Third Annual Caring for the Human Spirit Conference
April 11-13, 20166
San Diego, Calif.
“I’ve been a chaplain for 16 years, and this was the best conference I’ve attended.”
More than 300 in-person attendees and thousands via webcast from 13 countries – chaplains, physicians, nurses, social workers, researchers, educators and others – participated in the 3rd annual Caring for the Human Spirit® conference hosted by HealthCare Chaplaincy Network (HCCN) in San Diego, Calif. April 11-13, 2016. The conference included six major addresses, 30+ workshops on a wide variety of topics, poster sessions, and considerable opportunities for small group and one-on-one dialogue.
In a major development at the conference, Rev. Eric J. Hall, HCCN’s president and CEO, announced the formation of a new HCCN affiliate, the Spiritual Care Association. It is the first interdisciplinary international membership organization with evidence-based curriculum, board credentialing and certification, and offers membership to chaplains and other health care disciplines, clergy and organizations. Watch the announcement.
The keynote speaker was Harvey Max Chochinov, M.D., Ph.D., FRSC, Distinguished Professor in the Department of Psychiatry of the University of Manitoba in Canada. Dr. Chochinov is known around the world for his research into the emotional and psychological needs and dying patients and the author of the book Dignity Therapy: Final Words for Final Days (Oxford University Press).
Dr. Chochinov said data show that Dignity Therapy provides benefits for patients and their families, an increased sense of meaning and purpose, and that studies with higher base rates of distress indicate with the application of Dignity Therapy lower depression, anxiety, and increased hopefulness. He described “Personhood on the Clinical Radar” with this question to the patient:
“What should I know about you as a person to help me take the best care of you that I can?”
In his presentation “Dignity, Person and Deconstructing Connectedness,” Dr. Chochinov addressed the issues that dignity is often described as the cornerstone of palliative care. Yet, within the culture of contemporary medicine, issues such as dignity and considerations regarding personhood are often overlooked or relegated to the niceties of care. The role of health care provider as witness also implicates perceptions of dignity and notions of affirmation, requiring a deeper understanding of how to achieve effective empathic communication.
Dr. Chochinov’s talk provided an overview of empirical work explicating the construct of dignity in palliative care, discussed the importance of affirming personhood within clinical encounters and the consequences of failure to do so, examined the concept of health care giver as witness within the context of clinical encounters, and presented an empirical model of optimal therapeutic effectiveness.
The Four Plenaries
The plenary by Carlo Leget, Ph.D., Professor in Ethics of Care at the University of Humanistic Studies, Utretcht, The Netherlands, was entitled “Towards the Integration of Spiritual Care: A Plea for a New Art of Dying.”
Dr. Leget, who is trained as a theologian and is the first author of a Dutch guideline on spiritual care in palliative care for physicians and nurses, noted that accompanying people in their spiritual journey towards the end of life is one of the traditional goals of chaplaincy. In recent years, however, fierce debates have been going on both in Europe and the U.S. about whether it is ethically allowed to pursue a self-chosen death.
Dr. Leget’s presentation noted that one of the questions in this debate is whether chaplains should have a role in accompanying people who make such a choice. Against the background of the developments in Europe in general, and Dutch society in particular, he suggested taking an approach that integrates spiritual care into the ethical debates— a retrieval of the ancient Ars moriendi tradition in a way that helps us deal with the contemporary complexities around death and dying. In this new Ars moriendi the chaplain plays a key role.
Dr. Leget said:
- The patient should have access to a new ‘art of dying’, an ars moriendi that helps patient and proxies to deal with their situation.
- In this new art of dying the influence of the cultural context should be taken into account.
- This new art of dying should help transforming the cultural context.
- All health care professionals should assist patients and proxies in this process.
- This should also transform the professional practice of the health care professionals, and integrate spiritual care.
