perhaps we need to drag the shirt out again
So I’ve written several times on the topic of board certification for Chaplains, especially regarding APC/BCCI and CPSP. Those weren’t the only players on the certification game, though. There are certification programs through the National Association of Catholic Chaplains and Association of Jewish Chaplains for example, as well as a smattering of other groups and agencies. Some have been around for a while and are well recognized, while others you will probably never hear of unless you look for them. The newest group to organize and enter the board certification mix has caused controversy though.
The HealthCare Chaplaincy Network, which was founded in 1961, recently announced the formation of a new venture called the Spiritual Care Association (SCA) as a response to what they saw as the growing need to provide “an organized, strong, united, proactive and representative national voice.”
Rather than just rehash or improve upon current standards, SCA looked to design a program from scratch that not only recognized the changing health care world but the changing educational one. Many requirements are the same: CPE, verbatims, work requirements and so on. However, while most (if not all) programs require CPE training, significant documentation and peer review, the SCA chose to add formal testing and simulated patient reviews (like those med school students participate in) to ensure that clinical competencies were standardized and met across the board.
As well as including testing as a key feature, the SCA chose to loosen some of the requirements, including CPE. While BCCI requires at least four units of CPE (1600 hours) through an accredited center, SCA notes that some may be able to become certified with as few as 800. Furthermore, certification does not require a theological or seminary degree, but instead requires a Master’s degree or equivalent in an area relevant to chaplaincy. This includes not only theology but degrees in ethics, counseling and nursing. And regarding CPE, the SCA is going to employ not only traditional CPE programs but distance learning as well. All of these changes were done, according to the SCA, in order to meet the needs of a changing field as well as provide objective, evidence-based grounds for certification. It also recognized that it’s not as much about how many units of CPE you take but how well you are able to integrate what you’ve learned and practice at a high level. Some may do this in 800 hours, some in 1600 or even more.
These changes really rubbed some people the wrong way. Almost immediately I found folks on social media writing “open letters” asking the HealthCare Chaplaincy to reconsider. Many saw the SCA as at best unnecessary, and at worse making an already fractured chaplaincy field even more so. There were calls about “lowering standards” and “betrayal”, among other things. The presidents of the APC, NACC, NAJC and ACPE co-drafted a letter stating “we have not, and will not, water down the standards through a bottom-line-driven, one-size-fits all, multiple-choice approach to certification.” Some took the formation quite personally, seeing the questioning of current standards as dismissive of not only the APC but their own qualifications. Tellingly, I haven’t heard much any negative feedback coming from CPSP, perhaps as they also are viewed as a bit of a “splinter group” from the APC.
This friction between the APC and other groups isn’t lost on anyone. In a post reflecting on the formation of the SCA, George Handzo, Director of Health Services Research and Quality at HealthCare Chaplaincy Network and President of Handzo Consulting, wrote “For those who may not be professional chaplains or who may be new to the profession, one of the great embarrassments in the profession (to me and many others) is our inability and/or unwillingness to have one organization that would speak for the profession- or even sometimes to get along among ourselves.”
I am not a member of either organization currently, so sitting from the sidelines watching this unfold has been interesting, and a bit disheartening. There are many, myself included, who fail to see the cause for so much consternation and negativity. While some don’t see the need to improve the visibility and respect of chaplaincy, I most wholeheartedly can say that this is not the case. While there are certainly health care agencies that support and recognize the need for chaplaincy this is neither nationwide nor across-the-board. In fact I see more of the opposite in effect. Educational opportunities for CPE in my region are few, and health care agencies that require board certification for their chaplains are even fewer. This has promoted the idea, which I wrote about previously, that board certification just isn’t necessary – nice to have, but not as valuable as real work experience. If the HeathCare Chaplaincy can work within the current health care milieu outward to improve knowledge and reception of spiritual care services from within rather than from the outside I think this will be a tremendously valuable contribution to the field. I actually plan to investigate certification further, especially as SCA is recognizing certification through other agencies including CPSP as fulfilling their own requirements, except for the test.
