Jewish Spiritual Carejewishchaplain.net/wp-content/uploads/2018/09/JSCJ_vol09_no1.pdf · Jewish Spiritual Care The Journal of the National Association of Jewish Chaplains Volume 9,

Jewish Spiritual Care The Journal of the National Association of

Jewish Chaplains Volume 9, Number 1

Winter/Spring 2009/5769

NAJC at the Spiritual Care Collaborative

Contributions: Dr. George Fitchett

Rabbi Maurice S. Kaprow & Rabbi Doniel Kramer Julie Ann Berger, D.Min. & Rabbi Dale Alene Schrieber

Rabbi Bonita E Taylor Rabbi Dayan Charles P. Rabinowitz

Jewish Spiritual Care Journal Volume 9, Issue 1,Winter/Spring 2009/5769 Table of Contents

First Words Rabbi Dayan Charles P. Rabinowitz, BCC, Editor……………………………..1 We Weren’t Grasshoppers: List of NAJC Spiritual Care Collaborative Presenters Rabbi Dayan Charles P. Rabinowitz, BCC, Editor…………………………… 2 Building our Case with Cases George Fitchett, D Min, PhD……………………………………………………...5 Caring for Military Folk and Their Families Rabbi Maurice S. Kaprow, B.C.C. and Rabbi Doniel Kramer………………….11 Collaboration in Building a Better Team: Spiritual Care Programming in Oncology Nursing Julie Allen Berger, D.Min., BCC and Rabbi Dale Alene Schreiber,MA……….21 The National Association of Jewish Chaplains honors Rabbi Bonita E. Taylor for Exemplary Leadership in Professional Chaplaincy Education: An Acknowledgement Rabbi Bonita Taylor………………………………………………………………...38 Book Review: Flourishing in the Later Years: Jewish Perspectives on Long-Term Pastoral Care. Edited by Rabbi James Michaels and Rabbi Cary Kozberg. Rabbi Dayan Charles P. Rabinowitz, BCC, Reviewer………………………...41 Statement of Purpose and Writer’s Guidelines……………………………………… 44

Published by the National Association of Jewish Chaplains 901 Route 10, Whippany, NJ 07981 (973) 929-3168 ©National Association of Jewish Chaplains, 2009/5769. All rights reserved. We will provide permission for non-profit educational or religious use provided the source is noted. For permission, contact NAJC. Jewish Spiritual Care Journal Volume 9, Issue 1, Winter/Spring 2009/5769 1 First Words Rabbi Dayan Charles P. Rabinowitz, BCC, Editor The Spiritual Care Collaborative Summit ’09 brought together all six chaplaincy organizations from Canada, Israel and here to promote and ensure the highest standard of professional clinical spiritual care practice. This is the second time we met as a whole. The psychospiritual and social interactions energized all of us. I’m sure that all our NAJC attendees experienced the same pleasure of seeing each other, and interacting with old colleagues from the cognate groups from other parts of the country. Perhaps the summit is not as successful for me as a movement biennial but it came close.

The small but active presence of our own NAJC colleagues is the focus of this issue. I listed all of our presenters and their topics. Some of our colleagues turned their presentations into articles. I am grateful to Rabbis Kaprow and Schreiber for doing so. Also, I’m grateful to our menschy teacher, Rabbi Taylor for sharing her acknowledgment to our celebration of her service. There is a wonderful Chasidic teaching about how we learn more from watching how our teachers tie their shoes. Certainly, I feel that way whenever I am with her. I am honored that Dr. George Fitchett agreed to turn his own presentation into a short article for us. I believe very strongly that the research component is an important aspect of our clinical pastoral work. Like some of our colleagues, I add periodically a small piece to our collective voice. But there is also a special connection between Dr. Fitchett and my present institution, Calvary Hospital. Every week as I prepare for Shabbat

services, before closing them, I say a prayer to his father, who created and designed the marguetry doors, which adorn our Tabernacle, and are in memory of his mother. Finally, there is a book review of a new book in Jewish spiritual care. Rabbis Michaels and Kozberg edited with contributions from a number of our colleagues an excellent work on long-term care. Editorial Board Rabbi Dayan Charles P. Rabinowitz, BCC, Larchmont, New York (Editor) Rabbi Dayle A. Friedman, BCC, Wyncote, Pennsylvania Rabbi H. Rafael Goldstein, BCC, Glendale, AZ Rabbi Karen Bookman Kaplan, BCC, Kearny, NJ Rabbi Joseph Ozarowski, Chicago, Illinois Rabbi Harold Tzvi Stern, BCC, Flushing, New York (Assistant Editor) Rabbi Robert P. Tabak, BCC, Melrose Park, Pennsylvania Rabbi David J. Zucker, BCC,Aurora, Colorado Jewish Spiritual Care Journal Volume 9, Issue 1 Winter/Spring 2009/5769 2 We Weren’t Grasshoppers: A List of NAJC Presenters at the Spiritual Care Collaborative Summit 2009

A Note from the Journal Editor:

The Spiritual Care Collaborative “Summit 2009” took place February 1 - 4,

2009 at Disney’s Coronado Springs Resort at Walt Disney World, Florida.

Many NAJC members presented at workshops, and we had one of the

Plenary Session speakers as well.

For those many members, who could not attend, here is a list of

the workshops in order of their presentations. If you wish more

information on one of them, then please contact the individual presenter.

I include their email addresses from our directory as well.

Rabbi, I’m not religious, But I am Spiritual: Special Paths for the non-

religious – Rabbi Eliot Baskin, D.Min. [email protected]

Praying with the Dying & Their Families: Reflections from Different

Traditions- Rabbi Bennett M. Rackman [email protected]

Collaboration in Building a Better Team: Spiritual Care Programming in

Oncology Nursing

Life Cycle of a Disaster: Pastoral Care and Pastoral Counseling after a

Disaster- Rabbi Stephen B. Roberts [email protected] and

Rabbi Myrna Matsa, D.Min- [email protected]

Removing Planks from Our Eyes: Caring Without Judging-

Jewish Spiritual Care Journal Volume 9, Issue 1, Winter/Spring

2009/5769 3

Rabbi Suzanne Griffel [email protected]

Texts of our Disciples/ Texts of our Lives: A New/Old Model for Exploring

Cross-Cultural and Cross-Disciplinary Creativity-

Rabbi Nancy H. Wiener [email protected]

Spirituality and Mental Health: Pastoral Care in the Treatment of the

Mentally Ill- Benjamin A. Samson [email protected]

It Takes a Village: Spiritual Care for Family Caregivers across the

Healthcare Continuum- Rabbi Dayle A. Friedman [email protected]

What Do I Do When the Well Runs Dry

- Dr. Barry M. Kinzbrunner [email protected]

Chaplains in Interfaith Dialogue-Rabbi Naomi Kalish [email protected]

The Fox, The Ship & The Carpet: Utilizing Sacred Stories to Address

Dilemmas at the End-of-Life-Rabbi Shimon Hirschhorn

[email protected]

