The Role of the Chaplain in Health Care
Role and Qualifications of Health Care Chaplains
The chaplain is the spiritual care specialist on the health care team. They support patients, families, their caregivers and staff to draw on their spiritual, religious, emotional, and cultural resources, as well as their personal values to cope with their experiences in the health care context. They are unique and essential members of the interdisciplinary team with the goal of providing person-centered care.
The role and qualifications of health care chaplains in the United States have evolved significantly in recent decades. Originally, chaplains focused on providing religious interventions to those who could not access their own resources and were peripheral to the health care teams. However, the ever-evolving world of health care, including the increasing appreciation for the role of religion and spirituality, requires a professional spiritual care provider who can address complex spiritual, religious, emotional, ethical and existential needs that often produce spiritual distress and when properly addressed can promote health.
It is clear that spiritual distress can arise from such issues as a lack of meaning or purpose, isolation from one’s community and/or sense of the sacred, feelings of injustice, indignity, disrespect for personal/communal/cultural values, or a heightened sense of their own mortality. Unaddressed spiritual distress can lead to inappropriate use of health care resources, increased symptoms, reduced quality of life and reduced patient and family satisfaction. Chaplains have become the spiritual care specialists fully integrated into health care teams who focus on dealing with these issues. Yet there is wide variation in practice and no widely supported consensus statement clearly defining the role and qualifications of these health care chaplains.
This consensus statement was developed by a panel of chaplains and health care leaders from a wide range of spiritual traditions and health care related contexts. For a list of panel members see Addendum 1. The panel hopes that this statement will serve as a guide to health care chaplains and those who support them to promote the full integration of professional chaplains into health care. This statement is a call to action for greater commitment to the role of chaplaincy. It describes what fully trained professional chaplains can, and are trained to, contribute to health care institutions and those they serve. This statement is meant to be aspirational rather than a description of the current status across all settings.
1 Spirituality is recognized as a fundamental aspect of compassionate, patient and family-centered care. “Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred.”
Puchalski C, Ferrell B, Virani R et al. Improving the Quality of Spiritual Care as a Dimension of Palliative Care: The Report of the Consensus Conference. J Palliat Med. 2009;12(10):885-904. doi:10.1089/jpm.2009.0142
Who is a professional health care chaplain?
The professional health care chaplain has master’s level education in an academic field related to chaplaincy care and has completed formal clinical training in chaplaincy care. The chaplain is accountable to a code of ethics that includes a commitment to appropriate professional boundaries and respect for the values and beliefs of those for whom they care. A professional chaplain has a command of a core knowledge base and array of spiritual-care competencies, including the ability to draw on the chaplain’s own spirituality. Board-certified chaplains have demonstrated advanced training, knowledge and skill according to a spiritual care standard and may have additional specialty certification, e.g., in hospice and palliative care.
The role of health care chaplains is unique and essential. They provide evidence-based spiritual care and support the continued development of evidence-based practice. They provide evidence-based assessment, counseling and advocacy. They support patients, families, caregivers and staff, irrespective of their faith tradition or spirituality, who experience spiritual, emotional, existential or moral distress or who want support and compassionate caring to promote resilience and health. They support ethical decision making. The chaplain is also a psychosocial-care generalist and collaborates with social workers and other mental-health experts to provide unified psychosocial-spiritual care.
As the essential, fully integrated spiritual care specialist on the care team, the chaplain develops and documents a spiritual care plan, provides input during clinical team rounds, educates clinical colleagues in generalist spiritual care, establishes comprehensive referral processes in response to spiritual distress and supports the spiritual well-being of team members both as professionals and persons. Chaplains often focus their care on high acuity and high-volume patient care areas but are also increasingly present in outpatient and telehealth settings.
Chaplains contribute beyond the care of individuals and families to support the institutional commitment to person centered compassionate care practices and policies at all levels of the organization. They support effective, efficient, and ethical use of institutional resources and serve as institutional liaisons to community spiritual and faith groups. They actively support institutional values such as dignity, respect, and equity and work to facilitate the institution welcoming patients, families, and staff of all cultures, races, religions/spirituality, ethnicities, sexual orientations, gender identities, ages, generations, disabilities, languages, nationalities, and immigration statuses.
As spiritually-based clinicians, leaders, educators, and advocates, professional health care chaplains champion caring for the whole person at the individual, team and system levels.2
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2Adapted from the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care, 4th ed, 2018.