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Fall 2003 Newsletter
On-Line Newsletter Volume 2, Number 1
Published September 15, 2003.
Edited by Chaplain John Ehman, Network Convener
Note: Network members are encouraged to submit articles for upcoming issues of the Newsletter, which is published three times a year: Fall, Winter, and Spring (but may be published more frequently in the future). The Winter 2004 issue is scheduled to be posted on the site in January.
Table of Contents
- Introducing Students to Pastoral Care Research: Thoughts on Discussing Epistemological Questions
- Grant Available to North Central Region Supervisors
- Excerpts from "A Brief History of the Joint Council on Research in Pastoral Care and Counseling," by John R. Thomas
- An Article of Interest about Richard C. Cabot
- Convener's Report
- Agenda for the Network Meeting at the Fall 2003 ACPE Conference
1. Introducing Students to Pastoral Care Research: Thoughts on Discussing Epistemological Questions
Questions of how we know and how we make claims of knowledge may at first strike CPE students as either too commonsensical or too esoteric to be engaging, but basic issues of epistemology may lie behind some of the tensions that can arise when chaplains read or participate in research or even work daily in a scientific, clinical environment. It has been my practice--and I would be interested in feedback on this from others in the Network--to introduce students to pastoral care research by beginning with a discussion of ways of knowing and the differences between ways that theologians may make claims of knowledge and ways that scientists may. My goal is to have students first think about scientific methodology simply as a way of knowing, and then to have them think about how this particular way of knowing may offer valuable insights for their professional and pastoral practice. Highlighting these issues at the outset when introducing students to research has, in my experience, tended to establish a useful context for dealing later with many chaplains' seemingly inevitable feelings of impatience with, or antagonism towards, a scientific approach to pastoral subjects.
Even for students initially very interested in learning about pastoral care research, the historic tensions between science and religion can emerge in subtle ways, and unless students have worked as scientists (which some second-career CPE students have), scientific methodology and reporting is often perceived as "dry" and "tedious." Many chaplains unfortunately come to the subject of pastoral care research with expectations that reports of studies will offer grand generalizations that support religious convictions, and they can become disappointed and frustrated by the careful particularity of good scientific methodology. So, for example, students may want to hear about studies that "prove that prayer is effective," but have little interest in the methodological concerns in such studies. Other students may interpret the objective approach of empirical science to the investigation of things like prayer as essentially antagonistic to what is important to them as religious people and pastoral care practitioners. Clarifying and reiterating the epistemological issues implicit in students' expectations and reactions and in the character of the scientific enterprise itself can help students distinguish between the potential value of a study and larger and more personal questions about their own position on the value of science to pastoral care.
My approach to broaching epistemological issues is generally fourfold. First, I ask students to think carefully about the various ways that they use the phrase, "I know," and I offer the following illustration:
I know that 2+2=4, I know that the sun will rise in the east, I know that there are no monsters under your bed, I know that there is a working water fountain around the corner, I know that Bob was born in 1957, I know that Sally is a good person, I know that broccoli tastes bad, or I know that God exists. The word know would seem to mean something different in each of these varied cases, but exactly what is the nature of the claim of knowledge in each case? On what basis--what way of knowing--does each statement rest?
Students usually begin to explore what it means to claim to know something along two separate lines: objective "facts" that lend themselves to verification (e.g., the existence of a working water fountain around a corner) and personal beliefs that hold great individual importance but are not simply verifiable (e.g., that Sally is a good person). Also, they may--with some prompting--consider how assumptions play into claims of knowledge (e.g., the water fountain around the corner may have broken, or your taste for broccoli may have changed). It is usually observable at this point that every student is comfortable using the phrase, "I know," in multiple ways, according to different criteria. The complexity of the commonplace usage of this phrase begins to emerge.
Second, I ask students to think about four categories of ways of knowing: knowing on the basis of sensory perception/observation (empiricism), knowing on the basis of reason/logic (rationalism), knowing on the basis of someone's authority, and knowing on the basis of intuition/inspiration (or in a theological sense, revelation). For each of these ways, I encourage them to discuss potential advantages and disadvantages of that method for making claims of knowledge. For example, claims based upon the method of empiricism can usually be tested relatively easily by others through repeated observation, but some important things may be very subjective and not easily observable or may not be observable at all, and the way that raw data are organized influences meaning. On the other hand, claims of knowledge based on inspiration may be powerfully affecting and may touch upon realities beyond our normal human capacity to discover them, but knowledge in this way tends to be so personal and private as to be virtually inaccessible directly to others or to others' critical evaluation, and it is a way of knowing that is not invulnerable to individual misconceptions. This discussion helps students think in practical terms about the ways that knowledge can be claimed, and some of the "I know"-statements that have so far come up can be revisited in light of these four basic categories.
