Pastoral Report Articles 

  • 01 Mar 2017 8:28 PM | Krista Argiropolis (Administrator)


    Diane Peterson, a member of CPSP, Board Certified Clinical Chaplain and Pastoral Counselor, is a recent recipient of the President's Lifetime Achievement Award, for her lifelong commitment to building a stronger nation though volunteer service. While numerous Americans have been awarded some degree of the President's Volunteer Service Award, very few have been awarded the highest honor - the President's call to Service Award (also referred to as the President's Lifetime Achievement Award). 

    Diane Peterson has volunteered more than 4,000 hours of her time to help first responders who come face-to-face with the unspeakable. 

    Chaplaincy Alive! host, Susan McDougal talks with Diane Peterson about her work, accomplishments and goals. 


  • 27 Feb 2017 10:28 AM | Perry Miller, Editor (Administrator)


    What are our responsibilities regarding the world that corrupts and wounds the people we serve?  Despite our embracing differences and human rights, there was a bit of a hubbub (so archaic but so fitting...) when the CPSP expressed its support of the LGBTQ concerns. And now there have been some interesting letters to me regarding Raymond's recent comments about the Lord's Prayer as a political tool. 

    The CPSP does not back candidates or contribute to political parties. However, we are citizens and religious leaders, and we do have the obligation to speak truth to power. Our priesthood is not reclusive but out in the highways and byways, reaching into places of suffering and imprisonment, providing therapy to individuals and families in deep crisis and chaos. When cruel politics hits us and our ministries, when the state seeks to tear down our chapels of care, we have every reason to resist and speak. 

    Do we already forget that our new President has filed for candidacy in 2020?  The rally in Florida where Mr. Trump had his wife recite the Lord's Prayer, was entirely political and received tax advantages, the ones we all pay for. The Prayer of our Lord (I speak as a Christian) was used for specific effect and not a reverent act; we should all be offended and even frightened. 

    The word "narcissist" has been thrown around lately by both professionals and lay people. I am impressed by the “borderline" quality of the actions and attitudes of Mr. Trump. Things like "let's you and him fight" (furthering the differences between evangelicals and progressives), blatant lies, the denial of any error, all things either black or white, impulsivity and inconsistency, the rejection of boundaries (laws and conventions do not apply) and discipline, no concern for consequences, the use of any tactic in the moment, and the need to have an enemy to attack.  He is also brilliantly intuitive about the weaknesses of others, which forms the basis for his nicknaming his enemies.

    I lived for 20 years in Palos Verdes, CA.  The Los Angeles Trump National Golf Club was built literally in my neighborhood by the ocean; as is his pattern, he took over a failed enterprise already under construction. Mr. Trump continually broke agreements and contracts with our city, which had granted him many concessions to begin with. The art of the deal is pure borderline...make an agreement, break it, make threats, mockingly beg for forgiveness, force concessions, then break that agreement. This caused dissension and sorrow in our community, and most of us wished the thing would fall into sea, which one hole did do. We could call his behavior callous or dishonest or untrustworthy or reprehensible...he calls it business.  He assumes the stances of a demagogue. It is also patently clinical…so I say it is a duck. 

    When a parent acts in these ways, it leads to lots of business for us therapists. We provide care to children and "adult children" that embraces every resource to help the patient cope with that destructive world they were raised in, and find the healthy boundaries that lead to the hope of a good life. Then there are those who cling to this parent and themselves deny and ignore every abuse and lie...they project themselves onto the abusive parent so that any criticism of the parent is an attack on them, thus protecting the authoritarian abuser. And some of us still wonder how the German people could deny the holocaust as it was happening…it could happen anywhere.
     We are chaplains and therapists grounded in a psychoanalytic awareness of the human condition. You and I serve in the places where people don't want to be...the hospitals, prisons, nursing homes. You and I serve in the emotional prisons of addiction, depression, physical and emotional abuse, psychosis, acute and chronic distortions of the reality we believe to be true. 


    You and I are in a here and now that needs our very best care.  Our skills, beliefs, and commitment bring peace and comfort and hope. And, once in a while we must speak truth to power and point out the public actions that harm the soul.

