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Tunks Leach K, Demant D, Simpson P, Lewis J, Levett-Jones T. Chaplaincy and spiritual care in Australian ambulance services: an exploratory cross-sectional study. J Health Care Chaplain 2024:1-24. [PMID: 38574262 DOI: 10.1080/08854726.2024.2323371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Ambulance staff wellbeing programs aim to support the bio-psycho-social and sometimes spiritual needs of paramedics. While evidence demonstrates strong connections between spirituality and/or religion to wellbeing outcomes, little is known about spiritual care in ambulance services or its impact. The aim of this study was to investigate paramedics' perspectives on the role and value of Australian ambulance chaplains. A cross-sectional online study of registered paramedics in Australia was conducted between November and December 2022. Analysis of the 150 responses identified that paramedics viewed the chaplain's role as one built on professional caring relationships that provided proactive and reactive care in paramedic workplaces. Chaplains were perceived to promote wellbeing by incorporating emotional, psychological, social and spiritual care, and assisting paramedics to access additional support. Perceived religiousness of chaplains and organisational factors were barriers to paramedics accessing chaplains, while pre-existing relationships and shared experiences positively influenced paramedics decision to seek chaplain support.
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Affiliation(s)
- Katie Tunks Leach
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Daniel Demant
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- Faculty of Health, Queensland University of Technology, Brisbane, OLD, Australia
| | - Paul Simpson
- School of Health Sciences, Western Sydney University, Sydney, NSW, Australia
| | | | - Tracy Levett-Jones
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Layson MD, Carey LB, Best MC. The Impact of Faith-Based Pastoral Care in Decreasingly Religious Contexts: The Australian Chaplaincy Advantage in Critical Environments. JOURNAL OF RELIGION AND HEALTH 2023; 62:1491-1512. [PMID: 36976458 PMCID: PMC10044095 DOI: 10.1007/s10943-023-01791-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 05/15/2023]
Abstract
This article considers the contribution of faith-based chaplains who provide holistic pastoral and spiritual care within critical environments such as the military, first responders, and hospitals. The contribution of faith-based chaplains can sometimes be taken for granted or not properly understood, particularly in some Western countries which are currently experiencing a decline in religiosity. Following on from a previous paper regarding chaplaincy utilization (Layson et al. 2022), this article presents an alternative argument to the secularist-humanist perspective by noting five ways by which the faith based chaplaincy model provides best practice service and builds a capability advantage for organizations that engage faith-based chaplaincy services. The first section discusses faith-based chaplaincy and organizational holistic care; the second section considers the role of faith-based chaplains-much of which is largely unknown and poorly appreciated; the third section considers the unique capability of faith-based chaplains to provide spiritual and religious care to those of faith and for those of none; the fourth section explores how faith-based chaplains can leverage the positive impact of religious organizations to provide additional low-cost resources for other organizations and their staff; and lastly, the operational advantage of faith-based chaplains on the world stage is considered, particularly in light of culturally and linguistically diverse populations to whom religiosity is increasingly important.
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Affiliation(s)
- Mark D. Layson
- Faculty of Arts and Education, St Mark’s National Theological Centre, Charles Sturt University, Canberra, ACT, NSW Australia
| | - Lindsay. B. Carey
- Palliative Care Unit, La Trobe University, Melbourne, VIC Australia
- Institute for Ethics and Society, University of Notre Dame, Sydney, Australia
- Centre for Spirituality, Theology and Health, Duke University, North Carolina, USA
| | - Megan C. Best
- Institute for Ethics and Society, University of Notre Dame, Sydney, Australia
- School of Medicine, University of Sydney, New South Wales, Australia
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3
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Wortmann JH, Nieuwsma JA, Cantrell W, Fernandez P, Smigelsky M, Meador K. Chaplain Training in Evidence-Based Practices to Promote Mental Health and Improve Care for Suicidality in Veterans and Service Members. Arch Suicide Res 2023; 27:122-134. [PMID: 34520687 DOI: 10.1080/13811118.2021.1972884] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Chaplains are key care providers in a comprehensive approach to suicide prevention, which is a priority area for the U.S. Department of Veterans Affairs (VA) and the Department of Defense (DoD). In a cohort of 87 VA and military chaplains who completed the Mental Health Integration for Chaplain Services (MHICS) training-an intensive, specialty education in evidence-based psychosocial and collaborative approaches to mental health care-we assessed chaplains' self-perceptions, intervention behaviors, and use of evidence-based practices, including Acceptance and Commitment Therapy (ACT), Problem-Solving Therapy (PST), and Motivational Interviewing (MI), in providing care for suicidality. METHOD Chaplains responded to a battery of items Pre- and