Nurses, Clergy, Chaplains, Parkinson's Disease, Workplace Religiosity, Women's Health and Family Issues.

This issue of JORH explores a broad range of topics looking at the professions of nursing, clergy and chaplains. This issue also concludes the series on Parkinson's disease (Part 2), and for the first time, JORH presents a collation of articles relating to workplace religiosity. Finally, this issue revisits the topics of women's health and family issues in relation to religiosity and spirituality.

The University Chaplain: An Often Unrecognised Resource in Suicide Prevention-Initial Qualitative Results from Exploratory Research into the Roles of University Chaplains at One Australian University.

University chaplains are often unrecognised as resources in suicide prevention. This exploratory article highlights the valuable contributions university chaplains at one Australian university make to suicide prevention. Three overarching themes related to the contributions of university chaplains to suicide prevention were generated: (1) person-centred care; (2) the role of university chaplains in suicide prevention; and (3) professional development. Of particular note is that university chaplains actively contribute to all three phases of the suicide prevention framework: prevention, intervention, and postvention.

Engaging the AQ10 to Predict Professional Burnout or Poor Work-Related Psychological Wellbeing Among Anglican Clergy in Wales.

The ten-item Autism Spectrum Quotient (AQ10) is a self-report instrument originally designed to identify referrals for professional diagnosis for Autism Spectrum Disorders (ASD). Recent studies suggest that this instrument may also be tapping more generalised affective disorders. Working with this interpretation, this study examines the predictive power of the AQ10 to account for additional variance, after personal and personality factors have been taken into account, on the two scales of the Francis Burnout Inventory. Data provided by 220 Anglican clergy serving in Wales demonstrated that 8.6% of the participants recorded six or more red flags on the AQ10 (and so qualified for referral for specialist diagnostic assessment) and that higher scores on the AQ10 are associated with significantly lower levels of satisfaction in ministry and with significantly higher levels of emotional exhaustion in ministry. These data suggest that screening with the AQ10 may be helpful in identifying clergy vulnerable to professional burnout and to poor work-related psychological wellbeing, in addition to its primary purpose of screening for ASD.

Black Pastors' Experiences of Occupational and Life Stress During COVID-19 in the USA.

This study sought to identify the occupational stressors Black pastors experience, who serve in Black Church denominations and Black nondenominational churches. A total of 218 pastors completed the survey out of 2786 for a response rate of 10.1%. Black pastors identified their most challenging stressors as member dynamics, financial stress, leading a church to fulfill its mission, and pastor's workload. Black women pastors faced the additional stressor of having their pastoral leadership challenged by male congregants. Black pastors faced more stressors during the COVID-19 pandemic including church closures, transitioning to virtual services, unexpected deaths, and an increased workload with 72.5% of pastors reporting moderate to extreme stress levels. Approximately 77% of pastors acknowledged experiencing from moderate to extreme stress levels during social protests for the deaths of Black people by law enforcement. Black pastors further acknowledged experiencing an additional three to six life stressors outside of their pastoral roles.

Competencies in Pastoral Counseling: The Lived Experiences of Filipino Diocesan Parish Priests.

Pastoral counseling has been a significant part of the priestly ministry in the Philippines. Nonetheless, literature about Filipino priests' lived experiences and competencies in counseling is almost non-existent. Using Interpretative Phenomenological Analysis (IPA), the researcher explored the lived experiences and competencies of Filipino diocesan parish priests in their role as pastoral counselors. The study was framed in Phenomenology, the Philippines Psychology Act of 2009, and the 2009 competencies of the Association for Spiritual, Ethical, and Religious Values in Counseling (ASERVIC), a division within the American Counseling Association (ACA). Data were collected using a semi-structured interview, and the analysis yielded seven (7) themes under three (3) clusters. The findings revealed that the participants lack the prerequisites to be rightfully called pastoral counselors. As priests continue to attend to people in need of counseling, the researcher calls on church leaders, the Psychological Association of the Philippines (PAP), and the Professional Regulation Commission (PRC) to address the practice of pastoral counseling in the country.

Towards a Holistic Model of Care for Moral Injury: An Australian and New Zealand Investigation into the Role of Police Chaplains in Supporting Police Members following exposure to Moral Transgression.

