1. MINISTRY ISSUES
T he student chaplain was ner-
vous with the referral from the
nurse. A Mii.slim patient had
asked for spiritual care, stipulating that
rhe chaplain did not need to be a
peutic. In Ontario, there is a strong
move to regulate .spiritual care as a ther-
apy in the College of Regulated Health
Professions and Psychotherapy.
Incamational spirituality.
Muslim, only someone who believed in
Underlying spiritual care and therapy is
God and in doing what is right. The
a strong theological emphxsis on incar-
student confided in her supervisor that
national spirituality. This view sees that
she did not know what to say and had
lhe Divine/God is already present in
little knowledge of the Muslim faith.
patients' lives. God is incarnate in
She didn't want to say anything inap-
events, iti relation.ships, in one's jour-
propriate. How could she proceed?
ney. Indeed, as the Hebrew Scriptures
This situation would have heen assert, humans arc made in the image
unthinkable 50 years ago, when the and likeness of God.
ecumenical movement was weak and
Thus, when a spiritual care pro-
the multifaith movement was almost
vider visits a patient, he or .she can
nonexistent. Folk stayed within their
assume that God is already working in
own faith group and did not venture Pastoral counseling in the 20th the patient's life, even if the patient
out except to convert outsiders to their century was a development of pastoral is not aware of it. In this approach, the
own beliefs and practices. Now, there care and rooted in the sacred texts spiritual care provider doe.s not bring
is much variety in religion and taith. incorporating the counseling theory God to someone who is "godless."
In this article, we outline changes in and skills from the social sciences. In Rather, the spiritual caregiver brings
die spiritual care map and explore some many North American hospitals, there God and knows that God is already at
guiding principles tor spiritual care- was often a pastoral care department work in the pa[ient's life. Spiritual care
givers. We draw on ideas from our that addressed the spiritual needs of is developing a conversation that helps
new book The Spiritual Care Giver's patients and most often was ecumtni- in facilitating awareness oí God's pres-
Guide to Identity, Practice and Rela- cal. Some ventured into multifaith spir- ence already in the patient. Ultimately,
tionship (Canadian Association for Pas- itual care. the patient needs to figure out, with the
toral Practice and Education, http://
As the number of indivitluals help of the spiritual care provider, what
www.cappe.org).
from other faith traditions increased in God is calling her or him to do now.
North America, and these people ended Diversity of truth and ambtguiiy
Changes in the Spiritual Map up in hospitals, the notion of paste ral of experience. The acceptance of diver-
From pastoral care and counseling to care was challenged. For those not from sity of truh and ambiguity of experi-
spiritual care and therapy. The term a Christian background, the word/>as- ence also underlies what has happened
pastoral care has dominated Western toralwas associated with Christianity in spiritual care. In the past, each faith
spiritual care for the last 500 years. The and not a term they used. Pastoral care group and religion believed that they
term arises from the Judeo-Christian did not fit for Muslims, Hindus, Bud- had the truth and others should con-
heritage. The pastor/rahbi ordained by dhists, and other iaith groups. Spir'ttial form to that truth. Now chcre is a
the faith group offered pastoral care to care was fine tor alt faith groups. Many greater respect for diversit)' and more
those in need. In the Hebrew Scrip- pastoral care departments have changed dialog among faith groups. Different
tures, pastoral care is helping the sick, their name to the department of spiri- beliefs and practices are not wrong.
rlie widow, the poor, and the stranger. tual and religious care; some have not.
Aiso, within taith groups, there is
In the New Testament, it is based on
Added to this changing content is more variety. Liberals and conservatives
the parable of serving "the least" (Mt
the growth of a hody of research indi- exist within most inainliiic faith groups,
23) and in the healing miracles and
cating religion and spirituality as h.tving and there is usually quite a variety of
ministry of Jesus.
a positive influence on health. Witli this beliefs and practices within one faith
research, spiritual care is seen as thi^ra- group. For example, within Roman
JANUARY/FEBRUARY 2009 •> IHl aEROYJOURNAL 4 9

2. MINISTRY ISSUES
Catholicism, there are lib- these. The therapist focuses
erals, conservatives, radicals, on the solutions, becoming
an archeologist digging for
and many others. A Roman it a>v those solutions in the client's
Catholic chaplain born and
raised in the United States history. As these solutions
might have many different emerge, therapist and client
beliefs and practices than a create a new story of success,
Roman Catholic patient who dispelling the problem-satu-
was raised in the Philippines. rated story of failure.
