Advancing Spiritual Care Through Research

Does Faith Concordance Matter? A Comparison of Clients’ Perceptions in Same Versus Interfaith Spiritual Care Encounters with Chaplains in Hospitals – Christina Shu

Research into the impact of chaplain and spiritual care services rarely explores the intersection between concordance of the spiritual background or identity of the chaplain, and that of the patient or client receiving care.  In the United States, interfaith or cross-faith spiritual care training and practice has become the norm for healthcare chaplaincy. At the same time, Americans express high levels of religious diversity and chaplains seek to attend to faith-specific requests and needs, as well as care for non-religious or secular patients.

In “Does Faith Concordance Matter?  A Comparison of Clients’ Perceptions in Same Versus Interfaith Spiritual Care Encounters with Chaplains in Hospital,” researchers Anke Liefbroer and Ineke Nagel publish a study surveying 209 clients and 45 chaplains in hospitals in the Netherlands. The study evaluated a number of hypotheses including that clients who were more highly observant, or have a more exclusive faith, would report a higher evaluation of faith-concordant spiritual care encounters. Overall, they found that clients rated their encounters with chaplains very highly but found no significant differences between faith-concordant encounters versus faith-discordant. In their report they suggest several possible explanations for these results: that religious differences are less important than other personal qualities in the chaplain-client relationship; that chaplains were very positive about their ability to provide interfaith care; or that in the Netherlands, with a pluralistic and secular society, religious differences are not as important as broader existential themes. Similarly, they describe limitations of the study such as study size, and the small percentage of clients who were affiliated with religious traditions such as Islam, Buddhism, and Judaism. The majority of the clients surveyed were affiliated either with Catholicism, Protestantism, or no religion, and thus the type of faith concordance was either between providers and clients who were both affiliated with Christianity, or discordance between Christianity and no-religion or humanism.

This study poses a number of interesting questions for chaplains in the United States. Liefbroer and Nagel point out in their Introduction that they identified only five studies focusing on clients’ perspectives on faith concordance or lack thereof. Liefbroer also published a systematic review examining empirical studies since 2000 of interfaith spiritual care provision. Given the interfaith training of chaplains in CPE and that there are many hospitals where there is limited access to chaplains who match the religious tradition of every patients – interfaith or faith-discordant spiritual care occurs often. However, what evidence do we have that these interfaith spiritual care encounters have the same level of efficacy and meaning to patients as those that are faith-concordant encounters? Might this perception of the importance of faith-concordance be different for patients of different religions, as well as different levels of religiosity? Are there other factors, such as shared culture, shared language, shared educational background, that are also of significance when “matching” patient and chaplain?

As a chaplain working in a Jewish hospital, the goal of supporting the spiritual needs of historically oppressed or marginalized religious communities is of great importance to our Spiritual Care Department. Chaplains within my department anecdotally report a high level of satisfaction from patients who receive faith-concordant care. However, we also provide interfaith care, especially at times of emergency or other specific contexts such as within the Cancer Center. As identified in Liefbroer and Nagel’s article, spiritual care includes a variety of activities, some of which may be more important in faith concordant encounters (rituals, spiritual practices, end-of-life care), and some of which may be universal (active listening, compassionate presence). Having a greater understanding of patients’ perceptions of chaplaincy care and the relative importance of faith-concordance, would be illuminating for issues such as the structure of spiritual care departments, the way chaplains are assigned or deployed, chaplain training, and how chaplains of all backgrounds can provide evidence-based spiritual care to their patients.

Liefbroer and Nagel’s article is an important contribution to the study of faith-concordance in spiritual care and opens additional questions and need for replication in the context of the United States. I hope that other researchers will consider examining the issue of faith-concordance, especially given the great diversity of religious and non-religious populations in the U.S. and the desire among chaplains to find the best way to meet their patients’ spiritual needs.


Liefbroer, A.I., Nagel, I. Does Faith Concordance Matter? A Comparison of Clients’ Perceptions in Same Versus Interfaith Spiritual Care Encounters with Chaplains in Hospitals. Pastoral Psychol 70, 349–377 (2021).

Liefbroer, A.I., Olsman, E., Ganzevoort, R.R. et al. Interfaith Spiritual Care: A Systematic Review. J Relig Health 56, 1776–1793 (2017).

Leave a Comment