Pastoral Report Articles 

  • 25 Dec 2015 9:44 AM | Perry Miller, Editor (Administrator)

    2015 has been a hard year. We have suffered through the slaughter that occurred in a black church in Charleston, SC where members were gathered for prayer and fellowship. We have learned of the many accounts of violence inflicted on black males by police officers charged to protect the public, not to harm, yet harm was done. We have Donald Trump aspiring to be the President of the USA, creating division and strife against racial and religious groups that is pure demagoguery.  Recently, we have been horrified by the images of the slaughter in Paris where people were enjoying the simple pleasures of attending a concert and dining out with friends and family. And there was another terrorist attack in San Bernardino, CA where colleagues and family members had joined together at an office ChrIstmas party to celebrate the holiday. The media is full of emotional images telling the story of the shocked and despairing  Mid-East refugee. Refugees fleeing for their lives while desperately dependent upon the the hospitality of strangers that might understand their plight and open their arms to receive them. Sadly, governments are not so compassionate, nor understanding. 

    It has been a hard year.

    Unintentionally, I’m sure, Apple and Microsoft created from my perspective, a heart warming   “sermon”  for us in their recent Christmas commercials. They remind us in the face of these harsh realities that there are good human relationships, there is goodwill, even to strangers, and we do have love in this world. 

    In this season our hopes and dreams are for a world that, in the words of Stevie Wonder, is a world where:

    "Someday at Christmas we'll see a land
    With no hungry children, no empty hands
    One happy morning people will share
    A world where people care".
    -Stevie Wonder


    Perry Miller, Editor
    perrymiller@gmail.com

    Microsoft Commercial

    Apple Commercial

  • 22 Dec 2015 9:00 AM | Perry Miller, Editor (Administrator)


    Christmas: Beliefs Without Borders
     


    Amy Eva Alberts Warren and William Alberts published a significant article in CounterPunch.org that does not adhere to the usual sentimental interpretations of Christmas. 

    Warren and Alberts: There is a “sign” in the manger that does point the way to “peace on earth.” Ironically, the “sign” is obstructed by the special supernatural effects accompanying the birth of that baby. These divine trappings help to legitimize Christian exceptionalism and creation of The Other. Quite simply, the peace “sign” in that manger is the baby himself—not his assumed special divine delivery. The pathway to “peace on earth” is not by way of his divinity, but his humanity—his human potential for great love and compassion, which he shares with every other human being. (See A.E.A. Warren, Strengthening Human Potential for Great Love-Compassion Through Elaborative Development, in Thriving and Spirituality Among Youth: Research Perspectives and Future Possibilities, edited by A.E.A. Warren, R.M. Lerner, & E. Phelps, John Wiley & Sons, Hoboken, N.J., 2011)

    Editors Note: A good point about the virgin birth. It is over emphasized.

    Warren and AlbertsPeace does not come to “those whom he favors,” but through those who are loved for themselves, rather than the objects of favoritism—or conditional acceptance. Parental love provides the emotional bonding that enables children to identify with and feel empathy for other persons. Children have no preconceived notions about others—or themselves. Respect for others begins with self-respect. Caring for others begins with being cared for. "Loving begins with being loved." In homes where there is emotional room for children to explore, question and grow. Free of biases and indoctrinating restraints. Free to be and to belong and to become. Nurtured by those who possess beliefs without borders. Humanizing beliefs that transcend religious and political exceptionalism and revere all people as members of one human family. In Christianity’s case, it is a child in a manger, who is not unique but representative of every child everywhere and thus the real “sign” for “peace on earth.”

    Editors Note: A powerful paragraph by Warren and Alberts and a reminder that  Christmas is about what it means to be human and loving, especially to the vulnerability of the "least of these". For now one of the the most concrete example of the "least of these", are the immigrants fleeing from their war torn countries with their children to save their lives and spirit.