“Spirituality in Medicine: From Asclepius to P-Values” was the plenary presentation by Tracy A. Balboni, M.D., M.P.H., Associate Professor, Radiation Oncology, Harvard Medical School,Dana-Farber Cancer Institute, Boston, Mass.
Dr. Balboni’s plenary addressed that modern Western medicine, formed in the embrace of spiritual life and thought, owes much of its founding principles to its spiritual heritage, exemplified in the ubiquitous symbol of the rod of Aesclepius within medicine. However, passage through modernity has yielded an estranged relationship between spirituality and the practice of medicine; bodily and spiritual care are now largely performed in isolation from one another. And though the complexities of body and spirit can be served well by specialization, the lack of integration of spiritual and material care has led to notable tensions in the care of the sick, particularly at the end of life.
Dr. Balboni discussed that another ubiquitous symbol within medicine is the “p-value” – the probability that a research finding is due to chance. Though at first glance it may seem to be a concept antithetical to spirituality, it is an emblem of the language of the medical culture – empirical research. Research, though certainly fraught with limitations, can act as a critical tool to shine light on the complex interplay of spirituality and the experience of illness. Research thus far has demonstrated the multifaceted roles of spirituality within illness and how the integration of spiritual care can serve to uphold patient and family well-being. Future steps in research are needed to continue to tell the untold stories of our patients’ lives, and ultimately to reintegrate care of persons, body and spirit.
Her talk presented the historical context of the relationship of spirituality and the practice of medicine and how that influences medical practice and spiritual care today, and how empirical research can be used as a tool to help medical practitioners to understand the role of spirituality and of spiritual care in the lives of their patients.
The third plenary speaker was George Fitchett, D.Min., Ph.D., Professor and Director of Research, Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, Ill.
His topic plenary topic was “Small, Medium and Large: Three Approaches for Advancing Chaplaincy Research.” Dr. Fitchett said that the past 25 years have seen a remarkable beginning for chaplaincy research. Building on this beginning is a substantial task that will require effort from many chaplains and our health care and research colleagues. A review of past efforts suggests that advancing chaplain research should be pursued with three complementary approaches: small, medium and large. He presented the types of research and the research resources associated with each approach as well as the preparation needed for each approach to chaplain research. He described three approaches to advancing chaplaincy research, identified the approach to advancing chaplaincy research that is most appropriate for them given their interests and resources, and outlined next steps needed to advance chaplaincy research.
Dr. Fitchett cited this definition of evidence-based spiritual care by Tom O’Connor: “Evidence-based spiritual care is the use of scientific evidence on spirituality to inform the decisions and interventions in the spiritual care of persons.” Also the European Network of Healthcare Chaplaincy 2014 Statement: Healthcare Chaplaincy in the Midst of Transition:
“Although it is not straightforward to evaluate spiritual care practice it is important to construct research in order to improve the quality of care. Sharing research findings will also inform healthcare providers and faith communities of the role and importance of chaplaincy and thus promote chaplaincy services.”
Rev. Kevin Massey, M.Div., BCC, Vice President, Mission and Spiritual Care Advocate Lutheran General Hospital, Park Ridge, Ill. presented as the fourth plenary, “See Change: Health Care Chaplaincy of Tomorrow.” Rev. Massey explained that as health care itself is undergoing paradigmatic changes, health care chaplaincy as a field will transform. The systems and structures of training and certification will evolve to focus on measurable goals of chaplaincy care that positively affect tangible health outcomes. The inherent strengths of health care chaplaincy, namely resilience and creativity, are what will guide this field through this transition.
His presentation helped participants to understand the shape of paradigmatic change in health care and how it relates to health care chaplaincy, discern between the true core inner strengths of health care chaplaincy and the present structures and systems that govern it, and reflect on ways that innovative methods of training, certification and validation of clinical competency will improve the field.
Dr. Massey said in summary:
“Three elements that added to the way we form and train and certify chaplains will guide the field of health care chaplaincy into being able to be counted on to do the things that we need to be able to do. First, building in the perspective of the recipient of care into the way we are trained. Second, adopting objective observation and behavior demonstration of the chaplain role into the certification process, and finally use of a normative language describing what we do and what we hope to achieve from it.
