The Work of the Chaplain book review

Abstract:

This is a book review on “The Work of the Chaplain” by Paget and McCormack. The subject is chaplaincy. The purpose is to offer insights into many different chaplain ministries and to clarify the nature of the work of the chaplain. The thesis is that chaplains carry out the Great Commission when they go and serve people in crisis in a pluralistic arena as representatives of God. The authors have remained focused on describing the work of the chaplains throughout the book. However, they are too ambitious in their purpose, as there are many articles in the literatures on role confusions in chaplaincy, and a lack of a clear definition of “spirituality.” Nevertheless, it is a good introductory book as most of the tasks and skills needed by a chaplain are mentioned. However, “work” is practical and one cannot understand the work of a chaplain without practical experience in chaplaincy.

This is a book review on “The Work of the Chaplain” by Paget and McCormack. The title tells us that the subject of this book is chaplaincy. The target audience is Christians, especially “pastors, students, chaplains and laity who seek to provide effective spiritual care.” The purpose of this book is “to offer insights into many different chaplain ministries and to clarify the nature of the work” of the chaplain.^[1] The thesis is that chaplains provide spiritual care to people even when they are not in church, and especially in crisis situations.[2] Therefore, chaplains carry out the Great Commission when they “go” and meet people in their pain and suffering[3] in pluralistic settings, providing the same spiritual care to all people in the identified ministry group.[4] Christian chaplains act as ambassadors for God through their “character, integrity, compassion and witness.”[5]

The book structure consists of an introduction, three major parts, and a conclusion. The introduction gives us the purpose of the book. Part one talks about the foundations for chaplaincy and consists of two chapters. The first chapter is on the historical and legal foundations for chaplaincy. The second chapter is on the biblical basis for chaplaincy. Part two talks about the work of the chaplain and consists of seven chapters. The first chapter covers the ministry tasks and competencies for chaplains in general. The next few chapters talk about specific settings of chaplaincy: military chaplaincy, health-care chaplaincy, workplace chaplaincy, correctional and prison chaplaincy, first-responder chaplaincy, and other chaplain specialties. Part three talks about the person of the chaplain and consists of three chapters. The first chapter talks about keeping the chaplain accountable. The next chapter is on “minefields” for the chaplain. The third chapter talks about health and empowerment for the chaplain. In the conclusion chapter, the book closes with a repetition of the words from the Great Commission, “therefore go…”

Paget and McCormack use a catalogue of relevant topics to provide information about the work of the chaplains. Chapter one gives us background knowledge about the origins of chaplaincy. The word chaplain has to do with a holy man in the fourth-century, Bishop Martin, who shared his cloak with a beggar.^[6] The most documented type of chaplaincy is military chaplaincy. The second most documented is health-care chaplaincy. Many other types of chaplaincy have developed as an outgrowth of military and hospital chaplaincy, such as workplace chaplaincy.[7] Chaplain ministry developed because people needed spiritual care even when they are not in church, and especially in crisis situations. Furthermore, the chaplain is to provide service to everyone who requests it, not just those in the same faith tradition as the chaplain.[8]

Chapter two gives the biblical basis for chaplaincy using various passages. Matthew 25 is used to illustrate the importance of caring for the marginalised people in our society,[9] that chaplains are to take the initiative to seek out those in need of ministry,[10] and that “good works” must accompany faith.[11] Matthew 26:36-45 explains the ministry of the presence, where the chaplain acts as a representative for God in “keeping watch” over people in their darkest moments.[12] Acts 17:16-34 is a reminder for chaplains to be culturally sensitive in a pluralistic environment.[13] This is a very important chapter to place in the beginning of the book as it explains why the work of the chaplain is consistent with God’s command in the Scriptures.

