Pastoral Care & Clinical Pastoral Education: Home

J Health Care Chaplain. 2025 Oct-Dec;31(4):239-245. doi: 10.1080/08854726.2025.2569223. Epub 2025 Oct 12.

ABSTRACT

Modern society is characterized by pluralism. We examine how chaplaincy encounters pluralism and what this might mean for chaplaincy and chaplaincy education. Religious pluralism impacts both how the profession is organized and how it is practiced. Financial and legislative structures play an important role in creating space for religious pluralism in chaplaincy. This intersects with "professional pluralism" within spiritual care. In many countries, spiritual care is increasingly considered a responsibility of a wide variety of healthcare professionals. This requires interprofessional collaboration in which different understandings of and approaches to spirituality and spiritual care need to be made explicit and negotiated. For chaplaincy and chaplaincy education, this has five important implications: a) developing interfaith competence as a Core Professional Skill; b) building a shared professional identity while honoring diversity; c) mastering interprofessional collaboration; d) addressing structural inequalities and power dynamics; and e) embracing both generic and specialized approaches to spiritual care.

PMID:41076643 | DOI:10.1080/08854726.2025.2569223

J Health Care Chaplain. 2025 Oct-Dec;31(4):277-291. doi: 10.1080/08854726.2025.2564598. Epub 2025 Oct 5.

ABSTRACT

This article examines how hospital chaplains in Norwegian specialist healthcare support patients at risk of suicide, with particular attention to existential care within a pluralistic society. Based on qualitative data from four focus group interviews involving 16 chaplains across somatic and psychiatric units, the study explores how chaplains understand, experience, and reflect on their role in existential conversations. Three main themes emerged: the chaplains' theological and worldview profiles, their openness to diverse worldviews, and the dilemmas they face in balancing professional identity with interdisciplinary expectations. The findings highlight chaplains' capacity to create meaningful, non-judgmental spaces for dialogue, where suffering and hope can be explored. However, the absence of explicitly articulated frameworks may limit their visibility and integration in interdisciplinary care. The study underscores the importance of clarifying the chaplain's role in modern healthcare and developing shared professional language to strengthen existential care for patients in crisis.

PMID:41046461 | DOI:10.1080/08854726.2025.2564598

Sociol Health Illn. 2025 Nov;47(8):e70095. doi: 10.1111/1467-9566.70095.

ABSTRACT

Health policy that aims for patients to take greater responsibility for self-managing their long-term condition has had increasing global significance. Sociologists, drawing on Foucault's governmentality theory, have explored the way in which 'responsibilised' identities are constructed for patients, encouraging them to make well-informed and self-sufficient decisions about their health, as well as how health professionals, acting as 'pastors', attempt to shape these desirable patient subjectivities. This paper draws on ethnographic data collected within a community-based integrated care (CBIC) service in England to explore how community nurses were encouraged to seek out and eliminate 'waste' by discharging patients to self-management. Building on Waring and Martin's model of pastoral practices, this paper demonstrates how nurses engaged in pastoral 'practices of ethical negotiation' when trying to reconcile sometimes competing discourses of 'waste watching' and their professional values of care. This was enacted collectively when community nurses shifted their gaze outwardly from 'technologies of the self' to others on their team, demarcating appropriate practice for nurses more broadly through 'technologies of the collective'. This paper contributes to governmentality studies by demonstrating the ongoing work required by professional communities to render themselves ethical within the modern neoliberal state.

PMID:41036695 | PMC:PMC12489973 | DOI:10.1111/1467-9566.70095

Nursing. 2025 Oct 1;55(10):23-33. doi: 10.1097/NSG.0000000000000217. Epub 2025 Sep 22.

ABSTRACT

Spirituality is an integral part of patient-centered care: Inclusive nursing, which encompasses assessing and responding to patients' spiritual needs, can improve patient outcomes. It is important to determine a patient's religion and spirituality at the beginning of care because this may affect how a patient wishes to be treated. In support of patients' spirituality, hospital chaplains are experts in providing spiritual care to patients, families, and staff. This article discusses the role of hospital chaplains and central aspects of different religious beliefs, with the aim of better equipping nurses to support patients' spiritual needs across diverse backgrounds.

PMID:40981629 | DOI:10.1097/NSG.0000000000000217

R I Med J (2013). 2025 Sep 2;108(9):23-26.

ABSTRACT

Patients in the Emergency Department (ED) have a diverse set of spiritual challenges. As part of a clinical initiative to embed palliative care in the ED, our palliative care department looked to provide timely spiritual care (SC) to this population. We worked with three of our chaplains to identify ED-specific spiritual care challenges and benefits. Several themes arose on nuances of SC consults in the ED: quality of consults (less focused on actively dying patients, more upstream support), challenges (physical environment, staff limitations, distractions), benefits (continuity of care, support to the ED staff, high moral/spiritual distress in the ED setting, provider- rewarding care, taking advantage of long ED stays), and ways to improve (embedding SC in the ED, education on scope of service provided by SC). Addressing spiritual and moral distress is a key component of high-quality palliative care and may be a feasible patient-centered outcome to address in future research.

