Is CPE broken? Reconsidering the “CPE horror story”

anyone having flashbacks to their CPE supervisor’s office?

If you Google “CPE” chances are pretty good that it will start autofilling “horror stories” in the search box. It seems like there are much more stories about bad experiences in CPE than good. Perhaps this is just bias toward the negative, but it certainly does seem to be that CPE is not a good experience for many.

If you follow that search you’ll see why. I read stories about supervisors that destroyed boundaries and exercises designed to tear people down in front of their peers. One person even wrote that “Clinical Pastoral Education is nothing more than a systematic ‘weeding out’ of orthodox seminarians through a process of enforced radical leftist indoctrination.” It’s criticized as being unnecessary, unhelpful, “navel-gazing”, pseudo-psychoanalysis. So why is it still required for those entering ministry? Is there something wrong with the program? Are supervisors adequately trained and supervised themselves? Or are seminarians missing the point of CPE entirely? Continue reading

Chaplain Certification: APC vs CPSP vs … SCA??

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. Continue reading

Why Certification Makes a Difference for Chaplains

The question of the necessity of certification is common today among chaplains, especially those who are already working as a chaplain in the field. During my CPE experience all of us were encouraged to go on to be certified. It was the “gold standard” and would put you ahead of someone who isn’t certified. After completing my four units and having all of the paperwork I needed mostly done (verbatims, theology papers, biography) I didn’t bother getting certified for several years. It just didn’t seem necessary. Continue reading

Verbatim: Ms. F, “Maybe it’s not so bad”

(watch the video above before you read on: it’s funny, creative and has cute doggies)

I wanted to share my most recent verbatim which I’m also using for my certification. It’s in a bit of a different format and is definitely longer than most of my posts. Read on and I hope you benefit from it. You’ll catch why I included the video at the end of the paper. Continue reading

Gerald May: The Chaplain as Physician

I’ve been reading the excellent book Simply Sane by Dr. Gerald May, primarily for my personal benefit but secondarily for professional benefit. It wasn’t recommended to me by anyone, and I honestly can’t remember how I stumbled upon it, but I’m glad I did.

Dr. Gerald May

It’s an excellent book for those doing pastoral care as well as teachers and educators. I recently read a passage that struck me as to how well it spoke to the position that many Chaplains find themselves in: wondering what to do.

I had an older woman come on service a few days ago who appeared to be greatly depressed. When I introduced myself and gave the usual opening “how are you today?”, her response was “I want to die. Can you give me a shot?” Continue reading

A. James Rudin: Clergy education for end-of-life questions inadequate

Rabbi A. James Rudin recently wrote about the growing need for clergy of all faiths to be prepared to help those dealing with tough choices related to end of life care. He asserts that often the questions being asked at the bedside of the dying are not as much related to deep metaphysical questions but are much more pragmatic and ethical:

Rather, [the] questions, usually asked in a hospital room, go like this. “My beloved family member is gravely ill. The doctors are recommending some extraordinary and complex medical treatments. I am confused and I am being asked to make a decision. As my spiritual leader, please tell me, what should I do?”

Unfortunately many clergy are not provided much opportunity for education in medical ethics and how it relates to their particular faith. Some denominations require some clinical pastoral education which, depending on the training center, would provide invaluable insights into the day-to-day decisions encountered in trauma units and hospices. But this represents only a very small group of those in ministry training, and an even smaller percentage of those currently in ministry. Other seminaries offer courses in medical ethics, but these are almost always elective. Because of these deficits, Rudin concludes:

Medical science and technology will move forward with or without the religious community. Major decisions about health care in the U.S., including the staggering question of withdrawing and withholding life support systems from desperately ill or comatose patients, will be made with or without the “benefit of clergy.”

If the best thinkers within our faith communities do not address these issues in a thoughtful and informed way, others will decide for us, and that would be an abdication of religious leadership. If that happens, rabbis, priests, pastors and imams will have no one to blame but themselves, and worst of all, desperately ill patients and their troubled families will be the losers.