Post-training and provided deidentified case examples describing their use of evidence-based practices in spiritual care for service members and veterans (SM/V) on various levels of a suicide prevention continuum. RESULTS Post-training, chaplains reported increased abilities to provide care and mobilize collaborative resources. Over the course of MHICS, 87% of chaplains used one or more evidence-based practices with a SM/V at risk for suicide or acutely suicidal. Fifty-six percent of chaplains reported intervening with an acutely suicidal SM/V by using principles from ACT, 36% PST, and 48% MI. With persons at risk for suicide, 81% used principles from ACT, 66% PST, and 71% MI. Cases exemplified diverse evidence-based practice applications. CONCLUSIONS Findings indicate chaplains trained in evidence-based practices report effective application in caring for SM/V who are suicidal, thus offering a valuable resource to meet needs in a priority area for VA and DoD.HIGHLIGHTSChaplains provide essential care for SM/V who are at risk for suicide or acutely suicidalTraining helps chaplains mobilize interdisciplinary and community resources in suicide careEvidence-based practices can effectively integrate within the scope of chaplaincy practice for suicide care.
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4
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Grau PP, Valentine LM, Vuper TC, Rogers TA, Wong JD, Sexton MB. Military sexual trauma in context: Ethnoracial differences in ecological resources among treatment-seeking veterans. J Trauma Stress 2022; 35:1535-1545. [PMID: 35819929 DOI: 10.1002/jts.22859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 11/05/2022]
Abstract
Veterans who have experienced military sexual trauma (MST) are at increased risk for a host of negative outcomes, including posttraumatic stress disorder, depressive disorders, and substance use disorders. Previous studies have shown racial differences in MST exposure, namely that Black veterans experience MST more frequently than White veterans. One way to help clinicians and researchers understand the impact of these ethnoracial differences in MST exposure is through an applied theory of ecological resources, which has demonstrated ecological factors (e.g., aspects of identity, beliefs, and environmental stressors) contribute to veteran well-being in the aftermath of MST. The present study aimed to examine ethnoracial differences in ecological resources (i.e., available social support, spiritual coping, past-year interpersonal violence, financial sufficiency, and stable living environment). Participants (N = 505) were U.S. veterans who sought care at a Veterans Healthcare Administration clinic in the midwestern United States for mental health issues related to MST. Results demonstrated Black veterans were more likely than White veterans to report being financially insecure, U = 18,091.50, z = -2.04, p = .042, r = .10. Black veterans were also more likely to report spiritual beliefs that assisted with coping, Cramer's V = .19, but less likely to report having a social support system, Cramer's V = .16. These findings highlight the importance of assessing and addressing disparities illuminated by ethnoracial differences in ecological resources and barriers in veterans seeking care for MST.
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Affiliation(s)
- Peter P Grau
- VA Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC), Ann Arbor, Michigan, USA.,VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Lisa M Valentine
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Tessa C Vuper
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Travis A Rogers
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jennifer D Wong
- New Mexico Veterans Affairs Healthcare System, Albuquerque, New Mexico, USA
| | - Minden B Sexton
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
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5
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Layson MD, Tunks Leach K, Carey LB, Best MC. Factors Influencing Military Personnel Utilizing Chaplains: A Literature Scoping Review. JOURNAL OF RELIGION AND HEALTH 2022; 61:1155-1182. [PMID: 35059963 DOI: 10.1007/s10943-021-01477-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/30/2021] [Indexed: 05/11/2023]
Abstract
Chaplains have been embedded in military settings for over a millennium. In recent years however, the decline in spiritual/religious (S/R) affiliation of military personnel across Western cultures has led to some commentators questioning the utilization of religious chaplains by defence personnel. This scoping review maps the literature on S/R and non-S/R factors that influence utilizing military chaplains-with a particular emphasis on the Australian military context. A systematic scoping review of tertiary literature databases using Arksey and O'Malley (2003) and Joanna Briggs Institute methodologies (JBI, 2021), revealed a total of 33 articles meeting the inclusion criteria. Results fell into three broad categories: (i) how personal religious views influence utilization of military chaplaincy, (ii) barriers and enablers to personnel utilizing military chaplains, and (iii) the impact of chaplaincy. Despite the current reduction in religiosity in Western society, findings from this scoping review suggest there is little evidence that low religiosity among military personnel forms a significant barrier to utilizing chaplaincy services. To the contrary, the literature revealed that chaplains provide trusted, confidential, and holistic support for military personnel that if diminished or compromised would leave a substantial gap in staff well-being services.
