**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:
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:
While perusing some articles I found this on KevinMD. It brought me back to a prior post I had concerning burnout among caregivers. I think it has insights not only for those of us who serve as caregivers but to those who work with and among caregivers. Read on after the jump:
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
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
***update 5/7/20: I was recently forwarded an article noting how certain natural remedies, including tumeric, may have positive benefits for those suffering from Alzheimer’s disease and Parkinson’s disease. If you’re interested you can find it here. This is not an endorsement, just a passing along of information some may find beneficial.***
When I first started chaplaincy, I would walk out the door with bible in hand and a planned reading for the day for all my patients.
That lasted about two days.
The reason was not that I gave up or got lazy, but rather that I quickly found that the majority of the patients I saw didn’t benefit from it because they simply couldn’t understand what I was doing due to advanced dementia of some kind. Even if end-stage dementia was not their primary diagnosis, I’d say at least 2/3rds of the people I saw suffered from this. Many could communicate and talk with me, but lived in a world of their own. They would often misinterpret their environment, and in many cases couldn’t remember what I had just said to them a few minutes ago. Some were truly end stage, confined to a chair or to bed, nonverbal or nonsensical, and having no apparent understanding of what was going on around them. Organically, their brains were slowly dying, leaving them trapped in a world that I didn’t know how to enter.
That’s what makes dementia and Alzheimer’s Disease so tragic. A person can otherwise be relatively healthy, but as their brain deteriorates it can seem as if they are lost to us already. Continue reading
Back in seminary I had the opportunity to do CPE at a local hospital in New Haven. It was a great facility and a prime opportunity – the slots fill up fast. But I didn’t take it because I planned on doing more traditional church ministry, not chaplaincy. While some of my classmates jumped at the opportunity to get CPE, others, like myself, said “why bother if I’m not going to need it?” Looking back I can see that I missed out on a great opportunity.
So do you need Clinical Pastoral Education if you’re planning on traditional ministry? Is it really only for hospital chaplains or navel gazers? Absolutely not. Continue reading
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
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.
The following is an excerpt from a Level II verbatim I did several years ago to give you an example of how I wrote toward the Level II standards.
This case ended up being one of my most difficult, in that the patient was a child and I was good friends with his mother. His death was hard on all of us. As I have children this child’s age, it cut very close for me. Perhaps a bit too close. This visit is a follow-up regarding her son’s death. I think you’ll see several themes at work:
While I see these themes at work, I don’t think I touched on all of them in the conversation.
Feel free to comment!
The Chaplain's Report 