What has been your experience as a minister or as a chaplain? Did you have adequate training to help others cope with complex end of life issues?

“Do your worst!”

I came across this excellent post regarding CPE verbatims that I wanted to link to. In it, Allison Kestenbaum writes about how she asks students to present their “worst work”, that is the cases in which they have been stumped, messed up, or feel that they otherwise didn’t do their best. This goes against the grain for many of us especially in areas where we feel that we are being held up to critique. However Kestenbaum shows us that the real growth happens in the margins and troublesome areas of our lives.

“Vebatims also teach seminary students to develop more balanced assessments of their strengths and weaknesses.  I have encountered many seminary students who are achievement-junkies who seek to master every academic task put before them.  One of my students, an experienced Lutheran pastor and D.Min. candidate, told me that, “I am taking a leap of faith with writing verbatims about encounters I feel least secure about.  This is a completely new pursuit for me; I have not encountered this directive anywhere in my schooling so far.”

A rabbinical CPE student who was required to do CPE with no intention of becoming a chaplain told me that verbatims “have helped me not be so scared of my mistakes” and to learn from them.  For those going into a ministerial—really any—profession, the ability to have a nuanced perception of one’s strengths and weaknesses can help prevent burnout.”

I highly recommend that students and supervisors review the article as I think it’s insightful for all.

And I know that I’m not the only one who’s hyperactive mind went right to this scene after reading the title:

10 (+1) Tips For a Good CPE Verbatim

I’ve posted a few of my past verbatims as examples of how they can be written, but  each CPE program likely has its own format, things to include and so on. So please don’t use my examples as the standard for how they should be written in every case, as your supervisor likely has a particular format he or she wants to use. Many supervisors don’t even recommend a particular format, only elements that need to be included. Each member of my CPE group wrote differently, and we all tended to borrow from each others’ styles to find something that we all liked (including our supervisor!).

I thought it would be helpful to give what I think are some helpful hints and things to remember when writing any verbatim. Formats are pretty unique, but every good verbatim has some common elements. Continue reading

What Does it Mean to “Trust the Process”?

In any kind of Clinical Pastoral Education experience, you will probably hear this phrase at least once: “trust the process”. I know I heard it several times in my own CPE classes, and it was never spelled out what it meant to “trust the process”.

That is part of trusting the process.

Many seminarians enter CPE because they have to, because they want to enhance their pastoral care toolbox, or enhance their resume. I’m not going to pan these reasons at all. They are all good reasons to take a CPE unit. However this is only part of what CPE does. The tools and materials used in CPE to help develop interpersonal caregiving skills – books, group work, role-play, writing essays and reports, films – are also designed to work intrapersonally as well. When entering in to the work at first, the focus is outward. We come to learn to help others, to manage others’ crises better, and see how caregiving fits in to our theological and scriptural paradigms. Continue reading

Verbatim: Being good to the person in the mirror

At my recent CPSP meeting I presented this verbatim and got some new insights from the group. I’m going to shorten it a bit just to make it easier to read.

This happened quite some time ago and when my colleagues asked why I brought it up I responded that it deals with things that I still deal with today: self-care, tiredness, and burnout.

The patient in this visit, Mrs. S, is 67 years old and has been on hospice now for a few months. She has a history of alcoholism and is on hospice for chronic pain and malnutrition. She is extremely thin and emaciated even though she eats fairly well. She smokes regularly 3-4 times a day. She is a widow and has children but they are not involved with her and she does not want them contacted. Mrs. S is Roman Catholic but has not attended church in some time. She maintains her own prayer practices and she says that she finds these comforting. She almost always presents herself as happy and content unless she is in pain, and even then she tends to minimize her pain. Her pain is regularly 8 out of 10. She is very friendly but not always open regarding her own feelings, family and past. She tends to use humor to divert attention and make light of her situation. She is frequently in bed as this is most comfortable for her. Continue reading