Disclaimer: nothing in this post should be taken or held as clinical instruction, clinical supervision, or advisory concerning patient care.
Spiritual care is a clinical discipline.
The simple proof of the reality of this is seen daily in the routine work of systems that include spiritual care in their interdisciplinary process. But there is one example I would like to show you, and this example might reveal a way to better utilize spiritual care even where it already exists and is integrated.
Imagine a treatment team in a residential addiction treatment program serving those with co-occurring psychiatric conditions. And imagine that the treatment team consists of primary health clinicians, nurses, addiction counselors, clinical psychology, spiritual care, and a physician specializing in psychiatry. And the team is reviewing how each patient is doing.
The team leader asks, “How is (name of patient) doing?”
The assigned counselor says, “Good.”
After a moment, a nurse calmly states, “Not good.”
The team leader says, “Oh?”, as if to ask for more information.
The nurse says, “They’re not taking their medication for their bipolar disorder.”
To which the team leader then asks aloud to the team, “How do we understand this?”
The nurse adds, “They don’t believe in it. Neither do their parents.”
After waiting and hearing no other input, the team leader then asks, “What’s our plan?”
And at that point a pause in the team process ensues and an extended silence is held. The silence is finally broken by the Spiritual Care team member who speaks directly to the prescribing psychiatrist, saying “Here’s the open door…”
And spiritual care then provides person-specific coaching to the prescriber in understanding the basic cosmology of the patient in real-world matters. And quickly coaches the team and its members in identification and use of an open door in the patient’s world view.
And we now return to our scenario.
Prescribing psychiatrist: “Great. Thanks. I’ll be speaking with the patient and the family.”
Team leader: “Any other inputs to our plan?”
And hearing no other needed inputs to the plan, the meeting moves on.
In this way, spiritual care contributed to patient adherence to the plan.
Some systems limit spiritual care to the support of patients and family members in times of crisis and end-of-life matters.
In doing so the system seems to function as if the basic bio-psycho-social-spiritual nature of all people is not understood. And that the simple value of spiritual care in all care is not understood.
Rather, it’s almost as if the “inter-disciplinary treatment team” is not about the person as a person, but is rather:
It’s almost as if “inter-disciplinary” does not start with what a human being is in the first place (a bio-psycho-social-spiritual being). And thus, the team is not formed in a way to include those 4 components of a person.
If any of this is accurate, does it matter, and is it practical?
In the industrialized medicine environment of today:
And that environment of today leaves me amazed that:
Suggested Reading
Goodheart, C. D. & Lansing, M. H. (1997). Treating People with Chronic Disease: A Psychological Guide. American Psychological Association.