Animal-assisted therapy with adolescents in a psychiatric facility

Reports personal experiences and research findings which suggest that pets may serve various therapeutic functions in working with children and adolescents in a psychiatric environment. Outlines research data on animal-assisted therapy and urges caregivers to include it in their armamentarium of therapeutic aids.

The quagmire of HIV/AIDS related issues which haunt the Church

Identifies and explores the extreme difficulties of HIV/AIDS realities for the evangelical Christian churches and which tend to stymie effective ministry. Discusses the issues of morality, morbidity, mortality, reality, responsibility; and concludes that the church has fallen short in its mission to HIV/AIDS persons. Claims that this shortfall has created an integrity question in the minds of those whose lives have been touched by this contemporary health crisis.

Patient rights issues and their implications for pastoral caregivers

Reports on actual results of operationalizing the "spiritual concerns" dimension of the Patient Self-Determination Act in one hospital setting. Opines a variety of implications for hospital chaplains and for Clinical Pastoral Education.

The pastoral counselor as mental health professional: a comparison of the training of AAPC Fellow Pastoral Counselors and Licensed Clinical Social Workers

Compares the academic and clinical training requirements for Fellow level members of the American Association of Pastoral Counselors (AAPC) with those of Licensed Clinical Social Workers (LCSWs). Concludes from the empirical findings that AAPC Fellows receive more education, clinical training, and continued supervision than do Licensed Clinical Social Workers. Notes a need for additional and similar types research comparing education and clinical requirements of pastoral counselors with those of other mental health professionals.

The religiosity variable and personal empowerment in pastoral counseling

Claims that therapeutic fuzziness and unexplored assumptions contribute to an all-too-ready devaluing or dismissal of what is important to religious clients. Argues that sorting out the client's religiosity components into facets of religion, spirituality, and theology to reflect respectively the process, capacity, and product of meaning-making serves to shed light on why consideration of religiosity is important in therapy. Notes that such processes of discernment provide a bridge between the sciences (e.g. psychology) and humanitarian (e.g. religiosity) endeavors in that both engage in the same meta-process of meaning-making in their search for empowerment, although they do so from different perspectives and different initial suppositions. Concludes that the art of psychotherapy can draw on the content of both science and religiosity to facilitate well-being in clients and in therapists alike.

Pediatric pastoral care: a case study

Uses the case of a four-year-old boy to illustrate ways in which psychosocial, religious, and spiritual concepts and notions are translated into actual acts of pastoral and clinical care carried out by a chaplain.

Another look at physician-assisted suicide

Responds to a previously published article on the topic of physician-assisted suicide and argues against it from a bioethical standpoint. Suggests guidelines for pastoral caregivers in providing help to patients who may feel compelled to consider physician-assisted suicide.

What pastoral psychotherapists need to know about lesbians and gay men in the 1990s

Alerts pastoral counselors and psychotherapists to the need for a new vision, new knowledge, and new skills if they are to work effectively with lesbians and gay men. Pays particular attention to providing pastoral counseling to HIV Infection/AIDS clients as well as to those lesbians who choose to have children. Acknowledges that not all therapists are able to work well with these populations and in such instances ought to make good referrals.

"Hear a just cause, O Lord, attend to my cry": organ donation and pastoral care

Reports the findings of a survey of hospital chaplains, congregational clergy, and seminary students on the subject of organ donation. Points out the need for additional education and theological discussion focused on the donation of organs.

A twist on Tarasoff: is there a duty to warn one's client?

Describes a famous legal case in which the court's decision obligates a therapist to protect potential victims from harm that may be done to them by the therapist's client and relates it to the issue of confidentiality as frequently understood by pastoral counseling specialists.

Ethical awareness and healthcare professionals

Reports the results of a survey that sought to measure the "ethical awareness" of healthcare professionals at a number of area hospitals and nursing homes. Notes that the survey was helpful in isolating areas for needed inservices on ethical issues. Indicates that in creating the ethical environment necessary for the making of ethical decisions, pastoral care staff can offer encouragement to administrators in assessing the ethical awareness of the hospital's employees in such a way that not only clinical staff, but support staff and administrators as well, become more aware that many "non-clinical" situations are also the arena for ethical decision-making.

