Melissa A Smigelsky, Jesse Malott, Ryan Parker, Carter Check, Brad Rappaport, Steffanie Ward
{"title":"Let's Get \"REAL\": A Collaborative Group Therapy for Moral Injury.","authors":"Melissa A Smigelsky, Jesse Malott, Ryan Parker, Carter Check, Brad Rappaport, Steffanie Ward","doi":"10.1080/08854726.2022.2032978","DOIUrl":"https://doi.org/10.1080/08854726.2022.2032978","url":null,"abstract":"<p><p>Moral injury is a particular response to profoundly distressing life events that manifests in damage to basic human/relational capacities, such as trust, autonomy, initiative, competence, identity, and intimacy. This paper describes and presents preliminary outcomes of \"Reclaiming Experiences And Loss,\" or \"REAL,\" which is an innovative moral injury group therapy that was developed collaboratively by Veterans Affairs mental health and spiritual care providers. Clinical outcome measures collected pre- and post-group indicates that REAL is effective at reducing symptoms of post-traumatic stress disorder and depression. Additionally, a cohort case example demonstrates the impact of REAL as told through individual stories as well as the intersectionality and interactions that comprise a typical REAL cohort and are considered central to care. Implications for ongoing care and future research are discussed.</p>","PeriodicalId":45330,"journal":{"name":"Journal of Health Care Chaplaincy","volume":"28 sup1","pages":"S42-S56"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39745970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Savithri Nageswaran, Quincy Banks, Shannon L Golden, W Adam Gower, Nancy M P King
{"title":"The role of religion and spirituality in caregiver decision-making about tracheostomy for children with medical complexity.","authors":"Savithri Nageswaran, Quincy Banks, Shannon L Golden, W Adam Gower, Nancy M P King","doi":"10.1080/08854726.2020.1755812","DOIUrl":"https://doi.org/10.1080/08854726.2020.1755812","url":null,"abstract":"<p><p>Children with medical complexity (CMC) receive life-sustaining treatments such as tracheostomy. The objective of this paper is to explore the roles of religion and spirituality (R&S) of caregivers of children with medical complexity (CMC) in their decision to pursue tracheostomy for their children. We conducted 41 in-depth interviews of caregivers of CMC who had received tracheostomies in the prior 5 years. Four themes emerged: (1) Caregivers believed R&S to be powerful for their children's healing, and helped them cope with their children's illnesses; (2) Spirituality was an important factor for caregivers in the decision to pursue tracheostomy for their children; (3) Many caregivers did not discuss their spirituality with clinicians for a variety of reasons; (4) Clergy and hospital chaplains played a major supportive role overall; however, they did not play a significant role in the decision-making process. Our study shows the importance of R&S, and the roles of clergy and chaplains in pediatric tracheostomy decision-making.</p>","PeriodicalId":45330,"journal":{"name":"Journal of Health Care Chaplaincy","volume":"28 1","pages":"95-107"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08854726.2020.1755812","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10460630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer H Wortmann, Jason A Nieuwsma, Heather A King, Paola Fernandez, George L Jackson, Melissa A Smigelsky, William Cantrell, Keith G Meador
{"title":"Collaborative spiritual care for moral injury in the veterans Affairs Healthcare System (VA): Results from a national survey of VA chaplains.","authors":"Jennifer H Wortmann, Jason A Nieuwsma, Heather A King, Paola Fernandez, George L Jackson, Melissa A Smigelsky, William Cantrell, Keith G Meador","doi":"10.1080/08854726.2021.2004847","DOIUrl":"https://doi.org/10.1080/08854726.2021.2004847","url":null,"abstract":"<p><p>The psychospiritual nature of moral injury invites consideration regarding how chaplains understand the construct and provide care. To identify how chaplains in the VA Healthcare System conceptualize moral injury, we conducted an anonymous online survey (<i>N</i> = 361; 45% response rate). Chaplains responded to a battery of items and provided free-text definitions of moral injury that generally aligned with key elements in the existing literature, though with different emphases. Over 90% of chaplain respondents indicated that they encounter moral injury in their chaplaincy care, and a similar proportion agreed that chaplains and mental health professionals should collaborate in providing care for moral injury. Over one-third of chaplain respondents reported offering or planning to offer a moral injury group. Separately, nearly one-quarter indicated present or planned collaboration with mental health to provide groups that in some manner address moral injury. Previous training in evidence-based and collaborative care approaches appears to contribute to the likelihood of providing integrated psychosocial-spiritual care. Results and future directions are discussed, including a description of moral injury that may be helpful to understand present areas of emphasis in VA chaplains' care for moral injury.