Holding On or Letting Go: Helping Patients and Families Make End-of-Life

Medical Decisions- A Guide for Chaplains from the Jewish Tradition

-Rabbi Zev Schostack [email protected]

Caring for Military Folk and Families

- Rabbi Maurice S. Kaprow [email protected] and Rabbi Doniel

Kramer, Ph.D. [email protected]

The Evolution of Spiritual Care in Israel: A Multi-Disciplinary Approach

Developed to Address a Diverse Multi-Cultural Society


2009/5769 4

-Rabbi Zahara Davidowitz-Farkas [email protected]

-Elisheva Flamm-Oren [email protected]

-Yakir Kaufman [email protected] and

- Dvora Corn [email protected]

Plenary Session- Seek and You Shall Find: Crossing Disciplinary

Boundaries within the Village of Care- Benjamin W. Corn, MD

[email protected]

Jewish Spiritual Care Journal Volume 9, Issue 1, Winter/Spring 2009/5769 5 Building Our Case with Cases* George Fitchett, DMin, PhD

On what grounds can health care chaplains justify the spiritual care

they provide? For the most part the justification for what today’s health

care chaplains do with patients comes from the traditions of the

profession and from expert opinion. However, these justifications are no

longer adequate. Chaplains need to demonstrate that there are solid

theories that support the care they provide. Also, they need to develop

evidence that care based on those theories produces positive effects.

There are two reasons why we must develop this theory-driven, evidence-

based model for our work. The first and most important reason is that our

responsibility to our patients requires that we do all that we can to assure

that the care we are providing is having positive effects. The second

reason is that in order to tell our story effectively to our health care

colleagues, in order to build the case that we are productive members of

the health care team, we have to provide evidence for the difference that

we make.

Another way to put this is to say that health care chaplains must

make a shift from being a tradition-based profession to a research-

informed profession. Being a research-informed profession does not mean

that every chaplain, or even most chaplains, need to be researchers. Most

colleagues in other research-informed professions, like medicine and

psychology, are not active investigators. They are, however, research

literate. Health care chaplains need to become also


2009/5769 6

research literate. We need to be able to read and understand research

and to be able to apply thoughtfully relevant research findings to our

work. This includes research produced by other chaplains as well as

informative research produced by colleagues in related professions.

Additionally, as a research informed profession, some chaplains will be

qualified to collaborate in research conducted by health care colleagues,

and some chaplains will be qualified to lead research projects.

The work of transforming health care chaplaincy into a research-

informed profession cannot be limited to a few leaders or researchers in

our profession. It is a transformation that will require the participation of

all members of our profession. Let me make two suggestions for ways

that all professional chaplains can contribute to this transformation. First,

I suggest that for the next ten years we change the continuing education

(CE) requirements to maintain board certification to require that ten

percent (5 hours) of the annual continuing education hours be in

research-related activities. Second, I suggest we create a new

requirement for becoming a board certified chaplain. That requirement is

a two page summary of a research study demonstrating an understanding

of the study and its application to one’s ministry. Of course, making these

changes will have other implications. We will need to teach research

literacy skills in our CPE residency programs and we will need to increase

research-related CE opportunities.


2009/5769 7

As we make these changes in our continuing education and

certification requirements we must remember why it is important for us

to become a research-informed profession. We must become a research-

informed profession so we can develop evidence-based spiritual care.

Developing evidence for any health-related intervention is a complex

process and we in health care chaplaincy are a long way from this goal.

One model for developing evidence for health care interventions

describes a three stage process (Rounsaville et al., 2001). Stage 1

focuses on developing the basic elements of the intervention and

measures of its effects. The first part of this process, Stage 1A, includes

developing a detailed description of the intervention, often called a

protocol or manual, demonstrating with a few cases that the intervention

is feasible and acceptable, and selecting and testing measures of the

effects of the intervention. Stage 1B consists of pilot testing the

intervention with a small number of cases. In Stage 1B investigators focus

on whether there is any evidence the intervention has the intended

effects, on whether there are any negative affects associated with the

intervention, and on maximizing consistency in the delivery of the

intervention. It is only after this work has been completed successfully

that investigators move to Stage 2, in which the efficacy of the

intervention is tested in the familiar randomized clinical trial (RCT). If

there is evidence the intervention has the intended effects in the ideal

world of the RCT,


2009/5769 8

then investigators move to Stage 3 in which further research examines

whether the intervention is effective in the real world of clinical practice.

I would argue that, while we have two interesting examples of RCTs

of the effects of chaplains’ spiritual care (Bay et al, 2008; Iler et al.,

2001), it is premature for us to conduct further Stage 2 or Stage 3 tests

of our work. I believe that before we do any further clinical trials we need

good case studies of our work. These case studies should provide detailed

information about three things we need to understand in Stage 1A: 1)

descriptions of the patient (or family) to whom we provided care, 2)

descriptions of the spiritual care that was provided, and 3) descriptions of

the changes that occurred as a result of that spiritual care. I also believe

that developing these case studies is the work of our most skilled and

experienced chaplains, not the least experienced members of our

profession, our students or candidates for certification.

Once we have several case studies about a specific type of spiritual

care we need to link the spiritual care described in them with theories

about our work. When we have a sufficient body of theoretically-

illuminated case material then we will be in a position to design preliminary

Stage 1B trials to see if similar spiritual interventions, provided to

patients with roughly similar conditions, have measurable effects on the

outcomes that we have specified. It is only if these preliminary trials yield

evidence for an effect from the chaplain’s visit that it is


2009/5769 9

time to consider a Stage 2 randomized trial in which the effects of the

chaplain’s care are compared to no care or some other intervention.

It will be a big job to build a body of case studies, link them to

theories, and later test the interventions described in them. And we will

have to do this over and over for different types of patients and different

chaplain interventions. The shifts I have described may feel very alien to

many chaplains practicing today. However, we should remember that

research, including a strong emphasis on case studies, was a key

component of the work of Anton Boisen, one of the founders of modern

health care chaplaincy (Asquith, 1992; Boisen, 1936). We should also

keep in mind that a central reason for developing evidence-based spiritual

care is to help us provide our patients and families with the best spiritual

care possible. My conversations with chaplain colleagues suggest that we

recognize the importance of this work and we are ready to take up this

challenge. I look forward to being part of this process.

*This article is based on a presentation, “Evidence-Based Spiritual Care – How Do We Get There?” at the Spiritual Care Summit held in Orlando Florida, February 2009. References Asqith GH Jr. (Ed.). (1992). Vision from a little known country: A Boisen reader. (Decatur, GA: Journal of Pastoral Care Publications). Bay PS, Beckman D, Trippi J, Gunderman R, Terry C. (2008). The effect of pastoral care services on anxiety, depression, hope, religious coping, and Jewish Spiritual Care Journal Volume 9, Issue 1, Winter/Spring

2009/5769 10

religious problem solving styles: A randomized controlled study. Journal of Religion and Health, 47:57-69. Boisen AT. (1936/1971). The exploration of the inner world: A study of mental disorder and religious experience. (Philadelphia: University Pennsylvania Press). Iler WL, Obershain D, Camac M. (2001). The impact of daily visits from chaplains on patients with Chronic Obstructive Pulmonary Disease (COPD): A pilot study. Chaplaincy Today, 17(1):5-11. Rounsaville BJ, Carroll KM, Onken LS. A stage model of behavioral therapies research: Getting started and moving on from Stage I. Clinical Psychology: Science and Practice, 2001, 8(2):133-142.