Police members can be exposed to morally transgressive events with potential for lasting psychosocial and spiritual harm. Through interviews with police members and police chaplains across Australia and New Zealand, this qualitative study explores the current role that police chaplains play in supporting members exposed to morally transgressive events. The availability of chaplains across police services and the close alignment between the support they offer, and the support sought by police, indicates they have an important role. However, a holistic approach should also consider organizational factors, the role of leaders, and access to evidence-based treatment in collaboration with mental health practitioners.

Pilot Evaluation of the Online 'Chaplains-CARE' Program: Enhancing Skills for United States Military Suicide Intervention Practices and Care.

Chaplains frequently serve as first responders for United States military personnel experiencing suicidal thoughts and behaviors. The Chaplains-CARE Program, a self-paced, e-learning course grounded in suicide-focused cognitive behavioral therapy principles, was tailored for United States military chaplains to enhance their suicide intervention skills. A pilot program evaluation gathered 76 Department of Defense (DoD), Veterans Affairs (VA), and international military chaplain learners' responses. Most learners indicated that the course was helpful, easy to use, relevant, applicable, and that they were likely to recommend it to other chaplains. Based on open-ended responses, one-quarter (25.0%) of learners indicated that all content was useful, and over one-quarter (26.3%) of learners highlighted the usefulness of the self-care module. One-third (30.3%) of learners reported the usefulness of the interactive e-learning features, while others (26.3%) highlighted the usefulness of chaplains' role play demonstrations, which portrayed counseling scenarios with service members. Suggested areas of improvement include specific course adaptation for VA chaplains and further incorporation of experiential learning and spiritual care principles. The pilot findings suggest that Chaplains-CARE Online was perceived as a useful suicide intervention training for chaplains. Future training can be enhanced by providing experiential, simulation-based practice of suicide intervention skills.

Chaplains of Color: Histories and Practices.

From the gallows and fields of war to the street and bedside, chaplains of color have been present and instrumental in providing spiritual and emotional support in public and private settings across the United States. Their histories and experiences are not well documented and integrated into the field of spiritual care and chaplaincy, a field often understood as predominantly White, male, and Christian. This article introduces this special issue by offering historical context-particularly for Black chaplains-and naming the key themes that weave through the articles included. Naming the experiences of chaplains of color is a central step in responding to historically grounded racial inequities in the work of chaplaincy and spiritual care in the United States.

Spiritually Well, Mentally Well? Examining the Early Life Religious Antecedents of the Impact of Spiritual Well-Being on Mental Health Among United Methodist Clergy in North Carolina.

Research has consistently shown that the seeds of religiosity are planted and begin to take form during early life socialization, but little attention have been given to these dynamics among clergy members. In this study, we consider whether early life religious exposure may amplify the beneficial effects of spiritual well-being (having a "thriving" spiritual life) for mental health and burnout for clergy. Drawing from a life course perspective, we use longitudinal data from the Clergy Health Initiative, which sampled United Methodist Clergy in North Carolina (n = 1330). Key results suggest that higher frequencies of childhood religious attendance were consistently associated with lower depressive symptoms and burnout. The beneficial associations between spiritual well-being and lower depressive symptoms and burnout were also stronger for clergy with greater church attendance in childhood. The accumulation of "religious capital" for clergy who were raised in religious households with regular service attendance appear to accentuate the positive effects of spiritual well-being, which encompass a greater sense of closeness to God in their own lives and in ministry. This study identifies the importance of researchers taking a "longer" view of the religious and spiritual lives of clergy.

"I've never seen a Black woman chaplain before:" From personal narratives to hypotheses.

This article shifts the traditional approach to case studies in healthcare chaplaincy from questions about what chaplains do to questions of who chaplains are and how they experience the work. We draw insights from womanist theology to offer three narratives written by African American healthcare chaplains that illustrate themes of intersectionality, the effects interview contexts have on training and work, and key questions that emerge while doing the work. These narratives honor the largely invisible work of African-American chaplains while raising central hypotheses for research and intervention we outline in conclusion.

"It's Taboo to Talk About It": Korean American Clergy Members' Views of Mental Health.