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Affiliation(s)
- Mark D Layson
- Faculty of Arts and Education, Charles Sturt University, Bathurst, NSW, Australia.
- St Mark's National Theological Centre, Charles Sturt University, Canberra, ACT, Australia.
| | - Katie Tunks Leach
- University of Technology Sydney, Sydney, NSW, Australia
- New South Wales Ambulance, Sydney, NSW, Australia
| | - Lindsay B Carey
- Palliative Care Unit, La Trobe University, Melbourne, VIC, Australia
- Centre for Spirituality, Theology and Health, Duke University, Durham, NC, USA
| | - Megan C Best
- Institute for Ethics and Society at the University of Notre Dame, Sydney, NSW, Australia
- School of Medicine, University of Sydney, Sydney, NSW, Australia
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6
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Bush E, Cupery T, Turner RW, Sonnega A, Weir D, Whitfield KE, Jackson JS. The Price of Playing Through Pain: The Link Between Physical and Behavioral Health in Former NFL Athletes. Am J Mens Health 2020; 14:1557988320975541. [PMID: 33251947 PMCID: PMC7705796 DOI: 10.1177/1557988320975541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Over the past decade, media outlets have drawn attention to some of the health consequences of playing in the National Football League (NFL), including how wear-and-tear and injuries accumulated during athletes’ playing years can affect their physical, emotional, and behavioral health after retirement from professional sports. Through a secondary analysis of a cross-sectional telephone survey of former NFL athletes, this study estimated logistic regression models to assess the relationship between several forms of physical pain and anger attacks, controlling for binge drinking, signs of depression, functional limitations, NFL career duration, religious service attendance, and demographic characteristics (age, marital status, race, education, income, and wealth). The analytic sample included 1030 former NFL players. Neck pain, lower back pain, headaches/migraines, and the number of sites of pain were positively and significantly related to anger attacks. There was no significant association between joint pain and anger attacks. NFL career duration was negatively associated with anger attacks, as was religious service attendance. Future research should focus on factors that protect against affective aggression in former professional athletes and how protective factors can be adapted to the broader population.
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Affiliation(s)
- Evelyn Bush
- Department of Sociology and Anthropology, Fordham University, Bronx, NY, USA
| | - Tim Cupery
- Department of Sociology, College of Social Sciences, California State University, Fresno, CA, USA
| | - Robert W Turner
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
| | - Amanda Sonnega
- Survey Research Center of the Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - David Weir
- Survey Research Center of the Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | | | - James S Jackson
- Department of Psychology, College of Literature, Sciences, and the Arts, University of Michigan, Ann Arbor, MI, USA
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Nwagu EN, Dibia SIC, Odo AN. Community Readiness for Drug Abuse Prevention in Two Rural Communities in Enugu State, Nigeria. SAGE Open Nurs 2020; 6:2377960820963758. [PMID: 33415302 PMCID: PMC7774345 DOI: 10.1177/2377960820963758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/13/2020] [Indexed: 12/02/2022] Open
Abstract
Background Drug abuse is an issue that affects all people regardless of gender, race,
ethnicity, age, or socioeconomic status. It is associated with a range of
physical, social, and economic consequences at both individual and community
levels. Community involvement is necessary for effective drug abuse
prevention. Communities need to be ready for such involvement. Methods We applied the Community Readiness Model and its assessment tool to determine
the level of readiness for prevention of drug abuse in Obukpa and Ubollo
communities of Nsukka and Udenu Local Government Areas of Enugu North
Senatorial zone, Nigeria. Community Readiness Model and the Tool are very
useful in identifying gaps in community readiness and capacity as well as
guiding strategies for community initiatives. Twelve key informant
interviews were conducted and analyzed according to procedures outlined in
the Community Readiness handbook. Results The results of the study showed that members of Obukpa and Ubollo communities
were at the vague awareness stage. SWOT analysis of the qualitative data
revealed the strengths, weaknesses, opportunities and threats within the
communities for an intended intervention to increase level of readiness. One
such strength is the church, which was identified as a viable means of
disseminating information on drug abuse prevention in both communities. Conclusion Rural communities are vulnerable to drug-related problems as a result of low
levels of awareness of the dangers of drug abuse. The findings of this study
provided strategies and directions for future intervention programmes in the
study area. Nurses and other health personnel involved in Community Health
Education should take cognizance of the strengths, weaknesses and
opportunities within the communities in designing drug abuse prevention
intervention programmes.
