The History of Spiritual Care

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The History of Spiritual Care

Catherine OConnor, CSB, Ph.D.

Covenant Health SystemsLexington, MA


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Objectives

1. Participants will understand threehistorical events which influenced thedevelopment of Spiritual Care

2. Participants will name three keypeople and their contribution inshaping the history of spiritual care

3. Participants will be able to name threecurrent strand in the ongoingdevelopment of spiritual care


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Scripture The Lord God has given me the tongue of a teacher, that I

may know how to sustain the weary with a word.Morning by morning he wakens me to listen like a

disciple(Isaiah 50:4)

I was ill and you cared for me (Mt. 25:36)

I came that you may have life and life to the full (John

10:10)

..And he had compassion for them (Mark 6:34)

Is there anyone sick among you? He should ask for the

presbyters They in turn are to pray for him, anointinghim in the name of the Lord James 5


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Scripture

Where are you?

What do you want me to do for you?

Whom do you seek?

What are you discussing as you go on

your way?


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Ministry of Cure of Souls

The ministry of the cure of souls,or pastoral care, consists ofhelping acts, done byrepresentative Christian persons,directed towards the healing,sustaining, guiding andreconciling of troubled personswhose troubles arise in thecontext ofultimate meanings andconcerns.

Seward Hiltner 1958


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Four functions of Pastoral Care

1. Healing

2. Sustaining

3. Guiding

4. Reconciling

Clebsch & Jaekle 1975


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Eight epochs of Christian Pastoring

1. Primitive Christianity2. Under Oppression

3. Christian Culture

4. The Dark Ages5. Mediaeval Christendom

6. Renaissance & Reformation

7. Enlightenment

8. The Post-Christendom Era

9. Modernity; Post-Modernity


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20th Century Trends

Shift from classical models of academics

to a more practical model

Influence ofFreud and William James

Medical Social Work Movement at MASS.

General Hospital, Boston


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20th Century Trends.

Emmanuel Movement Rev. Elwood

Worcester at Emmanuel Episcopalian

Church, Boston

CPE movement in early 1920s


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Clinical Pastoral Education

(CPE)

Dr. William Keller

Dr. Cabot LodgeRev. Anton Boisen

Dr. Helen DunbarFlanders


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1930 -1990

1930s - New England Group

- New York Group

1940s - Institute of Pastoral Care (ICP)New England

- Council of Clinical Training

New York

- Southern Baptist CPE

- Lutheran Advisory Council


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1930- 1990

1950 Development of Standards

1965 Canadian Council formed

1967 Strands merged and the Association of

Clinical Pastoral Education formed

(ACPE)

1970 - National Association of Catholic

Chaplains formed (NACC)1980s NAJC

1988 COMMISS

2007 Common Standards

2009 - Spiritual Care Collaborative (SCC)


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Anton Boisen

Brush Clearing

Fragmentation Learning from Failure

Living Human Document

Case Study Methodology

Pastoral Diagnosis


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The Self as The Instrument of

Healing

Vulnerability

Anxiety

Story


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Praxis Methodology

Think Learn Do

Do - Think - Learn


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Diagnosis

Dia gnosis

The meaning we give to theknowledge available

Carl Jung


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Hermenutical Approach

Allow people to disclose their word,their meaning

Reverence for the text, the word of theperson, as we have reverence for theWord, the text of Scripture

Sometimes interpreter of the person to

themselves, of theirsstory; sometimesthe interpreter of the Story, of Godssaving events of salvation


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The Minister as DiagnosticanPaul Pruyser, MD

Awareness of the Holy

Providence

Faith Grace

Repentance

Communion Vocation


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Themes

1930s What must I do to be of help?

1940s What must I know to be of help

1950s What must I say to be of help

1960s Who must I be to be of Help

1990s - Focus on Competencies-

personal, professional, spiritual


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The Illness Narratives: Suffering, Healing and the

Human Condition

Illness

Dis-ease

Sickness

Arthur Kleinman, MD


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20th Century Trends

Shifts:

Pastoral Care - Pastoral Counseling

Pastoral Counseling - Pastoral Psychotherapy

Pastoral Care - Spiritual Care

Individual Spiritual Direction Group Spiritual Direction

Individual - Systems


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Influences

DSM - IV

Rediscovery of Spirituality in the 1990s

Differentiation between Spirituality and

Religion


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Themes

The Diagnostican - Paul Pruyser

Gardener - Edgar Draper

Living Human Web Bonnie J. Miller-

Mclemore

Wounded Healer H. Nouwen

Midwife B.Gill-Austern


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Definition of Spiritual Care

Spirituality is the aspect of humanitythat refers to the way individuals seekand express meaning and purpose and

the way they experience theirconnectedness to the moment, to self,to others, to nature, and to thesignificant or sacred.

J. of Palliative Care, Vol. 12, No 10, 2009


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Spiritual Assessment of

Patients and Families

Spiritual Screening

Spiritual History

Spiritual Assessmentwww. icsi.org, November 2009


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Who does Spiritual Screening?

Spiritual Screening: Nurse/Social Worker/

Admissions

Spiritual History: Physician, Nurse, Social

Worker, other clinician

Spiritual Assessment: Chaplain


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Spiritual Assessment Tools

H.O.P.E

F.I.C.A.

S.P.I.R.I.T.


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Spiritual Assessment Toolswww.icsi.org 11/2009

H: Sources of Hope, meaning, comfort,

strength

O: Member of organized religion

P: Personal Spirituality

E: Effects of beliefs on medical care, end oflife

(Anandarajah, 2001 [R])


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F: Do you have spiritual beliefs or faith

that helped you cope in the past?

I: How do these beliefs influence you?

C: Involvement in religious communityor church?

A: How would you like your health careproviders to be with you in addressing

spiritual issues and concerns?

(Puchalski, 2000 [R])


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S: Spiritual belief system

P: Personal spirituality

I: Integration with a spiritual communityR: Ritualized practices and restrictions

I: Implications for medical care

T: Terminal events planning(Maugans, 1996 [R])


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Documentation

Where?

Who?


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Clebsch & Jaekle

Four guidelines during times of transition


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Issues and Challenges of the 21st Century

Metrics - what do we measure and how?

Inpatient to Outpatient Care

Shortened LOS

Medical Science and Ethics

Individual vs. Systemic Thinking Cultural Diversity

Religion and Spirituality

Training/Compensation for Chaplaincy Having A Voice at the Table

Other?


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SourcesClebsch, W. & C. R. Jaekle (1964) Pastoral Care in Historical

Perspective. New York: Prentice-Hall, Inc.

Dykstra, R.C. (Ed). (2005) Images ofPastoral Care: Classic Readings

St. Louis: Chalice Press.

McNeill, J.T. (1951) A History of the Cure of Souls New York: Harper &

Row.

OConnor, T. St. J. Pastoral Counseling andPastoral Care: Is There a

Difference. J. of Pastoral Care & Counseling, Spring 2003, Vol. 57,

No. 1.

www. icsi.org, November 2009

Improving the Quality of Spiritual Care as a Dimension of Palliative

Care: The Report of the Consensus Conference . J. of Palliative Care,

Vol. 12, No 10, 2009

The History of Spiritual Care

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