Korean Americans are more likely to seek guidance from church leaders than to use traditional mental health services. Through semistructured key informant interviews with 16 Christian clergy members serving later-generation Korean Americans, the authors explored clergy members' perceptions of the mental health needs of their congregants. Insights from the study suggested that communication and collaboration between mental health professionals and church leaders may be helpful in addressing the Korean American community's emotional and mental health needs.

Relationships Between Perceived Importance of Chaplain Presence and Health Professionals' Emotional Well-Being in the United States.

Hospital-based chaplains receive specialized training to provide spiritual support to patients and healthcare staff during difficult health transitions. However, the impact of perceived chaplain importance on healthcare staff's emotional and professional well-being is unclear. Healthcare staff (n = 1471) caring for patients in an acute care setting within a large health system answered demographic and emotional health questions in Research Electronic Data Capture (REDCap). Findings suggest that as perceived levels of chaplain importance increase, burnout may decrease and compassion satisfaction may improve. Chaplain presence in the hospital setting may support healthcare staff emotional and professional well-being following occupational stressors including COVID-19-related surges.

"The First Person They Call is Their Pastor": The Role of New York City Faith Leaders in Supporting Their Congregation's Health and Well-Being During COVID-19.

This article reports findings from a qualitative study of New York City faith leaders' efforts to mitigate the effects of the COVID-19 pandemic on their communities during the first two years of the pandemic. Faith leaders were recruited via reputational case sampling to participate in individual, key informant interviews. This study used a social-contextual approach to health promotion by exploring the influence of faith leaders and religious communities on health behaviors. Results suggest that engaged faith leaders worked individually and collaboratively to support the changing physical, emotional, and spiritual needs of their religious communities and those in the surrounding area. This study highlights the importance of faith leaders as supporters, communicators, and advocates, and provides directions for future research on the impact of faith leaders on individuals' experiences and health behaviors during a pandemic.

A Mixed-Methods Pilot Study of a Well-Being Intervention for Healthcare Chaplains.

This mixed-methods pilot study explored the psychological and emotional experiences of chaplains and the feasibility, acceptability, and impact of workshops designed to support chaplain well-being. After the workshops, scores on a measure of self-compassion increased, while secondary traumatic stress and burnout scores decreased. Qualitative data reflected the range of experiences of chaplaincy as well as the benefits of the workshops. This pilot study supports further exploration of organizational interventions to promote chaplain well-being.

Who owns spiritual care, and why does it matter?

At our unique juncture in history, challenged by a global pandemic, the impact of climate change, and a polarized political landscape, more and more people are seeking mental health assistance (Mochari-Greenberger & Pande, 2021), and a larger proportion of those who seek help are describing existential or spiritual concerns (Chirico, 2021; Kondrath, 2022). Many psychologists may be experiencing themselves as insufficiently prepared to help with spiritual concerns (Vogel et al., 2013); the mission of this special section is to facilitate discourse and dissemination of resources among chaplains and psychologists to explore the interdisciplinary dynamics of spiritual care and to establish a foundation for the expansion of ethically appropriate, spiritually integrated care where needed. All of the articles presented in this special section were reviewed by both chaplains and psychologists, and often by professionals cross-trained in both fields. Our hope is that this special section will serve to increase interdisciplinary collaboration so that both chaplains and psychologists can provide appropriate services to rise to the present constellation of crises. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Gap in Mental Health Service Utilization Among United Methodist Clergy with Anxiety and Depressive Symptoms.

Clergy are tasked with multiple interpersonal administrative, organizational, and religious responsibilities, such as preaching, teaching, counseling, administering sacraments, developing lay leader skills, and providing leadership and vision for the congregation and community. The high expectations and demands placed on them put them at an increased risk for mental distress such as depression and anxiety. Little is known about whether and how clergy, helpers themselves, receive care when they experience mental distress. All active United Methodist Church (UMC) clergy in North Carolina were recruited to take a survey in 2019 comprising validated depression and anxiety screeners and questions about mental health service utilization. Bivariate and Poisson regression analyses were conducted on the subset of participants with elevated depressive and anxiety symptoms to determine the extent of mental health service use during four different timeframes and the relationship between service use and sociodemographic variables. A total of 1,489 clergy participated. Of the 222 (15%) who had elevated anxiety or depressive symptoms or both, 49.1% had not ever or recently (in the past two years) seen a mental health professional. Participants were more likely to report using services currently or recently (in the past two years) if they were younger, had depression before age 21, or "very often" felt loved and cared for by their congregation. The rate of mental health service use among UMC clergy is comparable to the national average of service use by US adults with mental distress. However, it is concerning that 49% of clergy with elevated symptoms were not engaged in care. This study points to clergy subgroups to target for an increase in mental health service use. Strategies to support clergy and minimize mental health stigma are needed.

