Using Spiritual Assessment to Facilitate Spiritual Care - PowerPoint PPT Presentation


PPT – Using Spiritual Assessment to Facilitate Spiritual Care PowerPoint presentation | free to view - id: 9a389-MjQyM


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation

Using Spiritual Assessment to Facilitate Spiritual Care


Ritual as comfort in times of pain or anxiety ... The role of rituals. The place of mystical events and understandings of divine intervention ... – PowerPoint PPT presentation

Number of Views:787
Avg rating:3.0/5.0
Slides: 54
Provided by: grebelUw


Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Using Spiritual Assessment to Facilitate Spiritual Care

Using Spiritual Assessment to Facilitate
Spiritual Care
Caring for the Spiritual Lives of Seniors
Presenter Rev. James W. Ellor, Ph.D., D. Min.,
School of Social Work, Baylor University Editor
Journal Of Religion, Spirituality and
Aging Parish Associate First Presbyterian Church
of Waco
Planning Teams -1 (10 minutes)
  • Find a group of 4-6 persons that you can work
    with as a team throughout the day. Consider
    finding people that you do not know ahead of
  • Discuss together what your goals are for today.
    What do you want to get from today?
  • You have 10 minutes for this exercise

Discuss with the group the tools you hope to
  • Religion
  • Spirituality
  • Faith
  • Faith Development
  • Faith Development
  • Spiritual Coping
  • What else?

Theoretical Issues
Why do assessment?
  • Offers voice to spiritual needs
  • Enhances inter-disciplinary cooperation
  • Mandated by Joint Commission for Long Term Care
    and Hospice

Joint Commission
  • Minimum Standards
  • Determine the patients denomination
  • Beliefs
  • What Spiritual Practices are important
  • Hope, Despair, views of death
  • Is the patients spiritual practice helpful in
    coping with suffering and life in general?
  • All Joint Commission Standards are intended to be
    integrated with other logical standards, such as
    Behavioral Health

Where to find Joint Commission Standards
  • The Joint Commission directly requires Spiritual
    Assessment in
  • Long Term Care
  • Hospice
  • The Hospice Standards offer a fuller reflection
    of the thinking of the commission

Spiritual Assessment
Definitions are the first step then
  • Definition
  • Assessment
  • Treatment
  • outcome ?

Constructing a new wholistic paradigm
The Person
A Matter of Perspective
  • Theology
  • Theo centric
  • Anthro centric
  • Psychology
  • Paradigms
  • Philosophies
  • And More

Anthro centric
  • Starts from understanding that humanity can not
    fully understand God
  • Therefore it is understood that humanity can only
    view God through human eyes. In other words,
    humanity looks up at God
  • Key is role of revelation

An Anthrocentric perspective
Thibault, Jane M., James W. Ellor, and F. Ellen
Netting. "A Conceptual Framework for Assessing
the Spiritual Functioning and Fulfillment of
Older Adults in Long-Term Settings." Journal of
Religion and Aging 7, no. 4 (1991) 29-46.
Fowlers Stages
  • Pre-stage Infancy Undifferentiated Faith Stage
  • Stage 1 Intuitive-Projective Faith
  • Stage 2 Mythic-Literal Faith
  • Stage 3 Synthetic-Conventional
  • Faith
  • Stage 4 Individuative-Reflective
  • Faith
  • Stage 5Conjunctive Faith
  • Stage 6 Universalizing Faith
  • James W. Fowler, 1995, Stages of Faith, San
    Francisco Harper and Row.

Coping Model Based on the work of Ken Pargament
Interrelations of Stress Buffers
  • Social Support
  • Coping Skills
  • Perception of stressor and coping ability
  • Sources of Meaning
  • Biological resilience
  • Hartz, G. W. (2005). Spirituality and mental
    health Clinical applications. Binghamton The
    Haworth Press.

