APC18 Report PDF

The Impact of
Professional Spiritual Care

A joint publication of the CLICK HERE TO
ACPE: The Standard for Spiritual Care & Education | Association of Professional Chaplains | LEARN HOW TO READ
Canadian Association for Spiritual Care/Association canadienne de soins spirituels |
National Association of Catholic Chaplains | Neshama: Association of Jewish Chaplains
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Our spiritual health profoundly impacts our physical health, well-being, and quality of life. Just as medical professionals care for our
bodies and minds, spiritual care practitioners care for our spirits.
The increasing need for spiritual care makes these practitioners even more crucial. However, many of us have limited access to quality,
professional spiritual care. At times of struggle, this lack of spiritual care can have a negative impact on our health and well-being.
Investigators and researchers are creating a growing body of evidence for the innumerable benefits of professional spiritual care, yet
many people still do not have a lot of accurate information about these practitioners.
To create this publication, the six largest healthcare chaplaincy organizations in North America collaborated to share the facts about
spiritual care and practitioners’ roles, training, and standards.
By providing evidence and dispelling myths, the thousands of spiritual care practitioners represented by these organizations hope to
increase access to spiritual care for the benefit of all.
Notes on Terminology
Because the term chaplain is well known, this publication sometimes uses chaplain and spiritual care practitioner interchangeably to
increase understanding. However, the terms are not truly synonymous, and the term spiritual care practitioner is preferred in Canada.
Chaplains are spiritual care practitioners, but not all spiritual care practitioners are chaplains.
Similarly, the term spirituality is inclusive of religion, but religion is only one of many expressions of spirituality. Many spiritual care
practitioners are employed by secular organizations, such as hospitals, schools, the military, police and fire departments, and correctional
institutions.
Spiritual care also may be known as pastoral care. A type of spiritual care practitioner, pastoral counselors are clinical mental health
professionals.
The Authors
ACPE: The Standard for Spiritual Care & Education | www.acpe.edu
Association of Professional Chaplains | www.professionalchaplains.org
Canadian Association for Spiritual Care/Association canadienne de soins spirituels | www.spiritualcare.ca
National Association of Catholic Chaplains | www.nacc.org
Neshama: Association of Jewish Chaplains | www.jewishchaplain.net
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Table of Contents
1 2
Demystifying Spiritual Care Professional Chaplains’
Spiritual care practitioners are uniquely qualified to fill
a growing a need. Qualifications and Competencies
The rigorous certification process requires chaplains to
master a comprehensive skillset.
3 4
Professional Chaplains’ The Evidence for Spiritual Care
Standards of Practice A growing body of research reveals how chaplains benefit
Standards guide chaplains as they deliver quality spiritual care. patients and hospitals.
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1 Demystifying Spiritual Care

Spiritual care practitioners are uniquely
qualified to fill a growing a need.
Holistic health care entails caring for the whole person, comprising three Spirituality and religion were once so intertwined that trying to separate
interrelated parts: body, mind, and spirit. the two seemed pointless.1 This is no longer the case.
We experience spirit, just as we experience our minds and bodies, and this Today, the number of people with no religious affiliation is increasing. In
is called spirituality. 2017, more than a quarter of U.S. adults (27%) identified themselves as
“spiritual” but not “religious,” up from 19% in 2012.4
Although there are several dozen definitions of spirituality,1 healthcare
practitioners are forming a consensus regarding spirituality’s central In short, all religions are expressions of spirituality, but not all expressions
aspects: meaning, purpose, and connectedness. The following definition of spirituality may be tied to religious beliefs.
captures this well.
How does spirituality affect our well-being?
The World Health Organization defined the four dimensions of well-being
Spirituality is a dynamic and intrinsic aspect of humanity as physical, social, mental, and spiritual health. The spiritual dimension “is
through which persons seek ultimate meaning, purpose, not material in nature, but belongs to the realm of ideas, beliefs, values,
and ethics that have arisen in the minds and conscience of human beings,
and transcendence, and experience relationship to
particularly ennobling ideas.”5
self, family, others, community, society, nature, and the
The spiritual dimension plays a significant role in our health, well-being,
significant or sacred. Spirituality is expressed through
and quality of life.6
beliefs, values, traditions, and practices.”2
World Health Organization Four Dimensions of Well-Being
Spirituality Versus Religion
Religion is “an organized system of beliefs, practices, rituals and symbols
designed (a) to facilitate closeness to the sacred or transcendent (God,
higher power or ultimate truth/reality) and (b) foster an understanding
of one’s relationship and responsibility to others in living together in a
community.”3 Physical Social Mental Spiritual
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What is spiritual struggle or distress? • “I can’t have normal conversations with my wife anymore
because of her dementia.”
Illness can cause spiritual struggle or spiritual distress, “a state of suffering
related to the impaired ability to experience meaning in life through Serious illness may prompt us to think of our own mortality:
connections with self, others, the world, or a superior being.”7
• “I had hoped to travel more before this hit me. Now, it may be too
A health crisis—experienced first-hand or by a loved one—can challenge a late.”
person’s entire belief system or view of life.
• “I don’t know how much time I have left, but I have to make it to
The negative emotions we experience and express during a health crisis my daughter’s wedding.”
are evidence of our spiritual distress: • “I need to make amends with my sister. It’s been too long, and I
• Shock: “I never thought this would happen to me!” may not have much time left.”
• Disruption: “Why did God let my child die?” • “What happens when I die? Will I go to heaven?”
• Anger: “That drunk driver should get what he deserves for what Simply being in a hospital may complicate your ability to deal with an
he did to my son!” illness, regardless of the impact of the illness itself. Hospital patients are
• Hopelessness: “I was hoping the clinical trial would work. What’s • isolated from family and loved ones
left?”
• depersonalized in the hospital environment
• Resentment: “My mom doesn’t deserve this. She’s the kindest
• disconnected from their worshiping community
person I know!”
• not able to employ their traditional coping methods, such as
• Guilt: “My children have been after me to stop smoking. I guess I
using religious literature and artifacts, journaling, walking
got what I deserved.”
through nature, enjoying quiet time or privacy, or eating their
• Abandonment: “Where is God now?” favorite foods.
Spiritual struggle also can be caused by a death or loss because these Patients and their families aren’t likely to use the terms spiritual struggle
experiences can change our connections with ourselves and others, and spiritual distress, but that doesn’t mean they aren’t experiencing it. The
sometimes permanently. spiritual distress they feel may not be expressed in language traditionally
associated with religion or faith; however, spiritual struggle or distress is
• “I could always count on my dad’s advice. Now that’s gone.” always revealed as a change or loss of meaning and, sometimes, trying to
• “How can I continue jogging now that I’m losing my leg?” reconstruct what is purposeful.
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How does spiritual care benefit hospitals and patients? team and are able to determine and document a spiritual care plan that
A 2010 study found that 41% of patients wanted to discuss their religious/ can be integrated into the patient’s comprehensive care plan.
spiritual concerns with their healthcare team while hospitalized—but only
half of those reported having done so.8 Shouldn’t community religious leaders supply spiritual care?
Although faith-group leaders are a welcome and crucial link in spiritual
This need is met when patients are able to share religious and spiritual care, they cannot fill the role of professional chaplains and spiritual care
concerns with a professional member of the healthcare team who has practitioners in hospitals. Prepared by and focused on their religious
specific competencies in spiritual assessment and can help them develop a bodies, faith-group leaders might visit their own congregants in the
spiritual plan of care. hospital but they lack the expertise of healthcare chaplains. Faith-group
Patients who discussed religious/spiritual concerns with a member of their leaders are not part of the healthcare team and have no experience
healthcare team—such as a chaplain—were more likely to rate their care creating spiritual care plans. Certified chaplains must uphold a professional
at the highest level on four measures of patient satisfaction (i.e., doctor’s code of ethics common to all certifying organizations, but community
care, confidence/trust in doctors, collaboration/teamwork between doctors faith-group leaders may not be bound by a professional code of ethics that
and nurses, and the overall rating of care), regardless of whether they had mandates respect for diversity and prohibits proselytizing.
expressed a desire to discuss these issues.
Can the existing healthcare team supply spiritual care without a
This can benefit the bottom line, in addition to improving the hospital’s spiritual care practitioner?
reputation and marketability. The Hospital Value-Based Purchasing
The interdisciplinary team cannot be held to the same high level of
Program, an initiative of the Centers for Medicare & Medicaid Services
expectations as a certified spiritual care practitioner in completing a
(CMS), rewards hospitals that enhance patients’ experiences of care during
thorough spiritual assessment or addressing spiritual needs. Nurses,
hospital stays. By leading to higher patient satisfaction scores, quality
physicians, and other members of the healthcare team may address a
chaplain services could result in higher hospital reimbursement from CMS.
person’s spiritual needs, but spiritual care is outside their traditional scope
of practice. Although they can bring a general understanding of spiritual
Who should provide spiritual care?
needs, spiritual care practitioners are specially trained to provide the
Board-certified chaplains and certified spiritual care practitioners have expert care recipients need and expect.
the skills and knowledge required to provide excellent spiritual care and
engage care recipients in identifying and addressing their own spiritual Spiritual care practitioners rely on these important members of the
needs, questions, and concerns. They are part of the interdisciplinary care interdisciplinary care team every day to screen for spiritual needs and
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Among 46 million
adults with no
religious affilation
distress among patients. It takes a team of professionals In the absence of a professional chaplain, these patients are
working together to provide patient-centered care, and unlikely to be visited by anyone to discuss spiritual matters.
68% chaplains are a necessary part of that team.