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Affiliation(s)
- Evelyn N Nwagu
- Department of Human Kinetics and Health Education, University of Nigeria, Nsukka, Nigeria
| | - Samuel I C Dibia
- Department of Human Kinetics and Health Education, University of Nigeria, Nsukka, Nigeria
| | - Amelia N Odo
- Department of Human Kinetics and Health Education, University of Nigeria, Nsukka, Nigeria.,Department of Anthropology, Michigan State University, East Lansing, United States
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8
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Smigelsky MA, Nieuwsma JA, Meador K, Vega RJ, Henderson B, Jackson GL. Dynamic Diffusion Network: Advancing moral injury care and suicide prevention using an innovative model. HEALTHCARE-THE JOURNAL OF DELIVERY SCIENCE AND INNOVATION 2020; 8:100440. [PMID: 32919579 PMCID: PMC7405892 DOI: 10.1016/j.hjdsi.2020.100440] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/24/2020] [Accepted: 05/23/2020] [Indexed: 11/19/2022]
Abstract
Healthcare providers across a wide variety of settings face a common challenge: the need to provide real time care for complex problems that are not adequately addressed by existing protocols. In response to these intervention gaps, frontline providers may utilize existing evidence to develop new approaches that are tailored to specific problems. It is imperative that such approaches undergo some form of evaluation, ensuring quality control while permitting ongoing adaptation and refinement. “Dynamic diffusion” is an innovative approach to intervention improvement and dissemination whereby care practices are delivered and continuously evaluated under real-world conditions as part of a structured network experience. This “dynamic diffusion network” (DDN) promotes cross-pollination of ideas and shared learning to generate relatively rapid improvements in care. The pilot Mental Health and Chaplaincy DDN was developed to advance suicide prevention efforts and moral injury care practices being conducted by 13 chaplain-mental health professional teams across the Veterans Health Administration. Lessons learned from the pilot DDN include the importance of the following: geographic and cultural diversity among innovation collaborators to ensure the broadest possible relevance of solutions; leadership support to facilitate engagement of frontline providers in quality improvement efforts; and participation in a community of practice to motivate providers and offer opportunities for direct collaboration and cross-pollination of ideas.
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Affiliation(s)
- Melissa A Smigelsky
- Mental Health and Chaplaincy, Department of Veterans Affairs, Durham, NC, USA; Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, USA.
| | - Jason A Nieuwsma
- Mental Health and Chaplaincy, Department of Veterans Affairs, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Keith Meador
- Mental Health and Chaplaincy, Department of Veterans Affairs, Durham, NC, USA; Departments of Psychiatry and Health Policy, Center for Biomedical Ethics and Society, Vanderbilt Divinity School, Vanderbilt University, Nashville, TN, USA
| | - Ryan J Vega
- VHA Innovation Ecosystem/Diffusion of Excellence, Department of Veterans Affairs, Washington, DC, USA
| | - Blake Henderson
- VHA Innovation Ecosystem/Diffusion of Excellence, Department of Veterans Affairs, Washington, DC, USA
| | - George L Jackson
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, USA; Department of Population Health Sciences and Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, USA
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9
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Fleming WH. The Warrior's Journey Intervention: A Chaplain-Led Motivational, Preparatory Exercise for Enhancing Treatment Success. THE JOURNAL OF PASTORAL CARE & COUNSELING : JPCC 2020; 74:99-107. [PMID: 32496954 DOI: 10.1177/1542305020919684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Outcome literature has shown poor treatment engagement in efficacious, evidence-based post-traumatic stress disorder (PTSD) programs among returning veterans with combat-related psychological symptoms and calls for the development of motivational, preparatory exercises that circumvent stigma-related barriers and are delivered before or during the orientation phase of treatment. The psychological states of hope, meaning, and guilt have been found to impact motivation for treatment and the development and maintenance of post-trauma pathology and symptom severity. Given a chaplain's less stigmatized role, as compared to mental health providers, and proficiency in assessing these states and providing interventions that mediate change, often before a veteran is enrolled in a PTSD treatment program, this paper introduces a brief, chaplain-led, preparatory exercise called the "Warrior's Journey Intervention" (WJI). This narrative based, meaning-making exercise is designed to improve motivation for treatment and mitigate post-trauma symptoms by impacting hope, meaning, and guilt through use of a universally shared, metaphoric story of trauma recovery. A case study will demonstrate use of the intervention, observe its effects, and analyze mechanisms of change. Research is recommended at the end of the article to test the hypothesis that the intervention promotes motivation for treatment and reduces symptoms of PTSD and Moral Injury (MI). A standardized manual for the exercise is available from author.
