Chaplaincy Innovations – George Fitchett
It seems like every few months there is a new report of a chaplaincy intervention. Several months ago I began keeping a list of them. Currently I have ten interventions on my list. You may recognize some of them; Kate Piderman’s Hear My Voice intervention (1) and the SCAI framework (Spiritual Care Assessment and Intervention) from colleagues at IU Health (2). Let me briefly mention three others.
Grace Notes is the name of an intervention developed by chaplain Margaret Thompson and colleagues at Courage Kenny Rehabilitation Institute, Minneapolis, MN (3). It was designed to support the spiritual well-being of adults with acquired brain injury (ABI). Grace Notes is a group intervention that pairs activities associated with ABI rehabilitation and adjustment (e.g., awareness, memory, problem solving, social skills, attention, community) with an array of spiritual practices. The article describes implementation of Grace Notes by chaplain Thompson and another rehabilitation professional who was trained to offer it. Their study found preliminary evidence for the acceptability and benefits of Grace Notes. The article includes a link to a facilitator’s manual and participant resources.
Chaplain Petra Sprik and colleagues from the Levine Cancer Institute in Charlotte, NC recently described their Telephone-Based Chaplaincy Intervention in Outpatient Oncology (4). Oncology outpatients completed distress screening that included questions about religious/spiritual (R/S) concerns. Chaplains followed up with a phone call to patients whose responses indicated some R/S concern (30% had some R/S concern). The chaplains provided a telephone R/S intervention to just over a quarter of the patients who had R/S concerns. Among the 41 patients who completed a follow-up survey, 90% were “very satisfied” with the chaplains’ ability to listen to them and make them feel comfortable.
For a number of years, chaplain-researcher Daniel Grossoehme has led a program of research describing and addressing spiritual struggle (SS) among adolescents with cystic fibrosis (CF) and parents of children with CF. In a recent report, his team described GuideSS_CF, a telephone-based intervention designed to address three types of SS among parents of children with CF (5). The team randomized 23 parents who had at least mild SS to receive the three-session GuideSS_CF telephone intervention or a control intervention. They found the intervention was acceptable to the parents and it appeared to reduce their SS. They also found fidelity to the protocol (which is included in the report) for the two chaplains who delivered it.
I have been thinking about what these projects have in common. First, they all began with chaplains who paid careful attention (listened) to R/S needs of the patients (or parents) with whom they worked. Second, the chaplains developed ways to address these needs that involved thinking outside the usual box of chaplaincy care as active-listening or being present. Third, the chaplains used research to develop, implement and test their interventions. This meant working with teams whose members brought important additional competencies to the project. It also meant finding appropriate ways to measure the feasibility, acceptability and effects of their interventions. Each of these initial, small projects set the stage for future, larger studies that will support more rigorous tests of the benefits (outcomes) associated with the interventions.
These projects are a testimony to the remarkable growth and development of an evidence-based approach to spiritual care. These colleagues are transforming chaplaincy. I look forward to reading more reports of new chaplain interventions and adding them to my list.
1. There are a number of publications for the Hear My Voice project. These two provide a good starting place to learn more about it: Piderman KM, Radecki Breitkopf C, Jenkins SM, Ingram C, Sytsma TT, Lapid MI, Tata BS, Chatterjee K, Egginton JS, Jatoi A. Hearing and Heeding the Voices of those With Advanced Illnesses. J Palliat Care. 2020 Oct;35(4):248-255. doi: 10.1177/0825859720928623. Epub 2020 May 28. PMID: 32466734; Piderman KM. On These Holy Mountains. J Health Care Chaplain. 2020 Apr 6:1-6. doi: 10.1080/08854726.2020.1745488. Epub ahead of print.
2. Torke AM, Maiko S, Watson BN, Ivy SS, Burke ES, Montz K, Rush SA, Slaven JE, Kozinski K, Axel-Adams R, Cottingham A. The Chaplain Family Project: Development, Feasibility, and Acceptability of an Intervention to Improve Spiritual Care of Family Surrogates. J Health Care Chaplain. 2019 Oct-Dec;25(4):147-170. doi: 10.1080/08854726.2019.1580979.
3. Thompson M, Rabusch S, Radomski MV, Marquardt V, Kath K, Kreiger R, Squires K. Grace Notes: Feasibility of a Manualized Intervention to Advance Spiritual Well-Being for Clients with Acquired Brain Injury. J Health Care Chaplain. 2021 May 23:1-13. doi: 10.1080/08854726.2021.1929764. Epub ahead of print.
4. Sprik P, Keenan AJ, Boselli D, Cheeseboro S, Meadors P, Grossoehme D. Feasibility and Acceptability of a Telephone-Based Chaplaincy Intervention in a Large, Outpatient Oncology Center. Support Care Cancer. 2021 Mar;29(3):1275-1285. doi: 10.1007/s00520-020-05598-4.
5. Betz J, Szczesniak R, Lewis K, Pestian T, Bennethum AS, McBride J, Grossoehme DH. Feasibility and Acceptability of a Telephone-Based Chaplaincy Intervention to Decrease Parental Spiritual Struggle. J Relig Health. 2019 Dec;58(6):2065-2085. doi: 10.1007/s10943-019-00921-8.