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