Abstract
This edited collection of reflections by a diverse group of professional chaplains, supervisors, and other colleagues within the hospice setting in Britain explores some of the most pressing questions for the discipline: How do we introduce chaplaincy to patients, colleagues, and multiprofessional teams? How do multidisciplinary teams understand the contributions of chaplaincy within the organization and in relation to patient care?
Each chapter is given introductory framing by the editors, then filled with wide-ranging personal writings on many facets of spiritual care. Although the division of the book into three sections seems somewhat arbitrary, each contribution is concise and contributes to the whole, and includes end-noted references, which in their diversity give a good indication of the broad vision of the book. The foreword by Baroness Finlay of Llandaff gives a concise and focused three-page vision statement of spiritual care at the end of life: “The ability to listen, not just with one's ears but also by observing everything that is happening, sensing the atmosphere, listening with undivided attention, and above all listening with heart and soul, that constitutes the core of effective communication,” well represents the values exemplified by the reflections throughout.
This collection is at its best when contributors provide concrete stories of their work, vignettes of patient relationships, supervisory relationships, and collegial collaborations. I find it helpful in its collection of many practitioners' hard-fought articulations of what makes their practice come alive. Some of the stand-out contributions are written by nonchaplains, such as Ruth White's essay about the chaplain role from her vantage as the executive director of a hospice facility. She vulnerably describes the ways that chaplains have given vital support to her in her leadership and have been essential team members on her staff. Nell Mellerick, an artist who leads art therapies at a hospice home, describes with surprise and delight when chaplain visits sparked creativity in patients and exemplified unexpected synergies between disciplines.
Of the reflections written by spiritual care providers, one that I found particularly relevant was Martin Hill's, a subtle exploration of the considerations of a chaplain when introducing spiritual care in the broad context of a “multi-cultural and post-Christian society.” He writes about the nuances of situating and explaining his role, exploring some of the projections, resistances, and assumptions built into chaplaincy from its origins, as he revisits some of his most cherished experiences of giving care to those who do not identify as associating with any particular religion.
For an American audience, although a great deal of the material astutely addresses cultural issues that will resonate with many, I found the section covering multireligious care less helpful in its approach to minority religion and care, especially when it strays from stories of patient care into more generalized statements about religious diversity. This may be the result of cultural differences between Britain and the United States, where the social context of “spirituality” and “religion” and the demographics of denominations, belief backgrounds, and minority religions take on different dynamics. The broader story this book tells about spiritual care to a diverse people does bring out the virtues of curiosity, deep listening, and presence that represent exemplary core values of spiritual care and will help spiritual care providers and those who work with them to understand and articulate that dimension of spiritual care.
Another built-in dilemma of the format is that some of the selected essayists have a greater tendency to mystification, to become solipsistic about “the chaplain” or “hospice,” or otherwise leave context-specific language undefined. For example, I found that Lisa Waller's coined term, “Human ‘beingbodies,’” distracted from her message about embodiment, touch, and presence. Otherwise, her contribution gives an especially lovely portrait of the care that hospice residents give to one another in the context of a facilitated retreat. In contrast, including the distinctive voice of each writer demonstrates spiritual care providers exercising the communication skills that are the core of their practice, even when their style does not resonate.
Although this book's primary value will likely be for chaplains, all with an interest in spiritual care will find a faceted portrait of the key issues—personal, collegial, and systemic, and above all in patient care—that providers encounter daily in their work. It provides variety of perspective, relevance, and savvy to some of the contemporary dynamics of working within hospice settings. It is above all personal and full of unexpected insights that come from clinical experience. I discovered language and perspectives that resonate with and inform my own practice and understanding of my role as a spiritual care provider. What I would have wanted more, for this book to fulfill for me the brief of giving a depiction of spiritual care as a clinical practice well suited to the interdisciplinary setting of palliative care, would have been accounts of the uses of interventional models and the exercise of clinical choices on the part of these practitioners. Jessica Rose's contribution on pastoral supervision points toward her use of theory-based tools to guide a spiritual conversation, and if the book provided more accounts of similar dynamics in patient visits, a volume such as this would go further in demystifying spiritual care and speaking of what represents the best practices and daily discipline of spiritual care providers. Given the book's stated purpose to dispel myths about spiritual care and demonstrate its place in the interdisciplinary team, a greater focus on what makes spiritual care “clinical” in a palliative care or hospice setting would have been a welcome addition to the material.