    Warren and Alberts: The “sign” in the manger leading to “peace on earth” is embodied in all children everywhere. Peace is not a gift from above to “those whom he favors.” Peace is created by those who possess beliefs without borders. Who become free to love– like children.  As Jesus himself is quoted as saying, “Truly I tell you, unless you change and become like little children, you will never enter the kingdom of heaven.” (Matthew 18: 3)

    _______

    Perry Miller, Editor
    perrymiller@gmail.com

    Amy Eva Alberts Warren, PhD is the daughter of Eva and Bill Alberts.  Her Ph.D. is in Applied Child Development from Tufts University, where she is a Research Associate for Applied Research in Youth Development.  She is a co-author of the textbook, Visualizing the Life Span, John Wiley & Sons, 2015, and a co-author of Thriving and Spirituality Among Youth, Wiley, 2012. Her email address is amy.warren@alumni.tufts.edu

    Rev. William E. Alberts, Ph.D., a former hospital chaplain at Boston Medical Center, is both a Unitarian Universalist and United Methodist minister. His new book, The Counterpunching Minister (who couldn’t be “preyed” away) is now published and available on Amazon.com. The book’s Foreword, Drawing the Line, is written by Counterpunch editor, Jeffrey St. Clair. Alberts is also author of A Hospital Chaplain at the Crossroads of Humanity, which “demonstrates what top-notch pastoral care looks like, feels like, maybe even smells like,” states the review in the Journal of Pastoral Care & Counseling. His e-mail address is wm.alberts@gmail.com.

  • 21 Dec 2015 2:01 PM | Perry Miller, Editor (Administrator)

    As an advocate of experiential learning, I’m inviting the members of the College of Pastoral Supervision and Psychotherapy the opportunity to engage with other professionals who are intrigued with the practice of leadership and the exercise of authority. A conference, presented by the A.K. Rice Institute, titled “Leadership, Authority, and Passion: Risk and Opportunity,” is scheduled for January 20 - 24, 2016, in Dover, Massachusetts.

    A primary task of group training is to offer attendees opportunities to learn about their own understanding of where they “fit” in the spectrum of group dynamics, with a specific focus on learning about the nature of authority and the problems that are encountered in its exercise. This conference will allow you to have those experiences outside of your work environment. You will be challenged and invited to see yourself from a different perspective, and I can assure you that you will learn valuable things about yourself and how you relate to other people. The experiences you will gain in group relations work will bestow indescribable benefits to you, those you serve and to our entire CPSP community.

    Studies have shown that when two or more members from the same organization attend group trainings, they are more likely to apply their learned experiences more effectively when they return to their respective work places, so I highly recommend that you enlist a colleague and attend this very engaging conference. 

    _____________

    Ruth Zollinger
    runrz1@me.com


  • 19 Dec 2015 3:49 PM | Perry Miller, Editor (Administrator)

    We have confirmation that John was disconnected from his respirator Thursday night and died in the presence of his son David and daughter-in-law.

    A gathering of friends and family is planned for Monday evening at the Hunan Delight Restaurant in New Brunswick, John's favorite restaurant. It will be Dutch treat.

    A memorial service is tentatively scheduled for January 9th in New Brunswick. Further information will follow as it comes available.

    John was a Past President of CPSP, and had been a member and Diplomate since 1991.

    He will be greatly missed by many in our community.

    Raymond Lawrence
    General Secretary
    raymondlawrence@gmail.com


  • 11 Dec 2015 10:46 AM | Perry Miller, Editor (Administrator)

    I call on all in the CPSP community to make an effort to reach out collegially and in solidarity with members of the Muslim community in the face of the current irrational public outrage directed at Muslims as a whole. We are religious professionals, and now one particular religious group is being targeted and scapegoated irrationally.

