Book Review — The Discipline for Pastoral Care Giving: Foundations for Outcome Oriented Chaplaincy

September-October 2002


Larry VandeCreek, DMin, and Arthur M. Lucas, Mdiv, eds.
Haworth Pastoral Press, Binghamton, NY, 2001, 174 pp., $49.95 (hardcover), $24.95 (paperback)

Before its publication as a book, The Discipline for Pastoral Care Giving appeared as a two-part article in the Journal of Health Care Chaplaincy (vol. 10, no. 2, 2001, and vol. 11, 2001). Larry VandeCreek is the journal's editor; Arthur M. Lucas is director of the Department of Spiritual Care Services at Barnes-Jewish Hospital, St. Louis. Their book is largely composed of essays and case studies written by chaplains working at BJC Healthcare, St. Louis, the system of which Barnes-Jewish is a part.

The editors of (he Discipline for Pastoral Care Giving are well-known pastoral caregivers, and their book has been praised by a number of health care professionals, including Stanley J. Mullin, DMin, Clarian Health Partners, Indianapolis; Larry J. Austin, DMin, Shore Health System, Easton, MD; George Fitchett, DMin, Rush-Presbyterian-St. Luke's Medical Center, Chicago; Thomas H. Gallagher, MD, Washington University School of Medicine, St. Louis; Valerie J. Yancey, RN, PhD, Jewish Hospital College of Nursing and Allied Health, St. Louis; and Fred L. Brown, vice chairman, BJC Health System, St. Louis. All applaud the outstanding efforts made by BJC's staff of professional chaplains and see great value in the outcomes-oriented model of care discussed in this book.

A constant theme runs through all the book's chapters: In this era of outcome-based health care disciplines, chaplains need to speak in ordinary language (rather than theological jargon) that a multidisciplinary team of professionals can use to communicate with patients and their family members.

The Discipline for Pastoral Care Giving opens with an introduction by W. Noel Brown, who describes the medical profession of 25 years ago, when physicians were encouraged by the British epidemiologist Archie Cochrane to begin building an international library of treatment outcomes. The Cochrane Collaborative, based in Oxford, England, is today a voluntary collaboration through which physicians around the world report what on what works and what does not in the practice of medicine. Noel suggests that the time has come for chaplains to follow the Cochrane example — to examine and describe exactly what we do as chaplains and exactly what happens when we do it, and then determine whether or not it is of value.

In the book's first chapter, Lucas describes a methodology called "The Discipline," which he and his colleagues have been developing for the past 10 years. He discusses the methodology's elements, the process through which it was developed, its effect on the chaplains who use it, and its implications for the future of chaplaincy. The Discipline has challenged many of chaplaincy's former assumptions, Lucas says. Because it is a disciplined, outcomes-oriented model, the methodology has deepened participating chaplains' relationships with patients and significantly increased their integration into hospital care teams.

As Lucas says, The Discipline encourages chaplains to begin by identifying the patient's spiritual needs, hopes, and resources (e.g., family, friends, pastor). From these elements the chaplain will put together a patient profile. In fleshing out this profile, the chaplain will discover the patient's sense of the words "holy," "meaning," "hope," and "community." From this knowledge, the chaplain begins to get some idea of what the patient would like to see as the outcomes of his or her treatment.

Then, having acquired an idea of the patient's desired outcomes, the chaplain can pose two questions: What can our ministry contribute to this person's healing and well-being? What difference do we hope to make? From these proactive interactions, the chaplain develops a plan, which is shared with the patient, concerning how they can mutually work toward the patient's desired outcomes. The chaplain then develops specific interventions based on the plan. With the plan in place, the chaplain begins to measure the actual outcomes of care against the desired outcomes. The process is circular in that the patient's needs, hopes, and resources are reassessed to ensure ongoing spiritual growth.

In the book's remaining chapters, BJC staff chaplains write about their experience in developing The Discipline. I found them to be refreshingly honest in their assessments. Their case studies describe the process of utilizing this outcome-oriented model, which gives the patient and chaplain a common language and structure.

The book's organization is ideal and its content, from groundwork to conclusion, is well done. I appreciated the authors' openness to further discussions, research, trials, reshapings, and redefinings as they become needed. The book is an open invitation to the members of any health care discipline to discover the true value of chaplaincy, and it further demonstrates that chaplains are integral members of the care team.

Rita S. McShea
Director, Department of Pastoral Care
St. Anthony's Medical Center
St. Louis


Copyright © 2002 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Book Review - The Discipline for Pastoral Care Giving - Foundations for Outcome Oriented Chaplaincy

Copyright © 2002 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.