Patients who do not have a religious affiliation may seem
believe in God like unlikely candidates for spiritual care, but patients
How does religion affect spiritual care needs?
without religious affiliations are still likely to hold religious
In the past, hospitalized patients were expected to be beliefs. A 2012 study of 46 million adults who reported no
visited by their local church’s priest, pastor, or other religious affiliation found that 68% believed in God, 58%
58%
spiritual leader—someone familiar with the patient and felt a connection with nature, 37% described themselves as
their family—not a member of the healthcare system. “spiritual” but not “religious,” and 21% prayed daily.10
feel a connection However, demographics show us that this is no longer a
with nature reality. These individualized expressions of religion and spirituality
require and deserve personalized spiritual care, something
From 2007 to 2014, the number of Christians in the United board-certified chaplains are uniquely able to provide.
States declined 7.8% while the number of people who These chaplains design individual spiritual plans of care
37% identify with non-Christian faiths increased 1.2%. Over the
same period, the number of Americans with no religious
to meet the needs of each patient. Professional chaplains
are educated to care for and help individuals from different
describe themselves
affiliation rose from 16.1% to almost 22.8%.9 faith traditions or no tradition at all. This nonthreatening
as “spiritual” but not
“religious” No matter what their faith, many people who are approach welcomes care recipients to express their beliefs
affiliated with a religion are not active in their worshiping in a welcoming and safe environment.
community and do not have a long-standing relationship
with a rabbi, imam, clergy member, or other religious leader.
21%
pray daily
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Section 1 References 5. World Health Organization. (1991). Retrieved from http://new.worldlibrary.net/

wplbn0000152157-world-health-organization-publication--year-1991--issue-
1. Bregman, L. (2014). The ecology of spirituality: Meanings, virtues, and practices in a post- 9290211407--chapter-4-by-world-health-organization.aspx
religious age. Waco, TX: Baylor University Press.
6. Ross, L. (1995). The spiritual dimension: Its importance to patients’ health, well-being and
2. Puchalski, C. M., Vitillo, R., Hull, S. K., & Reller, N. (2014). Improving the spiritual dimension quality of life and its implications for nursing practice. International Journal of Nursing
of whole person care: Reaching national and international consensus. Journal of Palliative Studies, 32(5), 457–468.
Medicine, 17(6), 642–656.
7. NANDA International. (2014). Nursing diagnoses: Definitions and classification 2015-2017.
3. Koenig, H. G., McCullough, M. E., & Larson, D. B. (2001). Handbook of religion and health. 10th ed. Oxford: Wiley Blackwell.
New York: Oxford University Press.
8. Williams, J. A., Meltzer, D., Arora, V., Chung, G., & Curlin, F. A. (2011). Attention to inpatients’
4. Lipka, M., & Gecewicz, C. (2017). More Americans now say they’re spiritual but not religious and spiritual concerns: Predictors and association with patient satisfaction.
religious. Pew Research Center. Retrieved from http://www.pewresearch.org/fact- Journal of General Internal Medicine, 26(11), 1265–1271.
tank/2017/09/06/more-americans-now-say-theyre-spiritual-but-not-religious/
9. America’s changing religious landscape. (2015). Pew Research Center. Retrieved from
http://www.pewforum.org/2015/05/12/americas-changing-religious-landscape/
10. ‘Nones’ on the rise. (2012). Pew Research Center. Retrieved from http://www.pewforum.
org/2012/10/09/nones-on-the-rise/
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2 Professional Chaplains’ Qualifications and Competencies

The rigorous certification process requires chaplains to master
a comprehensive skillset.
Professional chaplaincy as it exists today is the result of chaplaincy groups These qualifications and competencies set the baseline for professional
from different religious backgrounds coming together to affirm and share practice for chaplains certified by each of these professional organizations.
common core qualifications and competencies. Each organization can add competencies in service to their mission,
culture, and organizational understanding, but the common qualifications
Common standards for certification of chaplains were developed and are shared by all.
affirmed in 2004 by six professional groups that certify and educate
chaplains:
The Canadian Association for Spiritual Care/Association canadienne
• Association of Professional Chaplains de soins spirituels (www.spiritualcare.ca) has its own scope of practice,
• American Association of Pastoral Counselors standards of practice, and competencies, viewable at
http://spiritualcare.ca/professional_practice_home/scope-of-practice/.
• National Association of Catholic Chaplains
• Neshama: Association of Jewish Chaplains The common qualifications and competencies detailed in this section
describe who is qualified to provide spiritual care. What chaplains actually
• Canadian Association for Spiritual Care/Association canadienne
do when providing care is detailed in the standards of practice for
de soins spirituels
professional chaplains, discussed in Section 3.
• ACPE: The Standard for Spiritual Care & Education
General Qualifications
When professionals attain certification through the U.S.-based groups, they
become board-certified chaplains; the Canadian organization’s designation The preparation for professional chaplaincy is rigorous and requires a
is “certified spiritual care practitioners.” solid foundation of academic accomplishment and personal spiritual
development. To that end, the common qualifications require a bachelor’s
In 2016, five of the six organizations updated and reaffirmed the common degree and a graduate-level theological degree from an institution
qualifications and competencies, as they are known today. accredited by the Council for Higher Education Accreditation (CHEA).
Chaplaincy is a dynamic field, and the competencies were expanded to Medical students follow, “First, do no harm.” Similarly, chaplains must have
include areas of research and business understanding that are essential the basic education, self-awareness, and critical judgment skills to avoid
today. causing harm—mentally, physically, emotionally, and spiritually.
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The certifying organization does not prescribe the spiritual beliefs or example of how the competencies continue to develop as the chaplaincy
practices of the chaplain or spiritual care provider. Chaplaincy recognizes profession matures. The value and effectiveness of spiritual care must be
endorsement as the process that helps determine the suitableness or demonstrated through research so chaplains can show how their practice
appropriateness of a person serving as a spiritual leader or caregiver. A contributes to the well-being of care recipients. The professional chaplain
spiritual or faith group endorses a chaplain, providing accountability and must be able to communicate with other care providers, and research
support for the chaplains’ work.1 literacy is an essential means for that communication.
The common qualifications recognize that cultures have different ways

Competency Section II | Professional Identity and Conduct | Nine
of developing spiritual practices and leaders. The certification process
Competencies
is dynamic, maintaining the standards and establishing new pathways
that uphold the standards while accommodating new understandings of Some of this section’s competencies address qualities needed by most
spirituality or religious practice. professionals, such as communicating effectively, dressing and grooming
appropriately, and respecting boundaries.
For example, some non-Western traditions and religions, such as
Islam or Buddhism, have a practice-based pathway of formation and Others are specific to chaplaincy, such as the chaplain’s ability to
development of the spiritual leader. In such cases, equivalencies can be • self-reflect, including on professional strengths and limits
written to demonstrate that certain practice-based experiences meet the
qualifications. • understand how practice is affected by feelings, attitudes, values,
and assumptions
Competency Section I | Integration of Theory and Practice | Six • attend to his or her own well-being and needs.
Competencies
The chaplain is not simply a friendly visitor to the care recipient but has
The theories of spiritual care, psychology, social science, ethics, group the knowledge, expertise, and experience needed to address the spiritual
dynamics, and basic research all apply to chaplaincy. Chaplains must be needs of the care recipient. Two competencies address these key abilities
able to by requiring chaplains to demonstrate their professional authority and how
• demonstrate a basic working knowledge of these theories they would advocate for the care recipient.
• apply these theories to spiritual care One competency requires chaplains to demonstrate that they operate
within the framework of their profession’s common code of ethics, which
• explain how they integrate these theories into their practice.
always respects the religious and cultural beliefs and values of the care
The sixth competency, which addresses research and research literacy, is an recipient. This is a central distinguishing feature of professional chaplaincy,

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separating a clinically trained chaplain from a clergy person. Operating It also distinguishes the work of a professional chaplain as distinct from a
within the framework of the code of ethics also is essential for the community clergy person, who may provide a religious ritual for the care
chaplain to be an advocate for the care recipient’s needs. Without respect recipient.
for what matters to the care recipient, the chaplain cannot provide care
Respect for diversity and difference is identified as a need in one
that is centered on the recipient’s needs.
competency in this section. This competency requires the chaplain to
be open to and nonjudgmental of care recipients and to advocate that
Competency Section III | Professional Practice Skills | Eleven
the interdisciplinary team respects the recipient’s values and beliefs. For
Competencies example, a chaplain may help teach staff about the beliefs of a Jehovah’s
These competencies sketch out the broad functions a chaplain can be Witness and how the plan of care can respect those beliefs.
expected to provide through demonstration of the ability to do so.
The Joint Commission recognizes the chaplain’s advocacy role, referring to
Within the scope of practice for chaplains is the ability to engage in chaplains as “culture brokers.”3 This competency reinforces the principle
relationships, provide effective support, manage crises, and facilitate group that it is never appropriate for chaplains to proselytize care recipients,
process. In addition, the chaplain is expected to be able to provide spiritual further distinguishing professional chaplains from other spiritual providers.
care that respects diversity and differences and offers appropriate spiritual
resources and public worship opportunities that fit the context of the Competency Section IV | Organizational Leadership | Five
organization. Competencies
Specific skills are addressed that align the chaplain’s work with that of The chaplain serves the wider organization—the healthcare system or
other clinicians on the care team. As an integrated member of the care hospital—through integration of spiritual care into the life and service of
team, the chaplain is responsible for assessing the spiritual needs of the the institution.
care recipient and formulating a plan of care with interventions, goals,
The people within these organizations need care to navigate the changes
and anticipated outcomes. Although some of the chaplain’s functions may
and loss that accompany the life of any dynamic entity. The chaplain can
overlap with other disciplines, the spiritual assessment and plan of care is
contribute to staff support for those who experience moral distress.
the chaplain’s area of expertise and must be articulated and coordinated
into the recipient’s plan of care.2 To accomplish this, competencies address integration of spiritual care,
maintaining interdisciplinary relationships, and functioning within the
One competency addresses documentation, a skill the chaplain must
institutional culture, including using business practices to manage their
master with an economy of words and great clarity. Documentation
department.
demonstrates accountability to the care recipient and to the organization.