    Some of us have lived long enough to have witnessed this kind of pogrom before. Most religionists in the 1930s and 40s were silent in the face of the Nazi assault on Jews. Only a small number of religious people in Germany in that era publicly challenged the murderous and irrational rage against Jews. We remember some of those few who went into exile or to their deaths for standing against actions of the Germany government in that era: Dietrich Bonhoeffer, Karl Barth, Paul Tillich, and others were a small minority of courageous religious dissenters in the face the assault on Jews in that era.

    Today in the United States we are witnessing an incipient replication of Nazi rage in all its irrationality and venom. Our silence in the face of this scourge will ultimately condemn us. I call you each of you to counter this terrible threat by doing all you can to embrace our fellow religionists in the Muslim community in any way that you are able.

    Raymond J Lawrence
    General Secretary, CPSP

  • 09 Dec 2015 11:34 PM | Perry Miller, Editor (Administrator)

    Front and Center: Dr. Paul Tabon, President of the Board of Trustees of CPSP-Philippines and Raymond J. Lawrence, CPSP General Secretary 

    Clinical Training is alive and well in Philippines. Some  twenty-five persons gathered in Baguio City for official business and for seminars over a three-day period in November.

    Supervisors-in-Training, and trainees at various levels gathered to present their clinical cases. I heard later that they were all very nervous, though they each seem quite well-composed to me. A dozen cases were presented. Cases coming from villages and cities of the Philippines have generally speaking a more earthy quality than what we are used to from American general hospital patients. 

    CPSP signed an agreement with CPSP Philippines (CPSP PI) composed by Charles Hicks whereby Filipinos are permitted to organize their own professional life according to what best fits the Philippines. They will do their own certifications and accreditations, and generally organize their own corporate life as best befits their culture. Every two years they will consult with CPSP leadership on their pr ogress, and CPSP USA will assure that they generally follow the basic values of CPSP.

    Persons certified by CPSP PI will not be permitted to practice supervision or pastoral psychotherapy outside the boundaries of the Philippines. If an individual certified in the Philippines intends to practice in the U.S., that individual must meet a relevant CPSP review committee prior to working in the U.S.

    This agreement allows persons in the Philippines to move forward with their work without being burdened by committees and oversight from the other side of the globe. Since the beginning of the work of CPSP in the Philippines, this burden has handicapped indigenous work. We believe this new agreement liberates Filipinos to move on a more self-directed path. We wish them godspeed.
    ___________________________

    Raymond J. Lawrence, CPSP General Secretary
    raymondlawrence@gmail.com


  • 26 Nov 2015 1:42 PM | Perry Miller, Editor (Administrator)

    On November 11, we celebrated Veterans Day with parades and sales, but four days later the mood, especially in France, swung to that of laying a wreath at the grave of the Unknowns.  

    My brother, for years one of the Unknowns, went "missing in action" in 1945. Our family stood at different times -- the namesake he never met, my father, and I -- above his "officially identified remains" in  Belgium, the country through which one of the Paris terrorists passed. 

    George, Jr., wrote eloquently of his father's sacrifice and those of other Americans for our country. He also told of the respect shown by a Belgium father who brought his children to Ardennes. I witnessed such respect when my Belgium volunteer driver joined me in prayer, at the gravesite, in the rain. My father never spoke of his visit. I wept, and believe he did. 

    I shared George’s story with my other nephews and nieces. A niece sent a DVD of my sister telling a funny story about our brother. A nephew, who served in the US Navy, offered to dedicate a brick in his uncle's name to a veterans memorial. My eldest nephew wrote that he associated a childhood memory with the visible grief of his grandparents, especially that of my mother. He added that my sister’s tale gave him a glimpse of how much we missed George’s presence in our lives. It also gave him an insight into our typical behavior, one of silence. Those were my adolescent memories, and our fear of further hurt explains his insight.

    As a reflection on recent tragic events, then, I suggest a moment of trying to understand this type of grief. Those who leave us, as my sister’s tale illustrates, may reappear in talk, but sometimes they continue to exist only in the silence of how much we miss and love them.  

