This is a review of “What Do Chaplains Do? The Role of the Chaplain in Meeting the Spiritual Needs of Patients” by Dr Harriet Mowat and Professor John Swinton, report number CSHD/MR001 Edition 2 from Aberdeen University, February 2007 and available online on this site (pdf).
I was given a copy of this report when at the Premier Mind and Soul conference in Edinburgh last week, and I was delighted to get it, because I am interested in the role of chaplains and have an ambition to work in that field myself someday. I am interested in mental health chaplaincy, although this study is a more general one, and does not focus on mental health. This is the report of a study undertaken in Scotland where all the full-time chaplains in the Scottish health service were interviewed, and the results analysed. The aims of the study were:
- To build on the existing knowledge around the areas of chaplaincy, spirituality, religion and their relation to the process of healthcare within the Scottish National Health Service.
- To describe the current role and function of the hospital chaplain.
- To explore the various perceptions of the work of the chaplain held within the health care context.
- To identify what patients perceive as the most beneficial approaches to spiritual care and comfort.
- To put these findings into the context of the national guidelines on spiritual care and subsequent policy documents produced by the Health Care Trusts.
This report gave me quite a different view of chaplaincy than I previously had – having only a patient’s view rather than that of the Scottish Executive and chaplains themselves. I was aware, for example, that a chaplain serves not only members of their own faith but all people of faith or no faith, but not that chaplaincy is focussed on spirituality over and above the religious aspect. There were other new things too, such as that chaplaincy is increasingly seeking to be seen as a healthcare profession, part of the team of people in a hospital rather than as an outsider. In part this is due to the Scottish government’s decision to make spiritual care mandatory in hospitals – something I was not aware of – and the report suggests that increasingly chaplains may be funded by the NHS rather than by a church of which they are a minister. They predict that we will see chaplains employed who are of no faith as well as those who have a particular belief, and that we will see more lay people and fewer ministers of religion.
All this arises from a different view of what spirituality is than I am used to. To me, spirituality is the search for God, it is related to religion and is part of my Christian faith. To others, apparently, spirituality is something all humans have, and is independent of any religious belief. In the report it says that “spiritual care, much more person-centred, relates to what makes you tick, feelings, emotions, big questions, meaning.” (p33) I wrote a little about spirituality in my report on the talks given at the conference here.
The meat of the report, rather than the analysis, is also fascinating. In this they interviewed by telephone 44 full-time chaplains, then they gathered information for case studies from three sites, and then interviewed the chaplains once again to ask further questions.
The information they found is that the majority of chaplains are male (28 vs 16 female), overwhelmingly Church of Scotland, of average age 47, all but two of them had had previous experience in a parish, their average length of time worked as a chaplain was 5 years and they had a wide range of qualifications including courses on counselling, bereavement and palliative care.
The report lists some really interesting information – from my point of view anyway – about the differences reported by the chaplains between what they do now and what they did in parish ministry – a sort of “pros and cons” approach. These included that the parish minister is a central figure whereas a chaplain is peripheral to the medical team; that people know what a parish minister does but may struggle to understand what a chaplain does and why they are needed; that a minister has an agenda, “bums on seats” whereas a chaplain “meets people where they are and better fits the Gospel picture and ministry of Christ” (p25); that a minister goes to an awful lot of meetings, and has corresponding paperwork whereas a chaplain is a more frontline worker, dealing with people at a time of need. They noted that a minister is less able to get away from the job, and can be called up at all times whereas a chaplain has office hours and many receive few call-outs after hours; that there is more crisis in chaplaincy and less building up relationships over time, and that chaplains work in the real world and not with “church people.”
Some of the core skills identified by chaplains are:
- Spiritual intelligence
- Emotional intelligence
- The ability to be with someone in a meaningful way (presencing)
- The ability to build meaningful relationships in a short period of time
- Religious, spiritual, personal and professional experience
- The art of prayerful listening (p29)
Core tasks of chaplaincy are written as seeking those who need them, identifying the nature of the need and responding to the need through theological and spiritual praxis. A handy infographic on p30 talks about seeking people via loitering, prioritising (those in danger of death, children), staff referral, lists, being around the wards. They talk about using the skills above to identify need, and responding by experience, having no clinical agenda, talking and listening, developing a relationship, and referring onwards.
A theme running through the report is that the current state of chaplaincy in Scotland is in transition, and that there is a degree of tension between the chaplain as spiritual carer, as someone who provides help for all, and the traditional interpretation of a chaplain as someone who provides religious services and succour to those with (especially Christian) faith. While chaplains themselves saw themselves increasingly as carers for all, patients and staff still saw them primarily as people to go to if they knew a patient was religious, or dying. In addition the chaplains, all of them Christian ministers, had a tension between their own faiths (particularly if evangelical) and the requirements of the “spiritual carer” role, between whether to present the Gospel or whether to just be alongside someone without mentioning Christian faith.
I found this report fascinating and would definitely recommend you read it if you are interested in chaplaincy. It is written for a general audience and they interpret the data for you (which is just as well as I am not versed in statistics!) I would particularly recommend this if you have any desire to work in chaplaincy yourself. There is more to the report than I could cover here – really without simply copy and pasting the report I could not relate it all! A very interesting read.