Chapter three describes the four main ministry tasks of chaplains: minister, pastor, intercessor and healer. As a religious minister, the chaplain performs rites and rituals and acts as a religious witness to his or her own faith tradition. The chaplain is a priest who stands before the people to cry out to God.[14] The chaplain is a pastor who provides spiritual care,[15] which includes emotional support, physical assistance, relational reconciliation and spiritual encouragement.[16] The chaplain assesses the needs of the person, offers counsel, and makes appropriate referrals.[17] Chaplains serve as intercessors and advocates.^[18] As a personal advocate, the chaplain helps, advises, exhorts, comforts, strengthens, encourages and intercedes for the individual. The chaplain acts as an institutional advocate by clarifying appropriate action, suitable outcomes, right behaviour, or proper protocol.[19] The chaplain is a healer concerned with a person’s holistic condition[20] and need the following skills to address the whole person: being present, listening, encouraging, crisis intervention and teaching or providing information.[21]

Chapters four to nine describe the works of the chaplain more specifically, with each chapter focusing on a type of chaplaincy specialty. It is natural that Paget and McCormack begin with military chaplaincy, the oldest and most regulated form of chaplaincy. This is followed by health-care chaplaincy, the second most documented type of chaplaincy, and then several other types of chaplain specialities. The authors give us the historical backgrounds, unique characteristics, basic training requirements and specific duties of each chaplain specialty. Since I am doing my fieldwork in hospital chaplaincy, I will examine what the authors say about health-care chaplaincy in more detail.

Chaplaincy in the US hospital developed in the mid-1920s.[22] There are several types of health-care chaplains, including PRN chaplains who need to do at least 400 hours of Clinical Pastoral Education (CPE), staff chaplains who need seminary education, ordination and endorsement, department chair chaplains who may need a DMin, CPE supervisors and CPE interns.[23] Professional health-care chaplains are employees of the health-care agency and often the first to be terminated when institutional administrators look for areas to cut costs.[24] Untrained volunteer clergy are often ineffective and sometimes damaging.[25] Health-care chaplains may perform all the rites and offices of a religious leader,[26] act as intercessors and advocates, and provide spiritual care through the ministries of presence, listening, and dialogue with patients, family and other staff, thus helping people re-evaluate values and beliefs that give meaning to life and relationships.[27]

Chapters ten to twelve move away from the works and onto the person of the chaplain. Chaplains maintain accountability themselves and others when they practice “according to their institutional expectations, individual faiths and beliefs, professional standards, legal statues and personal ethics.”[28] Chaplains need to be careful of “minefields,” especially with relation to confidentiality, making accurate assessments and setting personal boundaries.[29] Chaplains need care too, from their institutions and professional organisations, as well as developing good self-care habits, so that they do not develop compassion fatigue and burnout.[30] The book then closes with the Great Commission, so this is clearly the “take-home message.”[31]

The authors did a good job in remaining focused on the topic of “the work of the chaplain,” and at the concluding chapter returned back to their thesis about how chaplains carry out the Great Commission when they go and serve people in crisis in a pluralistic arena as representatives of God. The chapters flow logically in its arrangement. However, when I searched the literature, I was overwhelmed by the amount of articles and books on chaplaincy. What complicates the picture is that chaplaincy is still “a profession in process.”^[32] Therefore, the authors seem too ambitious when they say their purpose is to clarify the nature of the work of the chaplain.

Hospital chaplains are members of two professions.^[33] They are licensed by the church and employed as hospital staff, so there is confusion as to whether chaplains are clergy or health professionals.^[34] According to a survey of chaplains, more than 50% see themselves as counsellors, some see themselves as professionals, and only 11% think they are religious functionaries.^[35] Chaplains are placed at the intersection of issues: illness, health, secularisation, belief, professionalism, etc.^[36] and often experience role conflicts.^[37] They do not have a monopoly on the spiritual care of patients, as good nurses and doctors play a role in this too.^[38] Their work overlaps with social workers and local clergy.^[39]