Hierarchy of Sources of Meaning
Marginal Sources of Meaning
Secondary Sources of Meaning
Foundational Sources of Meaning
Hartz, G. W. (2005). Spirituality and mental
health Clinical applications. Binghamton The
Haworth Press.
Religious Coping Methods
  • Spiritual Support and collaborative Coping
  • Belief that one is receiving support and guidance
    from God God is seen as another member of the
    support network.
  • Congregational Support
  • Helpfulness of clergy, lay leaders, and fellow
    congregants in times of stress
  • Benevolent religious reframing
  • Attributing the stressful event to the will of
    God or to a loving God

Hartz, G. W. (2005). Spirituality and mental
health Clinical applications. Binghamton The
Haworth Press.
Four Reliable Aspects of Religion and Spirituality
  • Prayer helps
  • People use their beliefs in coping, particularly
    with tragedy
  • Religion seems to influence
  • Immune
  • Endocrine
  • Nervous systems
  • Ritual as comfort in times of pain or anxiety
  • Community Support come from Faith Based
    Community Services
  • Provides values and answers basic life questions

Outcome Examples (So what!)
  • If you learn that the senior employs religion as
    a coping mechanism, how will that impact working
    with the person when she/he is anxious?
  • If you learn that she/he is Presbyterian, how
    will that impact services, such as referral to
    chaplaincy or the selection of a pastor to come
    talk with the senior?
  • If you learn that the person is oriented toward
    mysticism, how will that impact the way you
    understand their discussions of future events or

Coping Defined
  • Coping refers to efforts to master conditions of
    harm, threat, or challenge when a routine or
    automatic response is not readily available.
  • Monat, A. and R. S. Lazarus (1977). Stress and
    Coping An Anthology. New York, Columbia
    University Press.

Coping Mechanisms
  • DenialKeeping negative events from conscious
  • Sublimation Aggressive impulses are diverted
    into prosocial behaviors
  • Projection
  • Attributing to someone else ones own thoughts
    or feelings.
  • Displacement Deflecting feelings from their
    original target to someone else
  • Reaction formation
  • Unacceptable wishes or impulses are transformed
    into their opposite
  • Intellectualism/rationalization
  • Symptom Conversion
  • Planning
  • Restraint
  • Reframing
  • Use of social support
  • Acceptance
  • Use of humor

  • Most common mechanism involving religion is
  • 3 natural Mechanisms
  • A system of beliefs Mental attitudes
  • Increased social support
  • Focus on others (transcendence)

Mechanisms for Optimism Hope
  • Positive Hymns
  • Positive Theologies pervasive within congregation
  • Prayer in times of trouble (We are never alone)
  • The concept of a loving, forgiving Devine partner
    in life

Social Support
  • Congregational Care giving
  • Congregational support for families
  • Congregational Information and Referral
  • Clergy most likely turned to in times of crisis

Assessment Keys
  • The nature of God
  • Is God approachable…if so how?
  • The on going role of, or presence of God in the
    life of the client/patient
  • The role of humanity in the on-going creation of
    our environment
  • The role of rituals
  • The place of mystical events and understandings
    of divine intervention
  • The nature of and need for critical elements of
    participation in the faith community, such as
    worship, prayer, anointing, etc.

Team Meeting 3 (20 minutes)
  • This is a time to brain storm with your team.
  • What types of topics do you need to cover in your
  • How will this fit into the other types of
    assessments being done, either by you, or by
  • What outcomes do you expect from this assessment?
    (This may be a good question to start your
    discussion with!)
  • Be prepared for a brief popcorn feedback session
    with the entire group by offering some ideas back
    to the group

Assessment Technology
  • The nuts and bolts of getting it done

Steps in Assessment
  • Determine what is to be assessed. Definition is
  • Determine the how, and by whom, the data will be
  • Determine who will do the evaluation
  • Develop an approach
  • Implement and constantly reevaluate process
  • Risk Factors

Possible Formats
  • Open ended Questions
  • Structured Questions
  • Targeted content with clear categories of
  • Still open
  • Closed questions
  • Full Psychometric design
  • Eco-mapping

Eco Map for Spiritual Assessment
Topics for Inclusion
  • Now that you have the big picture, what are the
    specific items that you want to put into your
    assessment tool?