George Fitchett, D.Min., Ph.D. is Associate Professor and Director of Research, Department of Religion, Health, and Human Values, Rush University Medical Center, Chicago, IL. He holds a PhD in epidemiology and is a certified chaplain (Association of Professional Chaplains) and pastoral supervisor (Association for Clinical Pastoral Education, Inc.). Since 1990

George has been conducting research examining the relationship between religion and health in a variety of community and clinical populations. His research has been funded by the National Institutes of Health and published in pastoral, medical, and psychological journals. Jewish Spiritual Care Journal Volume 9, Issue 1, Winter/Spring

2009/5769 11

CARING FOR MILITARY FOLK AND THEIR FAMILIES

CARING FOR MILITARY FOLK AND THEIR FAMILIES Rabbi Maurice S. Kaprow, B.C.C. and Rabbi Doniel Kramer, B.C.C.

With the onset of Operation Iraqi Freedom (OIF), i.e, the war in

Iraq; and Operation Enduring Freedom (OEF), i.e., our presence in

Afghanistan, our nation began to rely more heavily on members of the

Reserve Forces and the National Guard. Unlike active duty members,

these men and women and their families face far more stressors and

difficulties.

Active duty members face regular deployments. Depending on the

service, these times away from home and families can last from four

months for the Air Force, six months for the Navy and Marine Corps, to

fifteen months for the Army. Support systems exist on military bases to

help both service members and their families deal with deployment issues.

Reservists, however, do not live generally at or around a military base and

accordingly, those support systems are more difficult to access. National

Guard members reside within their state and are close generally to their

military units, reservists can live across many states, often needing to fly

half way across the country to their units and associated support

structures.

Active duty deployment concerns are limited generally to three

major areas:


2009/5769 12

(1) Pre-deployment issues:

a. Preparing to leave and separate

b. Legal issues – getting wills, powers-of-attorney, and

other necessary documents up to date and in place.

c. Financial issues – allotments, banking accounts, bill

payment, etc.

d. Family issues – childcare (especially for single parents),

separation anxiety.

(2) Deployment issues:

a. Safety – Where is s/he? Where is s/he going?

What is s/he doing?

b. Fidelity – Will my spouse cheat on me? (This

affects both the deployed member and the family

member remaining home.)

(3) Return and Reunion issues (examples include):

a. Time during the deployment does not stop. Things

changed over time. (Schedule, child-

rearing/discipline, bill paying, etc.)

Jewish Spiritual Care Journal Volume 9, Issue 1, Winter/Spring 2009/5769 13

b. New and reversed roles – The non-deployed member

now is the family bill-payer. How does the

deployment

c. member react? Does s/he attempt to retake the

old role? How does that affect the spouse who

performed the task throughout the deployment?

d. Money issues – During deployment there may have

been additional allowances that stop when the

deployment ends. How did the member spend

money during the deployment? How did the

remaining spouse use the “household” monies?

Were decisions made well – i.e., the car broke and

the remaining spouse bought a new car?

Adjusting to these changes is difficult enough when planned and

anticipated. “Normal” deployments are planned generally far in advance

and preparations for these concerns are addressed as part of the planning

process. Reservists, on the other hand, can be activated as individuals on

a few days notice. There is little, if any, time to prepare for the

deployment and because the person deploys as an individual, there is

minimal unit level support. Even when the entire unit deploys, because

they are scattered across many states, unit support is difficult, at best.


2009/5769 14

One typical difficulty facing Reservists and Guardsmen, who are activated,

is financial devastation. Take for example, a young woman, who is an

information technology specialist. In her civilian job, she earns $120,000

per year

In the military, where she is a sergeant (E-5) with three years of service,

she will earn $2135 per month. Even with housing allowances added in,

the salary becomes approximately $3000 per month. Unless her

company is “kindhearted” (and most are not), she and her family suffer a

$7000 per month loss in income. These figures become even worse for

most service members.

Medical insurance changes also. Where in civilian life her family’s

physicians accept her insurance coverage, once activated, she is covered

by the military’s Tricare program. Unless she happens to live around a

military base or a place where there are numerous military retirees, in all

probability her family will be forced to change physicians since many do

not participate in or accept Tricare.

Generally, these changes do not affect active duty families as

severely because they live in a military community on or around a military

installation, near military medical providers. The active duty member

does not suffer a loss in pay because his pay continues no matter where

he is located. In addition, the military provides support groups on its

bases to assist family members through the deployment.


2009/5769 15

In addition to the support issues faced by Guardsmen and

Reservists, all military members (including those on active duty), who

serve in a combat area,

and their families face other issues. Everyone, who goes to war, is

affected by what they see and experience, even those, who are in support

units far away from the battlefield. Remember that truck drivers running

convoys (a la Jessica Lynch) are prime targets. Remember that ships

either in port (USS COLE) or underway (those in the Straits of Hormuz

menaced by Iranian gunboats) are targets. Every service member sent to

the theater of operations is subject to extreme stress, regardless of

where they are located.

The dictionary1defines trauma as follows:

(1) A serious injury or shock to the body, as from violence or

an accident.

(2) An emotional wound or shock that creates substantial,

lasting damage to the psychological development of a

person, often leading to neurosis.

(3) An event or situation that causes great distress and

disruption.

Using this definition, every service member, who goes to war or

deploys in a wartime environment, suffers a traumatic event. Those, who

are in or near a combat zone, may well return with combat stress, or even

worse, traumatic stress. A large number of those, who are in combat or

survive an improvised


2009/5769 16

explosive device (IED), may suffer also from some form of brain injury.

We call these debilitating injuries often Post Traumatic Stress Disorder or

(PTSD) Traumatic Brain Injury (TBI). Couple those injuries with members,

1 http://www.thefreedictionary.com/trauma

who return as amputees (or other severe injures), and the system

established to deal with them bursts at the seams.

Recently the news media including the Washington Post (31

January 2008) and The New York Times (31 January 2008) reported on

increased levels of suicide and PTSD among returning soldiers. Often

these symptoms do not appear until months after homecoming. These

episodes of PTSD have been linked to concussions received during battle.

When explosive devices detonate near service members they suffer from

concussions when their brain hits the sides of their skulls continually.

New helmets prevent death, and enable people to survive the blast, but

they suffer still from concussion. Because it shows itself long after return

from the battlefield, the data is alarming.