[Added 8/27/05: For a fuller illustration of these Ways of Knowing, a handout has been developed to accompany this lesson plan and is available as an HTML file or a PDF file.
Third, I ask students to think about which of the four ways of knowing categories they use the most. This can be a fascinating exercise, as students will often state a preference and then note that they are surprised at their choice, or they will comment that they use one way of knowing regularly in one aspect of their life and another way of knowing in another aspect of their life. It usually becomes apparent that empiricism and rationalism are characteristic ways of knowing in scientific circles, and inspiration and authority are characteristic ways of knowing in religious ones. The discussion can then turn back to the seminal question: What sorts of things that are pertinent to pastoral care seem appropriate for investigation by scientific ways of knowing? Each student should have a different answer, but in every answer there is likely to be an enhanced sensitivity to the methodology by which knowledge is pursued and claimed and a certain appreciation of the careful particularity of good scientific studies.
Fourth and finally, I offer some example from the literature of an insight pertinent to pastoral care that has been suggested by scientific research but that may not have been discernable--at least easily--just from one's experience as a chaplain. There are, of course, many examples that could be used, but I often refer to the classic study by John Florell: "Crisis Intervention in Orthopedic Surgery: Empirical Evidence of the Effectiveness of a Chaplain Working with Surgery Patients," reprinted in Larry VandeCreek, ed., Spiritual Needs and Pastoral Services: Readings in Research (Journal of Pastoral Care Publications, 1995): 23-32. This study points out, among other things, that a pre-operative intervention with a patient may initially elevate some indicators of anxiety but that post-operative levels may be reduced. Here is an example of how a casual assumption that a intervention may be dysfunctional at first glance by a practitioner may discount the longer-term effect of an intervention: scientific methodology may be able to discover things that are not immediately apparent or that seem counter-intuitive. Moreover, Florell's article makes very specific claims of knowledge that are usually taken at first by students to be sweeping claims about the efficacy of pastoral care, until students read with a more critical eye exactly what the study concludes and on what bases. (I additionally like to use the occasion to point out Larry VandeCreek's book, which, even though it is now eight years old, remains an excellent resource for newcomers to pastoral care research.)
While this is admittedly a short course through the vast and complex realm of epistemology, it has worked consistently well in my practice to lay the groundwork for subsequent discussions with students about the value of scientific research for pastoral care in spite of the circumstance that science tends to use a different way of knowing than that used in resources that come purely from the vantage of religion. After all, science may be said to start from a point of skepticism, but religion from a point of trust/faith--there are real differences here. Nevertheless, when students can keep in mind two questions: What precisely is the claim of knowledge that is being made? and On what way of knowing does that claim rest? I believe that they can be readied to engage research critically and to allow research studies to spur their thinking about their practice of pastoral care. On the other hand, I believe that if basic epistemological questions are not explicitly raised at some point, such questions may silently feed tensions in discussions of pastoral care research or in students' general experience of working in clinical settings whose culture is essentially scientific.
[Comments may be sent to john.ehman@uphs.upenn.edu.]
2. Grant Available to North Central Region Supervisors
The North Central Region offers a yearly research grant of up to $3,000 to CPE Supervisors in that region. Applications are reviewed by the History and Research Committee, which may offer valuable consultation on the refinement of proposals. For more information, contact JThomas489@aol.com. This grant has been funded through the budget of the History and Research Committee for over 20 years and is part of a long-standing commitment of the NCR to encourage original research. (John R. Thomas will be providing a brief history of Research in the North Central Region as part of an NCR display table at the upcoming ACPE conference in Lake Geneva WI.)
3. Excerpts from "A Brief History of the Joint Council on Research in Pastoral Care and Counseling," by John R. Thomas
[Editor's note: John R. Thomas, whose interests have long included both research and history, wrote this account in 1978 and has offered it for our Newsletter. The extended excerpts below provide insight into the genesis of initiatives that influenced the development of research activity by chaplains in the ACPE and other organizations. --JE]
Several of us in the late 1960s initiated a small breakfast meeting [at the College of Chaplains' conference] for chaplains interested in research. This led to the formation of a research committee, and the breakfasts became a regular part of the College's conference.
In Washington DC, in March of 1970, this writer presented to LeRoy Kerney, the incoming president of the College, a proposal that the College encourage the formation of an inter-organizational Ad Hoc Research Committee or Council to pool the research interests of the several organizations and to get information out as to the research being done. This writer was appointed the chairperson of the College's committee to explore this development.