    ---------------

    Bill Scar, CPSP President
    presbill@cpsp.org

  • 19 Feb 2017 8:17 PM | Krista Argiropolis (Administrator)

    Donald Trump assigned his wife Melania lead the Melbourne, FL rally on February 18, in the Lord's Prayer, which was followed by a loud, raucous, football-crowd-type cheer. Some of the news outlets which are likely part of the Trump gang have reported that liberals and atheists have protested this action. It is not only liberals and atheists who should be alarmed. This cynical ploy on the part of Trump should send a chill down the spines of every thoughtful Christian in this country. And for all non-Christians, this cynical political ploy should keep them awake at night.

    I do not recall any American political leader in my lifetime so blatantly co-opting Christianity for political purposes. The founders were unrelentingly opposed to any actual or implied relationship between the new government and any particular religious tradition. 

    We do recall that Adolf Hitler in the 1930's co-opted the Roman Catholic Church with a treaty, the infamous Concordat. And he also co-opted the Protestant Church, establishing the so-called German Christian movement, which Dietrich Bonhoeffer, Karl Barth and Paul Tillich resisted. Bonhoeffer was hanged. Barth and Tillich escaped with their lives, the former to Switzerland and the latter to the United States.

    We in CPSP, as the religious leaders that we are, are obliged to resist this obscene  degradation of religion in the service of a political agenda. And those of us who identify as Christian are even more obliged to expose this travesty. In publicly linking the Lord's Prayer with his regime, Trump implicitly sets every Christian over against every non-Christian in the country. 

    Trump has used prayer - and the principal prayer of Christianity - to inflict a malediction on the entire religious community in this country. We will all be hard-pressed to bring healing in the face of such an abomination. We must do everything in our power to resist this execrable, sinister action on the part of the President.

    _____________________________________

    Raymond Lawrence
    raymondlawrence@gmail.com



  • 13 Feb 2017 2:02 PM | Krista Argiropolis (Administrator)



    The first bi-lingual CPSP event, National Clinical Training Seminar-Central, was held January 14–15, in San Antonio, Texas. At this historical event, forty-five attendees, consisting of members of CPSP, non-members and seminarians joined together for a group relations seminar, case studies, and to listen to guest speaker and CPSP General Secretary, Raymond Lawrence. 

    The first bi-lingual CPSP event, National Clinical Training Seminar-Central, was held January 14–15, in San Antonio, Texas. At this historical event, forty-five attendees, consisting of members of CPSP, non-members and seminarians joined together for a group relations seminar, case studies, and to listen to guest speaker and CPSP General Secretary, Raymond Lawrence. 

    "Over 40 participants, from the United States and Puerto Rico, attended this history-making event," CPSP Diplomate, Juan Loya, stated in a recent letter, "In their evaluations, the overwhelming majority of participants highly praised this training event. As a participant and as the Convener of the Alamo Chapter, I concur with their astute observations."

    The principal organizer for this event was Patty Berron, a member of the CPSP Certification Committee. Patty worked with members of the local chapters to facilitate the event, including the scheduling of fifteen certification candidates, and nine panel members, for a certification review panel on January 13. The candidates approved for certification will receive their certificates at the 2017 Plenary, on March 21, in Orlando, Florida. 

    "This was the first Spanish-English bi-lingual NCTS we've done and it was very well organized by Patty Berron. It seemed to be a success from my observation and reports I have received ," stated Raymond Lawrence. 

    Plans are in the works for a second NCTS-Central event, to be held in the near future. 








    Photo credits: Charlie Spruell and Patty Berron
  • 27 Jan 2017 12:12 PM | Krista Argiropolis (Administrator)

    Raymond J. LawrenceA very useful study was reported in the journal Palliative and Supportive Care in May, 2016, entitled "Documenting presence: A descriptive study of chaplain notes in the intensive care unit." The research was completed in September, 2015. The authors of the report were Brittany M. Lee, B.S.; Farr A. Curlin, M.D.; and Philip J. Choi, M.D. The setting of the research was Duke University Hospital, Division of Pulmonary and Critical Care Medicine, in Durham, North Carolina. The study was done with input from the Director of Pastoral Services, Jim Rawlings.