Our field medical care today has improved to such a point where

many, who would have died in previous wars, have returned alive, albeit

injured, from this war. Our military treatment facilities such as Walter

Reed Army Medical Center, National Naval Medical Center--Bethesda, and

Brooke Army Medical Center are doing a yeoman job in caring for these

young men and women. Our Veterans Affairs Hospitals are working above

capacity dealing with these issues.

Jewish Spiritual Care Journal Volume 9, Issue 1,Winter/Spring 2009/5769

17

Yet, many return to their home town, released from active duty,

with a minimal support system, at best. Once the Reservist or active

duty member, who was injured and then separated from the military

returns home, s/he faces even more problems than the active duty

soldiers. Away from a military base, the returning Reservist or separatee

lacks the infrastructure the active duty member has. Without a base,

military medical facilities are scarce, a VA center may or may not be

nearby, and individuals with unique military concerns have no place to

turn. Most civilian agencies, health care, religious, or other, are not

familiar with the special stressors military members face. They are not

familiar with a military mindset that places always mission first. And, they

are not attuned to the types of experiences the returning member faces.

Despite the best of intentions, civilian practitioners are not equipped to

deal with issues similar to these:

(1) In war, we have created a topsy-turvy world. While

killing in society at large is punished, killing during battle is encouraged

and rewarded. The returning service member faces a moral reeducation

to try to deal with understanding why they were rewarded for doing

something that is generally condemned.

(2) Often Post-Traumatic Stress Disorder (PTSD) does not

reveal itself until weeks or months after return. Recognizing PTSD

symptoms is not taught generally at our medical schools.


2009/5769 18

(3) Often return and reunion issues are complicated by one

or both party’s actions and behaviors during the separation. Coupled with

the “normal” reintegration issues, these stresses become even more

intense.

(4) Reintegration into civilian work may be difficult.

Employers do not follow always the law, and hold jobs for the service

members. Even when they do, there may have been other changes that

affect where the person works or the job title itself. Medical insurance

may change once again, from military to civilian policies. Continuity of

care becomes an issue.

Even if a VA Medical Center is located in proximity to the service

member, the member may have difficulties accessing services for several

reasons:

(1) Although “seamless transition” between the military

departments and the VA has been created, there are still difficulties in the

implementation. Active duty units have a better chance at truly

integrating their retiring/separating members into the VA system than do

reserve units and Reserve units have a better chance than individually

returning Reservists.

(2) Access to the VA medical system is based on service

connected conditions and disabilities. If the returning Reservist does not

fall high enough on the VA strata, s/he may be denied service at a VA

facility or be placed lower on a waiting list than other individuals.

(3) There are not enough providers who are expert in PTSD

issues. Although both the VA and the military are straining resources to

get more


19

expertise in this essential area, they are not yet there. (It may not be

certain that this expertise is available in the civilian community either.)

Others who often fall through the cracks in the system include

single parents, serious wounded veterans (i.e., amputees, etc.), and those

with Traumatic Brain Injury. While outstanding rehabilitation work is being

done in Military Treatment Facilities to deal with these people, problems

develop when they return to their communities.

In general, the public voices support for military service members

regardless of their perceptions or feelings about the war itself. We, as

professionals, have an obligation to put our political feelings aside and

deal with these hurting people.

Our communities organize drives to collect cards, letters, and other

sundries to send to service members. These gestures are very much

appreciated. They are not, however, what military members need really.

The most pressing need is helping family members, who stay home. For

example, a family whose husband has deployed, whose wife is at home

with three young children, may well need help doing chores the husband

did, for example mowing the grass. Instead of collecting cards, we can

and should be reaching out to all our military families finding ways to help

make their lives easier.

State Adjutants, local reserve units, Vet centers and the various

military endorsing agents are eager to provide information on contacting

local reserve


20

units. They welcome assistance from community professionals in helping

meet the needs of these service members. As professional chaplains we

are obligated to reach out to these young men and women and their

families. It is now time for us to act.

Rabbi Maurice S. Kaprow is a Board Certified Jewish Chaplain. He is a Commander in the United States Navy Chaplain Corps serving on active duty and is a member of the Board of the NAJC. Rabbi Maurice S. Kaprow, B.C.C. and Rabbi Doniel Kramer

The views or opinions expressed or represented in this article are the personal views or opinions of the author. They do not necessarily reflect the views or opinions of the United States Government, the Department of Veterans Affairs, the Department of Defense, the United States Navy, or any other branch of the United States military.


2009/5769 21

Collaboration in Building a Better Team

Spiritual Care Programming in Oncology Nursing Julie Allen Berger, D. Min., BCC

Dale Alene Schreiber, M.A., Rabbi, NAJC

The 2009 Spiritual Care Summit was my first NAJC or APC

experience. I am very fortunate for the wonderful collaboration with Julie

Allen Berger, BCC, anchor chaplain for Barnes-Jewish Hospital’s Oncology

Spiritual Care Service, who anchors me in a spiritually sound, outcome

focused, and developmentally aware oncology practice. Her twenty-three

year experience as a pastoral presence and spiritual care provider at our

hospital provides a model worth emulating. Her tenure under the

direction and supervision of Spiritual Care Director, Arthur Lucas,z’l,

advanced the field of professional chaplaincy as one of a team of

chaplains working toward Art’s vision of Outcome Oriented Chaplaincy.

Chaplain Berger’s interpretation of outcome based spiritual care in

oncology draws on her training as a pastoral counselor and use of

psychodynamic process. As a chaplain, she pays special attention to the

pastoral care paradigms for healing, sustaining, guiding, and reconciling in

all the permutations which arise in the lifecycle of an oncology patient,

family, or unit.

After completing a CPE residency in Trauma One at Barnes-Jewish

Hospital under the supervision of Director Art Lucas, my tenure in

oncology began six years ago. I asked for an Oncology assignment to

round out my Jewish patient care responsibilities, which I shared with

hospital Rabbi Jay Goldburg.


2009/5769 22

Chaplain Julie Allen Berger extended great hospitality in my entrance into

her world. I am very grateful for the way in which she recognizes and

receives my gifts, which stem from many years of experience as a clinical

audiologist, Jewish Educator, curriculum director, and rabbinical student.

Formerly, I used client centered and student directed approaches which

work well with our patient centered philosophy of care. My approach to

curriculum design derived from my interest in maximizing learning

environments. Patients with cancer enter a landscape where learning

needs range from understanding the significant medical language to

finding some essentials for a long stay away from home. As a rabbinic

student, Clinical Pastoral Education expanded my life-long affinity for

hakhnasat orkhim - welcoming strangers and bikur cholim, investigating

the patient worlds affected by illness. Worlds where physical changes

affect and are affected by emotional and cognitive states and where

unique and essential spiritual needs are critically important to recovering

or balancing sh’lemah – wholeness of the individual, family, or medical

unit.

