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Moving the Profession Forward: Being a Leader in the Spiritual Care Association

For those who don't know me or haven't known me long-- a little of my professional history. I have been a staff member of what is now HealthCare Chaplaincy Network (HCCN) since 1978 and certified by what is now the Association of Professional Chaplains (APC) since 1979.  I've served the APC as Chair of Education, State Certification Chair for NY, Chair of Certification, and President. I helped produce Professional Chaplaincy: Its Role and Importance in Healthcare (aka the White Paper) and chaired the project that produced Common Standards. I was awarded the Anton Boisen Award by the APC in 2011. And now I am the Director of Certification and Credentialing for HCCN's newly announced affiliate, the Spiritual Care Association (SCA) and I was centrally involved in helping design SCA, especially the certification standards, from the beginning of our discussions.

I know that many of my colleagues of many years are some place between mystified and outraged that SCA exists and has taken some of the positions it has, especially in regard to certification. So why am I completely behind it and involved in leading it?

Maybe clarifying a couple of oft-asked questions. Why not work with the current chaplaincy associations? The truth is I've been doing that for a very long time.  I hoped that both the White Paper and Common Standards would jump start the APC in particular into leading the field forward. It didn't happen. Common Standards was never even meant to be a statement of what makes a chaplain competent. It was meant to be what its title suggests- the standards the associations held in common at the time. It was never meant to be the end but the beginning of a journey toward having competent chaplains. But it turned out to be an end. Increasingly I hear health care administrators sharing their frustration that hiring a BCC does not reliably get them the quality of chaplain they need. In other words, the certification process is not doing its job. Just speaking with one voice was good enough in 2004. It is not good enough today.  And my judgment after years of trying is that the APC (and the ACPE, NACC, and NAJC) show no willingness to even consider making the changes needed.

Why form a new association? We need less not more. I completely agree with the latter statement. However, what we need more than fewer associations is a certification process that reliably and demonstrably produces chaplains who can deliver quality chaplaincy care where quality is defined by very specific and widely accepted indicators and deliverables. In this way, those who hire chaplains will know exactly what the chaplains they hire will be able to deliver because they have the competencies linked to those indicators. It is becoming clear to me that we have to do this and do it soon. Already, a survey we just conducted indicates the number of hospitals employing professional chaplains has not grown since 2004.  Our Quality Indicators document and new certification process have drawn rave reviews from many health care administrators and payers.

Why lower the standards for certification? The bar to become certified is not lower but higher. The SCA certification boils down simply to if you can prove through an objective testing process that you can do the things clinically that professional health care chaplains need to do and know what experts in the field think professional chaplains need to know, you should be certified. But that bar cannot and will not be low. If ordination and endorsement helps you be that chaplain as it does for me, then you should have it. If it has no meaning for you, then you shouldn't be required to have it. If you can demonstrate competence after two units of CPE, then you should have the opportunity to do that. If you need four units or six units (as I did) to reach a level where you can demonstrate competence, then that is what you are going to have to do.

How does the SCA know that this is the way to go? We don't for sure. What we do know is (1) what we propose meets needs that we hear coming from the health industry (2) it is consistent with the evidence as we now know it (3) it conforms to the best practice of other disciplines such as medicine and nursing (4) it has the capacity to verifiably deliver value (5) and it has the capacity to be continually tested, improved as indicated, and adjusted to meet changing needs.

I would love nothing better than for the current certifying bodies to join us in this effort and to bring their resources to bear on moving our field forward. A number of groups have reached out and we are engaged in some very productive conversations. Sadly for me as an APC Past President, the APC has chosen to defend the current system without any evidence that it is accomplishing its goals, not engage the issues we have raised, and worse, has not returned our phone calls.

So I have no choice. I am a loyal member of the APC and will remain so. I will do anything the APC leadership invites me to do to help it better serve its members and more importantly the patients, families and staff that those members care for. But I will not wait for that day to come. At the end of the day, this is not about associations or endorsers or who has what or what we want for ourselves. It is about giving patients, caregivers and institutions the best quality spiritual care we can give now. The time is past for yet another strategic planning process, restructuring or set of consultations. It is time for action to better serve our patients and loved ones. 

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