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10
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Drescher KD, Currier JM, Nieuwsma JA, McCormick W, Carroll TD, Sims BM, Cauterucio C. A Qualitative Examination of VA Chaplains' Understandings and Interventions Related to Moral Injury in Military Veterans. JOURNAL OF RELIGION AND HEALTH 2018; 57:2444-2460. [PMID: 30094678 DOI: 10.1007/s10943-018-0682-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This study examines VA chaplains' understandings of moral injury (MI) and preferred intervention strategies. Drawing qualitative responses with a nationally-representative sample, content analyses indicated that chaplains' definitions of MI comprised three higher order clusters: (1) MI events, (2) mechanisms in development of MI, and (3) warning signs of MI. Similarly, chaplains' intervention foci could be grouped into three categories: (1) pastoral/therapeutic presence, (2) implementing specific interventions, and (3) therapeutic processes to promote moral repair. Findings are discussed related to emerging conceptualizations of MI, efforts to adapt existing evidence-based interventions to better address MI, and the potential benefits of better integrating chaplains into VA mental health service delivery.
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Affiliation(s)
- Kent D Drescher
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System (MAILSTOP - NCPTSD-334), 795 Willow Rd., Menlo Park, CA, 94025, USA.
| | - Joseph M Currier
- Psychology Department, University of South Alabama, Mobile, AL, USA
| | - Jason A Nieuwsma
- Mental Health and Chaplaincy Program, Department of Veterans Affairs, Education and Clinical Center, Mid-Atlantic Mental Illness Research, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical School, Durham, NC, USA
| | - Wesley McCormick
- Psychology Department, University of South Alabama, Mobile, AL, USA
| | | | - Brook M Sims
- Psychology Department, University of South Alabama, Mobile, AL, USA
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11
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Cucciare MA, Scarbrough CB. Opportunities for Identifying and Addressing Unhealthy Substance Use in Rural Communities: A Commentary on Cucciare et al (2017). SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2018; 12:1178221818805980. [PMID: 30349283 PMCID: PMC6195001 DOI: 10.1177/1178221818805980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 09/14/2018] [Indexed: 11/26/2022]
Abstract
Unhealthy substance use is a public health problem facing rural communities across the United States. Unfortunately, numerous challenges including stigma, perceived need for care, and perceived accessibility of substance use treatment serve as barriers to many rural adults using substances in obtaining the care they need. It is therefore important to examine whether accessing health care options other than substance use treatment is associated with improved substance use. In a recent study published in the American Journal of Drug and Alcohol Abuse, we explored whether use of outpatient medical care (OMC) was associated with reductions in substance use among rural stimulant users over a 3-year period. Overall, the results showed that, among rural adults using stimulants, those with at least one OMC visit had fewer days of alcohol, crack cocaine, and methamphetamine use over time. However, most participants reported not having any use of an OMC over the 3-year period, suggesting the need for identifying innovative opportunities to provide substance use help for persons living in rural settings. In this commentary, we discuss opportunities for detecting and addressing unhealthy substance use in retail clinics, via clergy and pharmacists.