    Also, here's my open thank-you note after hearing President Obama speak in Vienna a few days after the bombing:

    Dear Mr. President,

    Thank you for not declaring war this morning, and please don't be annoyed with others seeking revenge. 

    Now 85, I have heard many reasons to fight. As a community worker in Chicago you've also heard them, mixed as they might have been, with self-interest and savagery. 

    I joined the USAF in 1948 during our brief peacetime with savage feelings after the death of my brother in WWII. Three years later President Truman froze the enlistments of volunteers as the Korean Police Action heated up. It doesn't sound as if you will do that. 

    As a chaplain intern I worked briefly in a veteran's hospital. There I talked with injured fighters, especially from the Vietnam Conflict. You have probably visited many more who returned from more recent wars than I have. Some of them you sent into harm's way, as you stated. I'm sorry.

    Finally, I applaud your words on behalf of Syrian refugees, who suffer collaterally with our injured and fallen. I am sure that President G.W. Bush, Pope Francis, and Chancellor Merkel, among other world leaders, would agree  that they deserve our compassion.  

    ________________________________

    Domenic is a retired CPSP Clinical Chaplain in Littleton, Colorado.
    maryfuccillo8901@comcast.net

  • 24 Nov 2015 10:24 PM | Perry Miller, Editor (Administrator)

    NCTS-East Tavistock Meeting: "Leadership and Membership in Diverse Organizations."

    I recently was invigorated by participating in the outstanding National Clinical Training Seminar (NCTS) – East of the College of Pastoral Supervision and Psychotherapy (CPSP) on November 2-3, 2015 at the Loyola House of Retreats in Morristown, NJ. Held in collaboration with the A. K. Rice Institute (AKRI), this year’s theme, “Leadership and Membership in Diverse Organizations,” explored the nature of our relationship with authority and the roles we take up in our own lives and how we fill them in a variety of settings.

    I discovered that I was comfortable playing the role of the Silent Observer. I then took a risk and experimented playing a different role, one of Supporter-Encourager in the group. In the process, I became more aware of how I take up the “driver” and “passenger” roles and how the group dynamically develops “leaders” and “followers.”

    Having attended only one other NCTS-East and just returning from the exceptional NCTS-West Group Relations Conference, I was really looking forward to experiencing this special conference which was chaired and coordinated by CPSP Past-President Rev. Dr. Francine Hernandez, Manager of Clinical Pastoral Education (CPE) at St. John’s Episcopal Hospital. This was a working conference.  Diplomate Training-Supervisors led small groups where every chaplain presented a case in our small group. We later reported our learning back to the large group. We also experienced the Tavistock approach to engaging group dynamics in various gatherings and group settings. We were fortunate to have wonderful expert consultants from AKRI, including Program Director Dr. Howard A. Friedman, Dr. Frank Marrocco and Rev. Dr. Kimberley A. Turner. The program provided us with opportunities for experiential, didactic and reflective learning.

    At the Opening Gathering and Presentation the task was introduced, and a theoretical framework for our work was provided. We divided into smaller Preview and Review Application Groups that worked together to understand where each individual fits in and applied our learning to back-home situations. I especially enjoyed these smaller discussion groups because they allowed for more intimate communication between members of the group. 

    All participants and staff also met together in a Large Group to study our own behavior in the “here and now” and see how it evolves. Sitting in configurations of inner, middle and outer concentric circles, we were free to explore questions about leadership, power and authority, membership and participation, sub-group formation, and issues of social identity as they emerged. A final Large Study Group provided members and staff an opportunity to debrief and to reflect together on our experience.

    I left this year’s NCTS excited, inspired and enthusiastic! There was warm collegiality and camaraderie amongst members, and ample time for professional networking. I made new friendships that I certainly cherish. I hope our close relationships will continue for many years to come.

    See you at next year’s NCTS-East!