When the call for SSC workshop presentations appeared, it seemed

to fit our work on so many levels; rabbi and minister, NAJC and APC, the

Spiritual Care Department and Oncology Nursing Programs, and chaplains

collaborating with a wide array of specialties who along with chaplains, all

work towards the greater good for our constituents. It was especially

meaningful to be present at this particular professional meeting, and to

be present as my mentor and


2009/5769 23

supervisor, our Director of Spiritual Care Services, Reverend and revered,

Chaplain Art Lucas received, posthumously, the APC Anton Boisen

Professional Service Award and the ACPE Helen Flanders Dunbar Award. I

watched, both grieving his recent passing from pancreatic cancer and

with great pride in his accomplishments, as the awards were received by

his children, Martin and Kate, and by his widow, Lou.

Chaplain Berger and I work collaboratively. We share both

hematological and medical oncology units. She staffs the bone marrow

transplant unit. I staff what became a critical care leukemia unit. Our

medical oncology patients are generally complex, living with the process

of cancer, diagnosed often with severe metastatic disease, and who are

readmitted frequently for symptom management. Many of our patients

are not local, which poses additional challenges in their hospitalization.

Chaplain Berger works closely with the Palliative Care team. I have

responsibility for a PICU (pulmonary intensive care unit), which is

transitioning into an intensive care unit for oncology patients. As the

current Rabbi of the institute, I provide for Jewish patient, family, and

staff needs. Chaplain Berger oversees the hospital volunteer visitation

program, and, as the anchor chaplain in oncology, has added

responsibilities for involvement with comprehensive rounds and executive

planning. We share medical oncology rounds. She attends discharge

planning rounds. I attend bi-weekly ACE oncology geriatric rounds.


2009/5769 24

We both serve the institute as appointees to the Hospital Ethics

Committee and its’ sub-committees. I serve on Ethics Consultation; she

on Ethics Education. My interest in pain management and advocacy led to

an appointment to what is referred commonly to as the Pain Committee,

comprised of pharmacists, surgeons, ICU intensivists, oncologists,

palliative care specialists, our hospital ethicist, and myself.

In short, we work cooperatively and collaboratively with attention

to being responsive to the many challenges of working in a rapidly

expanding cancer care center. What began as generic spiritual care

outpatient lobby talks and abbreviated lessons on spiritual care topics

moved to a more integrated teaching presence for oncology nurses. I

believe this integration of spiritual care is an outcome of several factors.

One is the interdisciplinary approach to care, which acknowledges spiritual

care as an active team member. Additionally, the field of nursing

professes standards for holistic care, which extends to self-care. Spiritual

Care is a resource, which invests in both holism and well-being for

patients and staff. As the oncology nursing division grew to meet clinical

expansions of both hematological and medical oncology practices, a need

developed for not only orienting nursing staff to the complex critical care

needs of cancer patients (and their families) but to support also staff

resiliency in their expanded roles.


2009/5769 25

While there are some discrete programs targeted at staff support,

the majority of programs fall into monthly nursing orientations to spiritual

care, annual skills day presentations on topics important for spiritual care

of nurses, and a quarterly 90 minute workshop on spiritual care roles for

oncology nurses. There is a dual focus in this workshop. One is helping

nurses understand spiritual care needs throughout the trajectory of the

disease with cancer patients. A second is to underscore the importance

of recognizing when self-care is essential.

In the initial proposal, we drafted three outcomes for the

presentation. We hoped to develop insight into ways of establishing and

sustaining collaborations with oncology nurses; increase their awareness

in how to identify challenges to oncology nurses, and feel more able to

translate spiritual care concerns about those nurse challenges into a plan

for staff support. We wanted our workshop to model the very

professional and collegial collaboration we use with each other and in our

support and teaching programs.

We identified six important keystones, which we believe advanced

the work of collaboration. We call them keystones because we perceive

them to be pivotal points of connection, which help us transform the way

in which chaplains collaborate within oncology. We hear these keystones

as a narrative, which describes the way it works in our hospital. We

believe the keystones are important for anyone who wishes to establish a

greater collaboration with nurses


2009/5769 26

in oncology. We believe that other oncology chaplains will find merit in

this sharing. Many do what we are doing already. Some may find the

template more cohesive than what is available currently in their own

institution of practice. We invite all to participate in this with us. Rather

than a show and tell of specific programs, we engage thoroughly in the

process, which leads to their formation.

Defining Presence We call the first keystone Defining Presence. It is

defining presence, which makes chaplaincy visible and credible. In our

practice, this begins with patient care. While patient care is what

chaplains do, outcome based chaplaincy puts special emphasis on what

the chaplain might hope for the patient. In helping a patient achieve a

level of integration, a sense of wholeness, an experience of being seen

and heard, it is often facilitative to be a bridge of sorts between the

patient, who is ill, and other important aspects of his/her life story.

Expanding the patient narrative with the staff feels like an important

consideration for maintaining a holistic view of the patient. As a way of

enhancing their hospital care, it is customary for us to ask patients if we

can share their perspective with specific staff. In those moments, when

we lift up an aspect of the patient story to help the staff see the broader

complexities of what is happening, we expose staff to deeper excursions

in the emotional, cognitive, social, and spiritual life of the person/family in

their care.

Jewish Spiritual Care Journal Volume 9, Issue 1 Winter/Spring 2009/5769

27

We have responsibilities on our specific units, which cover about

175 inpatient beds, as well as outpatient responsibilities for spiritual care

programs in outpatient treatment centers (radiation oncology, medical

oncology infusion centers, gynecological oncology chemotherapy infusion

center). Support groups are a good place to develop a defining presence.

Through shared personal experiences, support group dialogue helps us

learn more about the landscape of oncology. We participate with breast

cancer, gynecological, bone marrow transplant, and leukemia & lymphoma

support groups.

Visibility and credibility are important to a chaplain’s relationship

with clinical nurse managers, case coordinators, charge nurses, and any

person, who works routinely on an oncology unit. Pain might be an issue,

which interferes with physical therapy. Addressing this patient concern

with the patient’s nurse may lead to a small but significant adjustment

that allows the patient to participate because now he/she experiences

less pain. When the nurse isn’t available, I may go to the clinical nurse

manager or charge nurse and express the concern the patient has.

Almost always, this results in a better patient outcome.

Assessing Essential Needs Developing a planned intervention is

dependent upon what we identify as essential needs. Our experience

with the Discipline of Pastoral Care in outcomes based chaplaincy taught

us that what we do with patients is transferable to working with staff

needs. An essential need,


2009/5769 28

when met, leads to optimal engagement in good clinical practice, which

includes awareness that one’s mission is being met, and enables good

self-care. Unmet essential needs lead to less than optimal practice and

feelings of dissatisfaction, which are often contagious. Many of our nurses

have had an opportunity to write down the reasons they became

oncology nurses. They have a mission which can feel unfulfilled if they

see themselves disconnected from the core nursing values they wish to

live out in their professional life. When one sees chaplains as a defining

presence, they become valuable resources to help in unsettled times.

There are sensory data indicators suggesting unmet needs. We

observe them in the dynamic of nurse interactions with patients and

other staff. Our observations reveal nurses who sound cynical and feel

helpless about their ability to change what contributes to their

discomfort. We observed nurses who are more judgmental, less engaged

in teamwork, and who are less likely to be good advocates for patient

needs. In addition we note that the level of ‘sighing’ seems to increase.