PMID:40854026

J Prim Care Community Health. 2025 Jan-Dec;16:21501319251357528. doi: 10.1177/21501319251357528. Epub 2025 Jul 17.

ABSTRACT

INTRODUCTION: A broad range of studies have associated spirituality with health outcomes. However, the integration of spiritual care in primary and community care has substantially lagged behind. Chaplains, as specialist spiritual caregivers, are increasingly employed in primary and community care to fill the gap. To investigate the implementation of chaplains in these settings from the perspective of clients, this study focused on the following research question: what are primary and community care clients' reasons to seek chaplaincy care, their ideas of care goals, and what outcomes of care do they report?

METHODS: 24 Dutch chaplaincy clients were interviewed.

RESULTS: Clients sought support from a chaplain for existential concerns, or an existential struggle encompassing several areas of life. They described goals and outcomes of care in 3 domains: (1) the relationship with the chaplain, which included being seen, heard and acknowledged; (2) meaning-making, where they gained insight into and/or processed life-events, and connected more with themselves, others and/or the sacred; and (3) well-being, which included feeling better and finding peace.

CONCLUSIONS: This study provides novel insights into clients perspective on chaplains' contributions in primary and community care. Their experiences are key to further shaping the implementation of chaplaincy in these settings.

PMID:40673499 | PMC:PMC12276415 | DOI:10.1177/21501319251357528

Health Soc Care Deliv Res. 2025 May;13(16):1-119. doi: 10.3310/ZMLF1648.

ABSTRACT

BACKGROUND: The human experience comprises four interconnected dimensions: physical, psychological, social and spiritual. Our spirituality is evidenced in the need to make sense of and find meaning, to feel our lives have purpose, to feel we matter and to feel connected to ourselves, others, the natural world and the sacred or divine. Having a life-shortening or life-threatening condition threatens spiritual well-being and causes spiritual suffering. While health care aspires to be holistic, the evidence on meeting spiritual needs and spiritual care in healthcare settings is limited, particularly for neonatal and paediatric populations.

OBJECTIVE(S): To generate evidence to support evidence-informed approaches for the spiritual care of children/young people and their parents, including the role of chaplaincy.

DESIGN AND RESEARCH PARTICIPANTS: A mixed-method, multicomponent design was used with the quantitative and qualitative data collected. There were four work packages. Work package 1: survey of chaplaincy services in the National Health Service acute trusts in England (n = 98/136). Work package 2: focus groups with National Health Service chaplains across 13 acute trusts (n = 77). Work package 3: interviews with young people (12-25 years) (n = 19) and parents (n = 62). Work package 4: focus groups with National Health Service clinical staff and allied health professionals based in services caring for children with life-threatening or life-shortening conditions (n = 48).

RESULTS: Multiple threats to children's/young people's and parents' spiritual well-being were identified. These included struggling to make sense and find meaning in their situation; existing belief systems (or personal philosophies) found wanting, existential worries and concerns; a sense of disconnectedness from others and 'normal life'; and a lack of pleasure and joy, moral distress and feelings of insignificance and invisibility. Almost all described hiding their spiritual distress from themselves and others. At the same time, parents and young people also spoke of wishing for people on whom they could unburden themselves: either at critical moments, or to 'journey' with them. For some, chaplains had provided this care and support. Many, including those identifying themselves as not religious, described drawing comfort from religious rituals and practices (e.g. prayer and blessings). For some, a religious faith protected against spiritual distress. For others, it was regarded as irrelevant or unhelpful. All work packages revealed barriers to children's/young people's and parents' spiritual needs being met. Healthcare staff's accounts revealed a lack of understanding and an uncomfortableness with raising and exploring religious needs and spiritual distress and, for some, a mistrust of chaplaincy services. Survey findings indicated that chaplaincy services are less likely to have a routine presence in paediatric compared to adult settings. Key reasons for this were staff capacity and gatekeeping by healthcare staff.

LIMITATIONS: Minority faiths are under-represented in the samples recruited to the qualitative components.

CONCLUSIONS: Having a life-threatening or life-shortening condition brings multiple threats to the spiritual well-being and lived experiences of children/young people and their parents. There are a number of barriers to National Health Service staff recognising and responding to these needs. These include workforce training and adequate resourcing of chaplaincy services and ensuring spiritual care is integrated into care pathways.

FUTURE WORK: Priority topics for future research include effective training for clinical staff on spirituality and spiritual care and integrating spiritual care into care pathways.

STUDY REGISTRATION: This study is registered as Current Controlled Trials ISRCTN41288313.

