This is the second in a two-part series about spirituality and collaborative care. Click here for part 1.
Spiritual Collaboration in Family Centered Health Care
The role of spirituality in healthcare is a constantly evolving topic requiring dedicated time and attention from medical and mental healthcare providers alike. As a whole, Americans are a highly religious people with 89% reported believing in God, 75% indicating that religion is “very important” or “fairly important” in their lives, and 73% saying they try hard to incorporate their religious beliefs into all areas of their lives.1, 2 Furthermore, researchers have demonstrated that religion and spirituality have significant effects on physical and mental health alike.3
Although many Behavioral Healthcare Providers (BHPs) and medical providers ascribe to the practice of incorporating religion and spirituality into their clinical practices, others may not do so as readily. While interdisciplinary teams focus on patients’ spiritual concerns, those most commonly recognized for their specific training in this area are chaplains (also referred to in the literature as “hospital chaplains,” “healthcare chaplains,” and “non-denominational spiritual healers”).4 It is important to understand the services provided by chaplains in order to seek opportunities for collaboration.
Roles and Benefits of the Hospital Chaplain
Chaplains serve in a variety of contexts, often fulfilling numerous roles within those contexts. Chaplains spend time with patients before surgeries and during the disclosure of diagnoses or therapeutic procedures by other healthcare professionals, and may assist in discharge planning and referrals to the faith community.5 Chaplains who serve within hospice settings may provide spiritual care to end-of-life patients and their families, addressing various religious and spiritual concerns that may surface during times of suffering, death, and loss.5-7
The benefits of the services provided by chaplains are noteworthy. Various researchers have linked spiritual well-being to a better quality of life 8, and other health benefits including lower anxiety and depression.9, 10 Flannelly and colleagues11 even linked chaplaincy services to “significantly lower rates of hospital deaths compared to hospitals that did not provide chaplaincy services” (p. 4).
Roles of Chaplains
As discussed in previous CFHA blog entries, behavioral and medical providers should be seeking opportunities to address spirituality with their patients. Although some providers report discomfort or inadequacy regarding addressing spirituality concerns among their patients,6 various opportunities exist for collaboration with other healthcare providers and chaplains.
Chaplains fulfill a variety of roles within the healthcare system. They spend time with patients before medical procedures, assist in discharge planning, and provide referrals to the faith community.5 Chaplains may serve as a neutral professional when discussing diagnoses and treatment options with patients and their families at any point, but most often when addressing significant medical stressors and end-of-life care.5 By assisting patients and their families with coping during difficult experiences, chaplains fill an important role in the medical community.
Chaplains are also able to support staff by providing counseling and spiritual support5 as well as increase provider diversity as members of interdisciplinary healthcare teams. Chaplains who serve as members of interdisciplinary healthcare teams actually report higher satisfaction with communication among team members.12 Furthermore, chaplains may also serve as valuable resources when providing care to patients from multiple religious backgrounds. By informing team members of common beliefs and healthcare practices of various religious groups, BHPs and chaplains alike can increase the quality of patient-provider relationships and establish excellent continuity of care.
While chaplains are important providers of spiritual care services to patients, they are not the only members of healthcare treatment teams that have the ability to do so. Nurses, for instance, observe patients and their families in far greater frequency than chaplains or BHPs. Nurses may very well become aware of the spiritual needs of patients long before a referral to a chaplain is sought. One team of researchers noted that nurses, in fact, refer patients to chaplains more than any other medical discipline.13 In many cases, nurses serve as a link between BHPs, chaplains, attending physicians, and hospital administrators.
Although physicians, therapists, nurses, and clinical pastoral staff alike should receive training on the value of spiritual assessment,14 many providers do not actively implement these assessments into their practices. It is important to continue to seek opportunities to meet the spiritual needs of patients, whether in prayer, spiritual support groups, collaborative scripture reading, ceremonial or individual worship rituals, or other services.
In conclusion, as clinicians and researchers of family centered health care, it is crucial that we continue to look for new ways to meet the spiritual needs of our patients. Collaboration with chaplains and other members of interdisciplinary treatment teams may provide further opportunities to do so. Below are a few electronic resources specifically pertaining to chaplains that may be useful for those future collaboration:
- ACPE Research Network – http://acperesearch.net
- Australian Journal of Pastoral Care and Health - http://www.pastoraljournal.findaus.com/index.php
- Health and Social Care Chaplaincy Journal - https://journals.equinoxpub.com/index.php/HSCC
- Journal of Health Care Chaplaincy - http://www.tandf.co.uk/journals/WHCC
- Plainviews E-Newsletter - www.plainviews.org
1. Curlin FA, Lantos JD, Roach CJ, Sellergren SA, Chin MH. Religious characteristics of US physicians: a national survey. Journal of General Internal Medicine. 2005;20;629-634.
2. Gallup. Religion. http://www.gallup.com/poll/1690/religion.aspx. Accessed July 6, 2017.
3. Oh P, Kim SH. The effects of spiritual interventions in patients with cancer: a meta-analysis. Oncology Nursing Forum. 2014;41;E290-E301.
4. Bulling D, DeKraai M, Abdel-Monem T, et al. Confidentiality and mental health/chaplaincy collaboration. Military Psychology. 2013;25;557.
5. Dell ML. Religious professionals and institutions: untapped resources for clinical care. Child and Adolescent Psychiatric Clinics of North America. 2004;13;85-110.
6. Balboni TA, Vanderwerker LC, Block SD. Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. Journal of Clinical Oncology. 2007;25;555-560.
7. Daaleman TP, Frey B. Prevalence and patterns of physician referral to clergy and pastoral care providers. Archives of Family Medicine. 1998;7;548-553.
8. Frost MH, Johnson ME, Atherton, PJ, et al. Spiritual well-being and quality of life of women with ovarian cancer and their spouses. Journal of Supportive Oncology. 2012;10;72-80.
9. Gaston-Johansson F, Haisfield-Wolfe ME, Reddick B, Goldstein N, Lawal TA. The relationships among coping strategies, religious coping, and spirituality in African American women with breast cancer receiving chemotherapy. Oncology Nursing Forum. 2013;40;120-131.
10. Rawdin B, Evans C, & Rabow MW. The relationships among hope, pain, psychological distress, and spiritual well-being in oncology outpatients. Journal of Palliative Medicine. 2013;16;167-172.
11. Flannelly KJ, Emanuel LL, Handzo GF, Galek K, Silton NR, Carlson M. A national study of chaplaincy services and end-of-life outcomes. BMC Palliative Care. 2012;11;10.
12. Clemm S, Jox RJ, Borasio GD, Roser T. The role of chaplains in end-of-life decision making: Results of a pilot survey. Palliative and Supportive Care. 2015;13;45-51.
13. Vanderwerker LC, Flannelly, KJ, Galek K, et al. What do chaplains really do? III. referrals in the New York chaplaincy study. Journal of Health Care Chaplaincy. 2008;14;57-73.
14. Joint Commission on the Accreditation of Healthcare Organizations. Evaluating your spiritual assessment process. 2005. Accessed here July 10, 2017.
Jonathan B. Wilson, PhD, is an Assistant Professor at Oklahoma Baptist University in the Department of Behavioral and Social Sciences. He co-founded Oklahoma’s first advanced clinical training certificate in Medical Family Therapy, and has various publications and presentations in Medical Family Therapy and Integrated Behavioral Health Care. He has held leadership positions for the Oklahoma Association for Marriage and Family Therapy as well. His research interests include intimate partner violence, qualitative research methods, and sexuality in relationships.