Post on 02-Jun-2018
transcript
8/10/2019 Spiritual Care Nursing
1/34
The History of Spiritual Care
Catherine OConnor, CSB, Ph.D.
Covenant Health SystemsLexington, MA
8/10/2019 Spiritual Care Nursing
2/34
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
8/10/2019 Spiritual Care Nursing
3/34
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
8/10/2019 Spiritual Care Nursing
4/34
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?
8/10/2019 Spiritual Care Nursing
5/34
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 andreconcilingof troubled personswhose troubles arise in thecontext of ultimate meanings andconcerns.
Seward Hiltner 1958
8/10/2019 Spiritual Care Nursing
6/34
Four functions of Pastoral Care
1. Healing
2. Sustaining
3. Guiding
4. Reconciling
Clebsch & Jaekle 1975
8/10/2019 Spiritual Care Nursing
7/34
Eight epochs of Christian Pastoring
1. Primitive Christianity
2. 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
8/10/2019 Spiritual Care Nursing
8/34
20thCentury 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
8/10/2019 Spiritual Care Nursing
9/34
20thCentury Trends.
Emmanuel MovementRev. Elwood
Worcester at Emmanuel Episcopalian
Church, Boston
CPE movement in early 1920s
8/10/2019 Spiritual Care Nursing
10/34
Clinical Pastoral Education
(CPE)
Dr. William Keller
Dr. Cabot LodgeRev. Anton Boisen
Dr. Helen Dunbar Flanders
8/10/2019 Spiritual Care Nursing
11/34
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
8/10/2019 Spiritual Care Nursing
12/34
1930- 1990
1950Development of Standards
1965Canadian Council formed
1967Strands merged and the Association of
Clinical Pastoral Education formed(ACPE)
1970 - National Association of Catholic
Chaplains formed (NACC)1980s NAJC
1988COMMISS
2007Common Standards
2009 - Spiritual Care Collaborative (SCC)
8/10/2019 Spiritual Care Nursing
13/34
Anton Boisen
Brush Clearing
FragmentationLearning from Failure
Living Human Document
Case Study Methodology
Pastoral Diagnosis
8/10/2019 Spiritual Care Nursing
14/34
The Self as The Instrument of
Healing
Vulnerability
Anxiety
Story
8/10/2019 Spiritual Care Nursing
15/34
Praxis Methodology
ThinkLearnDo
Do - Think - Learn
8/10/2019 Spiritual Care Nursing
16/34
Diagnosis
Diagnosis
The meaning we give to theknowledge available
Carl Jung
8/10/2019 Spiritual Care Nursing
17/34
Hermenutical Approach
Allow people to disclose their word,their meaning
Reverence for the text, the word of the
person, as we have reverence for theWord, the text of Scripture
Sometimes interpreter of the person to
themselves, of their story; sometimesthe interpreter of the Story, of Godssaving events of salvation
8/10/2019 Spiritual Care Nursing
18/34
The Minister as DiagnosticanPaul Pruyser, MD
Awareness of the Holy
Providence
Faith Grace
Repentance
Communion Vocation
8/10/2019 Spiritual Care Nursing
19/34
Themes
1930s What must I doto be of help?
1940s What must I knowto be of help
1950s What must I sayto be of help
1960s Whomust I beto be of Help
1990s - Focus on Competencies-
personal, professional, spiritual
8/10/2019 Spiritual Care Nursing
20/34
The Illness Narratives: Suffering, Healing and the
Human Condition
Illness
Dis-ease
Sickness
Arthur Kleinman, MD
8/10/2019 Spiritual Care Nursing
21/34
20thCentury Trends
Shifts:
Pastoral Care - Pastoral Counseling
Pastoral Counseling - Pastoral Psychotherapy
Pastoral Care - Spiritual Care
Individual Spiritual Direction
Group Spiritual Direction
Individual - Systems
8/10/2019 Spiritual Care Nursing
22/34
Influences
DSM - IV
Rediscovery of Spirituality in the 1990s
Differentiation between Spirituality and
Religion
Th
8/10/2019 Spiritual Care Nursing
23/34
Themes
The Diagnostican - Paul Pruyser
Gardener - Edgar Draper
Living Human Web Bonnie J. Miller-
Mclemore
Wounded HealerH. Nouwen
MidwifeB.Gill-Austern
8/10/2019 Spiritual Care Nursing
24/34
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
8/10/2019 Spiritual Care Nursing
25/34
Spiritual Assessment of
Patients and Families
Spiritual Screening
Spiritual History
Spiritual Assessmentwww. icsi.org, November 2009
8/10/2019 Spiritual Care Nursing
26/34
Who does Spiritual Screening?
Spiritual Screening: Nurse/Social Worker/
Admissions
Spiritual History: Physician, Nurse, Social
Worker, other clinician
Spiritual Assessment: Chaplain
8/10/2019 Spiritual Care Nursing
27/34
Spiritual Assessment Tools
H.O.P.E
F.I.C.A.
S.P.I.R.I.T.
Spiritual Assessment Tools
8/10/2019 Spiritual Care Nursing
28/34
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])
http://www.icsi.org/http://www.icsi.org/8/10/2019 Spiritual Care Nursing
29/34
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 communityor church?
A: How would you like your health careproviders to be with you in addressing
spiritual issues and concerns?
(Puchalski, 2000 [R])
8/10/2019 Spiritual Care Nursing
30/34
Spiritual Assessment Tools
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])
D t ti
8/10/2019 Spiritual Care Nursing
31/34
Documentation
Where?
Who?
8/10/2019 Spiritual Care Nursing
32/34
Clebsch & Jaekle
Four guidelines during times of transition
8/10/2019 Spiritual Care Nursing
33/34
Issues and Challenges of the 21stCentury
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?
8/10/2019 Spiritual Care Nursing
34/34
SourcesClebsch, 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.
OConnor, 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