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Additional competencies address facilitating ethical decision making—a Section 2 References

function that benefits the organization, staff, and care recipients—and 1. Larocca-Pitts, M. (2018). Endorsement as communal verification. Retrieved from http://
fostering collaborative relationships with community clergy and faith www.professionalchaplains.org/content.asp?admin=Y&pl=463&sl=463&contentid=796
group leaders. 2. Massey, K., Barnes, M. J., Villines, D., Goldstein, J. D., Pierson, A. L., Scherer, D., . . . Summerfelt,
W. T. (2015). What do I do? Developing taxonomy of chaplaincy activities and interventions
Maintenance of Certification for spiritual care in intensive care unit palliative care. BMC Palliative Care, 14, 10.
The skills acquired during clinical pastoral education training are 3. The Joint Commission. (2010). Advancing effective communication, cultural competence,
foundational to the practice of spiritual care, but professional chaplains and patient- and family-centered care: A roadmap for hospitals. Oakbrook Terrace, IL: The
Joint Commission.
must continue to develop themselves and their practice as new knowledge
becomes available and the environment in which they provide care
continually changes. They must adhere to the code of ethics and maintain
current membership in their professional organization.
Every 1–5 years, depending on their professional organization, certified

chaplains must
• take part in 50 hours of ongoing education to ensure they remain
effective in these complex and rapidly changing settings
• participate in peer reviews to reflect on their professional
practice and receive feedback from colleagues
• demonstrate a good relationship with their faith community
through endorsement or its equivalent.

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3 Professional Chaplains’ Standards of Practice

Standards guide chaplains as they deliver quality spiritual care.
Professional chaplains provide care in their particular work setting, to their Care Recipients
fellow employees, and within the organization itself, using standards of Seven SOPs guide the professional chaplain’s practice as it relates to the
practice (SOPs) as their guides. care recipient.
Chaplaincy SOPs matured slowly, primarily in healthcare settings, over
decades of practice, reflection, and consensus-building among the major 1. Assessment
North American chaplaincy organizations. Now, they are applicable to The chaplain conducts an assessment with the care recipient in which the
all settings in which professional chaplains work, including correctional chaplain gathers and evaluates relevant information regarding the care
centers, schools, and workplaces. recipient’s spiritual, religious, emotional, and relational or social needs and
resources.
ACPE: The Standard for Spiritual Care & Education trains and
educates spiritual health providers and educators through internships, Assessment is a fundamental process of chaplaincy practice. To provide
residency, and educator-in-training programs, includes additional effective care, chaplains must assess and reassess care recipients’ needs
standards within its SOPs. and resources, modify plans of care accordingly, and prioritize care for
those whose needs appear to outweigh their resources.
For instance, if a care recipient needed continued spiritual support beyond

The Canadian Association for Spiritual Care/Association canadienne the walls of the chaplain’s organization, the chaplain would assess the
de soins spirituels (CASC/ACSS)—an organization committed to the care recipient’s access to such spiritual support, determine how external
education, certification, and support of spiritual care practitioners spiritual support might be called upon to help, or decide if the care
and psychospiritual therapists in their practice of spiritual care, recipient needs help to find such support.
counseling, and education—has its own SOPs.
2. Delivery of Care
The SOPs were developed by an Association of Professional Chaplains task The chaplain delivers care by developing and implementing a plan of care
force, then adopted and affirmed by the National Association of Catholic to promote the well-being of the care recipient. The chaplain delivers this
Chaplains, Neshama: Association of Jewish Chaplains, and ACPE: The care in collaboration with the recipients and other care providers. The plan
Standard for Spiritual Care & Education. They address the care chaplains includes interventions to achieve desired outcomes that were identified
provide to individual recipients and the organization as a whole, as well as during the chaplain’s assessment of the recipient. For example, if the
quality, competency, and effectiveness of provided care. chaplain determines that the recipient’s most pressing need is addressing a

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feeling of isolation, the chaplain may formulate a care plan to help identify, 5. Ethical Practice
cultivate, and use the recipient's psychosocial support system. The chaplain ensures ethical practice. The chaplain adheres to the code of
ethics required by the chaplain’s professional association to guide decision
3. Documentation of Care making and professional behavior. Chaplains establish professional
The chaplain documents the care provided in the appropriate recording relationships with vulnerable care recipients who may have cultural,
structure, using information relevant to the care recipient’s well-being. spiritual, and theological differences. Chaplains do not proselytize. They
Documentation contributes to the collaborative delivery of the best are trained to give empathic and compassionate spiritual care to people of
possible holistic care. all beliefs. The understanding and practice of professional boundaries and
ethical relationships is of utmost importance.
The format, language, and content of a chaplain’s documentation adhere to
the organizational and regulatory guidelines of the chaplain’s work setting. 6. Confidentiality
Examples of what the chaplain might document include Chaplains respect the confidentiality of information from all sources,
including the care recipient, legal or organizational records, and other
• the care recipient’s spiritual or religious preference care providers in accordance with federal and state laws, regulations, and
• desire for or refusal of ongoing chaplaincy care rules. Accordingly, chaplains must determine the level of confidentiality,
what information to keep to themselves, and what to share with other
• reason for the visit professionals, communicate to state or regulatory agencies, or publish as
• critical elements of the chaplaincy assessment chaplaincy-care vignettes.
• the care recipient’s desired outcomes regarding care

7. Respect for Diversity
• the chaplain’s plan of care relevant to the care recipient’s goals The chaplain models and collaborates with other care providers by
respecting and providing sensitive care to people of diverse abilities,
• relevant outcomes resulting from the chaplain’s interventions.
beliefs, cultures, and identities. Chaplains include in their assessments
the identification of care recipients’ cultural and spiritual/religious issues,
4. Teamwork and Collaboration beliefs, and values, because these factors may impact the plan of care.
Chaplains collaborate, within their scope of practice, with other care
providers to promote the well-being of the care recipient. Spiritual care is For example, a Jehovah’s Witness may not want to accept blood products,
a complex endeavor that necessitates the chaplain’s effective integration an Orthodox Jew will not eat pork products, and a Muslim needs a place to
within the wider organization, requiring the chaplain to be committed to pray with the direction of Mecca indicated. Through practice and education,
clear, regular communication and collegial, collaborative interaction. the chaplain assists other members of the care team in incorporating
respect for diversity into the care recipient’s plan of care.

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Organization SOPs • set up and lead corporate spiritual or religious rituals that
support transcendent aspects of the organization’s mission, such
When it comes to providing chaplaincy care for the organization, the
as National Organ/Tissue Donor Awareness Day or National Day
professional chaplain adheres to three SOPs. of Prayer.
1. Care for the Organization’s Employees and Affiliates 3. Leadership

The professional chaplain provides effective chaplaincy care to the The chaplain provides leadership within his or her work setting and
organization’s employees and affiliates through a wide range of chaplaincy profession. Chaplains are leaders within their work setting on issues
services. On the basic level, this may include one-on-one supportive related to spiritual, religious, and cultural care and observance. Chaplains
conversations and public worship opportunities, as desired. At a more also are leaders in their profession, advancing chaplaincy by providing
complex level, this care can include critical incident stress management education, supporting colleagues, and participating in their certifying
or psychological first aid interventions and formal counseling, all of which organization and local clergy community organizations.
require specialized training.
Quality, Competent, and Effective Care SOPs
2. Care for the Organization The final group of SOPs focuses on ensuring the professional chaplain
The professional chaplain provides chaplaincy care to the organization provides quality, competent, and effective chaplaincy care. The Canadian
in ways that are consistent with the organization’s values and mission Association of Spiritual Care/Association canadienne de soins spirituels
statement. (CASC/ACSS) further focuses these SOPs related to personal and
Chaplains are alert to potential means of expressing their organization’s professional growth in terms of self-awareness, spiritual and personal
spiritual aspirations. While respecting their organization’s diversity, development, and multidimensional communication.
chaplains are creative and proactive in implementing initiatives that
honor and champion the cultural, spiritual, and religious aspects of their 1. Continuous Quality Improvement
organization’s mission. For example, the chaplain may Professional chaplains seek and create opportunities to enhance their
quality of care. Chaplains contribute to their organizations’ quality
• plan and utilize appropriate public relations materials that
highlight spiritual components of the organization’s mission initiatives and identify chaplaincy processes that can be reviewed
for improvement, using current, established quality improvement
• design and maintain mission-appropriate sacred spaces that methodologies and with the support of the organization’s quality
meet the spiritual and religious needs of care recipients and department.
employees

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Examples include finding ways to Chaplains continue to grow and develop professionally, spiritually, and
religiously to meet the changing needs of care recipients, the profession,
• enhance overall care or chaplaincy care for a group of recipients
their practices, and their organizations.
• strengthen the chaplain’s care of staff, whether of a particular
group or overall 4. Technology
• improve the process of transferring a recipient’s spiritual care Professional chaplains appropriately use technology to enhance delivery
from the chaplain to community faith leaders. of care and advance the work of the profession. Chaplains use a variety
of technologies appropriate for their professional context, including
2. Research smartphones, telehealth, software, and e-mail, to facilitate and provide
Professional chaplains know research is integral to professional chaplaincy care in today’s world.
functioning and in keeping with their area of expertise. Chaplains stay
informed on relevant developments in evidence-based and best practices 5. Business Acumen
in chaplaincy care by reading and reflecting on current research and Professional chaplains value and utilize business principles and practices
professional practice. When practical, chaplains can collaborate on and and compliance with regulatory requirements appropriate to the chaplain’s
lead research studies. role in the organization.
This may be as simple as understanding and supporting the overall mission

3. Continuing Education and values of the organization and contributing to their realization. For
Professional chaplains seek knowledge and participate in continuing chaplains in leadership roles, their responsibilities may involve more
education. They take responsibility for their continued professional complex knowledge and skills, including budgeting, compliance, talent
development and demonstrate a working knowledge of current theory and acquisition and management, and strategic planning.
practice appropriate to their professional setting.