We hear evidence of unmet needs in a long list of complaints about

physicians, schedules, and patient assignments. We hear unmet needs in

inappropriate word choice and unfortunate gossip – motzei shem ra,

rekhilut, or lashon hara that creeps into daily interactions.


2009/5769 29

Chaplains feel for where the focus of this behavior arises. In our own

case, there are many changes in hospital staffing and policies resulting in

expansion, downsizing of certain populations, increase in critical care

patient populations, increases in responsibilities, and increased demands

for leadership skills. In addition there are the recurrent difficult patients

and common situations where we view the triggering of grief, fear, and

anxiety. Determining whether the essential need applies to a discrete

individual or is more systemic is a discernment process.

The plenary speakers at the Summit (David Dean, PhD, Ada Isasi-

Diaz, PhD, and Benjamin Corn, MD) all touched on the extra-sensory

contributions that aren’t visible and which shape attitudes and actions.

Also, we feel this extra-sensory aspect is important. How important it is

to hear beyond the spoken or see beyond the visible in feeling for a focus

that will lead to a programmatic intervention. Often, it is not a one time

event, but the cumulating aspects of a series of changes, events, or

contextual mishaps. Our standard of practice is to explore the intuitive

apprehension which helps to identify the evidence which support the

feeling. This adds clarity and intentionality to the way in which a chaplain

plans an intervention.

We shared a case study and invited approximately seventy

participants to help define what factors contribute to the example of a

very competent nurse who, under duress, loses sight of a critical element

in caring for a patient at the


2009/5769 30

end of life. This lapse in nurse perspective leads to an eight week support

program on resiliency, which helps establish an ongoing dialogue about

challenges, advocacy, and self care. In our packet of information, we

include the Feelings Inventory (www.cnvc.org) ,which describes how one

should feel when needs are satisfied or not satisfied.

Building Cohesive Alliances Becoming a defining presence and

assessing essential needs link to building cohesive alliances with the

medical team, between specialty groups, and within a single department.

The majority of persons who participate in our session come from

hospitals with some important medical and/or community resources. One

person is the lone chaplain in their hospital facility.

We established strong interdisciplinary alliances with oncology nurse

specialists like the education resource nurse on the unit, psychiatric

physician assistants and psycho-oncology specialists interested in coping,

demoralization, and depression among cancer patients. We have a

wonderful alliance with integrative pain services which provide invaluable

service for many oncology patients. We are fortunate to also have a

wonderful Palliative Care Team, who focuses on defining patient goals and

symptom management. As Chaplains we know that good patient care

translates into feeling good about caring for patients. Nurses, who can

see the value of these alliance interactions with


2009/5769 31

patients, feel they have an expanded tool kit and more advocacy choices

to support the patient during hospitalization.

When we perceive a situation that needs attention, the clinical

managers, case managers, or social workers are good resources to

engage in validating the observation. The intuitions about need

sometimes gather evidence from these interactions. One time each

month, chaplains update the spiritual care department on staff and unit

challenges. This helps us connect with each other and share strategies

that might be helpful.

Forces Driving Collaboration It is not surprising that there

are real forces driving collaboration between spiritual care and oncology.

National hospital standards are one force, which recognizes spiritual

assessment as important to understanding how to help a patient during

his/her hospital stay. JCAHO requires a spiritual assessment within four

hours of admission. Chaplains should know how their institution meets

this need, and whether there is an opportunity to help nurses engage in

this screening. Many professional nursing standards (American Nursing

Association, End of Life Nursing Education Consortium, and Oncology

Nursing Society) commit to holistic patient care, which includes the

spiritual dimension of care. The prestigious Magnet Nursing Award goes

to hospitals, which inspire professional growth,


2009/5769 32

provide a positive environment for patient care, demonstrate

interdisciplinary teamwork and work towards the retention of highly skilled

nurses.

According to the National Comprehensive Cancer Network, nurses

are responsible for a checklist identifying practical, family, emotional,

physical, and spiritual problems. This is perhaps the most telling indicator

about the need for spiritual care collaboration in oncology. There are

specific items listed under all the categories except spiritual care. The

nursing literature affirms the interest and responsibility for identifying

spiritual care needs, but offers very little in the way of practical

approaches. One inherent challenge is a lack of consensus about

spirituality. Participants read through ten spirituality definitions taken

from the medical literature and choose those definitions which resonate

with their own beliefs. In our own workshop, participants choose from all

the selections, which demonstrate a unique aspect of how people

understand the concept. The outcome in our workshop is similar to

outcomes when used with medical students, chaplains, and support group

participants. Responses vary and many people select several answers to

give fullness to their own sense about spirituality. Helping oncology

nurses demystify the term is part of an ongoing program in the Oncology

Nurse Fellowship Program. We invite Nurse Fellows to review the

definitions and then ask them to turn to the person next to them and

share the reasons they select those particular responses. After a period

of time, we invite them to identify the definitions which they feel

represent their


2009/5769 33

view of spirituality. I find the groups more than willing to share their

interests after discussing their choices in dyads.

Meeting Expressed Needs Linked integrally to the

fourth keystone, meeting expressed needs, we identify persons and/or

specialty groups who concern themselves also with patient/ staff care

and development. Nurse Managers or other principle members of the

oncology team state explicitly some of these needs. A support group talk,

a grief session or debriefing as identified by someone other than the

chaplain falls into this category. Some expressed needs identify

themselves through chaplain observation, analysis and/or reflections,

which are part of our practice for defining presence. Chaplain Berger has

a broad knowledge of the developmental effects of cancer on

patients/families from diagnosis to end of treatment. We both are aware

of the learning curve for new oncology nurses. Also, we know how

uncomfortable many nurses are about spiritual care patient issues. When

we use this kind of information to generate programs, we do so with

attention to our own expectations for a hospitable, interactive,

responsive, and engaging dialogue about hopes, needs, and resources for

oncology nurses or nursing.

It goes without saying that chaplains should say YES to invitations

and that relevant programs increase the frequency of invitations to

collaborate. Relevant programs are a mix of information, support, and

affirmation. Relevant


2009/5769 34

programs provide information important to nurses, take into account

diversity factors, and balance the interaction level to meet the learning

needs for many kinds of nurses.

Relevant programs give rise to information also that is important

for clinical directors to be aware of. One example of this is an Oncology

Skills Day exercise during which we ask teams of nurses (total of 155

nurses) if they had ever experienced a job related ethical dilemma that

went unresolved. Every nurse raised their hand. This is important

information to pass along which results in more ethics based education to

help nurses learn how to prioritize important competing bioethical

principles and when to call an ethics consult.

Relevant programs should be supportive. By that we mean the

objectives or outcomes of what we hope to achieve relate directly to

what we choose to engage in. In order to achieve professional goals, a

supportive program should show the direction that actions or attitudes

should shift towards. One example relates to grief support for nurses.

There are many articles about grief in nursing literature and very few,

which highlight the landscape of moving through it to a place of recovery.

