Advancing Spiritual Care Through Research

Thanks to John Ehman for 240 Articles-of-the-Month!

George Fitchett, DMin, PhD

Department of Religion, Health & Human Values, Rush University Medical Center

In his email to subscribers last month, John Ehman announced the 20th anniversary of his Article-of-the-Month (AOTM). He wrote that August’s AOTM marked “20 years of Article-of-the-Month features –a total of 240 topical explorations of research, linked to thousands of citations of related interest, supporting CPE curricular/program development and informing professional practice.” John is often very modest, so I was pleased that he called our attention to this amazing accomplishment. It is a milestone for chaplaincy research and research literacy that deserves our attention and deep appreciation.

While John has been a leader in chaplaincy research, and especially chaplaincy research literacy, many people may not be familiar with him and his work. He currently serves as Manager for Pastoral Care at Penn Presbyterian Medical Center in Philadelphia Pennsylvania. He is also the Editor of the ACPE Research Article-of-the-Month. From 2002 to 2018 John served as the Chair of ACPE’s Research Network. The Fall of 2002 saw the launch of the Network’s website ( At that time John wrote in the Network’s Newsletter, “At last, I am pleased to say that the site is now operational, and as the new convener I will focus on developing the content of the site to serve the interests and needs of the Research Network and the ACPE. I hope members will bookmark the site, check it regularly, and find valuable, up-to-date information that will serve not only researchers but supervisors and students in general.”

In that Newsletter John also introduced the Article-of-the-Month (AOTM). He wrote, “The value of this series is at least three-fold: for researchers, it may call attention to authors whose work speaks to our projects; for supervisors, it may suggest articles for use in CPE curricula, such as in student discussions or didactics; and for CPE students in general, it may raise awareness of the wealth of material being published and the sources where such material can be found. I believe that our Network should promote the idea that research is not some esoteric topic for only a handful of people but rather something pertinent for all ACPE members, even if only as a matter of awareness of the literature relevant to the field of pastoral care.”

To help chaplains appreciate the important work that he has done, I asked John if he would respond to a few questions.

1. How did you get interested in research?

I’ve always respected the epistemology of the scientific method, but I found that healthcare chaplaincy took little advantage of this way of knowing, in spite of being largely surrounded by the scientific culture of medicine. In the 1990s, I was asked to be involved in a number of chaplaincy research events and projects, and that drew me further into the field. While I personally have long felt a calling to direct patient care, I believe it is ethically incumbent upon chaplains to incorporate the insights and questions of research into the professionalism of our discipline, so the burgeoning literature of Spirituality & Health research naturally fascinated me. In 2002, when the future of the ACPE Research Network seemed uncertain, I offered to take the lead there and to transition it to an online-based network and research literature base. At the time, there were few research resources available for chaplains, apart from journal subscriptions: the Orere Source was a bibliographic service provided by Chaplain Noel Brown that was rich but limited in its reach (using US mail and a mostly consultative process), and the websites of the George Washington Institute for Spirituality & Health and of the Center for Spirituality, Theology and Health at Duke University held a certain amount of research material; but I believed the field needed more, and the ACPE could provide it to chaplains everywhere while supporting its own curricular needs.

 2. What are the origins of the idea for the AOTM?

In the early 1990s, Spirituality & Health research had been given a tremendous boost by the John Templeton Foundation’s focus on spirituality in medical education. In the conferences and programs that came out of that, and in my own institution’s efforts for funding, I was taken especially by the work of David B. Larson, MD, who championed spirituality research back when it was “tenure suicide.” Larson impressed upon me how important it was to have someone concentrating on the literature of the field and encouraging original, methodologically sound studies. That emphasis had been very important to his own sense of place in the overall development of study in this area. Also, about the same time, I deeply appreciated the article features that Larry VandeCreek used to publish in Chaplaincy Today. In addition, at ACPE conferences, I became aware of broad desire for curricular materials for research, for journal article discussions and for teaching research itself. As a result, I decided that one way the ACPE Research Network could step up would be in highlighting an article each month that had special potential for equipping ACPE educators to help CPE students become research-minded. The plan was to provide a somewhat detailed summary and commentary of an article (which would prepare an educator to read the original article with an enhanced perspective), particular thoughts on how to use the article with a CPE group, and a series of suggestions of how the article could open into further reading and exploration of a subject. My hope was to encourage people to enter into the world of an article and the thinking of the author(s), not just pay attention to some set of results.

