counseling

Kelsey Dallas: “What caretakers can do when their patient believes God has abandoned them”

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Deseret News National reported a study in which the health outcomes of those with positive beliefs about God were compared to those with more negative beliefs and found some striking differences. Reporter Kelsey Dallas wrote:

Researchers behind the study, published this past summer, concluded that caretakers should try to intervene to help patients gain a more positive spiritual outlook to guard them against harmful physical and mental health consequences. However, experts who have studied how people cope with negative spiritual beliefs said shifting someone’s spirituality is a difficult process, which can’t be undertaken lightly.

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The Chaplain and Mental Illness: When religion makes healing “sinful”

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The issue of how Christians deal with mental illness has been on my mind as of late. One reason is that I’ve been going through my own therapy for anxiety and depression, which rears its head from time to time in my life. Second is that I came across a LinkedIn discussion in a pastor’s network group that had some pretty ugly things to say about mental illness and psychotherapy.

Writer and musician Shaun Groves recently posted his own reflections on depression and faith on his blog, and while I can’t repost the whole article, I would certainly recommend it to you (here’s the link). He had written about his father-in-law’s death as a result of suicide and while many offered their sincere condolences some of the responses were a bit shocking. One wrote, “Did he not believe the words from scripture he read to his church?”. Another wrote, “The Bible tells us not to worry, not to fear, be afraid, etc. 366 times, one for every day of the year including leap year! What can stinkin thinkin do, but make a person sick?”. Continue reading →

Problems in Caregiving Relationships: Neglect of God

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We’ve seen how neglect can happen in caregiving relationships between the Chaplain and the person being cared for. For example the caregiver can neglect the other in the relationship by taking away their power and authority regarding healing, and the caregiver may neglect their own needs as well. These problems often show themselves in co-dependency, overcompensating and undercompensating, burnout and meaninglessness.

Now to the third member of the therapeutic relationship, God. It’s interesting to note that we tend to relate to God similarly to how we relate to others, yet God does not relate to us in the way others do. Perhaps this is why our relationship to God can be so puzzling and frustrating at times! Continue reading →

A Brief Theology of Care in Practice: The Therapeutic Triad

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Counseling and care have typically been seen as a dyad consisting of the counselor and the counselee. However this limits the scope of the relationship as it often fails to recognize the presence of a third other, which is God. Counseling done within the context of chaplaincy, as well as any other form of Christian or spiritual counseling, whether professional or not, is better thought of as occurring within a triad, recognizing the presence not only of myself and the other, but also of God.

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So Many Straws: Reflections on Self Care, and the Lack Thereof

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“You’d better be careful, Sam. You’re going to burn out like this.”

These were words from my CPE supervisor several years ago. At the time I was a bit taken aback. After all my schedule certainly seemed manageable, and I felt I was doing OK at work and at home. Sure I had my struggles, but found a way to pick up and keep going every time. This March I realized he was right. Continue reading →

Life Review and Meaning-Making in Hospice Care

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**update 9/5/17** Meredith Rogers passed along an excellent resource on depression she wrote on GeriatricNursing.com. I’ve linked it here – it’s well worth your time and is a good summary of types of depression and various treatments.

This article came through my LinkedIn inbox recently and I wanted to pass it along. While it refers to “Dignity Therapy” as a new tool it certainly seems as if many of the tools discussed are open to us already. Good reading after the jump:

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The Dying Art of Pastoral Care

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I may have said this before, but I think pastoral care is a dying art.

The evidence for this is overwhelming, at least from my vantage point. Seminaries demand multiple years of attention to developing skill and knowledge in exegesis, languages, hermeneutics, and preaching, but I doubt if most require more than a semester devoted to pastoral care issues such as counseling and crisis management. I’m thankful that at Yale Divinity School I was able to focus my attention on this area, and that it offered several different courses on pastoral care and counseling to different groups. I had a great deal of freedom to do this in that I was not tied to denominational requirements. I didn’t take any languages because I never saw myself as an exegete to that degree. However most of the other students there were following programs to meet their respective denominations’ requirements. In some cases this required a semester of pastoral care or CPE, but I don’t know if that was across the board.

When did ministry become an academic exercise, focused primarily on sermon writing and exegesis? When did ministry become a business for that matter? When did pastoral care become something that only happens in a couple marriage counseling sessions or when talking with a family about what songs or scriptures they want at their dad’s funeral? When did pastoral care get assigned to lay volunteer prayer and care groups, who may get little if any training or support beyond a space and time to meet at the church? When did clergy become too busy managing the church to provide care to the people in that church? Continue reading →

Why I’m a Chaplain – III: “The Church” and the wandering path

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At one point in my life I had wandered away from my faith. Not wandered, more like stormed out to be honest. That’s a whole other issue. I came back though, and a big reason I came back was I attended a Christmas service at a large megachurch here in Pittsburgh that changed my perspective on myself and my relationship with God. I started attending and joined about a year later. Continue reading →

Mixed Messages

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Every so often you’ll come across a case that’s difficult because of competing messages and needs. For example I have one patient that had declined spiritual support for several months. He was always on the forefront of people’s minds though, because of the many needs he had. He had alienated his entire family and been through most of the assisted living homes in the area, burning his bridges in the process. He suffered from a great deal of depression and anxiety, never seemed satisfied or comfortable (even after massive doses of pain medication), and seemed to be always wanting to change things in his care plan – though nothing made a difference. He had declined chaplain services for months (he was Catholic) but the team thought that he would greatly benefit from support, if only to give him someone else to vent to other than the on-call staff. Continue reading →

What counseling others reveals about yourself

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One of the things I learned through reflecting on and getting feedback to pastoral encounters through verbatims is that many times I am counseling myself without knowing it. It’s only in reflection, sometimes long after the fact, that you start to hear yourself talk to yourself. I decided not to go the whole CPE verbatim route, buyt I like this format for reading.

For an example I included part of a dialogue I had with one of my regular patients, an older woman on hospice. She typically has a lot of pain but rarely tells anyone about it. She puts on a pleasant front but typically doesn’t let much out. I decided one day to press her a bit.

C8: So how’s you’re back been? Better or worse or about the same.
P8: No, about the same.
C9: About the same? Just not a good day today.
P9: eh..
C10: eh…
P10: (pause) I’m not complaining too much. Stick around though.
C11: You’re not too much of a complainer though.
P11: Seems like I’m always complaining.
C12: Really? I’ve never seen you as much of a complainer.

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