We offer a program on grief which highlights various models about grief,

capitalizes on nurse humor/cartoons, and describes behaviors which

might require safety back-up. It describes what recovery looks and feels

like. It ends with a series of photographs of nurses and patients against a

back drop of beatitudes which reflect the soul of compassionate care.


2009/5769 35

When we say that relevant programs are affirming, we recognize

the challenges of the work. We affirm the complexity of the care, the

intensity of the challenges, the attributes of quality nursing, and the need

for renewable compassionate care. To this end, we try to identify the

emotional and spiritual danger zones, which may require additional internal

and/or external resources for comprehensive self care. Nurses, who

operate optimally, are able to address patient needs objectively, work

independently and autonomously, feel comfortable advocating for patient

needs, are tolerant to a patient/family illness dynamic, have self

knowledge about self care needs, and can acknowledge with some degree

of satisfaction, at the end of a long day, that their care made a

difference.

Translating Essential Needs into Programs There is

a folk proverb, ‘If you don’t know where you’re going, any road will do’.

The chaplain’s role in assessing essential needs, in relationship with good

nurse allies, in understanding the importance spiritual care for both the

practitioner and the patient, and in their professional mission to address

essential needs has a natural extension in creating an effective program.

As the saying above suggests, knowing what your outcome is helps to

shape the way in which you achieve it. When the oncology nurse

educators say they want a quick group intervention that addresses grief,

we meet them where they are.


2009/5769 36

Somewhere along the path of providing just what they ask for though, we

share some observations about nurses which become important outcomes

for formalizing the relationship between the oncology chaplain and the

oncology nurse. One observation over a year’s period of time has to do

with nurses new to oncology. Nurses, who are on a steep learning curve,

seem to have a single minded focus in attending to the task specifics of

patient care. I notice that it takes about six months before these nurses

expanded their comprehension of total patient care to include spiritual

care.

New nurses often don’t have the experience about the impact a

cancer diagnosis has as it progresses from start to recovery, or becomes

a chronic condition, or ends in death. This leaves nurses in a vulnerable

situation of not knowing how to interpret patient/family emotional

reactions. It is also very distressing for them when their patients are very

distressed. As oncology chaplains, we suggest that nurses might benefit

from educational programming addressing what we consider to be

essential needs. One need is to be familiar with common patient

reactions during the course of their illness. It feels also essential that we

present this information at the right time in their professional formation

as oncology nurses.

Programs need to fit into the practical constraints and, as

chaplains, we know how flexible we must be in last minute reorganizing

around noise, size of space, or other distractions. Since evidence based

medicine is a big concept at


2009/5769 37

our hospital, every program requires some kind of measure of

effectiveness. Routinely, we use surveys. Also, we keep track of

anecdotal evidence, which makes for good sharing. Nurse reports of

changes in behavior and reports of benefit are good feedback.

We end the presentation with a quick overview of several programs

in our collaboration with oncology nurses and some questions and

answers. The program overviews we included are: Oncology Nurse

Orientation, an 8 week staff support module piloted on a leukemia and

lymphoma unit, Oncology Skills Day, and Oncology Nurse Fellowship

programs.

It was a lively and rewarding group experience and we appreciate

this opportunity to provide a written summary to those members of NAJC

who were unable to attend.

Julie Allen Berger, D. Min., BCC and Dale Alene Schreiber, M.A., Rabbi are Chaplains at Barnes-Jewish Hospital in St. Louis, MO. Their pastoral care department provides cutting edge outcome oriented clinical pastoral care, and is known for its ground-breaking work. Jewish Spiritual Care Journal Volume 9, Issue 1, Winter/Spring

2009/5769 38

The National Association of Jewish Chaplains honors Rabbi Bonita E Taylor

for Exemplary Leadership in Professional Chaplaincy Education

Monday, February 2nd 2009/Shvat 8 5769

Acknowledgement by Rabbi Taylor

Thank you for your generous introduction. Thank you all for your very warm reception. Rabbi Kronick, Rabbi Fenner, Rabbi Stern, Rabbi Levinson Members of the NAJC Board and Tribute Committee Ms Asekoff, Esteemed colleagues, Treasured students, Honored guests: Thank you for honoring me for “Exemplary Leadership in Professional Chaplaincy Education.” On January 5th, I became a great-aunt for the second time. For months now, my family has been discussing: name possibilities, name meanings, Hebrew names, the names of deceased relatives that we would like remembered & whether our names really do have an impact upon our lives. When Judaism invited us to engage Parashat Shemot2 on January 17th, I was still thinking about baby names & whether what my great-niece was named would affect the fabric of her life. I also found myself wondering about how much my own name had affected the fabric of my life. As you know, I have an unusual first name. It invites commentary. As far back as I can remember - at least once a week – I have been asked: Do you know what your name means? This is then followed by various suggested meanings, like: “it’s an Ecuadorian banana,” “it’s a type of tuna,” “it’s Spanish for Linda,” & there are others. Like the old Johnny Cash song about naming a boy ‘Sue’ so that the boy develops character, the 2,000 or so times that I’ve deflected the issue 2 The Hebrew word Shemot means “Names.” It is also the title of a Torah portio

about what my name means have added to my character. But could there be more to my name Jewish Spiritual Care Journal Volume 9, Issue 1, Winter/Spring

2009/5769 39

than that? Could my name actually be meaningful in the context of God’s intentions for my life? This past Shabbat3, when we embraced parashat Bo - for the first time, I heard my first name as 2 words: “bo” & “nita” – or – “Go” & “plant.” Here is what else I discovered: The English Bonita Taylor can be divided into 4 Hebrew words: Bo, nita, tayl, and l’or where: bo is Hebrew for go nita is Hebrew for plant, uproot, or stretch & reach for (depending upon how it is spelled) tayl is Hebrew for hills & l’or is Hebrew for towards enlightenment or awakening (again, depending upon how it is spelled) If you will please allow me some literary license, here is how I now understand God’s charge to me through my name: Bo nita tayl l’or or Go – uproot the hills & plant [seeds] Stretch & awaken & reach for the light so that you become enlightened And now, with some humility, I ask you for a brief teaching moment - my colleagues and students - in this piece of the planet that we share: in chaplaincy, I invite you to: Go - uproot the hills & plant [seeds]: continue to educate your good intentions & deeply felt compassion as you serve compromised and vulnerable individuals …

3 January 31

Stretch & awaken: continue to bring meaning and comfort to individuals who are facing medical and spiritual challenges. Help them to connect to the secrets of their souls & to Divinity (however they define it) … Reach for the light so that you become enlightened: continue to facilitate dialogue across religious denominational & faith spectrums so that you can continue to learn and grow in each other’s company … Jewish Spiritual Care Journal Volume 9, Issue 1, Winter/Spring

