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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

The History of Spiritual Care

Catherine O’Connor, CSB, Ph.D.

Covenant Health Systems

Lexington, MA

  • 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


“ 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)

  • 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?
ministry of cure of souls
“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

four functions of pastoral care
Four functions of Pastoral Care
  • Healing
  • Sustaining
  • Guiding
  • Reconciling

Clebsch & Jaekle 1975

eight epochs of christian pastoring
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
20 th century trends
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
20 th century trends9
20th Century Trends.
  • Emmanuel Movement – Rev. Elwood Worcester at Emmanuel Episcopalian Church, Boston
  • CPE movement in early 1920’s
clinical pastoral education cpe
Clinical Pastoral Education(CPE)
  • Dr. William Keller

Dr. Cabot Lodge

Rev. Anton Boisen

Dr. Helen Dunbar Flanders

1930 1990
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

1930 199012
1930- 1990

1950 – Development of Standards

1965 – Canadian Council formed

1967 – Strands merged and the Association of

Clinical Pastoral Education formed


1970 - National Association of Catholic

Chaplains formed (NACC)

1980’s NAJC

1988 – COMMISS

2007 – Common Standards

2009 - Spiritual Care Collaborative (SCC)

anton boisen
Anton Boisen
  • Brush Clearing
  • Fragmentation – Learning from Failure
  • Living Human Document
  • Case Study Methodology
  • Pastoral Diagnosis
the self as the instrument of healing
The Self as The Instrument of Healing
  • Vulnerability
  • Anxiety
  • Story
praxis methodology
Praxis Methodology

Think – Learn – Do

Do - Think - Learn

  • Dia – gnosis
  • The meaning we give to the knowledge available
  • Carl Jung
hermenutical approach
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
the minister as diagnostican paul pruyser md
The Minister as DiagnosticanPaul Pruyser, MD
  • Awareness of the Holy
  • Providence
  • Faith
  • Grace
  • Repentance
  • Communion
  • Vocation

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

the illness narratives suffering healing and the human condition
The Illness Narratives: Suffering, Healing and the Human Condition
  • Illness
  • Dis-ease
  • Sickness

Arthur Kleinman, MD

20 th century trends21
20th Century Trends


Pastoral Care - Pastoral Counseling

Pastoral Counseling - Pastoral Psychotherapy

Pastoral Care - Spiritual Care

Individual Spiritual Direction – Group Spiritual Direction

Individual - Systems

  • DSM - IV
  • Rediscovery of Spirituality in the 1990’s
  • Differentiation between Spirituality and Religion
  • The Diagnostican - Paul Pruyser
  • Gardener - Edgar Draper
  • Living Human Web – Bonnie J. Miller- Mclemore
  • Wounded Healer – H. Nouwen
  • Midwife – B.Gill-Austern
definition of spiritual care
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

spiritual assessment of patients and families
Spiritual Assessment of Patients and Families

Spiritual Screening

Spiritual History

Spiritual Assessment

www., November 2009

who does spiritual screening
Who does Spiritual Screening?

Spiritual Screening: Nurse/Social Worker/


Spiritual History: Physician, Nurse, Social Worker, other clinician

Spiritual Assessment: Chaplain

spiritual assessment tools
Spiritual Assessment Tools




spiritual assessment tools www icsi org 11 2009
Spiritual Assessment Tools 11/2009

H: Sources of Hope, meaning, comfort,


O: Member of organized religion

P: Personal Spirituality

E: Effects of beliefs on medical care, end of


(Anandarajah, 2001 [R])

spiritual assessment tools29
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])

spiritual assessment tools30
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])

  • Where?
  • Who?
clebsch jaekle
Clebsch & Jaekle

Four guidelines during times of transition

issues and challenges of the 21 st century
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?

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., 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