Common Elements in Spiritual Assessment
  • Doug Olson, building on the work of the Fetzer
    Foundation in his study of common variables used
    in spiritual assessment found the following eight
    variables to be commonly found in all of the
    religious and spiritual research instruments
    gathered for their research These variables are
  • Olson, Doug, In press, Religiosity and
    Spirituality Assessment Approaches and Tools, in
    Robert and Rosalie Kane Assessing Older Persons.
    Oxford University Press.
  • Fetzer Working Group (1998). Brief Measure of
    Religiousness and Spirituality, Jointly sponsored
    by NIA and Fetzer. Kalamazoo, Michigan.

  • Dependent
  • Relationship
  • Religious History
  • Organizational Practice
  • Degree of Commitment
  • Independent
  • Private Daily Experience
  • Value Systems and Ethical Precepts
  • Spiritual and Religious Beliefs
  • Spiritual Development

Fetzer Institute 12 Domains
  • Daily Spiritual Experience
  • Religious/Spiritual coping
  • Private religious practices
  • Religious/spiritual history
  • Organizational religiousness
  • Religious preferences

Fetzer Institute 12 Domains, continued
  • 7. Meaning
  • 8. Commitment
  • 9. Forgiveness
  • 10. Values
  • 11. Beliefs
  • 12. Religious Support

Possible Elements
  • Spiritual History
  • Denominational history
  • Oral History
  • Coping
  • Meaning
  • Pathology Assessment
  • Activities
  • View of death and Afterlife
  • Important or Meaningful Symbols
  • View of God
  • Role of Prayer
  • Motivation for health or Wellness
  • Spiritual reminiscence
  • Eco mapping

  • Time/Staff
  • Need
  • Cognition on the part of the senior
  • Assess to family or other key informants
  • History

  • New Laws on confidentiality
  • Need Client/patient permission
  • Work out with supervisor and administration

How and by whom will data be used?
  • Chaplains office
  • Clinical Assessment
  • Interdisciplinary Team
  • Statistical Reporting
  • Community Liaison
  • Nursing Assessment

Determining who will do the assessment
  • Chaplain
  • Volunteer
  • Social Service
  • Nursing
  • Activities

Team Meeting- 4 (15 minutes)
  • Who will do it?
  • What format will you use?
  • Paper and pencil
  • Interview
  • Small group
  • What do you want to get out of it?
  • How will it interface with other assessments
  • How will it be used?
  • What Elements do you want in your assessment tool?

Intervention Examples
  • Different interventions require different
    assessment strategies

Role related construction for example Parish
Nurse or Chaplain Interventions
  • Spiritual Mapping
  • Spiritual Crisis Intervention
  • Counseling
  • Grief Support

Task Oriented Assessment Spiritual Crisis
  • Religion as coping mechanism
  • Spiritual community support
  • Ritual as comfort in times of pain

Task Oriented Assessment Counseling
  • Wholistic assessment to include the spiritual
  • Spiritual Crisis Intervention
  • Spiritual wellness or strengths
  • Religious community support

Task Oriented Assessment Grief Support
  • Comfort in times of loss
  • Religion as coping
  • Community support

Task Oriented Assessment Community Liaison
  • Assessment of residents in order to build bridges
    with community congregations
  • Knowledge data base for programming
  • Data base to bridge with needed faith communities.

Team Meeting 5
(30Minutes) Putting it all together
  • Work with your team to develop your own
    assessment tool

Building your own assessment - Goal
  • What is your goal
  • Basic assessment for brief intervention
  • May not want a paper and pencil tool, rather a
    short memorizable instrument
  • Short portable tool
  • Written tool that can be placed into a chart
  • Depth assessment to bridge with interdisciplinary

Developing the tool
  • Demographic Questions
  • Assessment of the spiritual
  • Assessment of the need for or types of
  • Assessment interface with psychology

Finalize approach
  • Finalize tool
  • Field test tool
  • Employ tool
  • Reevaluate tool

Where to go from here
  • Design a Spiritual Strategy
  • Discovery Assessment
  • Insight Team meeting
  • Action Intervention

Final Team Meeting - 6
  • Put it all together
  • Who?
  • Will do what?
  • To whom?
  • For what purpose?
  • How will it be evaluated?