    ___________________________

    Rabbi Dr. Hillel Fox, BCCC, BCPC
    Supervisor-in-Training Resident at St. John’s Episcopal Hospital
    rebhillel1@aol.com



  • 18 Nov 2015 10:38 AM | Perry Miller, Editor (Administrator)

    For those who don’t know me, I was in the second wave of those who became CPSP Diplomates in 1990.  Raymond was one of my ACPE training supervisors at St. Luke’s Episcopal Hospital, Houston, Texas, 1973-1974.  I was told by one of the members of the ACPE certification committee which I met in 1989 that if Raymond had not been on the committee that I would not have been certified as a full supervisor.  At that time, Raymond was just beginning to become the prolific writer that he is today.  I have always felt that his writings were provocative.  Now I think a better description is passionately defiant.  Perhaps parallel to one of Raymond’s gurus, the founding father of psychoanalysis, Sigmund Freud.  This is how I experienced Raymond in his new book:  Nine Clinical Cases:  The Soul of Pastoral Care and Counseling.

    This term, passionately defiant, came to me serendipitously.  It was while I was recently reading his book and happened also to be reading Peter Gay’s classic:  Freud:  A Life for Our Time.  I was struck how parallel Raymond and Freud are in being passionately defiant in their writings For this parallel, I draw upon Gay’s section in his book in describing Freud’s “Defiance Identity” (pp. 597-610).  “Freud’s defiant cast of mind,” as a Jew, Gay writes, “permitted him to offend Jewish sensibilities” in his “subversive attitude toward respectable sexual mores” (p. 610).  Is this not a striking parallel to Raymond as an ordained Episcopal priest confronting the sexual mores (ethics) of the Church in Poisoning of Eros: Sexual Values in Conflict?

    Another one.  As Gay instructs us, “Freud saw himself…as a marginal man” which he felt “gave him an inestimable advantage.”  For, identifying himself as a “completely godless Jew” and being offensive to some of his fellow professors, Freud felt “prepared the way for a certain independence of judgment” (p. 602).  His defiance gave him some creative objectivity in the development of his psychoanalytic thought and practice.  

    Isn’t this parallel to Raymond’s rather defiant remark in his book that the chaplain should be agnostic?  “The proper posture of a clinical chaplain is agnostic, regardless of the chaplain’s own personal beliefs and allegiances” (p. 29).  As Freud would, doesn’t Raymond see this  objective stance as a necessity vs. “indoctrination and proselytizing” (unacceptable “in the clinical setting,” p. 30)?  Much like Freud, I suspect, Raymond’s defiant opposition to the pious-powers-that-be would assert that the chaplain’s agnosticism vs. being doctrinal and evangelistic is a requirement for competent pastoral care and counseling.

    In a further Pastoral Report, I will explore in more detail some of Raymond’s passionately defiant, and some not so defiant, points in his rebuttal of the book he is addressing:  George Fitchett and Steve Nolan, Spiritual Care in Practice:  Case Studies in Healthcare Chaplaincy.  I had to smile as Raymond states in his Preface that his book was “actually little more than an expanded book review of the Fitchett-Nolan book” (p. 8).  I suspect that those on the Fitchett-Nolan side must wonder how much more defiant would Raymond’s critique be if he had chosen to write more than “just a little…expanded book review.”

    Like this one, my next article in a Pastoral Report will be more than just a little expanded book review.  After all, in the last paragraph of his Preface, Raymond invites as much.  He neither wants to coddle nor to be coddled.  He does not want “to be spared strong rebuttal” (p. 9).  

    _______________________________________________

    Ed Hennig, D.Min.
    edgarhennig@yahoo.com

  • 10 Nov 2015 8:51 AM | Perry Miller, Editor (Administrator)

    Editor's Note: The month of November is dedicated to Palliative Care. Chaplain Poorbaugh's article is not only informative but timely. CPSP offers a specialty certification in Hospice and Palliative Care.