“These elements I believe, added to how we currently train and certify chaplains will help us emerge in the changes happening right now in health care as being the trusted health care professionals who can capably assist patients in aligning their own cultural and spiritual and personal values into their care.
“Since we haven’t just recently invented spiritual care, then also how we currently train people to perform it, how we screen competencies in it, how we certify people to do it in a variety of contexts, those cannot be considered timeless and crystalized and codified. Those things are permanently open for scrutiny and re-examination and experimentation, always for exploring how we may improve it.”
In addition to these five addresses 60 presenters representing medicine, nursing, chaplaincy, and social work presented more than 30 workshops that covered a range of important topics such as:
- Quality Improvement: Hospice Chaplaincy Philosophy and Clinical Documentation Strategies
- Pastoral Care for Non-Responsive Patients
- The Importance of Community Engagement by Hospital-Based Chaplains: Why Do It? How Do It?
- Religious, Spiritual and Cultural Needs of Muslim Patients on Palliative Care
- A Chaplain-Led Support Group Decreases Burnout Among Palliative Care Clinicians
- Spiritual Care and Social Work: Partnering for Best Practice Outcomes for Team and Clients
- Reforming Chaplaincy Training • Using Systems Redesign to Integrate Chaplaincy with Mental Health Services
- Care for the Hispanic-Latino Patient: A Culturally Competent Approach
- A New National Survey of Hospital Directors: The Number, Roles and Functions of Hospital Chaplains
- Telechaplaincy: Best Practices for Telehealth Chaplaincy Care
- What is Spiritual Care in Health Care and How Do You Measure It?
Awarding of the Pioneer Medal for Outstanding Leadership in Health Care
Another conference highlight was HCCN’s presentation of its Pioneer Medal for Outstanding Leadership in Health Care to George Fitchett and Joseph Prevratil, CEO of The Archstone Foundation, Long Beach, Calif.
The Pioneer Medal recognizes an accomplished individual whose formative research and/or innovative practice shape the way we think about and understand complex and critical issues in contemporary health care, especially in spiritual care. Read more.
The Conference also featured the powerful Ceremony of Renewal of Commitment to Spiritual Care. HCCN President and CEO Rev. Eric J. Hall invited the many chaplains in the ballroom and the hundreds watching this via live stream to stand and to recite with him a communal prayer of re-commitment.
Denise LaChance, Director of Mission Integration & Spiritual Care for a California medical center, said:
“I know that a conference has been a good one for me when rather than feeling weary, as I drive home I feel eager and energized about getting back to work because inspiration and ideas are swirling together in my mind and I feel re-energized about my calling as chaplain and leader. The excellent plenary talks and workshops I attended and several in-depth conversations each addressed something specific we are working on at our hospital, from the big picture perspective of the importance of both research and story in communicating the significance of spiritual care to our healthcare colleagues to specific new screening tools we may be able to use to screen for spiritual needs. I am very excited about the future of chaplaincy and my place in it after this conference.”
Beth Delaney, a nurse practitioner and Assistant Professor of Nursing in Ohio, said:
“As a nurse practitioner who cares for cancer patients, my nurse research partner and I found attending the Caring for the Human Spirit conference provided a forum for ‘like minded’ healthcare individuals to form a community of inquiry, where learning and supporting one another encourage all of us to continually strive to improve the care for one of the most unique characteristics of all humans…the spirit.”
Wyatt Butcher, Associate President of the New Zealand Healthcare Chaplains Association and a member of the Editorial Board for the Health and Social Care Chaplaincy Journal, commented:
“It was very interesting and rewarding to be able to observe how interfaith chaplains work and interact with each other during the conference. I really appreciated the chance to meet colleagues from a different culture and the opportunity to expand my personal network.”