FUNDING: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR128468) and is published in full in Health and Social Care Delivery Research; Vol. 13, No. 16. See the NIHR Funding and Awards website for further award information.

PMID:40455663 | DOI:10.3310/ZMLF1648

J Health Care Chaplain. 2025 Jul-Sep;31(3):216-235. doi: 10.1080/08854726.2025.2506919. Epub 2025 May 27.

ABSTRACT

In 2022, the Spiritual Care (SC) program at Cedars-Sinai Health System in Southern California undertook an evaluation of their services. It included a survey and focus groups to learn how the staff at Cedars Sinai hospitals perceived and utilized SC services for patients, visitors, and themselves. Survey participants included 554 staff members; 314 of those reported direct contact with patients. The eight focus groups had 28 participants. Respondents with direct patient contact were aware that chaplains are available for patient and family support (302/314; 96%). A majority knew how to make a referral to SC (217/302; 72%). Focus group results emphasized the importance and value of SC while recommending ways to improve services. More education of staff is needed regarding what SC includes, when and how to refer patients to SC and the benefits of SC for staff.

PMID:40432324 | DOI:10.1080/08854726.2025.2506919

J Health Care Chaplain. 2025 Oct-Dec;31(4):246-260. doi: 10.1080/08854726.2025.2507411. Epub 2025 May 27.

ABSTRACT

Several studies have examined the goals and outcomes of chaplaincy within institutional settings. Our study contributes to the literature by examining whether chaplaincy goals and outcomes are specific to different outpatient, primary, and community care contexts. We conducted a round of 9 and one of 8 focus groups, with clients, chaplains, and other professionals from five contexts: the Dutch earthquake zone, general healthcare, pediatric palliative care, care for the unhoused, and veteran care. Using an explorative, descriptive and quantitative design, 77 goals and 59 outcomes are compared and categorized in a four-quadrant framework. Our findings show few differences between goals and outcomes of different contexts. However, the goals of care for the unhoused and veterans focus more on the inner experience of the relationship with the chaplain. Non-context-specific goals and outcomes might be related to how chaplaincy is approached, and the context-specific ones to existential concerns in the care contexts.

PMID:40424002 | DOI:10.1080/08854726.2025.2507411

J Healthc Manag. 2025 May-Jun 01;70(3):220-234. doi: 10.1097/JHM-D-24-00143. Epub 2025 May 9.

ABSTRACT

GOAL: Chaplaincy departments may be an important resource for directly improving patient experience, and they may indirectly provide staff support resources to address workplace well-being. However, there is little empirical evidence to support whether or not having a chaplaincy department is associated with positive benefits for acute care hospitals.

METHODS: This study used survey data from the American Hospital Association Annual Survey, the Area Health Resource File, and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data by the Centers for Medicare & Medicaid Services (CMS) to examine urban adult acute care hospitals between 2015 and 2019 and determine whether having a chaplaincy department impacted HCAHPS patient experience scores.

PRINCIPAL FINDINGS: Hospitals with chaplaincy departments reported higher HCAHPS global ratings and higher ratings of patients likely to recommend the hospital.

PRACTICAL APPLICATIONS: The study demonstrates that chaplaincy services may be an underutilized tool to improve patient experience scores. The scores are critical for hospital reimbursement, improved patient outcomes, and patient loyalty. In October 2022, CMS began allowing hospitals to start coding for chaplaincy service encounters. As a result, we may now see even more evidence demonstrating the positive relationship between chaplaincy services and other important hospital metrics.

PMID:40358111 | DOI:10.1097/JHM-D-24-00143

J Health Care Chaplain. 2025 Jul-Sep;31(3):201-215. doi: 10.1080/08854726.2025.2498848. Epub 2025 May 4.

ABSTRACT

Faith Group Endorsement (FGE) is required for the Association of Professional Chaplains (APC) board certification and the Association of Clinical Pastoral Education (ACPE) educator certification. It was established in the early days of professional chaplaincy but recent social changes, including changes in the U.S. religious landscape, create obstacles for obtaining and maintaining FGE for many candidates and raise questions about its value. We conducted focus groups and interviews with 78 key informants, examining the value of and the challenges associated with FGE. Participants reported that FGE is essential to the formation and identity of professional chaplains, but there are serious problems with the current process for obtaining FGE.

PMID:40319467 | DOI:10.1080/08854726.2025.2498848

Support Care Cancer. 2025 Mar 26;33(4):322. doi: 10.1007/s00520-025-09369-x.

ABSTRACT

PURPOSE: To provide a preliminary description of the scope and nature of spiritual care services in outpatient oncology settings.

METHODS: Qualitative thematic analysis of data collected from three focus groups with chaplains representing 13 unique cancer centers.