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Affiliation(s)
- Michael A Cucciare
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System (CAVHS), North Little Rock, AR, USA.,VA South Central Mental Illness Research, Education, and Clinical Center, Central Arkansas Veterans Healthcare System (CAVHS), North Little Rock, AR, USA
| | - Catherine B Scarbrough
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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12
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Kopacz MS, McCarten JM, Vance CG, Connery AL. A Preliminary Study for Exploring Different Sources of Guilt in a Sample of Veterans Who Sought Chaplaincy Services. MILITARY PSYCHOLOGY 2017. [DOI: 10.1037/mil0000061] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Marek S. Kopacz
- U.S. Department of Veterans Affairs, VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, New York
| | - Janet M. McCarten
- U.S. Department of Veterans Affairs, VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, New York
| | - C. Garland Vance
- U.S. Department of Veterans Affairs, Charles George VA Medical Center, Asheville, North Carolina
| | - April L. Connery
- U.S. Department of Veterans Affairs, Canandaigua VA Medical Center, Canandaigua, New York
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13
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Currier JM, Drescher KD, Nieuwsma JA, McCormick WH. Theodicies and professional quality of life in a nationally representative sample of chaplains in the veterans' health administration. J Prev Interv Community 2017; 45:286-296. [PMID: 28880810 DOI: 10.1080/10852352.2016.1197748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study examined the role of theodicies or theological/philosophic attempts to resolve existential dilemmas related to evil and human suffering in chaplains' professional quality of life (ProQOL). A nationally representative sample of 298 VHA chaplains completed the recently developed Views of Suffering Scale (Hale-Smith, Park, & Edmondson, 2012 ) and ProQOL-5 (Stamm, 2010 ). Descriptive results revealed that 20-50% endorsed strong theistic beliefs in a compassionate deity who reciprocally suffers with hurting people, God ultimately being responsible for suffering, and that suffering can provide opportunities for intimate encounters with God and personal growth. Other results indicated that chaplains' beliefs about human suffering were differentially linked with their sense of enjoyment/purpose in working with veterans. These results suggest that theodicies might serve as a pathway to resilience for individuals in spiritual communities and traditions in USA, particularly for clinicians and ministry professionals who are committed to serving the needs of traumatized persons.
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Affiliation(s)
- Joseph M Currier
- a Psychology Department , University of South Alabama , Mobile , Alabama , USA
| | - Kent D Drescher
- b National Center for PTSD , Palo Alto VA Healthcare System, Dissemination and Training Division , Menlo Park , California , USA
| | - Jason A Nieuwsma
- c Mental Health and Chaplaincy Program, Department of Veterans Affairs , Durham , North Carolina , USA.,d Department of Psychiatry and Behavioral Sciences , Duke University Medical School , Durham , North Carolina , USA
| | - Wesley H McCormick
- a Psychology Department , University of South Alabama , Mobile , Alabama , USA
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14
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From Whom Do Student Veterans Seek Help?: Understanding the Roles of Professional, Informal, and Religious Sources. J Nerv Ment Dis 2017; 205:491-494. [PMID: 28557884 DOI: 10.1097/nmd.0000000000000673] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this brief report was to ascertain student veterans' patterns of help-seeking from professional, informal, and religious sources. In total, 350 veterans from an academic institution on the Gulf Coast completed assessments of help-seeking intentions from a range of potential sources in their communities. Analyses revealed that veterans had a neutral probability to seek help from professional sources (e.g., physicians and psychologists) but were likely to pursue informal sources (e.g., partner/spouse, friend) in a psychological/emotional crisis. However, when compared with their nonclinical counterparts, veterans with a probable need for treatment for PTSD and/or depression generally reported less probability to seek help from informal and religious sources. In addition, sex, ethnicity, and religious background each contributed a significant influence in shaping preferences for seeking help for psychological or emotional concerns. Given unmet mental health needs of student veterans, findings highlight the importance attending to help-seeking preferences in this growing population.
