Abstract
In the course of clinical care, practitioners often wonder if their knowledge is sufficient for what is presented them. Beyond curiosity and dedication, caring for others highlights their professional uniqueness amid medical concerns that appear common. Such challenges generate the development of more and more tools with which to provide care. Newer diagnostic and interventional models emerge as efforts to simplify this complexity, often refining it to normative practices. Physician Beach Conger reflects on this reductionism in his recent book We Have Met the Enemy and He Us (Onion River Press, 2020) as he reflects on the emergence of the current emphasis on evidence-based practice. Dr. Conger muses on the models of care he learned as a medical student in the 1950’s. Lacking more specific knowledge and the development of new diagnostic and interventional tools, his mentors focused both on patients’ complaints as well as their contexts. Where they lived, how they earned their livings, their diets, their hobbies, and their social matrix were pursued in order to better understand one aspect of their maladies and the manners in which they needed to be addressed and remedied. In essence, their medical approach matched what my driver’s education class so long ago emphasized, “always get the big picture”.
In this context, those of us providing pastoral/spiritual care and counseling are always aware of peoples external and internal contexts. In this issue, Ann K. Riggs highlights this feature in her article, The COVID-19 Context Calls for a Broader Range of Healthcare Chaplaincy Models: An Exploratory Translational Study Utilizing Evolutionary Psychology and Social Neuroscience Loneliness Research. Christopher K. Kam expands this internal context in Growth in Adult Ego Development and Mentalizing Emotions for an increasingly Multidimensional God Image. And David Alexander, Zainah Abulhawa, and Josh Kazman offers The SOCOM Spiritual Fitness Scale: Measuring “Vertical” and “Horizontal” Spirituality in the Human Performance Domain to expand understanding of spiritual ideation.
Within the framework of this bigger picture, the field of pastoral/spiritual care simultaneously seeks to develop newer models and better tools for professional development and clinical practice. These are not reductions but enhancements. Robert Bond and Shira Brown offer Testing of a Spiritual Self-Assessment Tool (S)SAT in a Community Hospital Setting. Vivian Stang, Mary Beavis, and Genevieve Cote consider one increasingly important element of institutional pastoral care, Chart Audit of Spiriitual Care Documentation: Continuous Quality Improvement. Darlene Pranke and Margaret Clark consider a new training model in Out of the Ashes: The Alberta Consortium for Supervised Pastoral Education Program. In more specifically focused models of clinical care, Hossin Fasihizadeh and Khadijeh Nasiriani write about the Effect of Spiritual Care on Chest Tube Removal Anxiety and Pain in Heart Surgery in Muslim Patients, and Maya Bass considers Caring for Patients’ Reproductive Health During the COVID-19 Pandemic.
For pastoral/spiritual care providers, the big picture remains the fulcrum of clinical care. As such, unlike the medically appropriate but reductive movement toward evidence-based interventions, the broader context always remains the axis of clinical intervention. New tools and understandings continue to provide operational opportunities for care, but the individual context of each person continues to inform the focus of care. And for spiritual and pastoral caregivers, personal reflection and life’s poetry remain contextual components that reinforce what we bring along with each encounter; both of these topics continue as standing components of this journal.