Centering Neuro-Diversity, Inclusion, and Accessibility in Professional Fields of Care.

This issue has excellent material revolving around community inclusivity and support, and the research and reflections can call us to examine our professional approaches and the work of our associations. We can all grow in accessible and inclusive support for colleagues, patients, and clients. The two closing items emphasize neurodiversity, especially inclusion and equity of neuro-minorities. As Jonathan Alschech, in his review of the “Love on the Spectrum” media series writes: “As healing professionals that respect and encourage the expression of each person’s full humanity, we are invited to be informed and critical viewers” of the media and society around us. This editor would add our professional fields and associations to this critical study as well. Alschech addresses our responsibility in terms of an “emancipatory, equity-diversity-inclusion (EDI) centered approach” (2023). Our professional fields and practices of care require advocacy and uplifting of diverse perspectives and ways of being. Supportive and professional caregiving fields such as clinical counseling, chaplaincy, pastoral care, and teaching, will always include practitioners and clients/patients/students that have, as Alschech writes, “an open, wide, and complex multiplicity of ways in which people experience and process sensory stimuli, experience and understand other people and social interactions, use and understand language and non-verbal communication, and regulate their emotions and behaviors” (2023). In what ways are we allowing an appreciation of neurodiversity to inform our professions? Are we acknowledging the gifts brought by such varied perspectives and experiences in our colleagues as well as those from our clients? Are we accommodating and supporting providers who might be on the autism spectrum by making implicit processes more explicit? Many of the professional fields of care have, as the article in this issue by Robert Klitzman et al. highlights, subjective and imprecise roles and processes. In addressing “spiritual, religious and existential issues, stresses and care involve inherent subjectivities and are therefore ill defined, making the boundaries of chaplains’ roles relatively diffuse and blurry” (2023). There are many unspoken social cues in such practices of care, requiring the professional to make ongoing decisions about when to end particular visits as well as therapeutic relationships. Persons with autism or otherwise neurodiverse, whether professional care providers or patients/families, are likely to find implicit cues challenging to provide or interpret. Chaplains, pastors, and other professionals often rely on verbal and nonverbal cues to determine how to proceed with each patient and family, including frequency and duration of visits. Training programs should include education in these areas, including social stories and scripts to support practitioners in navigating this ambiguous and subjective space. Accommodating to make the implicit more explicit can help patients and clients as well, with several planned ongoing check-ins by the professional as the mutual discernment process of “gauging and evaluating the benefits and impacts of interactions over time” proceeds (Klitzman et al., 2023). In considering the articles in this issue through the lens of developing and interpreting social cues regarding expectations and professional responses, this editor reflects on neurodiversity and the gifts and challenges that it brings to professional lives. We can all consider the ways that professional associations and training institutes can help support those who are neurodiverse within the field—providers and their patients/clients/parishioners/students. The first article in the issue reports the results of a study examining the relationship between patient religiosity and the desire for professional spiritual care in the primary care clinic. The desire for chaplain support regarding mental health concerns and interpersonal conflict varies across the lowand high-religiosity populations. As the article notes, those who “spend time in private religious activities are very interested in spiritual care to help with mental health concerns (65.6%) and interpersonal conflict (80%) (Henderson et al., 2023).” The low-religiosity population reported less interest in spiritual care in those areas, but “even patients who rarely or never spend time in private religious activities desire chaplain help for several circumstances. Over half of respondents in the very low-religiosity group still desire chaplain support when they are near dying (53.9%) or when they would like prayer (52.3%). Just under Editorial