RESULTS: Eight of 13 chaplain respondents (61.5%) reported that they provided spiritual care exclusively and in a full-time capacity to a cancer center; the remaining 5 (38.5%) had additional inpatient responsibilities. Chaplains visited between 4 and 10 patients per day depending on departmental policies and case acuity. Respondents identified patients for care in a wide variety of ways and described it as a time-intensive aspect of their job. Chaplains noted providing traditional spiritual care and developing innovative strategies/techniques. Most spiritual care relationships were long-term and often focused on medical decision-making. Chaplains commonly faced organizational challenges and identified priorities for strengthening spiritual care integration in outpatient cancer care.

CONCLUSION: The results indicate that the provision of spiritual care in cancer centers differs widely, with chaplains frequently facing challenges with system integration. While chaplains consistently strive to build relationships with clinicians and effectively manage clinic workflows, more collaboration and strategic alignment are needed between chaplains, clinicians, and administrators to develop and advocate for outpatient oncology spiritual care.

PMID:40138045 | PMC:PMC11947033 | DOI:10.1007/s00520-025-09369-x

J Health Care Chaplain. 2025 Jul-Sep;31(3):183-200. doi: 10.1080/08854726.2025.2481816. Epub 2025 Mar 23.

ABSTRACT

Research to measure the value of chaplains is a burgeoning area of interest, as staffing decisions may be contingent on demonstrating a return on investment. Healthcare executives are often faced with difficult staffing decisions that require weighing the support of organizational mission with practical financial implications. This qualitative study utilized thematic analysis to present the perceptions of C-suite executives and two key constituencies - nurses and patients/family members - on the value of chaplains. Results indicate that all three groups value chaplains for their roles in providing support and comfort. Healthcare executives recognize the alignment of chaplains with organizational mission within a faith-based setting but also desire metrics that tie staffing to measurable outcomes. Other organizations exploring chaplain staffing and return on investment may benefit from using mixed-methods research to inform their decision-making.

PMID:40122132 | DOI:10.1080/08854726.2025.2481816

Cancer. 2025 Apr 1;131(7):e35797. doi: 10.1002/cncr.35797.

ABSTRACT

BACKGROUND: Spiritual care provided by chaplains plays a key role in cancer care in the United States, yet little is known about chaplaincy utilization among people of Dharmic religions (Hinduism, Buddhism, Sikhism, Jainism) with cancer.

METHODS: This multi-methods study reviewed the records of patients (aged 18 years and older) who were hospitalized at a dedicated cancer hospital (2015-2019) and conducted interviews with chaplains and adults of Dharmic religions (2020). Primary outcomes included measuring chaplaincy utilization (at least one chaplain visit) across different religions and identifying perceptions of chaplaincy. Secondary outcomes involved measuring unmet spiritual needs on admission, types of spiritual care needs, and variables associated with chaplaincy utilization.

RESULTS: Of 54,828 patients, 2% were of Dharmic religions (n = 1163; 58.4% Hindu, 33.2% Buddhist, 4.8% Sikh, 3.4% multiple, <1% Jain). Compared with others, those of Dharmic religions were younger (median age, 59 vs. 63 years; p < .001), predominantly East or South Asian (78.7% vs. 5.6%; p < .001), and had higher rates of advanced illness (22.6% vs. 15.2%; p < .001) but lower chaplaincy utilization (31.6% vs. 36.7%; p < .001). There were no significant differences in unmet spiritual needs on admission (Dharmic religions vs. others, 8.7% vs. 9.4%; p = .41). Ritual care was the most frequently documented spiritual care need (72%). Multivariable analysis indicated that longer length of stay, non-Dharmic religion, and advanced illness were associated with higher chaplaincy utilization. Themes identified from the interviews included unfamiliarity with chaplaincy, concerns about faith-discordant care, addressing spiritual care needs independently, and solutions for concordant care.

CONCLUSIONS: People of Dharmic religions with cancer were less likely to use chaplaincy services. Barriers included unfamiliarity and faith discordance. Spiritual care incorporating faith-specific resources is urgently needed.

PMID:40117339 | PMC:PMC11927932 | DOI:10.1002/cncr.35797

J Relig Health. 2025 Aug;64(4):2614-2625. doi: 10.1007/s10943-025-02290-x. Epub 2025 Mar 14.

ABSTRACT

Currently in the USA, there is increased interest in collaborative caregiving between mental health professionals and faith leaders. The "shepherding model" of pastoral care as reflected in Psalm 23 has deep religious roots across all major faiths: it is historic, scriptural, practical, and reflective of the activities of clergy and faith leaders. Many of the activities in Psalm 23 are also central to the role and function of psychological first aid (PFA). This commentary/study highlights similarities between Psalm 23 and PFA as a potential enhancement of the continuity of care delivered by both clergy and mental health professionals.

PMID:40085193 | DOI:10.1007/s10943-025-02290-x