2009/5769 40

For the privilege of making it possible for me to actualize my God-given name in my professional life, my profound gratitude goes: to Cecille Allman Asekoff, Rabbi Zahara Davidowitz-Farkas, Rabbi Lowell Kronick, Rabbi Jeffery Silberman, & Rabbi David Zucker, who were the 1st NAJC members to accept and nurture me and to my other NAJC colleagues who are honoring me this evening … to Rabbi Stephen Roberts and Rabbi Ya’acov Rone & my other New York Board of Rabbis colleagues who continue to support and bestow trust upon me … to My Academy for Jewish Religion colleagues who have always demonstrated faith in me … to The Rev Dr Walter J Smith SJ who has made me possibly the only rabbi that you will ever meet who has been mentored by a Jesuit priest … to my other HealthCare Chaplaincy colleagues, like Dr. Jackson Kytle, through whom I have become a better rabbi …

& to my Mother who heard God whispering my name to her. I do not have suitable words to express what it means to me to believe that I am doing what God truly wishes for me to do here on earth. I am appreciative of your trust in me & inspired by your response to me. I feel moved beyond language. I feel deeply humbled. Thank you. Jewish Spiritual Care Journal Volume 9, Issue 1, Winter/Spring

2009/5769 41

Book Review: Flourishing in the Later Years: Jewish Perspectives on Long-Term Pastoral Care. Edited by Rabbi James Michaels and Cary Kozberg. Mishawaka, IN: The Victoria Press. 2009. 267 pages. ISBN 978-1-929569-58-8. $24.95 paperback. Review by Rabbi Dayan Charles P. Rabinowitz, BCC, Editor.

Our colleagues, James Michaels and Cary Kozberg, gather together

a rich cross-section of Jewish and Christian clinical care team members to

share their wisdom on a variety of Jewish perspectives on long-term

pastoral care to Jewish and non-Jewish patients, their families, and staff

members. They represent the full spectrum of our field from interns to

well-established professionals. Like anything else that comes from these

two, the work reflects their fine clinical pastoral skills and their warm

menschlikeit.

The editors provide a user-friendly book for both the professional

and layperson. The language is clear, personable and empathic. Each

author shares a piece of his/her divine spark, and enthusiasm in their work

with this population. It is not a dry, scholarly work. It is a book full of

practical reflections on the issues and programming ideas that both sit in

the moments of the population, and reflect and reframe a sense of

meaning both for the clinical care team, the patients and their families.

This is both a strength and a weakness of the work.

It is a minor criticism but Chapter One has one title in the Table of

Contents and another in the chapter itself. It is a little off-setting but

does not reflect on the quality of the introduction to the roles of the

Jewish chaplain in long-term care


2009/5769 42

settings. Rabbi Kosberg presents the “4Ps” of the Jewish chaplain in a

succinct and clear manner- the priestly role, the pastoral role, the

pedagogic role, and the prophetic role. As Heschel taught, our most

important role to Rabbi Kosberg is just to be a blessing.

The editors divide the book into three sections: Clinical Issues,

Pastoral Programming and What Will the Future Bring. Each section brings

insights to the issues and solutions as well. In Clinical Issues, the authors

address such issues as empowerment, spiritual concerns and creating

sacred space, holocaust survivors, dementia, younger residents, the

ethics committee4, CPE and the Jewish Presence in clinical care teams.

The authors provide clear pictures of how these Jewish clinical care

professionals impact on the daily lives of their patients, their families and

fellow staff members. The Pastoral Programming section covers a wide

range of subjects from cultural competency for non-Jewish staff to

ministering to Jews in non-Jewish settings and non-Jews in Jewish

settings. The editors’ choice of a Christian chaplain to discuss ministering

to Jews in a non-Jewish setting is an interesting, albeit sensitive take

from him when there are so many Jewish chaplains providing Jewish

pastoral care in non-Jewish settings. This section includes the use of

text, technology, Israel and other psychospiritual programming concerns.

This reviewer finds some of the material a bit parochial, and not reflective

of some of the cutting edge programming occurring in Jewish

4 Our last journal issue included Rabbi Michaels chapter on the ethics committee.


2009/5769 43

pastoral care. The third section- What Will the Future Bring- presents an

interesting historical summary of the long term care system in America,

the development of our present system and some future trends by a

hospital executive. Rabbi Michaels presents a Jewish pastoral response

with some suggestions for future improvements to the system of care.

All in all, I recommend this book to all our members. Sitting on our

bookshelf, it serves as a good source for basic knowledge about Jewish

perspectives on long-term pastoral care. I believe that it will encourage

Jewish chaplains to brainstorm new places to take our care in long-term

pastoral care. I believe that other members of our clinical care teams will

benefit from reading its contents. I sense that it will bring comfort and

support to the families that our long-term colleagues serve so well.

Certainly, I find the eternal truth of Rabbi Tarfon’s words- lo alekka

ham’lakha ligmor v’lo atah ben chorine l’hebatayl memehnah. It is not your

duty to complete the work but neither are you free to desist from it-

echoing strongly from each page. I commend our colleagues, Rabbi James

Michaels and Cary Kosberg, highly for this empowering work, which will

encourage all spiritual caregivers and clinical care team members to

reflect and reframe their sense of presence, blessing and dor l’dor service

to our elders. Jim and Cary, you did a wonderful job.


2009/5769 44

Statement of Purpose and Writer’s Guidelines The National Association of Jewish Chaplains (NAJC) is an international, trans-denominational Jewish organization, which certifies professional Jewish chaplains, and which promotes the development of Jewish chaplaincy and the continued yearly growth and clinical pastoral skills of Jewish chaplains. Jewish Spiritual Care is the official professional journal of the NAJC, and publishes two issues per year. Ideas and opinions expressed by authors do not represent necessarily the opinions of the NAJC, its leaders, board or staff. A subscription to the journal is a benefit of membership of the NAJC. Single issues (when available) may be purchased at a nominal fee from the office of National Coordinator, 910 Route 10, Whippany, NJ 07981, phone (973)-884-4800, Ext. 287. The journal will accept both scholarly articles of an academic or research nature and experiential and reflective presentations, which discuss aspects of or topics related to Jewish chaplaincy, clinical pastoral education, Jewish healing, Jewish spiritual care and counseling, and Jewish medical ethics. The Editor and Editorial Board will make all decisions about the appropriateness of publication of each submission. The Editor requests that all submissions be a clean attachment to an email, in Microsoft Word with no editorial markups. Please keep texts to 2000-4000 words. Exceptions to this guideline will be made in unusual circumstances.

The Editor requests that the text be double-spaced. Citations of Biblical, Talmudic and Rabbinic texts should be in the text of the article, surrounded by parentheses, rather than citations in the notes. Transliteration of Hebrew should follow recognized academic usage. The Deadline for the Summer/Fall issue is November 1, 2009. Editorial Office: 9 Ferndale Place, Larchmont, NY 10538 Address all articles to the Editor’s email- [email protected].

Jewish Spiritual Carejewishchaplain.net/wp-content/uploads/2018/09/JSCJ_vol09_no1.pdf · Jewish Spiritual Care The Journal of the National Association of Jewish Chaplains Volume 9,

Documents