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The History of Spiritual Care. Catherine O’Connor, CSB, Ph.D. Covenant Health Systems Lexington, MA. Objectives. Participants will understand three historical events which influenced the development of Spiritual Care

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The History of Spiritual Care


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    1. The History of Spiritual Care Catherine O’Connor, CSB, Ph.D. Covenant Health Systems Lexington, MA

    2. Objectives • Participants will understand three historical events which influenced the development of Spiritual Care 2. Participants will name three key people and their contribution in shaping the history of spiritual care 3. Participants will be able to name three current strand in the ongoing development of spiritual care

    3. 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, anointing him in the name of the Lord” (James 5)

    4. 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?

    5. “Ministry of Cure of Souls” “The ministry of the cure of souls, or pastoral care, consists of helping acts, done by representative Christian persons, directed towards the healing, sustaining, guiding and reconcilingof troubled persons whose troubles arise in the context of ultimate meanings and concerns.” Seward Hiltner 1958

    6. Four functions of Pastoral Care • Healing • Sustaining • Guiding • Reconciling Clebsch & Jaekle 1975

    7. Eight epochs of Christian Pastoring • Primitive Christianity • Under Oppression • “Christian” Culture • The “Dark Ages” • Mediaeval Christendom • Renaissance & Reformation • Enlightenment • The Post-Christendom Era • Modernity; Post-Modernity

    8. 20th Century Trends • Shift from classical models of academics to a more practical model • Influence of Freud and William James • Medical Social Work Movement at MASS. General Hospital, Boston

    9. 20th Century Trends. • Emmanuel Movement – Rev. Elwood Worcester at Emmanuel Episcopalian Church, Boston • CPE movement in early 1920’s

    10. Clinical Pastoral Education(CPE) • Dr. William Keller Dr. Cabot Lodge Rev. Anton Boisen Dr. Helen Dunbar Flanders

    11. 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

    12. 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) 1980’s NAJC 1988 – COMMISS 2007 – Common Standards 2009 - Spiritual Care Collaborative (SCC)

    13. Anton Boisen • Brush Clearing • Fragmentation – Learning from Failure • Living Human Document • Case Study Methodology • Pastoral Diagnosis

    14. The Self as The Instrument of Healing • Vulnerability • Anxiety • Story

    15. Praxis Methodology Think – Learn – Do Do - Think - Learn

    16. Diagnosis • Dia – gnosis • The meaning we give to the knowledge available • Carl Jung

    17. Hermenutical Approach • Allow people to disclose their word, their meaning • Reverence for the text, the word of the person, as we have reverence for the Word, the text of Scripture • Sometimes interpreter of the person to themselves, of their story; sometimes the interpreter of the Story, of God’s saving events of salvation

    18. The Minister as DiagnosticanPaul Pruyser, MD • Awareness of the Holy • Providence • Faith • Grace • Repentance • Communion • Vocation

    19. 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 1990’s - Focus on Competencies- personal, professional, spiritual

    20. The Illness Narratives: Suffering, Healing and the Human Condition • Illness • Dis-ease • Sickness Arthur Kleinman, MD

    21. 20th Century Trends Shifts: Pastoral Care - Pastoral Counseling Pastoral Counseling - Pastoral Psychotherapy Pastoral Care - Spiritual Care Individual Spiritual Direction – Group Spiritual Direction Individual - Systems

    22. Influences • DSM - IV • Rediscovery of Spirituality in the 1990’s • Differentiation between Spirituality and Religion

    23. Themes • The Diagnostican - Paul Pruyser • Gardener - Edgar Draper • Living Human Web – Bonnie J. Miller- Mclemore • Wounded Healer – H. Nouwen • Midwife – B.Gill-Austern

    24. Definition of Spiritual Care “Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred”. J. of Palliative Care, Vol. 12, No 10, 2009

    25. Spiritual Assessment of Patients and Families Spiritual Screening Spiritual History Spiritual Assessment www. icsi.org, November 2009

    26. Who does Spiritual Screening? Spiritual Screening: Nurse/Social Worker/ Admissions Spiritual History: Physician, Nurse, Social Worker, other clinician Spiritual Assessment: Chaplain

    27. Spiritual Assessment Tools H.O.P.E F.I.C.A. S.P.I.R.I.T.

    28. Spiritual Assessment Tools www.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 of life (Anandarajah, 2001 [R])

    29. Spiritual Assessment Tools 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 community or church? A: How would you like your health care providers to be with you in addressing spiritual issues and concerns? (Puchalski, 2000 [R])

    30. Spiritual Assessment Tools S: Spiritual belief system P: Personal spirituality I: Integration with a spiritual community R: Ritualized practices and restrictions I: Implications for medical care T: Terminal events planning (Maugans, 1996 [R])

    31. Documentation • Where? • Who?

    32. Clebsch & Jaekle Four guidelines during times of transition

    33. 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?

    34. Sources Clebsch, W. & C. R. Jaekle (1964) Pastoral Care in Historical Perspective. New York: Prentice-Hall, Inc. Dykstra, R.C. (Ed). (2005) Images of Pastoral Care: Classic Readings St. Louis: Chalice Press. McNeill, J.T. (1951) A History of the Cure of Souls New York: Harper & Row. O’Connor, T. St. J. “Pastoral Counseling and Pastoral 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