There are many challenges hospital chaplains encounter in their work. They are often called when there is “nothing to do” from a medical perspective,^[40] which puts them at the danger of undervaluing the care they provide.^[41] Chaplains are pressured by a need to define their role in improving health care and being “therapeutically effective,”^[42] but their work is difficult to measure in conventional quality improvement (QI) terms, as the precise duties of their job are unspecified.^[43] Furthermore, it is widely agreed that “spirituality” is difficult to define.^[44] Goodliff contends that many clergy adopted aspects of ‘new-psychology’ uncritically to boost their credibility.^[45]

Mohrmann believes “the difference between chaplains and other clinicians is that chaplains are specialists in spiritual care” and are “professionals responsible for creating “sacred space” within the hospital.”^[46] SYWDC defines chaplains as “representatives of their faith communities which require them to live out the commitment of those communities to the wider world.”^[47] Macritchie describes the chaplain as a translator, whose work is to bridge gaps and create connections. The translator occupies the uncomfortable space between two languages, or between two ways of seeing things, and has to find a common language, language that is known to both parties.^[48] Chaplains also translate situations, eg. Is the family in denial?^[49]

Recurrent themes among the literature on the skills need by chaplains to provide spiritual care include offering presence, listening,^[50] and assisting with the search for meaning.^[51] More specifically, hospital chaplains are often seen as being experts on matters of life and death,^[52] who often have to address “questions of life, death and suffering,”^[53] help people find hope,^[54] and help relieve the spiritual suffering of patients and families.^[55] WHO spiritual-care intervention codings include that of spiritual assessment, spiritual counselling, spiritual support and spiritual ritual.^[56] Paget and McCormack’s overview of the main ministry tasks of chaplains in chapter three mentions most these skills and tasks, but only briefly. So reading this book alone is inadequate and other complementary materials are needed.[57] However, “work” is practical, and one cannot understand the work of a chaplain unless one has practical experiences in chaplaincy. Although a good introductory book, I cannot understand what chaplains do just from reading this book.

Bibliography:

Australian Broadcasting Corporation. Hospital Chaplains, episodes 1-8. Sydney: ABC, 2012.

Barger, George W. et al. “The institutional chaplain: constructing a role definition.” The Journal of Pastoral Care 38 (1984): 176-186.

Brault, Emily R. “Pastoral care and counseling in prison: what works?” The Journal of Pastoral Care & Counseling 68 (2014): 1-10.

Cadge, Wendy. Paging God: Religion in the Halls of Medicine. London: University of Chicago Press, 2013.

Carey, Lindsay Brian and Barbara Gleeson. “WHO-ICD-10-AM Spiritual-Care Intervention Codings.” Accessed December 7, 2018. https://www.researchgate.net/publication/322113563_Spiritual-Care_Intervention_Codings_-_Summary_Table_WHO-ICD-10-AM

De Vries, Raymond et al. “Lost in Translation: The Chaplain's Role in Health Care.” Hastings Center Report 38 (2008): 23-27.

Fitchett, George et al. “The Role of Professional Chaplains on Pediatric Palliative Care Teams: Perspectives from Physicians and Chaplains.” Journal of Palliative Medicine 14 (2011): 704-707.

Galek, Kathleen et al. “Referrals to chaplains: The role of religion and spirituality in healthcare settings.” Mental Health, Religion & Culture 10 (2007): 363-377.

Goodliff, Paul. Care in a Confused Climate: Pastoral Care and Postmodern Culture. London: Darton Longman and Todd, 1998.

Idler, Ellen L. et al. “Practical Matters and Ultimate Concerns, 'Doing,' and 'Being': A Diary Study of the Chaplain's Role in the Care of the Seriously Ill in an Urban Acute Care Hospital.” Journal for the Scientific Study of Religion 54 (2015): 722-738.

Lopez, Charles J Jr. “Hospice Chaplains: Presence and Listening at the End of Life.” Currents in Theology and Mission 45 (2018): 45-51.

Macritchie, Iain. “The Chaplain as Translator.” Journal of Religion and Health 40 (2001): 205-211.

Miller, David Ward and James Dennis LoRusso. “Faith at work.” U.S. Catholic 83 (2018): 19-22.

