As a healthcare educator in spirituality, I’m often asked, “What is Spiritual Care?” This is a great question and I thought it deserves some exploration. So I did some more research and came up with a way to describe spiritual care.
So, what is Spiritual Care? Spiritual Care is a type of counseling service that addresses three spheres of human experience when facing illness or crisis in the healthcare setting: existential, transcendental, and emotional. Spiritual Care is offered by Chaplains or Spiritual Care Practitioners who are trained as clinicians.
Many patients and staff included often feel confused by the term “spiritual care.” There’s actually a lot that this type of service in the hospital has to offer.
Many misunderstand it as just “religious care” but it’s much more than that. Let’s see how “It’s More than you thought!”
Definition of Spiritual Care
Spiritual Care as a service covers three major domains of Human experience –
First, when we face the unknown like a cancer diagnosis or the death of a loved one, we feel a lot of emotions. I call this the affective domain. It’s the place of deep feelings like:
- Feelings of anger, irritation, and frustration
- Feelings of sadness, loss, and grief
- Feelings of anxiety, fear, and anticipation
- Feelings of celebration, happiness when recovering and even joy with family.
- Trauma
Second, when facing a crisis we can enter the existential domain. That’s the place where we struggle with existence itself. In my view its a deeper place than emotion or the affective domain. It’s where you feel:
- Dread
- Trapped
- Isolation
- Meaninglessness
- Hopelessness or lack of purpose
- Feeling like a burden or feeling useless
Here, Spiritual Care works with you to make meaning out of your current circumstance through a client-centered and facilitative way. Spiritual Care finds a way to reframe the current situation to resource new possibilities.
For instance, one lady I met had lost her husband and her daughter was taking the lead in their family. this elderly lady knew that to carry her through this was a burden, a weight of
Working with this existential pain, I proposed to her that her experience was true, but needed to be reframed. Rather than seeing her self as some dead weight to be carried I asked her to envision herself being weighty in the same way a treasure chest would be heavy
Maybe you’re less like driftwood and more like a pirate’s treasure? Carrying you through this is not a pointless endeavor but a joy for those that see that you are treasure…a valuable human being just for existing.
Me
She laughed, “I’ve never thought of that way before.”
Third, Spiritual Care addresses the transcendent domain. What makes our discipline different from psychotherapists is that we help the person to look outside themselves to that which inspires them – a higher power, nature, a philosophy, a system or community. We go with what provides the Ultimate concerns of their life with some meaning.
The Feelings in this case are all sourced in the transcendent:
- Spiritual anger: anger at one’s ultimate Meaning (G-d, fate, Universe)
- Spiritual fear: fear of one’s Ultimate Meaning coming after them in a punitive way
- Spiritual abuse/trauma: abuse by a faith community that was psychologically harmful in promoting a theology of dehumanizing thought
- Spiritual isolation: disconnection from your Divine Source and/or faith community.
Spiritual care comes from a long line of pastors in the Judeo-Christian tradition, which believed that we grow from crisis once we are joined to a higher Ultimate Source.
What’s the Difference Between Spiritual Care and Religious Care?
Spiritual Care is not necessarily religious care. See these following differences between Spirituality and Religion:
| Spirituality | Vs | Religion |
| Individual and Integrated Growth | Creating a Community | |
| Informal and Eclectic practices; Autonomous – You set the terms to your belief and value expression | vs | systematic in doctrine, authoritarian in direction; formally prescribed behaviors |
| Subjective; difficult to identify | vs | Objective; clear to identify |
| Feeling-based; focus is on inner experiences | vs | Behavior-based; focuses on outward observable practices |
| Universal; emphasis on unity with others | vs | Particular and sometimes segregates one group from another |
| Creates vision and power for possibilities | vs | Gives Practical Form to that Vision |
| Personal Beliefs as Authoritative | vs | Sacred Texts, Tradition, or Clergy as Authoritative. |
Spiritual Care focuses its counseling on the individual. We generally use informal language i.e speech that is native to the person. Rather than focusing on objective “who said what,” spiritual care asks about your subjective experience.
Spiritual Care includes religious care of patients but is not just for those that identify as a Muslim, Buddhist, Christian, etc.
