While I appreciate a good discussion of ideas as much as anyone, when it comes to professional practice, and in chaplaincy's case, clinical practice, I pretty quickly default to the "so what" question. That is, does this question and any answer we come to really impact the care we are providing? If not, I tend to view it as a distraction to good care. It clutters my mind and makes it more difficult for me to focus on the clinical issues that are important to determining the spiritual care this patient should receive.
One of the questions I have never understood the clinical relevance of is whether a given patient is "spiritual" or "religious" or "secular" or whatever or whether the care we are providing is "spiritual" or "religious". To be clear, deciding whether a particular chaplain provides spiritual care or religious care or both is another question. Some chaplains are only trained to provide care to patients of their own faith tradition or are paid by their faith tradition to provide only that care. It may also be important to the patient how they label themselves. However, in the context of multi-faith professional health care chaplaincy providing care that is patient-centered, I would submit that approaching a patient with the idea that the care we provide is somehow of a different kind because the patient is spiritual or religious or that the care we can provide is colored by this distinction does not contribute to a good clinical outcome and may even impede it.
I have great respect and appreciation for the writing of Chaplain Steve Nolan from the UK. He and George Fitchett have taken on one of the great needs of our profession- to provide a body of published case studies. However, unfortunately, I believe Chaplain Nolan's latest published case, “He Needs to Talk!”: A Chaplain’s Case Study of Nonreligious Spiritual Care" published in the current issue of the J of Health Care Chaplaincy, suffers from getting hooked on this issue of whether the care is religious, spiritual or secular and, if non-religious, whether chaplains have a 'unique contribution" to make.
To start, I am not at all clear what "nonreligious spiritual care" is and Chaplain Nolan does not define those terms for us. The introduction is an interesting summary focusing on the distinctions between spiritual and religious. All of this left me to read the case with an unhelpful lens and to almost miss the salient point which Chaplain Nolan makes on the bottom of page 2.
However, all the work reported is pastoral care of the kind delivered by a religious pastor, and I would argue that, because it attends to that “natural extension of the conscious self” that some regard as “transcendent” (Elkins, Hedstrom, Hughes, Leaf, & Saunders, 1988, p. 10), it is spiritual care of the kind best delivered by a chaplain (Nolan, 2011).
For me, this is the point of the case -"this is spiritual care of a kind best delivered by a chaplains". Whether it is religious or spiritual or non-religious spiritual is not the point. Yes, it is care of a patient who might have claimed not to be religious although we don't even know that for sure. But, the point is that Chaplain Nolan sees this patient and family for who they are and uses his broad range of skills to provide spiritual care appropriate to their situation. Whether that care is religious or non-religious is an unhelpful distraction.
Betty Ferrell has suggested that there are some questions in the integration of spiritual care that we should not discuss any more because they have been decided and continuing to discuss them simply holds us back. If spiritual care should be integrated into health care is one of them. I would suggest that the question of whether a chaplain can make an important contribution to the care of someone who is not religious is another. Yes, we need many more cases like this to help us grow in how this care might best be provided and Denise Hess's commentary is very helpful in that regard.
Thanks to Chaplain Nolan for his continuing willingness to put his work out there and advance our profession.
Elkins, D. N., Hedstrom, L. J., Hughes, L. L., Leaf, J. A., & Saunders, C. L. (1988). Toward a humanistic-phenomenological spirituality: Definition, description and measurement. Journal of Humanistic Psychology, 28(4), 5–18. doi:10.1177/
Ferrell, B. Integration of Spirituality in Palliative Care Education and Research. 2015 Caring for the Spirit Conference. HealthCare Chaplaincy Network., Orlando, Fl. April, 2014.
Nolan, S. (2011). Psychospiritual care: New content for old concepts – Towards a new paradigm for non-religious spiritu