Mohrmann, Margaret E. “Ethical Grounding for a Profession of Hospital Chaplaincy.” Hastings Center Report 38 (2008): 18-23.

Nolan, Steve. “Chaplain as 'hopeful presence': working with dying people.” Practical Theology 4 (2011): 165-179.

Orchard, Helen. Hospital Chaplaincy: Modern, Dependable? Sheffield: Lincoln Theological Institute for the Study of Religion and Society, 2000.

Paget, Naomi K. and Janet R. McCormack. The Work of the Chaplain. Valley Forge: Judson Press, 2006.

South Yorkshire Workforce Development Confederation. Caring for the Spirit: A Strategy for the Chaplaincy and Spiritual Healthcare Workforce. Sheffield, 2003.

Swift, Christopher. Hospital chaplaincy in the twenty-first century: the crisis of spiritual care on the NHS. Farnham: Ashgate, 2014.

Threlfall-Holmes, Miranda and Mark Newitt. Being a Chaplain. London: SPCK, 2011.

Wittenberg-Lyles, Elaine et al. “Communication Dynamics in Hospice Teams: Understanding the Role of the Chaplain in Interdisciplinary Team Collaboration.” Journal of Palliative Medicine 11 (2008): 1330-1335.

Woodward, J.W. A Study of the Role of the Acute Health Care Chaplain in England. Open University, : School of Health and Social Welfare, 1998.

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[1] Naomi K. Paget, and Janet R. McCormack, The Work of the Chaplain (Valley Forge: Judson Press, 2006), v.

[2] Paget and McCormack, The Work of the Chaplain, 4.

[3] Ibid., 117.

[4] Ibid., 4.

[5] Ibid., 117.

[6] Paget and McCormack, The Work of the Chaplain, 2. His cloak (capella in Latin) was enshrined as a reminder of the sacred act of compassion. Chaplain is derived from capella.

[7] Ibid., 3.

[8] Ibid., 4.

[9] Ibid., 5.

[10] Ibid., 6.

[11] Ibid., 8.

[12] Ibid., 10.

[13] Ibid., 11.

[14] Ibid., 14-17.

[15] Ibid., 18.

[16] Ibid., 22.

[17] Paget and McCormack, The Work of the Chaplain, 19-20. If more than 4-6 counselling sessions are needed then referral to a clinician is needed.

[18] Ibid., 23.

[19] Ibid., 24.

[20] Ibid., 27.

[21] Ibid., 27-32.

[22] Ibid., 47.

[23] Ibid., 48-50.

[24] Ibid., 51.

[25] Ibid., 52.

[26] Paget and McCormack, The Work of the Chaplain, 53.

[27] Ibid., 52-54.

[28] Ibid., 96.

[29] Ibid., 101-111.

[30] Ibid., 112-114.

[31] Ibid., 116.

[32] Wendy Cadge, Paging God: Religion in the Halls of Medicine (London: University of Chicago Press, 2013), 247.

[33] Margaret E. Mohrmann, “Ethical Grounding for a Profession of Hospital Chaplaincy,” Hastings Center Report 38 (2008): 19.

[34] Christopher Swift, Hospital chaplaincy in the twenty-first century: the crisis of spiritual care on the NHS (Farnham: Ashgate, 2014), 58, 131.

[35] George W. Barger, et al. “The institutional chaplain: constructing a role definition,” The Journal of Pastoral Care 38 (1984): 182-183.

[36] J.W. Woodward, A Study of the Role of the Acute Health Care Chaplain in England (Open University: School of Health and Social Welfare, 1998), 229.

Swift, Hospital chaplaincy, 155.

[37] Elaine Wittenberg-Lyles, et al. “Communication Dynamics in Hospice Teams: Understanding the Role of the Chaplain in Interdisciplinary Team Collaboration,” Journal of Palliative Medicine 11 (2008): 1332.

[38] Mohrmann, “Ethical Grounding for a Profession of Hospital Chaplaincy,” 18.