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4 The Evidence for Spiritual Care

A growing body of research reveals how chaplains benefit
patients and hospitals.
Among
chaplain visits
Chaplaincy-related research has seen recent important • Of visits initiated by staff referral, most are
60%
include religious or
growth as researchers and chaplains seek to referred by nurses.6
spiritual activities,
• describe and improve practice such as prayer or rituals
What happens during chaplain visits?
30%
• assess the importance of spiritual care as A large, multi-institution study on this topic has not
determined by patient satisfaction and been conducted because comparing chaplain activities is
outcomes. difficult due to differing EMR templates. Several studies include emotional
Types of studies being conducted include of chaplain visits found that support as well
as religious or
• single- and multi-institutional analyses of • 60% include religious or spiritual activities, spiritual activities
chaplains’ records1-3 such as prayer or rituals
26%
• research projects using technology to help • 30% include emotional support as well as
chaplains describe care throughout the day4,5 religious or spiritual activities2,3
• 26% in the palliative care context “align care in the palliative
• studies analyzing electronic medical records
plan to patient values”5 care context
(EMRs). “align care plan to
• 72% include empathic listening2,3 patient values”
Data from recent studies give us a deeper understanding
of spiritual care and chaplaincy and answer questions • 92% include active listening.4
72%
with evidence.
Is there a comprehensive description of what
chaplains do? include empathic
Describing Chaplains’ Practice and listening
In 2015, investigators created a rigorous, evidence-
Improving Spiritual Care based taxonomy of 100 activities to describe chaplains’
What prompts chaplain visits?
• The majority of chaplain visits are initiated by
activities and outcomes, categorized as intended effects,
methods, or interventions.5
92%
include active
the chaplain, not other staff or patients.6,7 listening
Additional research has been done specifically on

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70% documentation. These studies revealed, among other things, an interest in improving and
standardizing templates and determining what information clinical team members want to see
of patients want at least
one visit from a chaplain. in chaplain notes.8-10
What do patients want from chaplains?

71% In a 2010 survey
of patients want chaplains to offer • 70% of patients wanted at least one visit from a chaplain.
support to their family and friends.
• 78% of patients wanted chaplains to remind them of God’s care and presence.
• 71% of patients wanted chaplains to offer support to their family and friends.
62% • 69% of patients wanted chaplains to be with them during times of particular anxiety or
of patients want chaplains to pray uncertainty.
or read scriptures or sacred text.
• 62% of patients wanted chaplains to pray or read scriptures or sacred texts.
78%
• 39% of patients wanted chaplains to counsel them regarding moral or ethical concerns
or decisions.11
of patients want chaplains to remind
them of God’s care and presence. How can hospitals maximize chaplaincy benefits?
The patients who most need spiritual care may not ask for it, and this may lead chaplains to
69%
spend valuable time querying hospital staff in an attempt to identify those most in need.
The development of an accurate screening for spiritual distress would enable other staff
of patients want chaplains to be with them members to conduct quick screenings and refer those in need, ensuring chaplains spend more of
during times of particular anxiety or uncertainty.
their time helping patients and focusing on patients in the most need.12-14
39%
The development of screening tools has been the subject of multiple studies that have tested
various models.15-18
of patients want chaplains to counsel them
regarding moral or ethical concerns or decisions.

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A recent study found limitations to all five approaches investigators • Of more than 700 newly diagnosed cancer patients undergoing
tested.19 The study determined that “the best choice to briefly screen” for chemotherapy or radiation, 77% reported using prayer and 19%
religious/spiritual distress among cancer survivors was “the simultaneous reporting using spiritual healing.22
use of meaning/joy and self-described struggle items”: • Of 406 people with persistent mental illness, 80% reported
• Do you struggle with the loss of meaning and joy in your life? that their religious beliefs and practices helped them cope with
symptoms and frustrations, and 59% used prayer to cope with
• Do you currently have what you would describe as religious or their illness.23
spiritual struggles?
• Of 170 patients with advanced cancer, those using positive
Another study examined the Spiritual Distress Assessment Tool, finding religious coping (such as seeking God’s love and care)
that 65% of elderly patients screened had unmet spiritual needs.20 There experienced better quality of life.24
is value in repeating the study in other clinical contexts to further validate • A study on how people use religion and spirituality to cope with
this tool. stressful events helps chaplains improve assessments and deliver
more effective care.25
The Importance of Religion and Spiritual Care to Do people with serious illness experience spiritual distress?
Patients and Families Research on religion and spiritual coping reflects a religious struggle, with
There is a growing and consistent body of evidence to support the some people who have serious illnesses doubting their faith or fearing
importance of religion and spiritual care. they have been abandoned or punished by God or alienated from their
religious fellowship.25
How do people with serious illnesses view religion and
• 50% of all patients may experience some religious or spiritual
spirituality? struggle.26
Religion and spirituality are among the most important resources
for people facing serious illness. Studies on how people use religion • For 10% of patients, that struggle may be moderate or severe.27
and spirituality to cope with stressful events help chaplains improve • Religious or spiritual struggle compromises patients’ health and
assessments and deliver more effective care. well-being.27
• Of 8,405 cancer survivors, 65%–88% (depending on race/
ethnicity) agreed “quite a bit” or “very much” with the statement How does religious/spiritual struggle affect patients’ health?
“My faith or spirituality has helped me through my cancer • Among medical rehabilitation patients, those experiencing
experience.”21 religious or spiritual struggle had poorer rehabilitation outcomes
and experienced more functional limitations.28

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• Among older medical patients, those experiencing religious Chaplaincy at Hospitals

or spiritual struggle had more depressive symptoms29 and
experienced poorer quality of life and increased mortality.30
Do all patients have access to professional chaplains?
A small but growing body of evidence finds that the need is not being met
Do patients want to talk about their religious and spiritual due to hospitals either not employing chaplains or not having enough
beliefs? chaplains on staff.
• At least 50% of patients want to discuss their religious or • 35%–70% of patients welcome or expect a chaplain visit (with
spiritual beliefs or concerns with their physicians or other health numbers varying depending on the study cited).11,35,36
professionals.31,32
• Just 54%–65% of U.S. hospitals employ chaplains.37,38
• A study of 921 patients seen in family practice clinics found that
83% reported wanting their physicians to ask about their spiritual What types of hospitals employ chaplains?
beliefs in at least some circumstances, so that their physician
would understand how their beliefs influence how they deal Surveys from approximately 500 hospitals found that hospitals are more
with being sick and would understand them better as a person.33 likely to have chaplaincy service if they are
Circumstances included
• larger
o life-threatening conditions
• in an urban area
o serious medical illness
• not-for-profit and faith-based.38
o loss of loved ones.
Do hospitals have sufficient chaplain staffing?
Are doctors having these religious and spiritual discussions with • There are an average of 1.5–2.3 chaplains per 100 patients at
their patients? hospitals with chaplain services.38
• The majority of patients report that their physician has never • About 10%–30% of hospitalized patients are visited by chaplains
inquired about their religious and spiritual beliefs and concerns.32 at hospitals with chaplain services.39
• In 249 conversations about end-of-life care between physicians • About two-thirds of hospitals with a chaplain service employ a
and family surrogate decision makers, religion or spirituality board-certified chaplain.38
was mentioned in only 16% (40 conversations) with the
family bringing up the topic more than half of the time (26
conversations).34

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The Impact of Spiritual Care on the Patient o The survey item that the most patients agreed with was,
“The chaplain helped me realize that God cares for me.”
Experience
More research has examined the relationship between chaplain care and • In a 2009 study of 250 patients in an orthopedic hospital in New
patient/family satisfaction than any other outcome related to chaplaincy. York41, 80% of patients with spiritual or religious needs reported
that the chaplain
Is there evidence that care from chaplains improves patient and  met these needs very well
family satisfaction?  made their stay easier
• Findings consistently indicate that care from chaplains
is associated with higher levels of overall patient/family  helped them tap into inner strengths and resources.
satisfaction, not just satisfaction related to chaplaincy.
• In a 2011 study of 3,000 general medical patients at the
• In a 2004 study of 1,440 patients at 14 U.S. hospitals :
40 University of Chicago Medical Center in Chicago36:
o Greater satisfaction with chaplain care was associated with o 41% wished to discuss their religious or spiritual concerns
greater satisfaction with the overall hospital stay. during hospitalization, but just 51% of those reported
having such a discussion, more than half of those
o Patients often reported that visits from the chaplain discussions were with a chaplain
contributed to their
o patients who had a discussion about religious or spiritual
 readiness to return home concerns were
 faster recovery  60% more likely to rate overall care as excellent
 easier hospitalization.  40% more likely to say they were extremely satisfied
with the care from their physicians
o Many patients reported chaplains helped them
 70% more likely to report always having confidence
 cope
and trust in their physicians
 feel more hopeful
 120% more likely to report excellent teamwork
 find the strength to go on. among their physicians and nurses.