    The researchers proposed that the recent emphasis on evidence-based practice may be leading chaplains to the use of a reduced, mechanical language insufficient for illuminating patients' individual stories.

    Whatever the cause may be, it is clear that the chaplains in this study are at sea on the matter of what should be appropriately reported in patients' charts.

    The researchers in this study reported that the patients' charts in this particular hospital unit contained both an 18-point checklist section and a free-text section. The checklist section consisted of the following:

    Compassionate presence

    Meaning-oriented presence

    Life review

    Continued presence and follow-up

    Supported patient's sources of spiritual strength

    Inquiry about spiritual beliefs, values, and practices

    Open-ended questions to elicit feelings

    Advocated with staff for patient/family needs

    Used story telling

    Reflective listening, query about important life events

    Facilitated communication with interdisciplinary team

    Facilitated expressions of lament

    Referral to spiritual care provider as indicated

    Celebrated/offered thanksgiving with patient/family

    Advance directive information given

    Spiritual support groups

    Spiritual practice interventions

    Reconciliation with self/others

    This research project did not focus on the checklist above, but on the section of the patient chart where the chaplain was asked to make free-text comments. There were such chaplain comments made on 109 patients in the survey. The free-text opportunity would in fact seem to be the only useful kind of clinical chaplain reporting.

    The summary conclusions of these researchers were not flattering. The chaplains' free-text comments consisted mostly of information already available in the charts. The notes seldom included what would be considered an assessment of needs and resources. The notes rarely referred to any plans or expected outcomes. And the notes did not convey a deeper connection that clinical chaplains, in fact, often have with patients. Chaplain interactions with patients appeared to the researchers more as "products for delivery." The researchers viewed the checklist as actually conveying to chaplains that their work consisted of delivering so many product units of "compassionate presence" and other such ambiguous objectives.

    The research team concluded that chaplains frequently resorted to code language that signified nothing more than the chaplain was present. Many of the free-text notes repeated vague terms already in the checklist itself. Chaplains typically described what they observed rather than interpreting its clinical significance. Chaplains generally indicated passive follow-up plans, waiting for patients or family to initiate further interaction.

    The chaplains often described in the free-text section simply what they observed, such as "family is quite large," or "patient's mother standing and holding patient's hand," observations bereft of any useful interpretation.

    The researchers also found that chaplains' free-text notes often recapitulated what was documented elsewhere in the chart, or readily available elsewhere, such as "patient has lung cancer and has been in hospice." Chaplains rarely made what would be considered a pastoral assessment. And the researchers concluded that the chaplains seldom incorporated in their notes what might be interpreted as "spiritual assessments." The chaplains' notes did not convey the deeper spiritual––or pastoral––connection that chaplains often have with patients and families.

    The free-text notes often described patient's spiritual and religious characteristics without any interpretation of significance, such as stating that "patient is a Presbyterian."

    On the other hand, the researchers found that chaplains did in fact provide what they considered a pastoral or spiritual assessment in three of the 109 cases. In one the chaplain wrote: "I believe the family is aware of the seriousness of their mother's situation." In another the chaplain described an upset wife determined to focus on assisting her ill husband. In the third the chaplain wrote a long note about each of three children of a dying mother and their differing postures toward the dying process. The researchers found such clinical observations promising, though few and far between.

    The researchers also found that follow-up plans for patients were mostly passive, indicating that the chaplains would be available if needed. Of the 109 free-text chaplain notes, only two referred to any prior chaplain visit, suggesting that there was a paucity of follow-up work with patients.

    The researchers argued for chaplains providing clinically relevant communication.

    This study should be examined by all serious pastoral clinicians. I believe that the results of this study are not idiosyncratic to Duke University Hospital. In my travels I have found that clinical chaplains are generally at a loss as to what appropriately belongs in a patient's chart. It should be a fairly easy task to decipher what is important and to orient chaplains to just that.

