain's role as one built on professional caring relationships that provided proactive and reactive care in paramedic workplaces. Chaplains were perceived to promote wellbeing by incorporating emotional, psychological, social and spiritual care, and assisting paramedics to access additional support. Perceived religiousness of chaplains and organisational factors were barriers to paramedics accessing chaplains, while pre-existing relationships and shared experiences positively influenced paramedics decision to seek chaplain support.