    Meriwether Lewis stood by the headwaters of the Missouri, a trickling stream that would become the mighty river. His first goal was thus done. His second goal - to find a good passage to the Pacific Ocean – might be done soon. Thomas Jefferson had told him to expect the West to be like the East: some big mountains like the Appalachians lowering slowly to the ocean. He decided to mount the ridge ahead, hoping he might look down on the Pacific Ocean. 

    Instead, he looked up at the Grand Tetons.

    (Paraphrased from Undaunted Courage, by David McCullough.)

    When I began Palliative Chaplaincy years ago, I felt like Lewis by the stream. Having been a pastor most of my life, with many hospital visits and beloved flock dying, I knew I could navigate the Appalachians.  When I got a little farther in the field I felt like Lewis on the ridge, seeing Palliative Chaplaincy as the Grand Tetons.

    For chaplains new to Palliative Chaplaincy, this article has three goals: to have fun, to see in the Q’s (questions) how big it is, and to gain from the A’s (answers) some nuggets of fundamental knowledge.

    Q

    Names:

    1.  What historical figure gives us both “Palliative” and “Chaplain?” ____________________



    Credentials:
    1.  Name all the specialties in which a BCCC or BCC can earn Board Certification. _______________
    2.  Who leads in certifying Specialty Chaplains? ____________________
    3.  What fact led to creating this Specialty? ____________________


    Basic: 

    Contrast Palliative Care and Hospice Care three ways.

    1. ________________________________

    2. ________________________________

    3. ________________________________

    Suffering:

    1.  Compare Pain and Suffering by circling all that are true:
    a.  Pain is physical; Suffering is spiritual.
    b.  Both are physical
    c.  Both are spiritual
    d.  Neither can be measured.

    2.  Match each medical writer with their theory of Suffering:

    Cicely Saunders
      Broken Personhood
    Ira Byock
      Loss of Capacity
    Jane Brody
      Total Pain
    Eric Cassell
      Loss of Meaning
    Thomas Gleich
    Broken Story


    Spiritual Distress:

    1.  Your Patient may have any of these spiritual conditions. Circle the three that count as Spiritual Distress.
    a.  Fear of being in the hospital
    b.  Isolation
    c.  Repentance
    d.  Ritual Need
    e.  Remorse/Regret
    f.    Hopelessness
    g.  Denial

    Preferred Practices:
    The National Consensus Committee for Quality Palliative Care has set preferred practices. For this question, try marking each option:

    +  we do that already

    0  we don’t do that yet 

    R  right answer

    !  Fat Chance! 

    1.  Everyone on the Palliative Care IDT must learn to spell “palliative.” ____
    2.  The IDT must provide access to spiritual care for all patients.  ____
    3.  The IDT must have a standard for spiritual assessment, use it for each patient, and include it in the care plan.  ____
    4.  The IDT must meet every morning to coordinate care.  ____
    5.  The IDT Chaplain must be Board Certified in Palliative Care.  ____
    6.  The IDT must work in the community for education and End of Life care.  ____
    7.  The IDT must order in pizza at least once a month.  ____

    A

    Names:

    1.  St. Martin of Tours

    A young Roman cavalryman, seeing a poor man freezing at the city gate, cut his heavy woolen cloak and gave away half. That night, he dreamed he saw Jesus wearing the half-cloak he had given. Later in the IVth Century, Martin became bishop of Tours. His cloak became a relic. The Latin verb for cloak –palliare – gives us palliative. The Latin noun for cloak –capella – gives us chaplain.

    Credentials:

    1.  Hospice and Palliative Chaplaincy

    2.  CPSP
    In 2013, CPSP certified its first Clinical Fellows in Hospice and Palliative Care. In 2014, the Association of Professional Chaplains followed with their Hospice and Palliative Chaplains.Entering 2015, CPSP had certified 43 Palliative Chaplains; APC, 4.

