Expanding Chaplain Competencies: Tradition-Aware Chaplaincy

Expanding Chaplain Competencies will be a presentation of research results from an ongoing project exploring the relationship between beliefs and practices of patients from multiple traditions and the ways participants engage healthcare in times of serious illness.

This project is approved by the University of Cincinnati’s IRB and is funded by one of the first Association for Clinical Pastoral Education grants for Innovation in Spiritual Care and Research. The project’s goal is to provide practical guidance equipping CEs and chaplains to offer tradition-aware chaplaincy education and chaplaincy. The project has been underway for nearly a year. The primary investigator is in the process of holding interviews and focus groups within the Buddhist, Humanist, Orthodox Jewish, Muslim, Baha’i, Roman Catholic, African Methodist Episcopal, Jehovah’s Witness, and Evangelical Christian traditions. These interviews and focus groups are on-going. Members of the Hindu tradition and Native American spiritual tradition have agreed to participate and will be interviewed in coming weeks. will be built on qualitative interviews with leaders in a variety of traditions. The questions these leader interviews and focus groups explore include:

1. How did or does your tradition help you or those in your community make meaning of why you or your loved one’s illness or accident happened?
2. How did or do beliefs and practices in your tradition help you find comfort, strength, and develop the ability to cope with serious illness or death?
3. What in your tradition guides or has guided you in medical decision-making?
4. Have you or those in your community experienced a spiritual or values struggle in the context of serious illness and if so, how did your tradition help you navigate that struggle?
5. How did or could a chaplain not from your tradition establish rapport with you such that they can represent your beliefs and practices to other members of the healthcare team?

This research serves to give voice to people from different traditions with the aim of helping healthcare chaplains better serve those from different traditions who are receiving healthcare. Each interview is audio recorded and professionally transcribed. The principal investigator review each transcript for accuracy and then share the transcript of the interview or focus group with the leaders or focus group members for correction and/or additional responses. This member check process is done to make sure participants affirm the transcript prior to analysis. Analysis of the interviews is being done by me in partnership with a clinical ethicist with a degree in Religious Ethics. After the results from a tradition have been completed, the results with be shared with each research participant to ask if the results resonate with the participants and to ask if any important element is missing. Papers submitted for publication will include suggested competencies for healthcare chaplains working with patients from the tradition under review as well as suggested curricular elements for Clinical Pastoral Education programs including care for members of specific traditions in as aspects of their programs. 

In the process of researching Association for Clinical Pastoral Education (ACPE) supervisory education and at the same time researching the use of religion/spirituality in healthcare for those receiving bone marrow transplants (BMT), the principal investigator noticed that at no point are Chaplains or Certified Educators (CEs), either in Clinical Pastoral Education (CPE) or for the purpose of Board Certification or ACPE Certification, required to demonstrate competence working with religious, spiritual, or secular traditions beyond their own. Based on Ken Pargament and colleagues’ work showing that different religious, spiritual, and secular traditions use those traditions to cope at times in markedly different ways[1], The principal investigator sought to incorporate a deeper understanding of a wide variety of religious, spiritual, and secular traditions into my CPE curriculum. Since that time, the research in religion and spirituality has grown enormously[2]. The role religion and spirituality in medical decision-making and the importance of spiritual assessments is being addressed by chaplain researchers as well as by researchers from disciplines including medicine, nursing, psychology, and sociology. Research in spiritual struggle with its possible costs and benefits is also growing with application to multiple traditions including atheism. Research is showing that patients and hospital staff and administrators expect chaplains to be well versed in different religious traditions. This discrepancy between the importance of religion, spirituality, and secular beliefs and practices in healthcare and the preparation of hospital chaplains directly relates to clinical education for chaplains by developing qualitative research describing how patients’ religious, spiritual, and secular beliefs and practices support and guide them in times of serious illness.

[1] Pargament, K. I. (1997). Psychology of religious coping. Guilford Press; Tarakeshwar, N., Pargament, K. I., & Mahoney, A. (2003). Initial Development of a Measure of Religious Coping Among Hindus. Journal of Community Psychology, 31(6), 607-628. https://doi.org/10.1002/jcop.10071;  Raiya, H. A., Pargament, K. I., Mahoney, A., & Trevino, K. (2008). When Muslims Are Perceived as a Religious Threat: Examining the Connection Between Desecration, Religious Coping, and Anti-Muslim Attitudes [Article]. Basic & Applied Social Psychology, 30(4), 311-325. https://doi.org/10.1080/01973530802502234; Rosmarin, D. H., Pargament, K. I., Krumrei, E. J., & Flannelly, K. J. (2009). Religious coping among Jews: development and initial validation of the JCOPE. Journal Of Clinical Psychology, 65(7), 670-683. https://doi.org/10.1002/jclp.20574.

[2] Balboni, T., Balboni, M., Paulk, M. E., Phelps, A., Wright, A., Peteet, J., Block, S., Lathan, C., VanderWeele, T., & Prigerson, H. (2011). Support of cancer patients' spiritual needs and associations with medical care costs at the end of life. Cancer (0008543X), 117(23), 5383. http://search.ebscohost.com/login.aspx?direct=true&db=edb&AN=67325676&si...  Fitchett, G. (2017). Recent Progress in Chaplaincy-Related Research. Journal of Pastoral Care & Counseling, 71(3), 163-175. https://doi.org/10.1177/1542305017724811; Balboni, T. A., VanderWeele, T. J., Doan-Soares, S. D., Long, K. N. G., Ferrell, B. R., Fitchett, G., Koenig, H. G., Bain, P. A., Puchalski, C., Steinhauser, K. E., Sulmasy, D. P., & Koh, H. K. (2022). Spirituality in Serious Illness and Health. JAMA : the journal of the American Medical Association, 328(2), 184-197. https://doi.org/10.1001/jama.2022.11086; Pargament, K., & Exline, J. (2022). Working with spiritual struggles in psychotherapy. Guilford.