Monday, December 11, 2006

The Discipline for Pastoral Care Giving

יום שני כ" בכסלו תשס" ז

The immediately below post was my handout for a presentation I gave, today, about The Discipline for Pastoral Care Giving (apologies for the poor formatting in the transfer to the blog). The "Discipline", as its creators like to refer to it, is a very sophisticated system for assessing patients (that is, doing a spiritual assessment) and then using that assessment for creating plans for how the chaplain will best care for the patient. The system is based on defining "outcomes" that can then be measured. Since they can be measured, the chaplain can better explain to others (and to patients) about what it is exactly that a patient does and how that work might benefit patients.

I got interested in learning about the Discipline because of an article I read about the Navy's adopting of the Discipline for its chaplains (the article was in a publication from the Association of Professional Chaplains ). One one hand, the article said that Navy wanted to start "thinking with a business mind about developing standards of practice."

I get very concerned whenever I hear people talking about chaplaincy (or any form of spiritual work) as a "business". In essence, I think this marginalizes what we're all about -- because a key part of almost all spiritual work is, in particular, to espouse and advocate for values that are non-material. That is, we (chaplains and clergy) by definition stand for the idea that there are Ultimate values far beyond the mundane and material concerns of everyday life (and business!). If we abandon that stance, I think we lose the very essence of who we are and why we are working in a setting like a hospital at all. We need to remind people -- and ourselves!!! -- that Holiness is a key part of what we do.

On the other hand, I am very attracted to many elements of the Discipline. It promises better coordination and communication with the rest of the medical care team (doctors, nurses, etc). As its creators like to say, it "demystifies" what it is that chaplains do. It allows the creations of documents authored by chaplains that other members of the team can easily understand.

In our discussion, today, we focused for a bit on the use of spiritual language that does not explicitly reference God. This is part of a trend in spiritual care -- to use what are, in effect, code words for God -- phrases like "spiritual values" and "ultimate hopes".

We use these _secularized_ phrases for at least two reasons:

  • To be more inclusive -- that is, not to offend people who do not believe in God, or who use different religious language than we might have in our own tradition.
  • To have our writings sound more like something anybody on the care team could write (that is, to make us more like the rest of the medical care team).

One person reflected that this all leaves us (that is, chaplains as a whole), two ways to go in the future:

  • Secularization, or
  • Marginalization (that is, other members of the care team -- doctors, nurses, social workers, psychotherapists -- do most of the spiritual care work, and a chaplain only gets called in for explicitly religious activity, like prayer).

I, of course, hope that marginalization is not where we are heading. I believe passionately that it is (trained!) chaplains who are by far best equipped to provide spiritual care, especially around death and crisis. This is for many reasons, but one of the biggest that comes to mind for me is that we base what we do upon the "wisdom of an ancient tradition." . . . . Or at least that is what I do. I believe that my authority -- to have the nerve, so to speak, to think I can care for people spiritually -- rests upon my having steeped myself in my ancient tradition. . . . In effect, that steeping in the tradition has been an encounter with God for me. It's shaped me profoundly. It informs the compassion and empathy I can feel for people. Without it, all my training in counseling and spiritual care techniques is for nought. It counts for nothing unless I bring with me my deeply held belief that every human reflects a piece of the divine. . . . That the Holy is found in the encounter between people.

In response to this, my supervisor imagined the cycle of "The Discipline" as a little circle floating on the ocean of wisdom we take from our ancient traditions -- that is, "The Discipline" is just the "surface" part of what we as chaplains can communicate with people outside our profession about what we do and what we are all about.

I look forward to imagining ways that frameworks like the Discipline can be applied in chaplaincy settings to improve what we do and make it more understandable to patients and staff. . . It's exciting work!!!!!!!!!!!!

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