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Three Doors to Spiritual Reflection. Ethnographic Research on the Role of Emotion, Images and Sacred Texts in Spiritual Reflection done by non-chaplaincy Health Care Professionals CASC/ACSS April 15, 2011. Authors.
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Three Doors to Spiritual Reflection Ethnographic Research on the Role of Emotion, Images and Sacred Texts in Spiritual Reflection done by non-chaplaincy Health Care Professionals CASC/ACSS April 15, 2011
Authors Thomas St. James O’Connor, ThDMichael Chow, MA, MDivElizabeth Meakes, MTS Janet Young, MTS Gary Payne, MDiv Myrta Rivera, MA Laura MacGregor, MSc Janet Howitt, MDiv/MSW
Introductions of Presenters • Michael Chow, M.Div, MA Director, St. Joseph’s Health System, Diocese of Hamilton Specialist & Teaching Supervisor (CASC) • Gary Payne, M.Div Professional Practice Leader, Spiritual Care St. Joseph’s Healthcare Hamilton Specialist & Teaching Supervisor (CASC)
Introductions of participants • Who am I? • Professional practice? • Special interest in this workshop …
Our Plan • Stepping Back a Little • Overall Research Question • Review of Literature • Sources • Definitions • Findings and Discussion • Moving Forward • Role of Emotions, Images & Sacred Texts • Discussion
Stepping Back a Little • Ethnographic qualitative study • 2 articles published • “In the Beginning: A Canadian Study on Sources and Definitions of Spiritual Reflection used by Health Care Professionals who are not Chaplains” In Journal of Pastoral Care & Counseling, Vol 64, No 1 (2010) • Focus on Sources & Definitions • “Three Doors” Has been accepted for publication by Journal of Healthcare Chaplaincy, NY (March 2011) • Focus on Images, Emotions and Sacred Texts
Overall Research Question What are the practices of spiritual reflection for health care professionals who are not chaplains who provide spiritual care to their clients?
Interview Guide 1) What are the sources you use for spiritual reflection? 2) How do you define spiritual reflection? Any spiritual authors you use? 3. How much time weekly on spiritual reflection? 4. Similarities & differences between prayer & spiritual reflection 5. Goal of spiritual reflection? 6. How important is spiritual reflection for identity? 7. Which groups-colleagues, clients, & other profession.? 8. Role of emotion and images in spiritual reflection? Is there an image or verse from a sacred text that describes spiritual reflection? 9. Give me an example of spiritual reflection from your practice 10. Image or verse from a sacred text and/or any other source that describes it. 11. Any other comments.
Review of Literature From “In the Beginning” publication: • No empirical research found on definitions, sources or methods of spiritual reflection used by health care professionals who are not chaplains. • Interviewees preferred “spiritual reflection”, whereas chaplains & pastoral counsellors also used “theological reflection”
Lit Review findings (cont) • Spiritual care and spirituality have become more important to many health care disciplines in the last thirty years • In the health care disciplines, there is an emphasis on reflective practice • Don Schon’s Reflective Practice is a common text used in many health care disciplines.
Lit Review findings (cont) • Literature Review focused on three health care disciplines: • nursing, • social work • occupational therapy • Examining barriers to practice of spiritual care which includes spiritual reflection
Barriers in Nursing • Lack of conceptual clarity of “spirituality” • Frequent assumption that spiritual care is same as religious/faith based care • Demands placed on bedside nurses in terms of patient care • Lack of confidence in dealing with spiritual matters • Lack of education regarding spiritual care and reflection
Barriers in Social Work • The notion that social work, like other health professions in recent decades, has distanced itself from religious belief • Increased emphasis on evidence-based practice • Lack of appropriate education in the realm of both spiritual care of clients and the role of spirituality as a health professional
Occupational Therapists:a philosophical dilemma • Canadian Model of Occupational Performance [CMOP], the model that describes the human participant in occupational therapy and the corresponding domain of concern for the profession, spirituality is placed at the central core of the person and model (Baptiste, 2005)
Barriers for OT’s • Debate within the profession: • How to define spirituality or • Whether spirituality belongs in the centre of the occupational therapy model • Lack of training in spiritual aspects of care • The fear of intruding on another’s beliefs
Barriers for OT’s (cont) • Discomfort by the treatment team when professions explored spirituality • Confusion about the role of spirituality • Lack of time • Their role in terms of spirituality was to refer to pastoral care • An assumption that discussing spirituality with clients is taboo or inappropriate • Too emotionally charged
Other findings • In some cases, nurses & OT’s became more comfortable providing spiritual care with experience • That therapists who considered themselves religious were more likely to have positive attitudes regarding exploring spirituality in their professional life • Spiritual reflection has not been addressed nor has the methods and sources for reflection. Nonetheless, spiritual care requires some level of reflection
Sample details • 20 interviews • Occupational Therapists, Nurses, Social Workers, Physiotherapists, Music Therapist, Recreation Therapist, Physician, Psychologist • Faith groups included: United Church , Evangelical Christian , Christian Reform , Mennonite, Buddhist , spiritual but no faith group • Gender mainly females 17:3 • Age: mainly over 40
Brief Check In For a few minutes please consider: • Is Spiritual Reflection part of your own practice? • What are some sources for Spiritual Reflection for you? • How do you define Spiritual Reflection?