    3.  Death
    Because modern medicine is based on the philosophy of materialism (only matter that can be measured is real), death means failure. Hospitals hate to have people die there.  Doctors hate to deal with dying people. As Atul Gawande, author of the best-seller Being Mortal, writes: “Our job is to fix someone; when we can’t fix someone, we have failed.”  Death is being transformed from the dirty work of medicine into the holy work of palliative chaplaincy.  


    Basic:

    1.  When does it start?
    Palliative – at diagnosis of a chronic or terminal illness
    Hospice – at prognosis of six months or less to live
    2.  May I receive curative treatment for my main disease while enrolled?
    Palliative – Yes
    Hospice – No
    3.  When does it end?
    Palliative – Hospice (unless declined)
    Hospice – Death (unless dis-enrolled)

      Suffering:

      • 1.  (c) and (e) -- Because neither can be measured, both are spiritual. 

      Medicine avoids suffering by reducing it to pain. Ira Byock claims in his book, The Best Care Possible, never to let a patient suffer, but the index for “Suffering,” reads: “see Pain and Suffering.” 

      Medicine must deal with pain to relieve the symptom, so measures pain with a highly precise scientific instrument – the frowny face cartoon.

      2.  Author/Title Match:

      Cicely Saunders
      Total Pain
      Ira Byock
      Loss of Meaning
      Jane Brody
      Broken Story
      Eric Cassell
      Broken Personhood
      Thomas Gleich (doesn’t exist,
      but if he did, he might have written Loss of Capacity)

      Spiritual Distress:

      Dealing with Suffering matters a great deal in the practice of Palliative Chaplaincy, but is too complex to do more here than point out as a Grand Teton we must surmount.

      1.  Isolation, Hopelessness, Ritual Need

        Isolation. One might think that life-threatening disease would produce above all fear of death. Cicely Saunders stated that what people in the end of life fear most is isolation. Next come pain and death. Anything scarier than pain and death must be distressing.

        Hopelessness.  The Gate of Hell in Dante’s Inferno commands “Abandon hope, all ye who enter here.” It comes - by its theological synonym despair- when I am so far down I believe not even God can help me. To be hopeless is to be already in Hell.

        Ritual Need.  A well-known formal example is a Roman Catholic who may believe that receiving the Sacrament of the Sick will ensure dying in a state of grace. A less-recognized informal example is an Evangelical who believes that a dying loved one must say the Sinner’s Prayer - accepting Jesus as personal Lord and Savior – to ensure going to Heaven. The formal and informal needs may be equally intense.

        Identified in the National Comprehensive Cancer Network Compendium and Guidelines, updated January 6, 2012.  These Guidelines have been vetted and revised for over 10 years, so provide solid evidence-based standards.   I find them both theologically and clinically accurate. http://www.nccn.org/about/news/ebulletin/ebulletindetail.aspx?ebulletinid=154     

        Preferred Practices:

        1.  (b), (c), (e) and (f) are real.  The others are just good ideas. Here are the real spiritual standards to be met for Quality Palliative Care.

        SPIRITUAL, RELIGIOUS, AND EXISTENTIAL ASPECTS OF CARE

        PREFERRED PRACTICE 20

        Develop and document a plan based on assessment of religious, spiritual, and existential concerns using a structured instrument and integrate the information obtained from the assessment into the palliative care plan.

        PREFERRED PRACTICE 21

        Provide information about the availability of spiritual care services and make spiritual care available either through organizational spiritual counseling or through the patient’s own clergy relationships.

        PREFERRED PRACTICE 22

        Specialized palliative and hospice care teams should include spiritual care professionals appropriately trained and certified in palliative care.

        PREFERRED PRACTICE 23

        Specialized palliative and hospice spiritual care professional should build partnerships with community clergy and provide education and counseling related to end-of life care.

        National Consensus Project for Quality Palliative Care, “Clinical Practice Guidelines for Quality Palliative Care, 3rd edition, 2013,”cited at http://www.nationalconsensusproject.org/Guidelines   

        __________________

        Frederick Poorbaugh

        fredpoorbaugh@stanfordalumni.org