</p>","PeriodicalId":45330,"journal":{"name":"Journal of Health Care Chaplaincy","volume":"28 sup1","pages":"S9-S24"},"PeriodicalIF":1.9,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39749734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C M Schuhmann, J Wojtkowiak, R van Lierop, F Pitstra
{"title":"Humanist chaplaincy according to Northwestern European humanist chaplains: towards a framework for understanding chaplaincy in secular societies.","authors":"C M Schuhmann, J Wojtkowiak, R van Lierop, F Pitstra","doi":"10.1080/08854726.2020.1723190","DOIUrl":"https://doi.org/10.1080/08854726.2020.1723190","url":null,"abstract":"<p><p>In this article, views on humanist chaplaincy of Northwestern European humanist chaplains are explored with a view to the question of how to understand chaplaincy in secular societies. Seventeen questionnaires were analyzed, filled in by humanist chaplains from Belgium, the UK, Ireland, and Denmark, who attended an international conference on humanist chaplaincy organized in 2015 in the Netherlands. In the Netherlands, humanist chaplaincy has a history of several decades and is meanwhile firmly integrated in public institutions; a brief overview over this history is presented. Using thematic analysis, respondents' understandings of 'humanist' in humanist chaplaincy were explored, yielding 4 key themes: humanist chaplaincy as a calling, caring for all fellow human beings, belief in (inter)personal potential, and struggling with a non-supportive environment. On the basis of these themes, building blocks are proposed for a future-oriented perspective on chaplaincy that allows for open dialogue between all chaplains and identification of common ground.</p>","PeriodicalId":45330,"journal":{"name":"Journal of Health Care Chaplaincy","volume":"27 4","pages":"207-221"},"PeriodicalIF":1.9,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08854726.2020.1723190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37606309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Casey Clevenger, Wendy Cadge, Irene Elizabeth Stroud, Patricia K Palmer, Trace Haythorn, George Fitchett
{"title":"Education for professional chaplaincy in the US: mapping current practice in Clinical Pastoral Education (CPE).","authors":"Casey Clevenger, Wendy Cadge, Irene Elizabeth Stroud, Patricia K Palmer, Trace Haythorn, George Fitchett","doi":"10.1080/08854726.2020.1723191","DOIUrl":"https://doi.org/10.1080/08854726.2020.1723191","url":null,"abstract":"<p><p>In light of questions that have been raised about education for professional healthcare chaplaincy, we examined the skills and knowledge Clinical Pastoral Educators believe students need to perform the essential tasks and responsibilities of a chaplain. At 19 recently re-accredited ACPE centers across the country, we asked educators about the knowledge chaplains need to be effective, the specific content areas they teach, and how didactic education is planned and organized within their programs. Beyond a focus on religious diversity, we found little consensus among educators regarding a core knowledge base that should be taught during CPE. While most respondents in our study recognize the importance of didactic education in preparing students to become chaplains, there is a lack of consistency in didactic curricula across programs. Our findings suggest the need for broader conversation and collaboration among educators, national chaplaincy organizations, and theological schools regarding the goals, priorities, and outcomes of CPE.</p>","PeriodicalId":45330,"journal":{"name":"Journal of Health Care Chaplaincy","volume":"27 4","pages":"222-237"},"PeriodicalIF":1.9,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08854726.2020.1723191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37620009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marcia J Ash, Elizabeth Reisinger Walker, Ralph J DiClemente, Marianne P Florian, Patricia K Palmer, Kathryn Wehrmeyer, Lobsang Tenzin Negi, George H Grant, Charles L Raison, Jennifer S Mascaro