Research Findings: Sources • Music 9/20 • Sacred text esp. Bible 6/20 • No sacred text mentioned 4/20 • Personal & client experiences 7/20 - (much of this was personal journey) • Variety of spiritual authors used • Nature – 4/20
Research Findings: Definitions • Connecting to Self & others…balance & grounded 9/20 • Accessing & discovering the divine 8/20 • Meaning and purpose 6/20 • Related to daily life 6/20
Unexpected Findings • Many mentioned no education in spiritual care/reflection • None mentioned receiving adequate education
Comparison against study on Theological Reflection Sources for Theological vs. Spiritual Reflection Chap/Past CounsellorOT, Nurses, SW 1. Sacred texts 63/75 1.Mus, Art, Lit 11/20 2. Pers. Exp. 50/75 2. Sacred text 11/20 3. Experience/Clients 42/75 3. Per/Prof Exp. 7/20 4. Faith Tradition 39/75 4. No sacred txt 4/20 5. Lit. & Soc. Sci. 26/75 5. Nature 4/20
Discussion on Definitions Definitions of Theological vs Spiritual Reflection Chap./Past. Coun. OT., Nurses, SW. • Both struggle to define • Meaning making Connecting with Self/Other • Discovering Divine Discovering Divine • Discipleship Meaning/purpose
Three Doors • Role of Emotion, Images & Sacred Texts • In the process of Spiritual Reflection • By non-chaplaincy health care professionals who offer spiritual care
Three Doors Main Finding: • That emotion and images are main doors, • With sacred texts being a side door
5 minute Check In Please consider: • What has been your experience with Spiritual Reflection? • What are the roles of emotion, images and sacred texts in Spiritual Reflection for you? • Is there an image or verse from a sacred text that describes Spiritual Reflection for you?
TRANSFORMATION Outcomes of Spiritual Reflection • Deeper sense of peace • Grounding and Letting Go Some form of Transformation results from Spiritual Reflection
The 3 Doors “In our research, we found that emotion and images were the two main doors to spiritual reflection … …A third door used by some was sacred texts but most participants acknowledged that they had little education in the sacred texts. Sacred texts were more of a side door and not the main doors. Also a consequence of this spiritual reflection … was transformation.”
Role of Emotion, Images and Sacred Texts • Affirmed by many writers (Killen & de Beer, 2002; Kinast 1996; Whitehead and Whitehead, 1995) • Anton Boisen coined “Living Human Document” (1952) • Gerkin expanded and insisted on hermeneutics (1984)
From Human Sciences Goleman, Emotional Intelligence (1995) • Cites work of Salovey & Mayer, 1990 • 5 Domains Fosha, Siegel & Solomon, 2009 • Emotions facilitate integration & motivation
Spiritual Needs “… many healthcare professionals … believe that addressing the spiritual needs of clients and patients is within their scope of practice and part of holistic care.” “Most research on spirituality and health is done by these non-chaplaincy professionals and researchers…”
Is there a gap? “However with these professionals, there is a gap between research, the interest and the actual practice.” “It is not known how much spiritual care is actually done by the non-chaplaincy disciplines.”
Spiritual Care & Therapy • Spiritual Care & Therapy traditionally domain of chaplains and community clergy • Some are critical of these other professionals doing spiritual care when many have little education and training in this area (Sloan et al., 2000)
Care involves Reflection • Spiritual Care involves Spiritual Reflection (Schon, 1983; Mezirow, 1997; Mamede & Schmidt, 2004) • “Reflective practice is important in all health care disciplines. Spiritual reflection can happen in the midst of a visit with patient, in a prayerful time after or in conversation with a colleague.”
Research lacking? “However, there has been no empirical research on the role of emotion, images and sacred texts in spiritual reflection among non-chaplaincy health care professionals.”
Rationale for study • Given lack of empirical research, qualitative study employed • Descriptive and ethnographic • Goal is to understand and explore the role of emotion, images and sacred texts
Secondary Rationale • Investigate if there are any similarities and differences between chaplains and other health care professionals in areas of spiritual and theological reflection