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• In a 2015 study at one of the nation’s leading hospitals, Mount When the need for spiritual care isn’t met, are patient and family
Sinai in New York, 9,000 patients responded to a satisfaction satisfaction ratings affected?
survey7:
• Several studies have shown that patient satisfaction suffers when
o 5.6% of patients, whose EMR indicated they had at least one spiritual needs are not met:
visit from a chaplain, gave higher ratings to all satisfaction
items surveyed, including o In a 2007 study of 369 oncology out-patients, 18% reported
that their spiritual needs were not being met. They reported
 overall care lower satisfaction with their quality of care.31
 likelihood of recommending the hospital to others o A 2012 study examined 150 patients with advanced cancer
who were getting less spiritual care than they desired. They
 whether staff addressed patients’ spiritual and reported higher levels of depression and anxiety.43
emotional needs.
o Authors suggest that “meeting patients’ spiritual needs
increases patient satisfaction and may have positive fiscal The Impact of Chaplain Care on Patient Outcomes
consequences” for hospitals. Research on effects of chaplain care is in its early stages, with studies
demonstrating the feasibility of studying the effects of chaplain care by
• A 2016 study with a larger sample42 found that for two itself or as a component of multidisciplinary intervention. Findings also
components of chaplain care (specifically religious/spiritual care
point to the positive effects of chaplain care on psychological distress,
and general psychosocial care)
quality of life, and spiritual well-being.
o both components of chaplain care were associated with
higher patient-satisfaction ratings • The small body of research, including two randomized clinic trials
(RCTs), indicates the positive effects of chaplain care on patient
o patient satisfaction rates were slightly higher for outcomes:
patients who received religious/spiritual care, rather than
psychosocial care. o A 2001 RCT involving 49 patients with chronic obstructive
pulmonary disease examined the effect of chaplain care on
anxiety and satisfaction by randomly assigning the patients
to the usual care or the usual care plus daily chaplain
visits.44

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 The groups had similar elevated anxiety levels at o A 2004 study involved a 12-month intervention for
admission. 90 palliative-care outpatients, 50 of whom received
comprehensive care team (CCT) intervention that included
 At discharge, those who had received chaplain care one chaplain visit. Of the CCT patients, 42% had additional
saw a greater decrease in anxiety and higher ratings consultations with the chaplain or religious advisors. The
on two measures of overall satisfaction with care. CCT group experienced
o A 2008 RCT involved 170 patients who were undergoing  reduced healthcare utilization
coronary artery bypass graft (CABG) surgery. The patients
were randomly assigned to a group not receiving chaplain  reduced shortness of breath
care or a group receiving four visits from a chaplain (one
preoperation and three postoperation, plus a visit with the  improvements in anxiety relief and sleep
family in the waiting room during surgery).45  improved score on a measure of spiritual well-
 After 6 months, patients who had received chaplain being.47,48
visits experienced higher levels of positive religious o In a 2016 study, 475 patients with nonsmall cell lung
coping and lower levels of negative religious coping. cancer who had family care givers (FCGs) sequentially
• Several relevant studies examined the effects of enrolled in either their usual care or multidisciplinary
multidimensional interventions: intervention, which involved assessment by a team that
included a chaplain, chaplain recommendations for
o A 2014 study involved 131 patients undergoing radiation spiritual care, and four education sessions by advanced
therapy for advanced cancer46: practice nurses, including one focused on spiritual well-
being. In this study,
 Half of the patients participated in six 90-minute
sessions that focused on various dimensions of  interventions for the FCG did not show significant
quality of life, with a board-certified chaplain benefit for spiritual well-being
addressing spiritual themes in three sessions.
 at 3-month follow-up, patients in the interventional
 At the 4-week assessment, the patients who received group had higher scores on the meaning/peace
the chaplain intervention scored better on various subscale of the FACIT-Sp, which measures spiritual
measures of quality of life, including spiritual well- well-being.49
being.

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Spiritual Needs and Chaplain Care in Palliative and o 72% reported their spiritual needs were met minimally or
not at all by their medical team
End-of-Life Care
Palliative care has been developing an important body of research about o 47% reported their spiritual needs were met minimally or
patient and family religious/spiritual concerns and the spiritual care not at all by their faith community.58
provided to them. • Several other studies examined levels of spiritual pain or
spiritual concern in patients receiving palliative care, showing
Several chaplains have been among those creating comprehensive notable levels of spiritual distress and unmet spiritual needs
overviews of the existing research about spiritual care in palliative care.50,51 among these patients:
What does chaplaincy look like in palliative care? o 61% of 57 hospice inpatients reported some spiritual pain
in a 2006 study in New York.13
The importance of attending to religious and spiritual concerns in
palliative care is widely recognized in practice guidelines52,53 and in o 44% of 91 palliative-care outpatients reported some
national and international consensus statements.54,55 Chaplains are spiritual pain in a 2011 study in Texas.16
recognized as the spiritual care experts on the palliative care team.54 o 86% of 69 palliative-care radiation outpatients endorsed
• A 2016 study of 410 U.S. palliative care programs found that only at least one spiritual concern in 2011 study in Boston. The
38% had funded chaplain positions.56 median number of spiritual concerns in the sample was
four.59
• A 2017 study of 382 chaplains working in palliative care57 found
that chaplains had high levels of o In a 2011 study of 113 patients in an inpatient palliative
care unit examining seven dimensions of spiritual need
o integration on the interdisciplinary team (such as hope versus despair, wholeness versus brokenness,
and guilt versus forgiveness):
o involvement in addressing treatment decision making and
existential and spiritual distress.  42% of the patients had no spiritual distress
 44% of the patients had distress in two or more
Are palliative care patients’ spiritual needs being addressed? dimensions
• A 2007 study of 230 cancer patients found that
 23% of the patients had distress in three or more of
o 88% reported that religion or spirituality plays an the dimensions.60
important role in coping with their illness

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How do chaplains benefit palliative care patients and programs? months, with poor communication about treatment decisions
• Several studies have shown benefits associated with spiritual with the healthcare team being described as a factor that may
care: contribute to this distress.
o In a 2012 analysis of 3,585 U.S. hospitals, the hospitals o Up to 20% suffered from depression.
with chaplaincy services had higher levels of enrollment in o 14%–35% suffered from PTSD.
hospice care and deaths occurring at home instead of the
hospital.61 (Other studies have demonstrated that patients o 46% had complicated grief.64,65
prefer to die at home.)
o In a 2007 study of 230 patients with cancer: Does chaplain care affect how family members view the care a
patient received in palliative care?
 Patients who received spiritual care from the
• A 2007 study of 356 family members whose loved ones had died
healthcare team, including chaplains, experienced a
in one of 10 ICUs in the Seattle area found that
higher quality of life at the end of life than patients
who did not receive spiritual care, were more likely to o 40% rated the chaplain care as excellent
receive comfort-focused care (such as hospice), and
were less likely to receive futile aggressive care (such o 25% rated the chaplain care as very good
as intensive care unit [ICU] admission or ventilation)
o higher satisfaction with spiritual care was strongly
in the final week of life.62
associated with higher satisfaction with ICU care overall.66
 Patients who reported their spiritual needs were
• A 2014 study of 275 family members whose loved ones died in
inadequately supported by the healthcare team were
an ICU at Harborview Medical Center in Seattle collected data
less likely to receive comfort-focused care in the final
from hospital chaplains about the care they provided to patients
week of life and had a higher cost of care in the final
and families in the ICU.67
week of life ($2,100 higher, on average, than those
who reported their spiritual needs were met).63 o Analysis revealed greater levels of spiritual care were
associated with higher ratings of overall satisfaction with
What happens when palliative care patients and their families ICU care.
don’t have access to chaplain care? o Greater levels of spiritual care were associated with higher
• In 2008 and 2010 studies of families whose loved ones died in levels of satisfaction with treatment decision making in the
an ICU, it was found that a high proportion of family members ICU.
experienced serious emotional distress in the subsequent

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Chaplain Care for Staff Colleagues o improved ability to reframe work and personal issues,
Many chaplains see care for staff as an important part of their role, but resulting in better work-life balance
a few, small-scale studies have examined this aspect of chaplains’ work. o improved ability to cope with workplace stress
These studies describe a number of ways chaplains provide care for
o greater collegiality, optimism, and initiative in problem
colleagues. solving.
Additional research is needed to understand the feasibility and potential • A 2015 study examined the feasibility and effects of offering
benefits of these efforts. 5-minute mindfulness sessions to PICU nurses. Sessions were
offered at the start of the day and evening shifts for a month.70
Do staff members appreciate chaplains’ care? o Forty-five of 104 staff signed up for the study. Forty
• A 2015 qualitative study interviewed five chaplains and seven attended at least one session, and 19 nurses came to at
staff members who had received care from a chaplain.68 Key least eight sessions (two per week).
themes were
o As a result, scores on a measure of job stress decreased
o the importance of chaplains building relationships with from baseline through the 1-month follow-up.
the staff and letting them know about their availability to
provide support and care • A 2004 report (not a formal research project) examined staff
support activities for colleagues in an oncology outpatient
o appreciation for the chaplains’ care, including support setting.71
for care of difficult patients, support in times of family
crisis, and assistance with personal, religious, or spiritual o Activities included discussion groups, providing follow-up
questions and struggles. information to staff about the deaths of patients for whom
they had provided care, and the use of a labyrinth.
How can spiritual care benefit staff members and their work? o Narrative reports discussed the positive reception of these
• For a 2010 study, six experienced pediatric intensive care unit activities by staff who participated.
(PICU) nurses were offered an intervention of five sessions (four
4-hour groups and one 8-hour retreat) over a 3-month period.69
Postintervention interviews found the nurses were experiencing

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Chaplaincy Care in Outpatient Settings  high levels of satisfaction with the service
In the United States, healthcare policy is attempting to focus care on  better ability to cope
preventing illness and hospitalization. Chaplain care has traditionally  new perspectives on life issues
occurred in the inpatient setting, so the profession is interested in learning
 increased adherence to recommended medical
more about spiritual care initiatives in outpatient contexts and their
regimens for some patients who had been seen by a
effects. chaplain.
Two studies of chaplaincy care in community contexts from the United • A 2015 study analyzed records related to chaplain visits for a
Kingdom provide models for such efforts. More research is needed on 2-year period from the Chaplain for Well-Being program.74
these initiatives, their benefits, and wider application, but initial evidence
o Key functions of the service include
shows mental health benefits of chaplain outpatient services.
 listening
• A 2012 study analyzed the Community Chaplain Listening service
in the Scottish National Health Service.72,73  compassionate presence
 facilitating the search for meaning
o Many patients described themselves as nonreligious but
had no issue talking with a chaplain.  offering appropriate ritual and prayer
o Concerns patients talked to the chaplains about included  providing support in death and dying
 pastoral care of staff.
 stress, depression, anxiety, ill health by the patient or
another, and issues with self-esteem or purpose in o The study had pre- and postchaplain visit Warwick and
life. Edinburgh Mental Wellbeing Scale (WEMWBS) scores for
107 patients, with an average initial WEMWBS score of
o 33% had bereavement as a primary concern. 35.7 (SD=11.2). The average final score represented clinical
significant improvement: 44.8 (SD 10.6).
o 16% had a relationship issue as a primary concern.
o Benefits of the chaplain visits were