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15
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Kopacz MS, Kane CP, Pigeon WR, Nieuwsma JA. Chaplaincy Encounters Following a Suicide Attempt. J Health Care Chaplain 2017; 23:167-173. [PMID: 28426335 DOI: 10.1080/08854726.2017.1312813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This descriptive study examines the provision of chaplaincy services to veterans who sought health care at a Department of Veterans Affairs (VA) Medical Center following a suicide attempt. A system-wide VA database of suicidal behavior was used to identify a cohort of n = 22,701 veterans who survived a suicide attempt. Next, an electronic review of VA clinical records found that n = 7,447 (32.8%) received chaplaincy services in the 30 days following their attempt. Of this group, the overwhelming majority of first chaplaincy encounters took place in in-patient settings: n = 6890 (92.5%). First chaplaincy encounters most often occurred 1-7 days following the attempt: n = 5,033 (67.6%). Most chaplaincy service users had only one chaplaincy encounter: n = 3,514 (47.2%). The findings suggest that, at VA Medical Centers, a relatively sizeable percentage of suicide attempt survivors have contact with chaplaincy services. Additional research is needed to ascertain if chaplaincy services yield any therapeutic benefit for this group.
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Affiliation(s)
- Marek S Kopacz
- a VISN 2 Center of Excellence for Suicide Prevention , Canandaigua , New York , USA
| | - Cathleen P Kane
- a VISN 2 Center of Excellence for Suicide Prevention , Canandaigua , New York , USA
| | - Wilfred R Pigeon
- a VISN 2 Center of Excellence for Suicide Prevention , Canandaigua , New York , USA.,b University of Rochester Medical Center , Rochester , New York , USA
| | - Jason A Nieuwsma
- c Mid-Atlantic Mental Illness Research, Education and Clinical Center, Mental Health and Chaplaincy , Durham , North Carolina , USA.,d Duke University Medical Center , Durham , North Carolina , USA
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McCormick WH, Carroll TD, Slagel BA, Drescher KD, Nieuwsma JA, Currier JM. Professional Quality of Life and Changes in Spirituality Among VHA Chaplains: A Mixed Methods Investigation. J Health Care Chaplain 2017; 23:113-129. [DOI: 10.1080/08854726.2017.1295675] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Olufowote JO, Matusitz J. "How Dark a World It Is … Where Mental Health Is Poorly Treated": Mental Illness Frames in Sermons Given After the Sandy Hook Shootings. HEALTH COMMUNICATION 2016; 31:1539-1547. [PMID: 27092739 DOI: 10.1080/10410236.2015.1089458] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In the aftermath of the Newtown, CT, massacre, the United States is engaging in public deliberations that will reshape future mental healthcare policies, practices, and systems. We know little about the clergy's contributions to these deliberations. Clergy, as with psychiatrists and mental health specialists, are members of the helping professions and are regarded as front-line mental health workers and gatekeepers to mental health services. To consider clergy contributions, we drew on Entman's framing perspective to study sermons given in the state of Connecticut after the Sandy Hook shootings. We examined 73 posted full-text sermons and performed the constant comparative method on 20 that made references to mental illness. We discovered clergy used "social support" and "social system" frames. Upon developing these frames, we discuss the study's contributions by considering clergy silence, their use of frames to delineate between the secular and the spiritual, their mitigation and promotion of mental illness stigma, and their incomplete social system frame.
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Currier JM, McDermott RC, Sims BM. Patterns of help-seeking in a national sample of student veterans: a matched control group investigation. Gen Hosp Psychiatry 2016; 43:58-62. [PMID: 27796259 DOI: 10.1016/j.genhosppsych.2016.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/15/2016] [Accepted: 08/18/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study examined patterns of professional and nontraditional help-seeking in a national sample of veterans from 57 colleges/universities and demographically matched students from the same institutions who had not served in the US Armed Forces. METHODS In total, 945 veterans and 2835 demographically matched nonveteran students from the same 4-year institutions completed assessments of help-seeking intentions and behaviors from professional, religious and informal sources in the Healthy Minds Study between 2011 and 2015. RESULTS Drawing on bivariate and multivariate logistic regression models, equal ratios of these samples (2:1) did not endorse professional help-seeking intentions or behaviors. When compared to nonveteran students, veterans had greater intentions for religious help-seeking but were less likely to seek help from family/friends. Nearly half of depressed veterans who had not utilized services had also not sought help from any religious or informal sources. CONCLUSIONS Unmet mental health needs might interfere with the success of a sizeable contingent of veterans pursuing new vocational goals. Community-based programs that can educate and/or equip nontraditional sources of support in veterans' naturally occurring relationships might offset these concerns.