    We should be clear however, that there are systemic problems in chaplain reporting stemming from the very recent shift in language use, a shift that has resulted in obfuscation of the chaplain's role. I refer to the substitution of "spiritual" for "pastoral" that has been in process on a wide scale for two decades now. (It is heartening to see that Duke still retains a "Department of Pastoral Services.") If chaplains simply can remember that they are pastors or in the pastoral arena and not spiritual gurus, they will be able better to describe what they do. The pastor, like the shepherd of a flock, actually needs to do neither more nor less than to see that the animals and crops are safe, healthy, and in all respects progressing. It is a broad-spectrum task. Much of the time that means doing nothing more than paying close attention. Thus the chaplain can write in the chart, "made myself known to the patient and will follow up as needed." No need to add any fancy new-age language. No need to parse the new fad of "spiritual but not religious." Just present oneself in a pastoral––like a shepherd––posture, establish a potential new relationship, and return later if possible.

    In any case, it is advisable for chaplains to present themselves as pastoral professionals if they want to be understood.

    Thus, in the typical hospital a high percentage of chaplain visits would likely be appropriately charted as "pastoral visit." That is to say, nothing much of significance occurs beyond the simple dramatization of the chaplain's availability. This is, of course, no small matter. Informing the patient by way of a brief visit, rather than by a written announcement, that there is a chaplain available for consultation or counseling, is an important contribution to a typical patient's sense of institutional well-being.

    Paradoxically, the clinical chaplain in making routine visits to patients will find that some of the most receptive and needy patients, in terms of pastoral counseling, are not those with acute medical emergencies in play, but rather those with routine, everyday medical problems. And generally such patients have the luxury of time for talking, unlike those facing critical emergencies. In my own experience through the years, I have found that the most significant pastoral counseling I was able to do was with patients (and staff) who had time on their hands and were happy to encounter a trained person willing to listen to them.

    [Having said that, we should note in seeming contradiction, that it is not unusual for a routine patient courtesy visit to morph quickly into what should be properly labeled pastoral psychotherapy. A competent clinical chaplain is always nimble and ready for surprises.]

    For a minority of patients, where something of note emerges in the chaplain's visit, or a crisis is underway, charting is especially important as a way to notify the staff of what specific action the chaplain is taking. The staff needs to know.  

    Clinical chaplains everywhere should take note of this credible and well-done piece of research. It should be considered a warning shot announcing the danger of the trend toward the irrelevancy of institutional chaplaincy. To counter this impending danger I recommend the following:

    1.     Clinical chaplains move away from "spiritual" as the supposed arena of the chaplains work, seeing it as a recently invented poorly defined category, and move back to the more concrete "clinical pastoral."

    2.     Clinical chaplains recognize that one-time pastoral visits are less likely to accomplish much more than introduction and minimal trust building. Effective pastoral work generally––but not always––comes from repeat visits, after which the patient has learned that the chaplain at least is able to get in and get out of a room and listen, without doing something foolish.

    3.     Clinical chaplains, more than any other professionals, take interest, theoretically, in the whole person, medical, social, mental, physical, et alia.

    4.     Clinical chaplains avoid all flowery language in defining their role, such as "compassionate presence," especially any that is similarly self-aggrandizing.

    5.     Clinical chaplains avoid any prefabricated "outcomes." Any chaplain-patient outcome should be rooted in the idiosyncratic needs and values of the particular patient. Not every patient seeks the same outcome. And most patients seek only an intelligent caring listener to hear his or her story. Most patients want to live, and to live fulfilling lives, but only they know what such a life might look like.

    On a given day most patient visits would likely qualify for a simple documentation of "pastoral visit." Beyond making him- or herself known and available, there typically is not much else to offer on a first visit. In a few cases, especially repeat visits, the chaplain may move into the role of counselor, therapist, confessor, or guide––cases in which persons expose their lives to an intelligent other, with the unspoken hope for both care and wisdom. A competent chaplain has the time, and hopefully the expertise, to fulfill that role where most other medical staff must keep moving. Such in-depth pastoral visits need to be documented for the benefit of the other staff members.

    ------------

    Raymond J. Lawrence, General Secretary
    lawrence@cpsp.org

  • 29 Dec 2016 3:36 PM | Krista Argiropolis (Administrator)

    "I'm creating a safe space for people to tell the truth and tell their own stories without judgement and with respect..." –Michael Eselun


    The fourth edition of our podcast, Chaplaincy Alive!,  is now available. In this poignant interview, host Susan McDougal talks with Oncology Chaplain Michael Eselun about his work with hospice and palliative care patients, his TEDx talks, and his background working in the entertainment industry. 