{"title":"Compassion Meditation Training for Hospital Chaplain Residents: A Pilot Study.","authors":"Marcia J Ash, Elizabeth Reisinger Walker, Ralph J DiClemente, Marianne P Florian, Patricia K Palmer, Kathryn Wehrmeyer, Lobsang Tenzin Negi, George H Grant, Charles L Raison, Jennifer S Mascaro","doi":"10.1080/08854726.2020.1723189","DOIUrl":"https://doi.org/10.1080/08854726.2020.1723189","url":null,"abstract":"<p><p>This study examines the effectiveness of incorporating compassion meditation training into a clinical pastoral education (CPE) curriculum to enhance compassion satisfaction and reduce burnout among hospital chaplain residents. Specifically, a longitudinal, quasi-experimental design was used to examine the impact of Cognitively-Based Compassion Training (CBCT), a group-delivered compassion meditation intervention. Hospital chaplain residents (<i>n</i> = 15) were assigned to participate in a CBCT intervention or a waitlist comparison group. Chaplains assigned to CBCT reported significant decreases in burnout and anxiety compared to the waitlist group; effects were not maintained at 4-month follow-up. Other outcomes, including compassion satisfaction, did not differ significantly but were trending in the expected direction. Findings suggest that compassion meditation training incorporated into CPE promotes chaplain wellbeing, although it may be necessary to extend CBCT throughout residency to sustain effects.</p>","PeriodicalId":45330,"journal":{"name":"Journal of Health Care Chaplaincy","volume":"27 4","pages":"191-206"},"PeriodicalIF":1.9,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08854726.2020.1723189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37640019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kelsey B White, Marilyn J D Barnes, Wendy Cadge, George Fitchett
{"title":"Mapping the healthcare chaplaincy workforce: a baseline description.","authors":"Kelsey B White, Marilyn J D Barnes, Wendy Cadge, George Fitchett","doi":"10.1080/08854726.2020.1723192","DOIUrl":"https://doi.org/10.1080/08854726.2020.1723192","url":null,"abstract":"<p><p>Changing U.S. demographics and the growing emphasis on diversity in the healthcare workforce requires professional healthcare chaplains to examine the characteristics of its own workforce. Previous research suggested that chaplains were mainly Caucasian/White and Mainline Protestant. To explore further, this paper presents a baseline sketch of the workforce and identifies important differences among board-certified chaplains (BCCs), certified educators, certified educator candidates (CECs), and clinical pastoral education (CPE) students. Although missing data quickly became the central story of the analysis and thus requires caution in comparison, the preliminary results suggest BCCs and Certified Educators are older and Whiter/more Caucasian than CECs and CPE students. At least one-third of chaplains and Certified Educators identify as Mainline Protestant, but students and CECs reported greater variation in religious affiliation. Chaplains may be similar to users of healthcare and hospitalized persons in terms of gender and race/ethnicity. Recommendations include suggestions for improving the data infrastructure of professional chaplaincy organizations.</p>","PeriodicalId":45330,"journal":{"name":"Journal of Health Care Chaplaincy","volume":"27 4","pages":"238-258"},"PeriodicalIF":1.9,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08854726.2020.1723192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37640023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A beacon in the storm: competencies of healthcare chaplains in the accident and emergency department.","authors":"Robin Pater, Anja Visser, Wim Smeets","doi":"10.1080/08854726.2020.1723188","DOIUrl":"https://doi.org/10.1080/08854726.2020.1723188","url":null,"abstract":"<p><strong>Introduction: </strong>In several Dutch hospitals, healthcare chaplains provide care to accompanying persons at the accident and emergency (A&E) department, even though they have not been trained for such a dynamic, high-intensity environment. We therefore examined the competencies they feel they need in this setting.</p><p><strong>Methods: </strong>Interviews were conducted with 14 healthcare chaplains from nine hospitals, and with five A&E nurses from two hospitals.