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Affiliation(s)
- Joseph M Currier
- University of South Alabama, Psychology Department, Mobile, AL, USA.
| | - Ryon C McDermott
- University of South Alabama, Department of Professional Studies, Mobile, AL, USA
| | - Brook M Sims
- University of South Alabama, Psychology Department, Mobile, AL, USA
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Morgan JK, Hourani L, Lane ME, Tueller S. Help-Seeking Behaviors Among Active-Duty Military Personnel: Utilization of Chaplains and Other Mental Health Service Providers. J Health Care Chaplain 2016; 22:102-17. [PMID: 27191375 PMCID: PMC4960506 DOI: 10.1080/08854726.2016.1171598] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Military chaplains not only conduct religious services, but also provide counseling and spiritual support to military service members, operating as liaisons between soldiers and mental health professionals. In this study, active-duty soldiers (N = 889) reported help-seeking behaviors and mental health. Using logistic regressions, we describe the issues for which soldiers reported seeking help, then outline the characteristics of those who are most likely to seek help from a chaplain. Of the soldiers who sought help from a chaplain within the previous year, 29.9% reported high levels of combat exposure, 50.8% screened positive for depression, 39.1% had probable PTSD, and 26.6% screened positive for generalized anxiety disorder. The participant’s unit firing on the enemy, personally firing on the enemy, and seeing dead bodies or human remains predicted seeing a chaplain. Future research should examine ways to engage soldiers who have had more combat experiences with the chaplain community to address spiritual issues.
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Affiliation(s)
| | - Laurel Hourani
- a RTI International , Research Triangle Park , North Carolina , USA
| | - Marian E Lane
- a RTI International , Research Triangle Park , North Carolina , USA
| | - Stephen Tueller
- a RTI International , Research Triangle Park , North Carolina , USA
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Kopacz MS, Connery AL, Bishop TM, Bryan CJ, Drescher KD, Currier JM, Pigeon WR. Moral injury: A new challenge for complementary and alternative medicine. Complement Ther Med 2016; 24:29-33. [DOI: 10.1016/j.ctim.2015.11.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 08/03/2015] [Accepted: 11/24/2015] [Indexed: 10/22/2022] Open
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Nieuwsma JA, Jackson GL, DeKraai MB, Bulling DJ, Cantrell WC, Rhodes JE, Bates MJ, Ethridge K, Lane ME, Tenhula WN, Batten SV, Meador KG. Collaborating across the Departments of Veterans Affairs and Defense to integrate mental health and chaplaincy services. J Gen Intern Med 2014; 29 Suppl 4:885-94. [PMID: 25355089 PMCID: PMC4239284 DOI: 10.1007/s11606-014-3032-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Recognizing that clergy and spiritual care providers are a key part of mental health care systems, the Department of Veterans Affairs (VA) and Department of Defense (DoD) jointly examined chaplains' current and potential roles in caring for veterans and service members with mental health needs. OBJECTIVE Our aim was to evaluate the intersection of chaplain and mental health care practices in VA and DoD in order to determine if improvement is needed, and if so, to develop actionable recommendations as indicated by evaluation findings. DESIGN A 38-member multidisciplinary task group partnered with researchers in designing, implementing, and interpreting a mixed methods study that included: 1) a quantitative survey of VA and DoD chaplains; and 2) qualitative interviews with mental health providers and chaplains. PARTICIPANTS Quantitative: the survey included all full-time VA chaplains and all active duty military chaplains (n = 2,163 completed of 3,464 invited; 62 % response rate). Qualitative: a total of 291 interviews were conducted with mental health providers and chaplains during site visits to 33 VA and DoD facilities. MAIN MEASURES Quantitative: the online survey assessed intersections between chaplaincy and mental health care and took an average of 37 min to complete. Qualitative: the interviews assessed current integration of mental health and chaplain services and took an average of 1 h to complete. KEY RESULTS When included on interdisciplinary mental health care teams, chaplains feel understood and valued (82.8-100 % of chaplains indicated this, depending on the team). However, findings from the survey and site visits suggest that integration of services is often lacking and can be improved. CONCLUSIONS Closely coordinating with a multidisciplinary task group in conducting a mixed method evaluation of chaplain-mental health integration in VA and DoD helped to ensure that researchers assessed relevant domains and that findings could be rapidly translated into actionable recommendations.
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Affiliation(s)
- Jason A Nieuwsma
- Mental Health and Chaplaincy, Department of Veterans Affairs, Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA,
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