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The Future of Research Are chaplains and other investigators likely to continue
Studies of chaplains’ attitudes about research and evidence-based care researching spiritual care?
offer hope that this research will continue and expand. • Various efforts are underway to contribute to growth in
chaplaincy research in the years ahead, including
Do chaplains feel that research and evidence-based approaches o advancing chaplain research literacy (such as
are important? through the Transforming Chaplaincy project at www.
• A 2014 study of 773 U.S. healthcare chaplains in the military, the transformchaplaincy.org)
Department of Veterans Affairs (VA), and civilian settings strongly
endorsed an evidence-based approach to chaplaincy.75 o encouraging chaplain participation in research77 (such as
through a helpful series of articles about research methods
o 75% of the healthcare chaplains from the VA and military in the Journal of Health Care Chaplaincy78,79).
considered their current chaplaincy practice to be
evidence-based. • Recently published reports of pilot studies of chaplain
interventions are another important indicator about the future of
o 42% of the healthcare chaplains from civilian settings research on chaplaincy.
considered their current chaplaincy practice to be
evidence-based. o A 2015 study of 32 brain cancer patients and their support
person examined a spiritual life review intervention called
o 50% of the healthcare chaplains from the VA and military Hear My Voice80 and found that the intervention was
would like their chaplaincy care to be more evidence- feasible and resulted in beneficial effects for the patient
based. and the support person.81 The intervention and study were
designed and executed by a chaplain and her colleagues.
o 94% of the healthcare chaplains from civilian settings
would like their chaplaincy care to be more evidence- o A 2017 study of 19 patients who participated in the
based. chaplain-created Hear My Voice intervention found key
themes of continued vitality, growth, and generativity.82
• A 2017 study of 2,000 chaplains in 23 countries found that
o A 2013 study examined the Life in Sight Application (LISA)
o 80% of chaplains thought research was definitely Intervention, which was designed to improve the quality
important of life of patients with advanced cancer by reviewing life
goals to assist with the integration of events such as cancer
o nearly 70% thought chaplains should definitely be research
into one’s life story.83 The intervention, which used chaplain
literate.76

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care, included a discussion of life events and life goals, o Chaplain-led studies in 201386 and 201587 examined the
assisted by an electronic application. A randomized clinical role of religion and spirituality in the lives of adolescents
trial of the intervention has been planned. with cystic fibrosis (CF). Those experiencing religious/
spiritual struggle had poorer adherence to their CF
o A 2016 pilot study examined Caregiver Outlook, a chaplain- treatment. Now, researchers are studying whether chaplain
led intervention for caregivers of patients with serious care can resolve the struggle and improve adherence to
illness.84 It aimed to support meaning-making among treatment.
the 31 caregivers in the pilot group through three phone
interviews with the caregiver that focused on a review
of their relationship with the patient, forgiveness, and What are some priorities in chaplaincy research?
building a legacy. • An important task for chaplaincy is to develop a research agenda
that will help the profession evaluate the care provided by
 The study found the intervention was feasible and chaplains and advocate for its benefits to patients, their loved
acceptable. ones, and healthcare systems.88
 The intervention helped the caregivers step back • An international survey of 807 palliative care professionals,
from caregiving and process emotions and changing including chaplains, has described research priorities for spiritual
roles. care in palliative care.89 Evaluating screening tools that can be
used to identify patients with spiritual needs was ranked as the
o A 2016 chaplain-led study of 50 mechanically ventilated
top priority in this survey.
ICU patients focused on improving spiritual care through
the use of illustrated communication cards that help assess • An international panel of chaplaincy leaders has described the
the patient’s spiritual affiliation, emotions, and needs.85 importance of an outcome-oriented approach for the future of
chaplaincy.90
 81% of the 26 survivors interviewed reported the
intervention. • An additional key to success will be collaboration with
nonchaplain research colleagues who can provide expertise to
 They said the intervention helped them feel more
carry out this work.
capable of dealing with their hospitalization and
helped lower their anxiety and stress.

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Section 4 References
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professional activities at Memorial Sloan-Kettering Cancer Center in New York City. . Mueller, P. S. (2010). Predicting patients’ expectations of hospital chaplains: A multisite
Chaplaincy Today, 20(2), 3–12. survey. Mayo Clinic Proceedings, 85(1), 1002–1010.
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seriously ill in an urban acute care hospital. Journal for the Scientific Study of Religion, oncology inpatient: a quality improvement pilot project between nurses and chaplains.
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5. Massey, K., Barnes, M. J., Villines, D., Goldstein, J. D., Pierson, A. L., Scherer, C., . . . Summerfelt, 16. Delgado-Guay, M. O., Hui, D., Parsons, H. A., Govan, K., De la Cruz, M., Thorney, S., & Bruera,
W. T. (2015). What do I do? Developing a taxonomy of chaplaincy activities and E. (2011). Spirituality, religiosity, and spiritual pain in advanced cancer patients. Journal of
interventions for spiritual care in intensive care unit palliative care. BMC Palliative Care, Pain and Symptom Management, 41(6), 986–994.
14, 10.
17. Grossoehme, D. H., & Fitchett, G. (2013). Testing the validity of a protocol to screen for
6. Galek, K., Vanderwerker, L. C., Flannelly, K. J., Handzo, G. F., Kytle, J., Ross, A. M., & Fogg, S. L. spiritual risk among parents of children with cystic fibrosis. Research in the Social Scientific
(2009). Topography of referrals to chaplains in the Metropolitan Chaplaincy Study. Journal Study of Religion, 24, 281–307.
of Pastoral Care and Counseling, 63(1–2), 6–1-13.
18. King, S. D., Fitchett, G., & Berry, D. L. (2013). Screening for religious/spiritual struggle in
7. Marin, D. B., Sharma, V., Sosunov, E., Egorova, N., Goldstein, R., & Handzo, G. F. (2015). blood and marrow transplant patients. Supportive Care in Cancer, 21(4), 993–1001.
Relationship between chaplain visits and patient satisfaction. Journal of Health Care
19. King, S. D., Fitchett, G., Murphy, P. E., Pargament, K. I., Harrison, D. A., & Loggers, E. T. (2017).
Chaplaincy, 21(1), 14–24.
Determining best methods to screen for religious/spiritual distress. Supportive Care in
8. Tartaglia, A., Dodd-McCue, D., Ford, T., Demm, C., & Hassell, A. (2016). Chaplain Cancer, 25(2), 471–479.
documentation and the electronic medical record: A survey of ACPE residency programs.
20. Monod, S., Martin, E., Spencer, B., Rochat, E., & Bu¨ la, C. (2012). Validation of the Spiritual
Journal of Health Care Chaplaincy, 22(2), 41–53.
Distress Assessment Tool in older hospitalized patients. BMC Geriatrics, 12, 13.
9. Johnson, R., Wirpsa, M. J., Boyken, L., Sakumoto, M., Handzo, G., Kho, A., & Emanuel, L.
21. Canada, A. L., Fitchett, G., Murphy, P. E., Stein, K., Portier, K., Crammer, C., & Peterman, A. H.
(2016). Communicating chaplains’ care: Narrative documentation in a neuroscience-spine
(2013). Racial/ethnic differences in spiritual well-being among cancer survivors. Journal of
intensive care unit. Journal of Health Care Chaplaincy, 22(4),133–150.
Behavioral Medicine, 36(5), 441–453.
10. Lee, B. M., Curlin, F. A., & Choi, P. J. (2016). Documenting presence: A descriptive study of
chaplain notes in the intensive care unit. Palliative and Supportive Care, 15(2), 190–196.