More personally, there were things about the responses to the SCA’s formation announcement that saddened me. So much of it reminded me of watching my church split down the middle many years ago. I remember showing up at a regular service to hear the senior pastor get on stage and talk about what he thought everybody knew about – that two other pastors had left and “taken” a chunk of the congregation with them in order to form a rival church not ten miles away. There was so much name-calling, false information, and hurt going around. However I had no idea what happened or why it happened. Even after I came on staff there “the split” was never formally explained, though there was plenty of insinuation and back-room talk. It was taken very personally by the senior pastor and staff. The emotional feedback of the split changed the dynamics of the church leadership itself. Rather than promoting unity, it became isolated and defensive, seeing other churches as competition. This was so much so that when I signed on as an assistant pastor there, I had to sign a noncompetition clause that stated that if I was let go I could not work for a church within 300 miles. The negativity ate its way through the leadership until it crumbled. New leadership came along with new collegiality. I would hate to see a similar result between the APC and SCA.
I relate this because this is absolutely the last thing I want to see happen between the APC and the SCA, however I already see it happening. Perhaps this is grief-work being done through social media and other platforms that we can shout from. However from the sidelines it seems to be more like defensiveness and pride. Hopefully there can be resolution down the line between not only the organizations in question but their members as well. The SCA certainly seems like a good direction for many, and the APC shouldn’t be threatened by it.
*updated 6/14/16*
The Chaplain's Report 
I greatly enjoyed your article and agree with a lot of what you shared. I answered the Call to Chaplaincy 8 years ago at age 50. Starting from scratch in an ACPE program in a major academic medical center. Of course I was the old man in each unit and often struggled with mind melting with the “younger residents during PPI. Regardless, to date I’ve managed to earn 3.5 ACPE Units (would’ve had four Units if it wasn’t for an ugly automobile accident) and 4 CPSP Units. My goal was to experience both programs. To try to determine which Certification I should ultimately pursue.
To my disappointment I discovered that there was great opinion as to which one was “King.” Between the two it was a war of Head v. Heart. ACPE and CPSP both provided great patient contact and hands on, bedside experiences; pre-Covid. After all patient care is key. However, I found that ACPE was considered the “gold” standard. It’s Certification process one built on Ivy league rigor. Focusing on stuff that may relate to patient care but more classroom focused. Certification in ACPE hinged on the “I” in BCCI. In a 40hr week not including On-Calls, a minimum of 25 Pastoral Care hours had to be logged in the system. CPSP, for me was about the “heart” of patient care. Being a Spiritual prescence focusing on the “Care” part of Pastoral Care. It’s Certification pointed to being a BCCC or BCPC both ministering to critical points of caring clinically or pastorally for the whole of those human documents. Ultimately, I worked hard to earn both the BCCC and BCPC through CPSP. The process was extremely rigorous and required just as much effort as my work toward my terminal degrees beyond Undergrad.
After working through both programs in some really strong Academic Medical institutions I loss my desire to teach/instruct. Focusing more on Spiritual growth and direction. My sufferings and family losses weighed into my certification decisions. My auto accident and heart surgery provided valuable experience from the other side of the hospital bed. All shaped and validated what was the best personal and spiritual path. Unfortunately, the “world” seems to prefer those with ACPE//BCCI credentials. Finding employment as a Chaplain is still a fire and ice experience. Most institutions that pay well want the BCCI/ACPE labels. Like most competitive fields it remains a profession of who you know and can you play well with others. It can be filled with biases that make it the job hunt frustrating and at times sad. Whether you’re a MDiv, DMin or just an Amen. In the end, Certification may open the door…but it won’t necessarily let you in/end (:-p
True words Jim! Thank you for sharing.