Why Is Spiritual Care Important? 3 Reasons
1.It Improves Decision-Making
First, when someone identifies as religious or spiritual, it makes a big difference in decision making, especially at the end of life.
Typically, those with religious or spiritual beliefs tend to seek more aggressive medical interventions.[ref]
True G, Phipps EJ,
I’ve seen this a number of times.
For one Pentecostal family, they believed their loved one was going to wake up from severe brain damage. Though it’s not my place to judge – especially since I happen to be one – they believed the holy spirit was going to wake him up if they prayed harder and fasted longer.
This was while I was a UCLA Ronald Reagan hospital, which had one of the best neuroscientists on the unit at that time. The loved one never recovered, but according to the family’s wishes, they wanted to make sure every medical procedure was in the playbook.
Every major religion of the world has a certain view of life that can rub against the individualism of the modern world. For the major religions, life is inherently sacred regardless of how one feels about it.
2. It Improves Quality of Life Outcomes
Second, spirituality/religion has a huge impact on quality of life outcomes. According to researchers in palliative care (palliative means to “alleviate suffering”), higher levels of spirituality are linked to better quality of life. In fact, check out these results.
Spirituality is associated with:
- Improved quality of life for those with chronic and serious illness[ref][ref]Thun6-Boyle IC, Stygall JA, Keshtgar MR, Newman SP. Do religious/spiritual coping strategies affect illness adjustment in patients with cancer? A systematic review of the literature. Soc Sci Med 2006; 63:151[/ref]
- regardless of how long someone will live[ref]Lin HR, Bauer-Wu SM. Psycho-spiritual well-being in patients with advanced cancer: an integrative review of the literature. J Adv Nurs 2003; 44:69.[/ref]
- Greater quality of life, social support, effective coping strategies, relieving stress, uncertainty for HIV patients [ref]Tuck 1, McCain NL, Elswick RK Jr. Spirituality and psychosocial factors in persons living with HIV. J Adv Nurs2001; 33:776[/ref]
- In one cancer study spirituality is associated with mental, physical, emotional, and even social well-being[ref]Tuck 1, McCain NL, Elswick RK Jr. Spirituality and psychosocial factors in persons living with HIV. J Adv Nurs2001; 33:776[/ref]
- Lower levels of depression,
better quality of life near death, and protection from despair or hastened death [ref]Breitbart W, Gibson C, Tremblay A. The delirium experience: delirium recall and delirium-related distress in hospitalized patients with cancer, their spouses/caregivers, and their nurses. Psychosomatics 2002; 43:183, and Greenstein M, Breitbart W. Cancer and the experience of meaning: a group psychotherapy program for people with cancer. Am J Psychother 2000; 54:486[/ref]
With results like these, who wouldn’t want spiritual care?
3. Helps Everyone Work Together
Whenever staff meets a patient’s spiritual need then the quality of life goes up. In another study, having staff who were caring for them decreased their depression symptoms and even increased the relationship between caregiver and patient.
In a randomized trial where 298 seriously-ill patients were examined for physical, medical, psychological, social, and spiritual needs experienced greater satisfaction with care, greater home deaths and with less emergency room visits.[ref]Kristeller JL, Rhodes M, Cripe LD, Sheets V. Oncologist Assisted Spiritual Intervention Study (OASIS): patient acceptability and initial evidence of effects. Int J Psychiatry Med 2005; 35:329[/ref]
This is one of the reasons I believe so much in spiritual care. It creates greater satisfaction in your hospital stay.
But what’s wild is how it can even keep you from coming to the ER less often!
Related Questions
What are the spiritual needs of a person? Spiritual needs are universal necessities that each person discovers when facing the ultimate concerns of life. There’s a lot of fluff out there on what a spiritual need actually is and I provide some research and some ways you can meet what I call “The Magnificent 7: Spiritual Needs in Depth.” I devoted a whole post to it here. Try it out.
How Does Spirituality Improve Health? Caring for our Spirituality has been linked to all sorts of physical health benefits. Spirituality has been associated with greater levels of life satisfaction and marital satisfaction. Spirituality has also been associated with lower levels of depression symptoms, delinquency, drug, and alcohol abuse. Studies on prayer have demonstrated a reduction in blood pressure and reverse of distress response.