Table of Contents
22. Yates, J. S., Mustian, K. M., Morrow, G. R., Gillies, L. J., Padmanaban, D., Atkins, J. N., . . . Colman, 33. McCord, G., Gilchrist, V. J., Grossman, S. D., King, B. D., McCormick, K. E., Oprandi, A. M., . . .
L. K. (2005). Prevalence of complementary and alternative medicine use in cancer patients Srivastava, M. (2004). Discussing spirituality with patients: A rational and ethical approach.
during treatment. Supportive Care in Cancer, 13(10), 806–811. Annals of Family Medicine, 2(4), 356–361.
23. Tepper, L., Rogers, S. A., Coleman, E. M., & Malony, H. N. (2001). The prevalence of religious 34. Ernecoff, N. C., Curlin, F. A., Buddadhumaruk, P., & White, D. B. (2015). Health care
coping among persons with persistent mental illness. Psychiatric Services, 52(5), 660–665. professionals’ responses to religious or spiritual statements by surrogate decision makers
24. Tarakeshwar, N., Vanderwerker, L. C., Paulk, E., Pearce, M. J., Kasl, S. V., & Prigerson, H. G. (2006). during goals-of-care discussions. JAMA Internal Medicine, 175(10), 1662–1669.
Religious coping is associated with the quality of life of patients with advanced cancer. 35. Fitchett, G., Meyer, P., & Burton, L. A. (2000). Spiritual care: Who requests it? Who needs it?
Journal of Palliative Medicine, 9(3), 646–657. Journal of Pastoral Care, 54(2), 173–186.
25. Pargament, K. I. (1997). The psychology of religion and coping: Theory, research, practice. New 36. Williams, J. A., Meltzer, D., Arora, V., Chung, G., & Curlin, F. A. (2011). Attention to inpatients’
York, NY: The Guilford Press. religious and spiritual concerns: Predictors and association with patient satisfaction. Journal
26. Thune´-Boyle, I. C., Stygall, J., Keshtgar, M. R., Davidson, T. I., & Newman, S. P. (2011). Religious of General Internal Medicine, 26(11), 1265–1271.
coping strategies in patients diagnosed with breast cancer in the UK. Psycho-Oncology, 20(7), 37. Cadge, W., Freese, J., & Christakis, N. A. (2008). The provision of hospital chaplaincy in the
771–782. United States: A national overview. Southern Medical Journal, 101(6), 626–630.
27. Fitchett, G., Murphy, P. E., Kim, J., Gibbons, J. L., Cameron, J. R., & Davis, J. A. (2004). Religious 38. Flannelly, K. J., Handzo, G., & Weaver, A. (2004). Factors affecting healthcare chaplaincy and
struggle: Prevalence, correlates and mental health risks in diabetic, congestive heart failure, the provision of pastoral care in the United States. Journal of Pastoral Care and Counseling,
and oncology patients. International Journal of Psychiatry in Medicine, 34(20), 179–196. 58(1–2), 127–130.
28. Fitchett, G., Rybarczyk, B. D., DeMarco, G. A., & Nicholas, J. J. (1999). The role of religion in 39. Flannelly, K. J., Galek, K., & Handzo, G. F. (2005). To what extent are spiritual needs of
medical rehabilitation outcomes: A longitudinal study. Rehabilitation Psychology, 44(4), 333– hospital patients being met? International Journal of Psychiatry in Medicine, 35(3), 319–323.
353. 40. VandeCreek, L. (2004). How satisfied are patients with the ministry of chaplains? Journal of
29. Pargament, K. I., Koenig, H. G., Tarakeshwar, N., & Hahn, J. (2004). Religious coping methods Pastoral Care and Counseling, 58(4), 335–342.
as predictors of psychological, physical and spiritual outcomes among medically ill elderly 41. Flannelly, K. J., Oettinger, M., Galek, K., Braun-Storck, A., & Kreger, R. (2009). The correlates of
patients: A two-year longitudinal study. Journal of Health Psychology, 9(6), 713–730. chaplains’ effectiveness in meeting the spiritual/religious and emotional needs of patients.
30. Pargament, K. I., Koenig, H. G., Tarakeshwar, N., & Hahn, J. (2001). Religious struggle as a Journal of Pastoral Care and Counseling, 63(1–2), 9-1-15.
predictor of mortality among medically ill elderly patients: A two-year longitudinal study. 42. Sharma, V., Marin, D. B., Sosunov, E., Ozbay, F., Goldstein, R., & Handzo, G. F. (2016). The
Archives of Internal Medicine, 161(15), 1881–1885. differential effects of chaplain interventions on patient satisfaction. Journal of Health Care
31. Astrow, A. B., Wexler, A., Texeira, K., He, M. K., & Sulmasy, D. P. (2007). Is failure to meet Chaplaincy, 22(3), 85–101.
spiritual needs associated with cancer patients’ perceptions of quality of care and their 43. Pearce, M. J., Coan, A. D., Herndon, J. E. 2nd, Koenig, H. G., & Abernethy, A. P. (2012). Unmet
satisfaction with care? Journal of Clinical Oncology, 25(36), 5753–5757. spiritual care needs impact emotional and spiritual well-being in advanced cancer patients.
32. Ehman, J. W., Ott, B. B., Short, T. H., Ciampa, R. C., & Hansen-Flaschen, J. (1999). Do patients Supportive Care in Cancer, 20(10), 2269–2276.
want physicians to inquire about their spiritual or religious beliefs if they become gravely 44. Iler, W. L., Obenshain, D., & Camac, M. (2001). The impact of daily visits from chaplains on
ill? Archives of Internal Medicine, 159(15), 1803–1806. patients with chronic obstructive pulmonary disease (COPD): A pilot study. Chaplaincy Today,
17(1), 5–11.

Table of Contents
45. Bay, P. S., Beckman, D., Trippi, J., Gunderman, R., & Terry, C. (2008). The effect of pastoral 54. Puchalski, C., Ferrell, B., Virani, R., Otis-Green, S., Baird, P., Bull, J., . . . Sulmasy, D. (2009).
care services on anxiety, depression, hope, religious coping, and religious problem solving Improving the quality of spiritual care as a dimension of palliative care: The report of the
styles: A randomized controlled study. Journal of Religion and Health, 47(1), 57–69. Consensus Conference. Journal of Palliative Medicine, 12(10), 885–904.
46. Piderman, K. M., Johnson, M. E., Frost, M. H., Atherton, P. J., Satele, D. V., Clark, M. M., . . . 55. Puchalski, C. M., Vitillo, R., Hull, S. K., & Reller, N. (2014). Improving the spiritual dimension
Rummans, T. A. (2014). Spiritual quality of life in advanced cancer patients receiving of whole person care: Reaching national and international consensus. Journal of Palliative
radiation therapy. Psycho-Oncology, 23(2), 216–221. Medicine, 17(6), 642–656.
47. Rabow, M. W., Petersen, J., Schanche, K., Dibble, S. L., & McPhee, S. J. (2003). The 56. Spetz, J., Dudley, N., Trupin, L., Rogers, M., Meier, D. E., & Dumanovsky, T. (2016). Few
comprehensive care team: A description of a controlled trial of care at the beginning of hospital palliative care programs meet national staffing recommendations. Health Affairs
the end of life. Journal of Palliative Medicine, 6(3), 489–499. (Millwood), 35(9), 1690–1697.
48. Rabow, M. W., Dibble, S. L., Pantilat, S. Z., & McPhee, S. J. (2004). The comprehensive care 57. Jeuland, J., Schulman-Green, D., Kapo, J., & Fitchett, G. (2017). Chaplains working in
team: A controlled trial of outpatient palliative medicine consultation. Archives of Internal palliative care: Who they are and what they do. Journal of Palliative Medicine, 20(5), 502–
Medicine, 164(1), 83–91. 508.
49. Sun, V., Kim, J. Y., Irish, T. L., Borneman, T., Sidhu, R. K., Klein, L., & Ferrell, B. (2016). Palliative 58. Balboni, T. A., Vanderwerker, L. C., Block, S. D., Paulk, M. E., Lathan, C. S., Peteet, J. R., &
care and spiritual well-being in lung cancer patients and family caregivers. Psycho- Prigerson, H. G. (2007). Religiousness and spiritual support among advanced cancer
Oncology, 25(12), 1448–1455. patients and associations with end-of-life treatment preferences and quality of life.
50. Balboni, T. A., Fitchett, G., Handzo, G., Johnson, K. S., Koenig, H., Pargament, K., . . . Journal of Clinical Oncology, 25(5), 555–560.
Steinhauser K. E. (2017). State of the science of spirituality and palliative care research. 59. Winkelman, W. D., Lauderdale, K., Balboni, M. J., Phelps, A. C., Peteet, J. R., Block, S. D., .
Part II: Screening, assessment, and interventions. Journal of Pain and Symptom Management. . . Balboni, T. A. (2011). The relationship of spiritual concerns to the quality of life of
2017 July 19. pii: S0885-3924(17)30293-2. doi:10.1016/j.jpainsymman.2017.07.029. [Epub advanced cancer patients: Preliminary findings. Journal of Palliative Medicine, 14(9), 1022–
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51. Steinhauser, K. E., Fitchett, G., Handzo, G., Johnson, K. S., Koenig, H., Pargament, K., . . . 60. Hui, D., de la Cruz, M., Thorney, S., Parsons, H. A., Delgado-Guay, M., & Bruera, E. (2011).
Balboni, T. A. (2017). State of the Science of Spirituality and Palliative Care Research The frequency and correlates of spiritual distress among patients with advanced cancer
Part I: Definitions and Taxonomy, Measurement, and Outcomes. Journal of Pain and admitted to an acute palliative care unit. American Journal of Hospice and Palliative Care,
Symptom Management. 2017 July 18. pii: S0885-3924(17)30292-0. doi: 10.1016/j. 28(4), 264–270.
jpainsymman.2017.07.028. [Epub ahead of print]. 61. Flannelly, K. J., Emanuel, L. L., Handzo, G. F., Galek, K., Silton, N. R., & Carlson, M. (2012). A
52. Institute of Medicine. (2014). Dying in America: Improving quality and honoring individual national study of chaplaincy services and end-of-life outcomes. BMC Palliative Care, 11(10).
preferences near the end of life. Washington, DC: The National Academies Press.
53. National Consensus Project for Quality Palliative Care (2013). Clinical practice guidelines
for quality palliative care. 3rd edition. Retrieved from http://www.nationalconsensusproject.
org/NCP_Clinical_Practice_Guidelines_3rd_Edition.pdf

