I should state right up front that I’m not a person who does change all that well. My default position on almost anything is to stick with what I have, what I’m doing, or what I believe. Staying with the familiar is comfortable. Changing is stressful. Sometimes this characteristic works for me in that I always try to work out issues with where I am rather than change but often it keeps me from realizing and taking advantage of new opportunities and experiences that would enrich my life.
So it is I think with many businesses, organizations and professions. Despite all we know about how our world and society is changing at an increasing pace and that to prosper and even survive in the new world emerging around us calls for at least re-examining if not changing some basic assumptions about how we function professionally, we resist-often to our detriment and to the detriment of the people who benefit from what we do.
I have had only one career in my life- clergyman. And for almost all of that career I have done my work focused on one setting- the acute care hospital and how to minister to people who are sick and suffering. Health care chaplaincy and ministry in general is based on some assumptions that are so fundamental that they are often not even acknowledged or discussed- let alone disputed. Maybe the most basic is that, to be “successful” -which I will translate as being able to help people relieve pain and suffering- one must be in “relationship” with them. Further, this “relationship” is assumed to be most effective or even only effective if it is face-to-face. It is assumed that to be “helpful’ we as chaplains need to be physically with the person to whom we are ministering. Anyone who wants to be certified as a chaplain must take clinical pastoral education (CPE) that focuses on teaching us how to satisfy this standard. To foster this goal, CPE has required that students be able to meet with a peer group face-to-face and meet in person with a supervisor.
To be clear, I do not want to argue that this model or the assumptions that drive it need to be abandoned. I know that the training I received and my ability to relate deeply to people has helped a lot of patients, caregivers and health care providers. However, it is increasingly clear that this model of training and assumptions about how chaplaincy care needs to be delivered are barriers to both raising the level of training for health care chaplains generally and to the deliver of spiritual care to many, many people in need. There are many people doing spiritual care who want to be trained but cannot do it because they live at a prohibitive distance from a training center, cannot take the time, or cannot afford the tuition. There are many people who want the services of a chaplain who cannot access one because they are home bound, live in rural areas, or otherwise have no way to go to a chaplain.
But maybe most importantly, these assumptions about how chaplaincy training and how chaplaincy itself “must” be done have never been tested. Do we have any evidence that CPE done remotely with virtual groups would produce less effective chaplains than the current model? No. Do we have any evidence that patients and their caregivers would feel less supported and have their suffering less well addressed by a chaplain who communicated with them over the telephone or even by email or Skype than one who communicated with them in person? No. What we do know is that our long-held and sacred assumptions are keeping many people from receiving care for their spiritual and religious suffering.
All health care disciplines are currently struggling with the pros and cons of delivering care remotely. Chaplaincy is not special in that regard. Many of us went into health care because we want to be with people and relate to people. Delivering care or even being trained over the phone or by Skype simply may not be as fulfilling. However, it seems very evident to me that given the realities of health care in the US and, more importantly, given the fact that our assumptions are barriers to delivering spiritual care to many people, new models have to be tried. The time for remote or virtual CPE has come. The given reasons for not doing this have no evidence to support them. Likewise, the time has come for leveraging emerging technology to deliver spiritual care to many who need it and want it but who won’t receive it any other way. There is no evidence that these delivery systems will produce results inferior to the current model.
Finally, this is all not about us- the chaplains. It is about what best serves those in need. What will be effective in the end? I have no idea. I do know we owe it to those in need of spiritual care to try new methods and models.