Fortunately, the American Association of Pastoral Counselors and the Association for Clinical Pastoral Education were meeting together in Newport MA in November of that year. This proposal was presented to a joint meeting of their research committees and was endorsed to their respective official bodies for action. In the meantime, the College of Chaplains' executive committee was already meeting there, and they approved it on November 14th, and the AAPC and the ACPE approved it on November 16th [1970] in their official business meetings. Through some fast, pre-planned efforts, the same proposal was presented to, and approved by, the Association of Mental Health Counselors' executive committee at its November 18th meeting. As several of us were active in all four of the organizations, what might have taken a long time actually went very fast....
Maurice Taggart served as chairperson of a consultation representing the several organizations at a follow-up planning meeting on May 21-22, 1971 at the O'Hare Inn in DesPlaines IL, with Harry DeWire serving as secretary. It had been hoped that each group would appoint two representatives so that we could begin the actual drafting of an organization at the November 1971 meetings in San Francisco. This was not possible, so this writer convened the first meeting of the Joint Council on an ad hoc basis on January 30, 1972, again at the O'Hare Inn. At this meeting, it was agreed to go forward with the development of a Clearinghouse and the publication of an annual Abstracts, with John Florell of the Virginia Institute of Pastoral Care serving as editor. It was agreed to delay any final formulation of By Laws, etc., until other groups had been given the opportunity to get in on "the ground floor." That decision proved to be a wise one, and by 1973, the Army Chaplains, the Navy Chaplains, and the National Association of Catholic Chaplains had became members.
At the October 18, 1972 meeting in Houston, it was agreed to call the publication Pastoral Care and Counseling Research Abstracts. John Florell was authorized to print the first volume with data collected in 1972, and with 1972 as the date for the volume. Membership contributions of the four [original] groups had given us enough money to underwrite the first publication costs.
...At the October 18, 1973 meeting in St. Louis MO, "Articles of Cooperation" were agreed to instead of By Laws, after much study and revision over the previous year. Agreement or approval was received from the parent organizations, [which subsequently supported] mailing out the research request forms yearly, paying the membership fees, and--more costly--expenses for representatives to attend the Annual Meeting as well as the Spring Meeting of the Executive Committee.
At the October 1973 meeting, officers were elected for the first time. They were, Chairperson: John R. Thomas; Vice Chairperson: Bob Carlson; Secretary: Dick Dayringer; Treasurer: Walter Smith; and Executive Committee members in addition to the officers: Danny Burtram and John Florell. Task forces were initiated in the areas of research seminars, research awards, and a research symposium. The main purpose of the Joint Council [was] to publish The Abstracts and to encourage research. The Clearinghouse function [was] to collect data on research being done in the United States.
...We who have been involved like to believe that the current interest in pastoral care and counseling research has been stimulated and facilitated by The Abstracts. We hope that the inauguration of an Annual Research Award by the Joint Council will provide recognition and encouragement to those doing research. [October 4, 1978, Madison WI]
4. An Article of Interest about Richard C. Cabot
The story of the relationship between physicians and clergy over the past century sets much of the context for the development of research into spirituality and health, and this story turns significantly on initiatives in education--from early efforts to train clergy in clinical settings to recent programs to educate clinicians about spirituality. An article in the Spring 2003 issue of the journal The Pharos of Alpha Omega Alpha Honor Medical Society [vol. 66, no. 2, pp. 14-19], "Growth at the Edges of Medical Education: Spirituality in American Medical Education," by S. Ryan Gregory, may be of special interest to CPE supervisors and researchers, as it offers an account of the influence of Richard C. Cabot, MD (1886-1939). While there are a few other good secondary resources on Cabot [e.g., Charles E. Hall's treatment in Head and Heart: The Story of Clinical Pastoral Education (Journal of Pastoral Care Publications, 1992)] and obviously good primary resources available [e.g., Cabot's collaboration with Russell L. Dicks: The Art of Ministering to the Sick (New York: MacMillan, 1936)], Gregory, who is a medical student at the University of Texas Medical Branch at Galveston and a PhD student at the University of Pennsylvania in Philadelphia, has written a very readable piece that could be used with CPE students or physicians, establishing elements of the background to present-day consideration of spirituality and health.