Table of Contents
62. Balboni, T. A., Paulk, M. E., Balboni, M. J., Phelps, A. C., Loggers, E. T., Wright, A. A., . . . Prigerson, 72. Mowat, H., Bunniss, S., & Kelly, E. (2012). Community chaplaincy listening: Working with
H. G. (2010). Provision of spiritual care to patients with advanced cancer: associations with general practitioners to support patient wellbeing. The Scottish Journal of Healthcare
medical care and quality of life near death. Journal of Clinical Oncology, 28(3), 445–452. Chaplaincy, 15(1), 27–35.
63. Balboni, T., Balboni, M., Paulk, M. E., Phelps, A., Wright, A., Peteet, J., . . . Prigerson, H. (2011). 73. Bunniss, S., Mowat, H., & Snowden, A. (2013). Community chaplaincy listening: Practical
Support of cancer patients’ spiritual needs and associations with medical care costs at the theology in action. Scottish Journal of Healthcare Chaplaincy, 16(special), 42–51. Retrieved
end of life. Cancer, 117(23), 5383–5391. from http://www.napier.ac.uk/_/media/worktribe/output-185074/1600p42bunnissmowats
64. Anderson, W. G., Arnold, R. M., Angus, D. C., & Bryce, C. L. (2008). Posttraumatic stress and nowdenpdf.ashx
complicated grief in family members of patients in the intensive care unit. Journal of 74. Kevern, P., & Hill, L. (2015). ‘Chaplains for well-being’ in primary care: Analysis of the
General Internal Medicine, 23(11), 1871–1876. results of a retrospective study. Primary Health Care Research and Development, 16(1), 87–
65. Gries, C. J., Engelberg, R. A., Kross, E. K., Zatzick, D., Nielsen, E. L., Downey, L., & Curtis, J. R. 99.
(2010). Predictors of symptoms of posttraumatic stress and depression in family members 75. Fitchett, G., Nieuwsma, J. A., Bates, M. J., Rhodes, J. E., & Meador, K. G. (2014). Evidence-based
after patient death in the ICU. Chest, 137(2), 280–287. chaplaincy care: attitudes and practices in diverse healthcare chaplain samples. Journal of
66. Wall, R. J., Engelberg, R. A., Gries, C. J., Glavan, B., & Curtis, J. R. (2007). Spiritual care of Health Care Chaplaincy, 20(4), 144–160.
families in the intensive care unit. Critical Care Medicine, 35(4), 1084–1090. 76. Snowden, A., Fitchett, G., Grossoehme, D. H., Handzo, G., Kelly, E., King, S. D., . . . Flannelly, K.
67. Johnson, J. R., Engelberg, R. A., Nielsen, E. L., Kross, E. K., Smith, N. L., Hanada, J. C., . . . Curtis, J. (2017). International study of chaplains’ attitudes about research. Journal of Health Care
J. R. (2014). The association of spiritual care providers’ activities with family members’ Chaplaincy, 23(1), 34–43.
satisfaction with care after a death in the ICU. Critical Care Medicine, 42(9), 1991–2000. 77. Tartaglia, A., Fitchett, G., Dodd-McCue, D. M., Murphy, P. E., & Derrickson, P. (2013). Teaching
68. Taylor, J. J., Hodgson, J. L., Kolobova, I., Lamson, A. L., Sira, N., & Musick, D. (2015). Exploring research in clinical pastoral education: A survey of model practices. Journal of Pastoral Care
the phenomenon of spiritual care between hospital chaplains and hospital based and Counseling, 67(1), 1–14.
healthcare providers. Journal of Health Care Chaplaincy, 21(3), 91–107. 78. Flannelly, L. T., Flannelly, K. J., & Jankowski, K. R. (2014). Fundamentals of measurement in
69. Charlescraft, A. S., Tartaglia, A., Dodd-McCue, D., & Barker, S. (2010). When caring hurts. . .A health care research. Journal of Health Care Chaplaincy, 20(2), 75–82.
pilot study supporting compassion-fatigued pediatric critical care nurses. Chaplaincy Today, 79. Flannelly, K. J., Jankowski, K. R., & Flannelly, L. T. (2015). Measures of variability in
26(2), 16–25. chaplaincy, health care, and related research. Journal of Health Care Chaplaincy, 21(3), 122–
70. Gauthier, T., Meyer, R. M., Grefe, D., & Gold, J. I. (2015). An on-the-job mindfulness-based 130.
intervention for pediatric ICU nurses: A pilot. Journal of Pediatric Nursing, 30(2), 402–409. 80. Piderman, K. M., Breitkopf, C. R., Jenkins, S. M., Lovejoy, L. A., Dulohery, Y. M., Marek, D. V., . .
71. King, S. D., Jarvis, D., & Cornwell, M. (2005). Programmatic staff care in an outpatient . Jatoi, A. (2015a). The feasibility and educational value of Hear My Voice, a chaplain-led
setting. Journal of Pastoral Care and Counseling, 59(3), 263–273. spiritual life review process for patients with brain cancers and progressive neurologic
conditions. Journal of Cancer Education, 30(2), 209–212.

Table of Contents
81. Piderman, K. M., Breitkopf, C. R., Jenkins, S. M., Lapid, M. I., Kwete, G. M., Sytsma, T. T., & Jatoi, 87. Cheng, J., Purcell, H. N., Dimitriou, S. M., & Grossoehme, D. H. (2015). Testing the feasibility
A. (2015b). The impact of a spiritual legacy intervention in patients with brain cancers and and acceptability of a chaplaincy intervention to improving treatment attitudes and self-
other neurologic illnesses and their support persons. Psycho-Oncology, 26(3), 346–353. efficacy of adolescents with cystic fibrosis: A pilot study. Journal of Health Care Chaplaincy,
82. Piderman, K. M., Egginton, J. S., Ingram, C., Dose, A. M., Yoder, T. J., Lovejoy, L. A., . . . Breitkopf, C. 21(2), 76–90.
R. (2017). I’m still me: Inspiration and instruction from individuals with brain cancer. Journal 88. Fitchett, G. (in press). Advancing research in healthcare chaplaincy: Why, how, who? In E.
of Health Care Chaplaincy, 23(1), 15–33. Kelly, & J. Swinton (Eds.), Re-membering the soul of healthcare: Critical Reflections on the future
83. Kruizinga, R., Scherer-Rath, M., Schilderman, J. B., Sprangers, M. A., & Van Laarhoven, H. W. of health and social care chaplaincy. London, UK: Jessica Kingsley Publishers.
(2013). The life in sight application study (LISA): Design of a randomized controlled trial to 89. Selman, L., Young, T., Vermandere, M., Stirling, I., Leget, C., & Research Subgroup of the
assess the role of an assisted structured reflection on life events and ultimate life goals to European Association for Palliative Care Spiritual Care Taskforce (2014). Research priorities
improve quality of life of cancer patients. BMC Cancer, 13, 360. in spiritual care: An international survey of palliative care researchers and clinicians. Journal
84. Steinhauser, K. E., Olsen, A., Johnson, K. S., Sanders, L. L., Olsen, M., Ammarell, N., & of Pain and Symptom Management, 48(4), 518–531.
Grossoehme, D. (2016). The feasibility and acceptability of a chaplain-led intervention for 90. Handzo, G. F., Cobb, M., Holmes, C., Kelly, E., & Sinclair, S. (2014). Outcomes for professional
caregivers of seriously ill patients: A Caregiver Outlook pilot study. Palliative and Support health care chaplaincy: an international call to action. Journal of Health Care Chaplaincy,
Care, 14(5), 456–467. 20(2), 43–53.
85. Berning, J. N., Poor, A. D., Buckley, S. M., Patel, K. R., Lederer, D. J., Goldstein, N. E., . . . Baldwin, M.
R. (2016). A novel picture guide to improve spiritual care and reduce anxiety in mechanically
ventilated adults in the intensive care unit. Annals of the American Thoracic Society, 13(8),
1333–1342.
86. Grossoehme, D. H., Szczesniak, R., McPhail, G. L., & Seid, M. (2013). Is adolescents’ religious
coping with cystic fibrosis associated with the rate of decline in pulmonary function? A
preliminary study. Journal of Health Care Chaplaincy, 19(1), 33–42.

Chaplaincy dates back centuries, but with the significant shifts in American and Canadian religious practices, the role of professional spiritual care is
more important than ever before. This spiritual care is not something people do simply because they are clergy or someone of strong faith. Specialized
training spiritual care is vital to equip professionals to meet the spiritual needs of others while remaining grounded in their own traditions. Chaplains
bring a high value of multifaith engagement that is rooted in a commitment to spiritual health. This work is not an add-on to a context; it speaks to
the very core of health care, education, criminal justice reform, emergency services, military service, and increasingly corporate, industrial, and business
settings.
Join us in the journey. For more information, contact any of our associations.
ACPE: The Standard for Spiritual Care & Education | www.acpe.edu National Association of Catholic Chaplains | www.nacc.org
Association of Professional Chaplains | www.professionalchaplains.org Neshama: Association of Jewish Chaplains | www.jewishchaplain.net
Canadian Association for Spiritual Care/Association canadienne de soins

spirituels | www.spiritualcare.ca
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The Impact of

Professional Spiritual Care

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Association of Professional Chaplains | www.professionalchaplains.org

Canadian Association for Spiritual Care/Association canadienne de soins spirituels | www.spiritualcare.ca

National Association of Catholic Chaplains | www.nacc.org

Neshama: Association of Jewish Chaplains | www.jewishchaplain.net

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1 Demystifying Spiritual Care

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68% chaplains are a necessary part of that team.

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Section 1 References 5. World Health Organization. (1991). Retrieved from http://new.worldlibrary.net/

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2 Professional Chaplains’ Qualifications and Competencies

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The common qualifications recognize that cultures have different ways

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Additional competencies address facilitating ethical decision making—a Section 2 References

Every 1–5 years, depending on their professional organization, certified

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3 Professional Chaplains’ Standards of Practice

For instance, if a care recipient needed continued spiritual support beyond

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• the care recipient’s desired outcomes regarding care

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1. Care for the Organization’s Employees and Affiliates 3. Leadership

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This may be as simple as understanding and supporting the overall mission

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4 The Evidence for Spiritual Care

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What do patients want from chaplains?

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• Among older medical patients, those experiencing religious Chaplaincy at Hospitals

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Association of Professional Chaplains | www.professionalchaplains.org Neshama: Association of Jewish Chaplains | www.jewishchaplain.net

Canadian Association for Spiritual Care/Association canadienne de soins

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