Examining the Relationship of Clergy Distress, Spiritual Well-Being, Stress Management and Irritation to Life Satisfaction among Black Pastors in the USA.

This study sought to determine the level of clergy distress and other psychological characteristics of Black pastors and their relationship to life satisfaction through a convenience sample of 2786 Black pastors in historically Black Protestant denominations and nondenominational Black churches. The response rate equaled 10.1% (283/2786) while the survey completion rate equaled 77% (218/283). These 218 Black pastors were serving as either senior pastors (86.3%) or co-pastors (13.7%). This study found clergy distress in Black pastors did not differ based on gender or age but differed by church size and denomination. Clergy distress (r = - .187, p = .023) and irritation (r = - .293, p = .003) possessed significant relationships with satisfaction with life as expected, but stress management (r = .039, p = .641), spiritual well-being in daily life (r = .140, p = .140), and spiritual well-being in ministry (r = - .064, p = .475) did not, which was surprising. Notably strong relationships existed between stress management and spiritual well-being in daily life (r = .469, p = .003) and stress management and irritation (r = - .359, p = .003). These two important relationships may offer some guideposts for Black pastors in developing strategies to combat the impact of both clergy distress and irritation. The study concludes with implications for Black pastors and suggestions for future research.

The Role and Value of Chaplains in an Australian Ambulance Service: A Comparative Study of Chaplain and Paramedic Perspectives.

Chaplains are embedded in several ambulance services across Australia, however as Australia's religiosity is currently in decline and questions are being asked about retaining chaplains, little is actually known about their role and value within Ambulance services. The aim of this paper is to present the key findings from interviews with chaplains about their role and value of being ambulance chaplains. These findings are then compared with those of paramedics derived from an earlier phase of this study. Thirteen chaplains participated in semi-structured interviews, and data were analysed using framework analysis. The results indicated that ambulance chaplains provided paramedic-centred emotional and spiritual care through proactively and reactively supporting paramedics in their work. Chaplains saw value in their relational approach which facilitated trust and access, did not seek to 'fix' or diagnose but instead offered physical and emotional presence, and promoted supportive conversations. Chaplains and paramedics valued operationally trained and equipped ambulance chaplains who provided a relational, around the clock, 'frontline' staff support presence in paramedic workplaces, regardless of the paramedic's personal religious/spiritual beliefs.

Relationships Between the Number of Chaplain Visits and Patient Characteristics: A Retrospective Review of a Large Suburban Midwest Hospital, USA.

It is critical to understand the characteristics of patients who receive spiritual care through chaplain visits. This study evaluated 2373 records from chaplain visits provided to 1315 patients over a three-month period (March-May 2021) at a large suburban teaching hospital, Midwest, USA. Approximately 70% of patients received one chaplain visit. However, data revealed that when patients were admitted emergently, or received visits for reasons related to self-harm or suicidality, the frequency of chaplain visits significantly increased. This study suggests a need for spiritual care services for patients with emergency or mental health conditions. Furthermore, it highlights the need for further training and resources for chaplains to increase clinical competencies in providing specialized spiritual care support to specific patient populations.

The Importance of Timing, Fundamental Attitudes, and Appropriate Interventions as Key Aspects of Chaplain Suicide Prevention: A European Expert Panel of Mental Health Chaplains.

An expert panel consisting of six mental health chaplains from several European countries was convened to ascertain the specific contribution of mental health chaplains to suicide prevention, and to generate good practices for suicide prevention. Three themes emerged: (1) the importance of timing; (2) fundamental attitudes of the chaplain towards the patient, and (3) appropriate interventions.