Gregory outlines various trends in the late 19th and early 20th centuries that helped to bring clergy into the clinical setting: including an explosion in the growth of hospitals in the US that created large inpatient populations of the sick and the poor--groups in which clergy tended to have strong interests--and progressivism in education that pressed for practical learning strategies for seminary students (as well as for medical students). However, he focuses particularly on Cabot's impetus to train ministers to work with patients: to counter the effect of medical specialism on patients, to create a source for constancy of support for patients, and to provide a resource for "cultivating the growth of souls" [p. 16]. He goes on to note that Cabot appears to have been motivated personally to improve the practice of Protestant pastoral care. Gregory's article revolves largely around the question of why Cabot, for all of his interest in spirituality, did not attempt to bring this subject directly into the curriculum of medical education but rather sought to bring clergy into the clinical care of patients. He concludes:
Cabot seems to have understood that the core of the medical profession and the education system that feeds it could someday grow to include spiritual concerns if ministers could first bridge the gap between spiritual and medical care. Such growth, like that of a cell culture or a human soul, could only happen at the "growing edges" of the profession and only in the right conditions. The cultivation of those conditions is the legacy that Richard Cabot left to both medicine and religion. [p. 19]
One particularly useful aspect of the article for setting a context for discussing spirituality and health research may be its emphasis on Cabot's conceptualization of spirituality as explicitly involving the idea of "the soul." Since current usage of the term spirituality in the health care literature tends to avoid such traditional religious language, and even recent articles that have incorporated the idea of "the scared" [e.g., Peter C. Hill and Kenneth I. Pargament's "Advances in the Conceptualization and Measurement of Religion and Spirituality: Implications for Physical and Mental Health Research," American Psychologist 58, no. 1 (January 2003): 64-74] have drawn criticism, Cabot's use of the idea of "the soul" may be ripe for discussion, especially with the twist that he employs a medical paradigm of the "growing edge" of cellular tissue to characterize the dynamic of soul growth.
5. Convener's Report
Over the past year, two tasks have been the focus of my work as Convener: to establish our web site and to work on membership. First, regarding the web site, I note that the project has clearly accomplished the goal of expanding communication beyond what was possible with our previously printed newsletters, which had been produced in recent years by the generous efforts Convener Joe Czolgosz and Editor Anne V. Sutherland. Talk of a web site began several years ago, after some of our members had undertaken the creation of their own internet message boards to facilitate communication on current research projects. A Network web site, it was agreed at our annual meeting at the 2002 ACPE Conference in Pittsburgh, would not only allow us to avoid the mailing costs of the old printed newsletter, but would increase our networking capacity within and beyond our membership, since material would be immediately available to anyone with an internet connection. The number of visitors to our site is, in my opinion, a continuing indicator of the project's success, but I believe that we have only begun to make use of the potential of our site, and I would especially like to see more postings of Current Research Initiatives--that should be a goal for our Network in the coming year. On this first anniversary of the site, I want especially to thank those members who have offered material for our Article-of-the-Month and Newsletter pages: Noel Brown, Joan Hemenway, Ward Knights, Jr., George Fitchett, Margot Hover, Sharon Brown, Dick Tibbits, John R. Thomas, and Larry VandeCreek. With their help, our site is becoming a rich resource for CPE Supervisors and students as well as for researchers. One final note here: our site was switched to a new host server (run by Yahoo Web Hosting) in August 2003 and was off-line for several weeks during that transition, but the new hosting arrangements seem to be serving us quite well.
Turning to the subject of membership, I have sought to revise our roll, to set a new procedure for collecting dues, and to seek new members. A detailed and updated record of membership and dues has now been created, and every former member, Supervisor (retired or active), and Associate Supervisor for which the ACPE had an e-mail address has been individually contacted about membership over the last year. I hope to establish a process for individually contacting new Supervisors and Associate Supervisors immediately following their certifications and for greater involvement of Clinical Members of the ACPE. Finally, it has become apparent to me that individual reminders about dues seem to be a necessity, and I hope to follow through on that this fall. The membership "invoice" page of the web site has been revised to be more user friendly: it can now be filled in on the computer and printed off for mailing with a dues check.
It is my hope that in the next year our web site will continue to grow, with further contributions of material by our various members, and our membership continue to expand to include more Supervisors who seek to integrate research into the CPE curriculum even though they themselves may not be researchers. With this in mind, I will work to publicize the Network at the ACPE's national conference in Lake Geneva WI, and I encourage suggestions ahead of time about the various ways that we might raise awareness of our group and the web site at that event--please contact me as soon as possible. I propose below an agenda for our annual Network meeting at the conference.
6. Agenda for the Network Meeting at the Fall 2003 ACPE Conference
According to the currently published conference schedule in the ACPE News, network meetings are to be held from 12:45-1:45 PM on Thursday, November 14th, with box lunches available. This one-hour time slot will require that we transact business quite quickly, so to that end I propose the following agenda and invite members to e-mail to me any further items they would like added for action by the group.
- Discussion of plans for the web site for the coming year
- Discussion of the Research Network Awards
- Financial report
- Authorization of expenses
- Other business
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