Tuesday, November 06, 2007

Stages of CPE -- Are we pushing our students too far?

At a recent chaplaincy conference in Dallas, the speaker laid out a challenge to the people who educate chaplains and clergy about how to care for sick and hurting people: Most of the people training to be clergy these days are no longer highly educated folks pursuing masters degrees and doctorates in seminaries, said Elizabeth Conde-Frazier (of the Claremont School of Theology). Rather, they're less educated folks (who generally have more conservative theologies) at Bible Colleges. And chaplaincy education -- founded by highly educated white, male (mostly Protestant) folks -- has a long way to go if it's going to be able to reach out to Bible College people and find a way to accept them into the world of professional chaplains, Conde-Frazier told the room full of the spiritual care educators of the Association of Clinical Pastoral Education (ACPE) on October 25.

I was thinking of Conde-Frazier's challenge this week at a regional conference of spiritual care educators (otherwise known as CPE supervisors) I was attending (at a wonderful retreat center) in Stony Point, NY. The speakers there gave us a framework for helping us with understanding -- and with working with -- Conde-Frazier's challenge: the adult development theory of developmental psychologist Robert Kegan.

Developmental theory has been around for a long time, but it's mostly been applied to understanding the development of children. It has special application to the education of children. It helps educators understand when they are pushing a child too hard and when they are not pushing a child hard enough. If a child, for example, has not developed to the point where he or she is capable of abstract thought then you would be pushing the child too hard to demand abstract thinking from them and they will only become frustrated and discouraged. But, if you don't push them hard -- including making them feel frustrated sometimes! -- to make the leap to abstract thought when they have developed to the point that they are just about ready, they may never make that developmental leap.

Kegan, and others, have worked to extend developmental theory to adults. The conference speakers, who both studied under Kegan at Harvard, said that in CPE our official standards, in effect, ask us to push students to the highest level most adults are capable of ever reaching -- Kegan's stage 4.

The speakers called stage 4 "The self-authoring mind." Unlike people at the earlier stages, the person at this stage does not need an authority or institution to tell him or her what is right or wrong or what is the right thing to do. They don't think something is right just because the church says so or their rabbi told them so -- they can, and will, decide that on their own. Similarly, the person at stage 4 is not threatened when people disagree with him or her. They see such conflict and critique as productive. If someone says to them, "you're a bad person!" they might say, "oh, that's interesting, why do you say that?" whereas an earlier stage person would seek to defend his or herelf -- "no I'm not! How can you say that!?"

The problem with this framework is that some people might find it offensive in that it implies an implicit criticism of their beliefs. For example, for many Orthodox Jews, accepting the authority of a rabbi (and going to him for a ruling on whether something is permissible or not) is a central part of their belief system (which they understand as coming from God!). Kegan seems to be saying that such an Orthodox person would be intentionally hobbling his or her development, and thus an Orthodox person might find his theory offensive. Conservative Christians might feel the same way.

For spiritual care educators (like myself) the challenge put to us by the speakers in Stony Point is clear: If CPE really demands that people reach stage 4 in order to become certified chaplains or certified educators of chaplains than maybe we are walling off our group to the Orthodox Jews and the conservative Christians of the world. And can we really justify doing that? Also, since the speakers found a correlation between how educated a person is and how likely they are to reach stage 4, are we cutting off the less educated and people from less-privileged economic backgrounds? In other words, it's the diversity question. [And, are we valuing things that have little or nothing to do with patient care?]

One thing that is interesting to contemplate are the parallels between Kegan's theory and James Fowler's Stages of Faith. Here, side-by-side are Fowler's stages 3-6 and Kegan's 2-5 (as described by the conference speakers, Deborah Helsing of the Change Leadership Group at the Harvard Graduate School of Education and Kathleen Pakos Rimer, an Episcopal priest):



Stage 3 - "Synthetic-Conventional" faith (arising in adolescence) characterized by conformity

Stage 2 - "The Instrumental Mind"

  • Capacity for concrete thought
  • Orients to explicit cause and effect
  • Dualistic
Stage 4 – "Individuative-Reflective" faith (usually mid-twenties to late thirties) a stage of angst and struggle. The individual takes personal responsibility for their beliefs and feelings.

Stage 3: "The Socializing Mind"

  • Capacity for abstract thought
  • Authority is external
  • Orients to inner states
Stage 5 – "Conjunctive" faith (mid-life crisis) acknowledges paradox and transcendence relating reality behind the symbols of inherited systems

Stage 4: "The Self-Authoring Mind"

  • Authority is internal
  • Conflict and critique as productive
  • Responsible for and can regulate inner states

Stage 6 – "Universalizing" faith, or what some might call "enlightenment".

Stage 5: "The Inter-Institutional Mind"

  • Orientation toward dialectical, paradoxical
  • Underlying morals and values that precede social institutions
  • The self as incomplete, in process evolving

Note that in both frameworks the understanding is that very few people ever reach the final stage. . . . . have you. :)


By the way, the example the speakers used to illustrate the transition from a three to a four (under Kegan's framework) was Nora from Ibsen's A Doll's House, which is available on DVD in a version starring Anthony Hopkins. (#*#)


Anonymous said...

I was at the National ACPE gathering. I am a newby SIT. I have many good friends who are psychologists (and who view me as a peer at my hospital). They have seen the SIT process and many have concluded that we are taking ourselves way too seriously. It seems that in many cases, it is easier to get a PhD than full supervisor. The question is, why? Market security? We live and operate in a small little world and most people outside our world have no clue was CPE really is or what we do.

abayye said...

Pat-- You remind me of how frustrated I feel when people say something to the effect of "your process sounds like of like the PhD process." Well, I think it's really oranges and apples. For one thing, the PhD is a credential that is recognized everywhere, whereas our credential is known in our world and only in our world. But more importantly, I think that even in PhD programs the institution that grants the credential (the dissertation committee) has a direct and personal investment in the candidate's success, something that is just not true of the kind of committees we appear before. I recently attended the (successful, thank God!) dissertation defense of a friend. He himself had selected (and recruited) his committee members. What a difference from our process!