The chaplain must be careful giver from one faith group can join This approach in
not to assume that the Philippine with a patient from another. Usually, therapy has had a great effect on spiri-
patient shares all the same beliefs and these experiences require much reflec- tual care and counseling. The focus is
practices. tion; a spiritual conversation around not on what patients have done wrong
the meaning of them can be helpful, - that is, the sin in their lives - but on
indeed even sacred. the grace that is present and has helped
Guiding Principles in the Spiritual Strength of not knowing. One them through many previous challenges
Caregiver's Map concern the student in the scenario and suffering. Resilience through grace
The diversity of the present culture, above had was that she did not know is a key concept in spiritual care. Cod's
along with growing acceptance of spiri- much about the Muslim faith. This is grace has been at work in the patient's
tual and religious differences, poses a certainly an area of growth for her - she life; and, while there is sin, grace always
challenge in spiritual care. One option can learn more about Islam. However, triumphs over sin. This strength-based,
is to have only spiritual caregivers from there is diversity within Islam as there grace-based approach gives the chaplain
the patient's faith group. Certainly, is in any religion. The challenge for the a new set of eyes in discussing the spiri-
there is some wisdom here and most chaplain is to discover what this par- tual needs of the patient.
chaplains will call in the patient's faith ticular Muslim person believes at this
group leader to help. time and how this belief helps her or Using these principles, the student
In the scenario above, a wise him deal with the illness. Usually the above was able to listen to the Muslim
response would be to have the local spiritual care provider has to discover patient's spiritual concerns. She joined
imam come in for a visit. However, this from the patient. him in his worry over his future around
what would happen if there was no
There is strength in not knowing, his health issues. With the patients per-
local imam available, the patient did
for it gives the chaplain an inquisitive mission, she contacted his imam and
not want help from that particular
stance that seeks to understand the the imam came in for a visit. The stu-
imam, or the imam was very busy
patient. Too many mistakes in spiritual dent focused on his strengths and the
and it would be days before he could
care occur from assuming that one many challenges that he had already
visit? Even more important, the Muslim
knows what the patient believes and overcome. Together, they examined
patient has specified that the spiritual
practices. With a stance of not know- what is the right behavior in this situa-
caregiver does not have to be Muslim,
ing, the patient becomes a teacher. tion.
only one who has a belief in Cod and
The chaplain also has something to
in doing what is right. Our experiences
offer: expertise in spiritual issues, help- - Thomas St. James O'Connor is Professor
as chaplains who provide spiritual care and Dekon Glebe Chair for Pa.s[oral
ful questions, and the observations
and therapy is that a person irom one Counseling at Waterloo Lutheran Seminary
of an outsider. The observations are
faith group can provide spiritual care in Waterloo, Ontario.
offered not in an "I know what is right"
to a person from another faith group. - Elizabeth Meakes is pastoral counselor
attitude, but as suggestions of insights
Here are some guiding principles: and family cherapist at K-W Counselling,
that may be helpful.
Joining at the human leveL Kitchener, Ontario.
Strength over weakness, grace
Human beings, regardless of faith group
over sin. There has been a revolution in
affiliation, all suffer. All experience pain
therapy in the last 20 years, now focus-
and sorrow, along with joy and hap-
ing more on the strengths of clients FREE Children's Sermons!
piness. All strive for meaning. Often,
than on their problems. Clients usually Your paid subscription includes FREE access to the
faith group beliefs and practices provide
come with a problem that they cannot Children's Sermon Index. You can search by theme,
a great help in discovering meaning, season of the church year, or keyword.
change. Most often, they have become
especially in suffering. All face • Locate your unique 5-dÍgÍt activation ccKie oti your
saturated with this problem and often
moments of despair and sometimes are mailing label (it begins wiih CJ).
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therapy began with the belief that cli-
hope. Most people strive to love and click on "Online subscriptions."
ents have solutions already in their
be loved. These basic human experi- ' In Canada visit www.woot|Ukcbooks.com and click
experience, but the problem saturation
ences are places where a spiritual care- on "Church resources."
has robbed the client of memory of
50 fflf arnymmL • JAHUARY/FEBRUARY 2009