Thursday, June 23, 2016

Further Considerations: More Reflections on "Testing the Efficacy of Chaplaincy Care"

So, I’m still in the process of thinking about Literature Review - Testing the Efficacy of Chaplaincy Care. This particular post isn’t really critique, but some thoughts.

One point to appreciate about the report is an entire section on “Limitation of Scope” (pp. 11 forward). The authors are discrete in describing what they are doing, and a clear sense of what they can and can’t do. For good reasons (again, it’s worth reading, so you can look at these yourselves) they note that they are looking at the North American environment for chaplains, and at acute care settings. They note specifically that “A review of the extensive literature on the influence of spirituality and religion on health is beyond the scope of this report.” (p. 12)

It seems to me that this highlights a theme in the report: to emphasize the research on chaplaincy specifically, and especially that done by and/or for chaplains.  It is an arguable approach. I can see the point, but it also misses a point. One of my concerns has been that we don’t read other professions’ research.

This is a comment I have made before, but I think it worth making again, and especially in considering this report on research that can guide and benefit chaplaincy. Research that speaks to spirituality, and so to the area of expertise of chaplains, appears in journals of a variety of professions. A review of the bibliography that the report includes demonstrates that to some extent. However, as the report focuses on chaplaincy specifically it doesn’t give a clear idea of the breadth of research to consider, whether in medical, nursing, psychology, or social work journals.

Now, I have noted that some of that research isn’t all that helpful (although I believe profoundly we need to be responding to it for that reason.) On the other hand, some of it is. We need to be reading it to see what our professional colleagues might be seeing, and to see what might be useful for us.

We need also to attend to the research on the correlation between religious behavior and health. The authors of this report allude to that work. They also note that there is criticism of that work. It often is hard to address the mechanism: that is, to identify the causative factor that brings the correlation about. While this is legitimate, I believe it overlooks the perspective of the individual patient that the motivation or association or affiliation that contributes to the result is religious. While not specifically about chaplaincy (and not always necessarily helpful for chaplaincy) it is research we need to be conversant about.  

I would also note that there is a good deal of research now to describe the current religious and spiritual landscape in the United States (and perhaps more broadly in North America). Most of this has been done for faith communities, most of them Christian, who want it to help focus evangelism. Evangelism is specifically not an interest of chaplains. However, the religious and spiritual landscape is very important for us. That includes both some sense of how people are affiliated, and also some sense of the spiritual lives of those who are not affiliated. One of my touchpoints with my own administrators is that with the growing number of folks who are indeed spiritual (expressed in familiar terms) but not religious (in the sense of being part of an institution) there is greater need for chaplains. We are those best prepared to support those with spiritual needs and no outside professionals to call on.

The authors are correct that chaplains need to be doing research to better describe and guide our work. We also need to be reading other professions’ research, whether it seems applicable initially or not. A report comparable to this that gave some review of where else we might be reading, and what we might want to recognize, appropriate, or challenge in the research of other groups would also be a valuable contribution.

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