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Respecting the dual sided identity of clinical pastoral education and professional chaplaincy: the phenomenological research model.

The question discussed in this volume opens a debate on what kind of scientific research model should be used by professional chaplaincy and Clinical Pastoral Education (CPE). The problem begins with the assumption that "becoming more scientific" means using the natural sciences approach employed by psychology; an approach unsuitable to account for factors relative to faith, spiritual and religious issues. I argue that CPE and professional chaplaincy need to be more scientific but not necessarily under the natural sciences model. Considering the predominance of that model in psychology, I believe pastors and chaplains should resist pressures to rely on the natural science model and adopt instead models that respect their dual sided identity. I conclude by suggesting that the phenomenological research model best allows investigation of patients' spiritual as well as psychological issues.

Health Care Reform↗

Treating patients who request assisted suicide. A closer look at the physician's role.

Growing interest in assisted suicide and more favorable attitudes toward it have led to a focus on the tasks of finding common ground with patients who wish to die and of defining appropriate procedural safeguards. Less attention has been directed to the unique opportunities and responsibilities that are inherent in the role of the physician as healer. This article suggests that rather than assisting in their suicide, physicians should address the needs that prompt patients to request it. In addition to relieving the physical causes of suffering, they can help patients to establish realistic hopes by expanding their possibilities, bear suffering by assuring them that their suffering is understood and by remaining with them, and achieve perspective by reviewing the meaning of their life. The argument that these opportunities constitute compelling responsibilities is rooted in the medical traditions of beneficence, virtue, and sharing of power. Physicians' inability to meet all of their patients' needs does not detract from the importance of the psychological, personal, and pastoral aspects of their role.

Adult↗

Cultivating psychological well-being in Hong Kong's future doctors.

There has been much recent attention on psychological well-being and pastoral care for medical students. This study examines psychological morbidity (depression, anxiety and stress) in Hong Kong medical students, as well as their concerns, coping mechanisms and their help-seeking. Medical students in Hong Kong reported a higher level of psychological morbidity as compared with other tertiary education students. Their main concerns include examinations, stress, career, adjusting to the new medical curriculum and commitment to the course. The coping skills adopted were largely adaptive. Maladaptive coping skills like 'denial', 'self-blame' and 'behavioural disengagement' were highly correlated with depression, anxiety and stress scores. Most of the students concerned wanted support services that were specifically tailored to their needs and at least partly provided by people who had been through medical training themselves. The faculty at the University of Hong Kong is establishing a Programme for Effective Transition and Student Support (PETSS) to provide a multi-faceted support system for its medical students. The findings in this study help to ensure that the services provided will be relevant, accessible and acceptable to the students.

Adaptation, Psychological↗

Referral preferences among the mental health professions.

A questionnaire presenting two clinical cases with questions about a diagnosis, type of treatment, and whether the respondent would treat or refer the person was administered to pastoral counselors, psychologists, social workers, and psychiatrists. Psychiatrists tend to see the most and social workers the least pathology in the cases. Psychiatrists see the least need for a psychometric evaluation, but no difference was found concerning need for a neurological examination. The majority prefer to treat the "neurotic" case, whereas there was an almost equal tendency to refer the "phychotic" case. Social workers most prefer to treat and pastoral counselors to refer the "psychotic" case. Overall, social workers refer the most, pastoral counselors the least. Credibility as referral source is ranked as follows: psychiatry, psychology, social work, counselors (both pastoral and marriage, family and child), with laymen ranking lowest. Rankings of credibility and effectiveness as referral sources are highly correlated. Furthermore, the more effective and credible a professional group, the supply of such persons is seen as ample.

Counseling↗

Healing through differentiation: a pastoral care and counseling perspective.

Focuses on the function of healing as central to the cure-of-souls tradition of pastoral care and counseling and describes two prominent but contrary styles of healing in ministry. Proposes an interactional model of pastoral care which integrates the two healing styles of compassion and competence through the principle of differentiation, drawing from the perspective of constructivism as practiced in narrative therapy and the theory of natural systems as applied to the role of the pastor.

Career Choice↗

The wounded healer.

This paper deals with the emergence, elaboration, and use of the concept of "the wounded healer." The term refers to a person whose personal experience of illness and/or trauma has left lingering effects on him--in the form of lessons learned that later served him in ministering to other sufferers, or in the form of symptoms or characteristics that usefully influenced his therapeutic endeavors. While such persons and their actions have been noted across the ages, in other cultures, and in many contexts, it was not until the early twentieth century that the patterns in the behaviors of such persons were recognized, named, explained, and categorized as "healing." Early in the century, the concept was commonly used in the fields of pastoral counseling and analytical psychology; by the end of the century it had been vastly expanded and extended and no longer referred mainly to a healer of psychological suffering. The term wounded healer is now in common use in areas such as rehabilitation medicine, medical-career choice, Alcoholics Anonymous and the self-help movement, and chronic-illness support groups, as well as in the original areas of psychotherapy and pastoral care.

Attitude of Health Personnel↗

Psychodynamic theory and pastoral theology: an integrated model.

The article proposes that a pastoral concern for gay and lesbian individuals must be sensitive to the psychological and social dynamics involved in their attachments, separations, and losses. Drawing on object relations theory and insights from self-psychology, a model is proposed whereby counselor and counselee can examine the cycle of attachment, separation, loss and reattachment that characterizes all important relationships. The suggestion is made that this cycle is applicable to the development and reformulation of life-giving myths and ways of being in the world. Finally, an analysis of the role of early narcissistic wounds and the healing process in therapy is presented.

Christianity↗

Uses of theories of depth psychology in ordained ministry and the institutional church.

Burgeoning understanding of unconscious processes should inform the work of the church and its ministries. Understanding derived from depth psychology can lead to deeper understandings of relationship with God and with one another, of the vicissitudes of spiritual life, of the meaning of ritual and sacraments, and to more profound and relevant scriptural hermeneutics and theological understandings. These claims are illustrated with examples.

Christianity↗

The elderly as prophets.

An understanding of the biological, psychological, and social factors of aging is just one part of helping older persons to view their own aging as the fulfillment of living, since spiritual growth takes place in the context of these factors but transcends them. Younger persons can facilitate such growth for themselves and their elders by helping the aging to function as "prophets" for the younger.

Aged↗

Wounding, doubting, and trusting in suffering.

Constructs a working model of pastoral care on the foundation of the reality of suffering. Explicates how suffering wounds the person both psychologically and spiritually and how doubting God can be a constructive phase leading to the reclaiming of trust in God.

Adaptation, Psychological↗

Seeking comfort through prayer.

The aim of the research was to discover the experience and meaning of prayer of patients in hospital when undergoing coronary artery bypass graft surgery. Ethnographic-type post discharge interviews with 13 participants formed the major data source. Using the grounded theory method, the basic social psychological process was labeled seeking comfort through prayer. This was the process of engaging in prayer with God. The participants believed that God listened to their prayers and answered them when they were seeking comfort. It was this reassurance that gave them the strength to face uncertainty and possible death, and also gave them comfort in their psychophysiological condition at the time. Seeking comfort had three stages (maintaining or re-establishing a relationship with God; making peace with God; and asking God to be with them during the hospitalisation). This last stage involved five levels of prayer (acquiescence, instinctive prayer, survival, confiding and honouring).

Adaptation, Psychological↗