  • 23 Dec 2016 6:37 AM | Krista Argiropolis (Administrator)

    This special season is dedicated to declarations that give expression to the best of the human spirit such as, "light that shines in the darkness", "good will to all", "peace on earth", etc. 

    It is a season when we want to hold love ones close, remember those we loved but lost, notice the homeless beggar on the corner with genuine compassion in our hearts. We want to give to agencies that feed the hungry and serve the desperate souls who live in the margins of life, relationships and love. Even TV ads that reminds us that abused and abandoned dogs and cats need our help and care touch cords of compassion.

    It is a tender season. It opens our hearts to both hurt and love. 

    Ultimately this season reminds us how desperately we need love and we need to give our love as the core of life that gives meaning and purpose to our being in this world as fragile yet courageous creatures on this earth. 

    Be of good spirit!

    ______________

    Perry Miller, Editor
    perry miller@gmail.com



  • 05 Dec 2016 9:01 AM | Krista Argiropolis (Administrator)

    Beginning in December of 2016, all site reviews for the accreditation of training centers and programs are the responsibility of CAPPT. The directing of these reviews to CAPPT as an independent accrediting body was made by the Governing Council of CPSP. In fact, the first site review to be performed by CAPPT will be completed before the end of the current year and it is anticipated that there will be more than 12 reviews in the calendar year 2017.

    After careful deliberation the Board of Trustees of CAPPT have initiated a fee schedule for all site reviews. The fees for an accreditation review are as follows:

    • $250.00 per diem for each person performing the site review
      • CAPPT will determine if more than one reviewer is needed based on a number of factors including size of the training program etc.
    • $250.00 for the writing and delivery of the site review report to CAPPT
      • If there are more than one site reviewer this fee will be split by the reviewers
    • All expenses for travel, room and board, parking, and other incidentals
      • Normally the site will arrange for housing if needed and receipts must be rendered for all expenses. Every effort will be made to arrange for the reviewers to be in as close proximity to the site being reviewed in order to keep these expenses reasonable. CAPPT will arrange the identification of the site reviewers and may consult with the AOC or the Chapter of Diplomates for this purpose. The selection of the reviewers is the responsibility of CAPPT alone

    Brian H. Childs, Chair, CAPPTThe payment of the per diem, the report fee and all expenses are the responsibility for payment by the site being reviewed. CAPPT will provide an invoice that the site reviewer(s) can use to facilitate the payment of these fees. CAPPT does not directly bill for these services. However CAPPT will not complete the accreditation process until all of these fees have been paid.

    The process for accreditation is outlined in the accreditation manual found on the CPSP website as well as the CAPPT site. The CPSP Accreditation Oversight Committee (AOC) keeps track of those programs ready for review, mentors those programs in the process of developing the self-study and then refers the application for accreditation to the Executive Chapter of CPSP. The Executive Chapter will then decide if the center is ready for the independent CAPPT review and if it is forwards the material on to CAPPT. CAPPT will then decide on who and how many site reviewers will be needed, recruit the reviewer(s) and then send a contract to both the site being reviewed and the reviewer(s) explaining both the site review process and the fees attended to that review. After the completion of the site review report that report along with the site self-study is referred to a committee of CAPPT for review and then that is sent to the entire CAPPT board for a final decision for accreditation including potential notations for remediation and completion if needed. All reviews are valid for seven (7) years. Again, refer to the CAPPT Accreditation Manual for all of the requirements for a review.

    Brian H. Childs
    Chair, CAPPT


  • 29 Nov 2016 5:06 PM | Krista Argiropolis (Administrator)

    The CPSP Communications Committee is pleased to announce the release of the third edition of Chaplaincy Alive!, a video-podcast, featuring Terry R. Bard, the Editor in Chief of the Journal of Pastoral Care Publications, Inc. 

    Our host, Susan McDougal, talks with Terry Bard about the articles and reflections offered by the Journal of Pastoral Care and Counseling, and some of the challenges that are faced by chaplains today, in our ever-changing healthcare systems in America, and abroad. 