Pastoral counseling and the informed relationship

Discusses the legal, ethical, and therapeutic advantages of the informed relationship. Guidelines for obtaining informed consent and a sample consent document are suggested.

Theological reflections on the ethics of pain control among the terminally ill

Explores the reality of pain thru explications of the theological notions of "justification by pain," "justification by death," and "justification by faith." Notes particularly the facilitating role of the hospital chaplain in the understanding of pain and its possible Christian meanings.

When dying is living: hospice pastoral care and education

Explores the relevance of Robert Kegan's concepts to the practice of pastoral care in a hospice context and illustrates the explanatory power of the concepts through the use of case histories. Outlines the implications of Kegan's theory for supervision in Clinical Pastoral Education within a hospice environment.

Evaluation of the hospital chaplain's pastoral care: Catholic and Protestant differences

Reports the results of a questionnaire survey of Roman Catholic and Protestant insurance claimants (N = 445) who were asked to evaluate their hospital stays in terms of pastoral care, social services, and patient representatives. Discusses the results--including a ranking of the levels at which spiritual needs were met--and offers guiding questions for future research.

The Sacred Circle: a conceptual framework for spiritual care in hospice

Hospice care has consistently recognized the need to integrate spiritual care into holistic plans of care for dying patients and their families. Designing and implementing spiritual care interventions can be potentially difficult for hospice practitioners who have not had specific training in theology or pastoral care. Matthew Fox, a theologian, has developed a model of spiritual development that utilizes an ecumenical, ethical framework that can be directly applied to the care of hospice patients and families. This model employs a Sacred Circle approach that begins with an emphasis upon the sense of awe and wonder (the Via Positiva), moves into the next cycle by recognizing problems and negative emotions (the Via Negativa), that then flows into the creative solutions to problems (the Via Creativa), which finally transforms the problem into a new level of understanding (the Via Transformativa).

Safeguarding patients' dignity. The revised directives discuss spiritual and professional considerations

The Catholic health ministry recognizes that caring for the spiritual nature of a person is a high priority. The rights of patients and residents in their relationship with care givers are also important. These topics are treated in Parts 2 and 3, respectively, of the Ethical and Religious Directives for Catholic Health Services. This article focuses on those directives. Directive 10 says pastoral care should be available to all persons in a Catholic healthcare facility, no matter their religious affiliation. Directives 12 to 20 are concerned with the reception of the sacraments of baptism, penance, anointing, and communion by Catholics. Directive 21 discusses the appointment of priests and deacons to the pastoral care staff. Directive 23 reminds care givers that respect for human dignity must inform all Catholic healthcare. Directives 24 and 25 discuss norms for responding to advance directives and the responsibilities of surrogates. Directives 26 to 28 are concerned with free and informed consent on the part of patients and surrogates. Directives 29 to 30 say care givers have a moral obligation to preserve a patient's anatomical and functional integrity. Directive 31 discusses the ethical limits on medical research, and Directive 33 discusses therapeutic procedures likely to harm the patient. Directive 34 says care givers must protect patients' privacy. Directive 36 discusses the care of women who have been raped, including treatment that would prevent ovulation as a result of the rape. Directive 37 says ethical consultation should be available to all Catholic facilities, usually through an ethics committee.

Ministering to persons who face death. Practical guidance for care givers of persons making end-of-life treatment decisions

It is time care givers learn how to minister effectively and sensitively to those making end-of-life treatment decisions. To do so, care givers need to be aware of the various meanings death and dying hold. Culture, religion, past experiences with death and dying, and current situations can all influence the way persons perceive death and dying. Sensitivity to who the patient and family are, to how they perceive the disease or illness, and to how this perception influences their ability to achieve their life goals is a critical care-giving skill. Sensitivity, however, need not result in value neutrality or tolerance. Care givers should not be mindless executors of patient or family demands. Care givers must learn to talk honestly with patients and families about how a particular disease is most likely to progress and about the types of decisions they are likely to need to make. And then care givers need to present options, remaining sensitive to the patients' beliefs, values, and interests. Persons who care for the dying will face three types of patients, who will require different types of responses. The three types are patients who welcome death, patients who accept death, and patients who fight death. For all types of patients, care givers must keep the care patient centered and responsive to patients' priorities; facilitate informed decision making; promote communication among the patient, family, and healthcare team; support autonomous decision making; mediate conflicts; and offer spiritual counseling.