 3. How do you find and select the articles you review?

My process for selecting articles grew out of my personal routine of checking the Medline data base daily for publication updates indexed by a number of key terms (e.g., spirituality, religion, chaplain) and noting any article of possible interest. By the end of each month, the list amounts to around 60 articles. I then go back through and identify those that seem especially insightful, useful, and methodologically well done. From these, I try to envision their potential to engage chaplain readers, especially students who may not be naturally given to reading the research literature; and I pick the one that seems to have the most promise. I also select a group of articles that look to deserve broad attention or that might have special appeal to chaplain researchers, to lift up in my monthly email announcing the Article-of-the-Month. The entire process takes about 10-11 hours a month. (From 2002-2019, I also raised awareness of studies as well as events in a regular Newsletter, but such a newsletter was subsequently made redundant by the wonderful initiatives of Transforming Chaplaincy and the Chaplaincy Innovation Lab.)

 4. Can you pick your 3 favorite articles out of the 240 you have reviewed?

This seems to me an elusive task, and I cannot say for sure what articles I might name if asked on a different day, but the three that come to mind at the moment would be the following, based upon their relevancy, methodology, and presentation.

 a) King, S. D. W., Fitchett, G., Murphy, P. E., Pargament, K. I., Harrison, D. A. and Loggers, E. T. “Determining best methods to screen for religious/spiritual distress.” Supportive Care in Cancer 25, no. 2 (February 2017): 471-479. This article signaled to me a key development in the Spirituality & Health literature: a comparative testing of a good range of accumulated empirical findings on a particular and very practical subject.

 b) Ragsdale, J. R., Orme-Rogers, C., Bush, J. C., Stowman, S. L. and Seeger, R. W. “Behavioral outcomes of supervisory education in the Association for Clinical Pastoral Education: a qualitative research study.” Journal of Pastoral Care and Counseling 70, no. 1 (March 2016): 5-15. This is a brilliant use of research to explore and enrich the educational and institutional processes within chaplaincy education. Not only does is offer important insights, but it models the potential for research within chaplaincy organizations.

 c) Fitchett, G., Murphy, P. E., Kim, J., Gibbons, J. L., Cameron, J. R. and Davis, J. A. “Religious struggle: prevalence, correlates and mental health risks in diabetic, congestive heart failure, and oncology patients.” International Journal of Psychiatry in Medicine 34, no. 2 (2004): 179-196. After many years, this article still offers a lot to the field of Spirituality & Health, raising generative questions and reporting important insights by delving into the complexity of the phenomenon of religious struggle and how its effects may be clinically significant, even when it might not be dramatically apparent in patients in general. Any chaplain looking to become a researcher would be edified by seeing how these authors went about this work.

Regarding his work, John also wrote,

If I could sum up my motivation for both my interest in research and my drive in promoting empirical studies in chaplaincy, it might be along the lines that I once wrote for an address: Chaplaincy to me is as complex as it is sacred, and the practice deserves our full effort. If we limit our knowledge in our pursuit of it, we limit our capacity to accomplish it. We should be utilizing every way of knowing in order to do it as well as we can, operating from as broad and firm an epistemological foundation as possible. Research is a way of knowing that is a very sound means to understand many things vital to our work, and we should use it for all it’s worth. We should look for every opportunity to connect it with our passion to help others. We should take it to heart, for the sake of those who turn to us in need.

It is hard to find better words than these to describe the important role of research in supporting excellence in spiritual care. John, thanks so much for all you have done to help us provide the best spiritual care possible. We look forward to being informed by your AOTM for many years to come.

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