</p><p><strong>Results: </strong>All respondents considered healthcare chaplaincy essential in the A&E department. Our findings support the need for psychosocial and communicative skills, knowledge of mourning processes, flexibility, sensitivity, and reflexivity. Additional competencies included sensitivity to existential concerns, practicing presence, a person-centered approach, medical knowledge, and letting go of a solution-oriented approach.</p><p><strong>Discussion: </strong>The chaplains questioned the sufficiency of their leadership skills, pragmatism, and medical knowledge. To ensure their sustained availability for people in crisis, more systematic efforts are needed with regard to aftercare, evaluation, and self-care on the part of healthcare chaplains.</p>","PeriodicalId":45330,"journal":{"name":"Journal of Health Care Chaplaincy","volume":"27 3","pages":"172-189"},"PeriodicalIF":1.9,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08854726.2020.1723188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37620056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Self-compassion and healthcare chaplaincy: a need for integration into clinical pastoral education.","authors":"C James Parker","doi":"10.1080/08854726.2020.1723187","DOIUrl":"https://doi.org/10.1080/08854726.2020.1723187","url":null,"abstract":"<p><p>Clinical chaplains are exposed to varying degrees of suffering and are not exempt from suffering themselves. This study took a phenomenological approach to examining self-compassion among 11 clinical chaplains, all of which had suffered from personal and/or professional hardships while providing spiritual care to medical staff, patients, and families. The three elements of self-compassion are mindfulness, self-kindness, and common humanity. Results showed that clinical chaplains' understanding of the aspects of self-compassion are limited or non-existent. Participants in this study ardently shared their experiences as they related to self-care activities during times of personal hardship. However, the intentional implementation of self-compassion practice was not displayed in these narratives. The need for education in this area would prove to enhance self-awareness and overall self-care within the profession of clinical chaplaincy.</p>","PeriodicalId":45330,"journal":{"name":"Journal of Health Care Chaplaincy","volume":"27 3","pages":"159-171"},"PeriodicalIF":1.9,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08854726.2020.1723187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37602354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lifting the Lid on Chaplaincy: A First Look at Findings from Chaplains' Case Study Research.","authors":"Steve Nolan","doi":"10.1080/08854726.2019.1603916","DOIUrl":"https://doi.org/10.1080/08854726.2019.1603916","url":null,"abstract":"<p><p>Since the publication of Chaplain Rhonda Cooper's case study in 2011, chaplain case studies have become part of the chaplaincy research agenda. Chaplains from North America, Europe and Australia have published almost 30, and this article offers a first look at the findings that are emerging from these cases. Locating chaplains' case studies at the juxtaposition of 'outcome oriented chaplaincy' and so-called 'process-oriented chaplaincy', the article argues chaplains' case studies dissolve what is a false dichotomy. Utilizing an analytical framework provided by ongoing debate among psychotherapists, the article argues that the emerging data suggests chaplaincy manifests features that are common to psychotherapy but also that there are significant factors specific to chaplaincy. From this analysis, the article observes the case studies paint a picture of chaplaincy care as a religious intervention. However, contemporary chaplaincy exists within a rapidly changing context, where increasing numbers of people are religiously unaffiliated. The article concludes by suggesting that chaplains' case study research poses significant theological, ethical and existential questions to chaplaincy about how to respond to its changing context. The article ends with a call for chaplaincy care to be radically and explicitly remodeled as care for the human spirit regardless of religious affiliation.</p>","PeriodicalId":45330,"journal":{"name":"Journal of Health Care Chaplaincy","volume":"27 1","pages":"1-23"},"PeriodicalIF":1.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08854726.2019.1603916","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37366204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}