Gentlemen,
Thank you for your thoughts on this subject. I have started serving as a chaplain at a cancer center 14 years ago. I was privilege to serve aside of chaplains that were seasoned and had various chaplain training backgrounds. I learned a lot from them all and helped me become the chaplain that I am today. I came in the back door of chaplaincy. I was hired because of ministry experience and passion for the affirmed. However, I did not have any CPE. At this time I am looking to get my first unit of CPE. I think it would be valuable for saying I have a unit of CPE for all those who have one or more units. I also believe I will learn something of value and look to work toward board certificate – through SCA. I noticed that many Chaplain positions desire for chaplains to have earned there units through ACPE. Do you gentlemen have any thoughts? Thanks and blessings, Carl
Right now ACPE remains the “gold standard”, however CPSP is working towards accreditation through the Department of Education which will greatly improve its standing if it goes through. As far as I know SCA still allows one to be a member of both SCA and another group such as ACPE, which is great. SCE is still very new and employers may not be familiar with it, or not be willing to take someone from so new a group.
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Thanks for this article. I have watched and observed both sides. While both have a lot to offer, I am leaning towards leaving APC and joining SCA. The reasons for me are that SCA makes sense. The cost for APC is very high. The standards are basically the same and SCA appears to more understanding to accept a persons varied circumstances. The control that APC, NACC, AJC are trying to exert is unhealthy to the field and to simply being an American. We should have many options and be free to make the choice without being penalized, etc….
CPSP had the courage to invite Eric Hall, SCA’s President and CEO, to our 2017 Plenary in Orlando, and he had the courage to accept. Let me assure you, there was negative reaction on the part of some CPSP members. However, we hashed it out in a, at times very vocal, town hall type meeting. Now, historically, there was an effort at forming a unified group for chaplain concerns back in the early part of this century. It was called the Spiritual Care Collaborative. Its downfall came as a result of the arrogance and hubris of both APC and ACPE. First, they stubbornly refused to allow CPSP to be admitted to the SCA, even when we had done everything asked of us. Second, at its meeting, ironically also in Orlando several years ago–if memory serves me, it was the SCC’s only meeting–they snubbed the delgation of Jewish chaplains from Israel, thereby alienating many in the NAJC. Also at that meeting, the APC leadership put forth a motion to the APC membership to merge APC with the ACPE. I was the first APC member to speak against that motion, followed by many others, and the motion was soundly defeated. However, in the months that followed, the leadership of both organizations proceded, agaibst the eill of APC membership, to begin the merger anyway by actually merging the ethics committees of both orgainizations. APC put so much money into that firsrt meeting of the SCC with so little to show for it, I doubt they have yet to recover. In addition HCA over the years has invested greatly in APC, again, with little to show for it for themelves. The national chaplain scene has been ripe for the formation of a group like the SCA for sometime. I was originally certified by the old College of Chaplains in 1992. I kept my APC membership until 2012, I believe. At that time I dropped my membership and certification because, well, the fees had risen exponentially and I had little to show for it too!
Thanks so much for your insights! It’s quite a shame that there is so much territorialism here. It mirrors our church in many ways. There is still mixed feelings toward the SCA among my colleagues as well. I think once one goes through a rigorous process toward certification that process can become sanctified. Marines and med students come to mind.
I am 73 and have been privileged to work in a variety of venues. I have served during Vietnam in the medical field, served in Law Enforcement and Paramedic Response Teams, and served as a Crisis Chaplain/Counselor/Chaplain Trainer (specializing in Hospice and Suicide Intervention/Prevention…..mainly for staff and students who worked with Jr. High/High School students…and those that needed to be certified for work with first responders (Fire, Police, and Jail). The main years have been serving in Education (33). I recently “retired” again and have been appalled at the lack of coordination and recognition in the Chaplain field (especially in regards to the Medical Field). I really like the way you presented the possible pitfalls and potential challenges that currently exists. Perhaps, if we had more intelligent approaches, we could collectively establish more meaningful guidelines that could meet our current challenges.
Thanks very much James! I’m sure you could teach us all a lot yourself!