  • 22 Nov 2016 8:49 AM | Krista Argiropolis (Administrator)

    While reading Raymond Lawrence’s newest book, Nine Clinical Cases:The Soul of Pastoral Care and Counseling, I was aware of disturbing contrast. 

    Recently I was reviewing a number of websites conveying the services of the chaplain in various medical and other institutional centers across the country. Certainly not an exhaustive review on my part. I was struck, however,  by how many of these chaplain websites tagged their top service was to provide prayer for the patient and their families. Equally true, they often used a photo of the chaplain at bedside holding the hand of a patient as a means to portray their service. 

    Of course chaplains pray and hold the hands of suffering patients and families. But prayer and holding hands is not the sine qua non activity of the clinical chaplain. After all, an untrained minister and layperson off the street can do so equally effectively. 

    These websites and language I hear from chaplains describing their services seemed to be limited in their effectiveness to stake-out the unique role of  a clinical chaplain beyond that which a non-clinically trained pastor could offer. Chaplains provide “prayer”, chaplains provide “presence”, chaplains “show up”, chaplains provide “spiritual guidance” and help people with their “spiritual pain”, chaplains connect patients with their "faith resources", etc.  

    It might be that having a prayer, holding a hand and reminding people of their faith resources has now become so embedded in the practice of chaplains now offering “spiritual care” that the notion they are clinical chaplains has dropped from their awareness and commitment.  I hope not but there is increased evidence this might be the case.

    Only after a few pages into Nine Clinical Cases  the reader cannot miss Lawrence’s challenge. The effectiveness of a chaplain, even the integrity of chaplaincy, he contends, resides in a genuine clinical approach when engaging people who face overwhelming life alternating/ending situations and human suffering. 

    The work of the clinical chaplain, Lawrence declares, must be informed by psychodynamic/psychoanalytical theory. In addition, the competent clinical chaplain makes creative use of the self. The latter typically means the clinical chaplain in addition to CPE training  has also undergone their own psychotherapeutic investigation in order to gain a healthy degree of self awareness. From Lawrence’s viewpoint, even with all of this, which is necessary, a chaplain without a good dose of "humanity and humility" will only be a performer doing an “official duty”, not a curer of souls. 

    The bottom line: Raymond Lawrence calls all of us in clinical ministry to correct the drift from our historic roots which demand our being well trained and informed clinical practitioners.  He directly and indirectly gives warning to the current lapse into the murky language and practice of “spiritual care”. 

    Nine Clinical Cases:The Soul of Pastoral Care and Counseling, stakes out the necessity that all practitioners of clinical ministry have a firm grounding in psychodynamic/psychoanalytical theory and have participated in a form of psychodynamic clinical supervision that invites depth of exploration; an integration of theory, theology with the person and their clinical practice. Failure to do so, in time, will become our undoing as chaplains and our place as a vital member of the health care team. 

    It could be that the health and well-being of the whole clinical pastoral movement will pivot on our re-consideration of our current emphases on “spiritual care” and its murkiness of definition and practice. 

    Lawrence calls for a more informed and effective clinical practice by returning to our historic roots as addressed in Nine Clinical Cases.This book represents a service, a dent, and possibly a disruption as he calling for a commitment to re-evaluate what it means to be a clinically trained chaplain/minister dedicated to the care of soul. 

    My strong impression is that our medical colleagues: physicians, nurses, social workers, psychiatrist, etc. will welcome such a reconsideration and a renewed commitment for chaplains to truly function as clinical members of the medical team. They want and need for us to be far more clinical and sophisticated in the knowledge and language of the social sciences we use with them as fellow consultants and members of the care team than we currently offer. They need us to have a deeper level of clinical acuity as providers of care and counseling for their patients and families who who are broken not only in body but in mind, spirit and in their relationships. Dr. Lawrence’s Nine Clinical Cases, reflects the same wish, even a plea. 

    Lawrence’s  Nine Clinical Cases:The Soul of Pastoral Care and Counseling should be required reading for all clinical chaplains and ministers. Equally true, it is an absolute  must read for CPE training supervisors and their trainees. 

    ______________________

    Perry Miller, Editor
    perrymiller@gmail.com
    NC State Board Certified Pastoral Psychotherapist/Clinical Supervisor
    CPSP Diplomate, CPE Supervision and Psychotherapist