[39] De Vries, et al. “Lost in Translation,” 25.

[40] Kathleen Galek, et al. “Referrals to chaplains: The role of religion and spirituality in healthcare settings,” Mental Health, Religion & Culture 10 (2007): 370; Steve Nolan, “Chaplain as 'hopeful presence': working with dying people,” Practical Theology 4 (2011): 165; Swift, Hospital chaplaincy, 183.

[41] Swift, Hospital chaplaincy, 184.

[42] Helen Orchard, Hospital Chaplaincy: Modern, Dependable? (Sheffield: Lincoln Theological Institute for the Study of Religion and Society, 2000), 151.

[43] De Vries, et al. “Lost in Translation,” 24.

[44] Swift, Hospital chaplaincy, 69.

[45] Paul Goodliff, Care in a Confused Climate: Pastoral Care and Postmodern Culture (London: Darton Longman and Todd, 1998), 18.

[46] Mohrmann, “Ethical Grounding for a Profession of Hospital Chaplaincy,” 18, 22.

[47] South Yorkshire Workforce Development Confederation, Caring for the Spirit: A Strategy for the Chaplaincy and Spiritual Healthcare Workforce (Sheffield, 2003), paragraph 33.

[48] Iain Macritchie, “The Chaplain as Translator,” Journal of Religion and Health 40 (2001): 206, 210.

[49] De Vries, et al. “Lost in Translation,” 24.

[50] Ellen L. Idler, et al. “Practical Matters and Ultimate Concerns, 'Doing,' and 'Being': A Diary Study of the Chaplain's Role in the Care of the Seriously Ill in an Urban Acute Care Hospital,” Journal for the Scientific Study of Religion 54 (2015): 735; Charles J. Lopez Jr., “Hospice Chaplains: Presence and Listening at the End of Life,” Currents in Theology and Mission 45 (2018): 46-47; George Fitchett, et al. Spiritual Care in Practice: Case Studies in Healthcare Chaplaincy (London: Jessica Kingsley Publishers, 2015), 18; David Ward Miller and James Dennis LoRusso, “Faith at work,” U.S. Catholic 83 (2018): 21; Emily R. Brault, “Pastoral care and counseling in prison: what works?” The Journal of Pastoral Care & Counseling 68 (2014): 1. Miranda Threlfall-Holmes and Mark Newitt. Being a Chaplain (London: SPCK, 2011), xvi.

[51] E. Williams, “Spiritual agenda for doctors?” Scottish Journal of Health Care Chaplaincy 11 (2008): 2–8; Mark Newitt, “The role and skills of a hospital chaplain: reflections based on a case study,” Practical Theology 3 (2010): 163; Lopez Jr., “Hospice Chaplains,” 49; Miller and LoRusso, “Faith at work,” 20; Swift, Hospital chaplaincy, 134.

[52] Williams, “Spiritual agenda for doctors?” 2–8.

[53] Swift, Hospital chaplaincy, 150.

[54] Newitt, “The role and skills of a hospital chaplain,” 163; Nolan, “Chaplain as 'hopeful presence',” 177.

[55] Fitchett, et al. “The Role of Professional Chaplains on Pediatric Palliative Care Teams,” 706.

[56] “WHO-ICD-10-AM Spiritual-Care Intervention Codings,” Carey, Lindsay Brian and Barbara Gleeson, accessed December 7, 2018, https://www.researchgate.net/publication/322113563_Spiritual-Care_Intervention_Codings_-_Summary_Table_WHO-ICD-10-AM

[57] Threlfall-Holmes and Newitt. Being a Chaplain; Australian Broadcasting Corporation, Hospital Chaplains, episodes 1-8 (Sydney: ABC, 2012). Threslfall-Holmes and Newitt’s book, “Being a chaplain,” which takes the approach of having different chaplains describing their experience in narrative forms, can be read to complement Paget and McCormack’s book. Watching video recordings on the day of a chaplain also helps. Books or videos on communication and counselling skills also help.