Burnout Syndrome Among Catholic Clergy: A Systematic Review

Burnout syndrome implies exhaustion, loss of motivation, low performance, and absenteeism. Catholic clergy are not exempt. This systematic review compiles and analyzes evidence related to burnout in Catholic clergy and potential modulating variables. Following the PRISMA methodology, systematic searches in different scientific databases identified 17 studies, revealing that burnout is related to age, personality traits, and type of priesthood. No relation between burnout and social support, self-care, spiritual practice, or workload was detected. It is necessary to adapt conceptual models to the peculiarities of burnout among clergy, extending assessment strategies and introducing working and organizational perspectives in the analysis of modulating variables, and in the development of prevention and intervention programs.

Nurses, Clergy, Chaplains, Parkinson's Disease, Workplace Religiosity, Women's Health and Family Issues

This issue of JORH explores a broad range of topics looking at the professions of nursing, clergy and chaplains. This issue also concludes the series on Parkinson's disease (Part 2), and for the first time, JORH presents a collation of articles relating to workplace religiosity. Finally, this issue revisits the topics of women's health and family issues in relation to religiosity and spirituality.

When Shepherds Shed: Trajectories of Weight-Related Behaviors in a Holistic Health Intervention Tailored for US Christian Clergy

Maintaining healthy behaviors is challenging. Based upon previous reports that in North Carolina (NC), USA, overweight/obese clergy lost weight during a two-year religiously tailored health intervention, we described trajectories of diet, physical activity, and sleep. We investigated whether behavior changes were associated with weight and use of health-promoting theological messages. Improvements were observed in sleep, calorie-dense food intake, and physical activity, with the latter two associated with weight loss. While theological messages were well-retained, their relationship with behaviors depended on the specific message, behavior, and timing. Findings offer insights into weight loss mechanisms, including the role of theological messages in religiously tailored health interventions.

The University Chaplain: An Often Unrecognised Resource in Suicide Prevention-Initial Qualitative Results from Exploratory Research into the Roles of University Chaplains at One Australian University

University chaplains are often unrecognised as resources in suicide prevention. This exploratory article highlights the valuable contributions university chaplains at one Australian university make to suicide prevention. Three overarching themes related to the contributions of university chaplains to suicide prevention were generated: (1) person-centred care; (2) the role of university chaplains in suicide prevention; and (3) professional development. Of particular note is that university chaplains actively contribute to all three phases of the suicide prevention framework: prevention, intervention, and postvention.

"Do you Really Believe that There is Something More?" - The Offer of Transcendental Communication by Pastoral Care Workers in German Hospices and Palliative Care Units: A Qualitative Study

BACKGROUND

Palliative Care also encompasses the dimension of spiritual pain. Pastoral care workers and chaplains are specialists in the provision of spiritual care. Decreasing religious affiliation and increasing spiritual diversification in modern societies raise the question of the function of pastoral care.

AIM

The goal of this study is to answer the question of what pastoral care workers can offer to dying residents in hospices and palliative care units.

DESIGN

A qualitative interview study was designed to explore the specific perspective of pastoral care workers in a multidisciplinary environment. The study is based on differentiation theory which is particularly well adjusted to reveal differences in perspectives in so called 'holistic' care settings. The reporting follows the COREQ guidelines.

SETTING

Problem centered interviews were conducted at five hospices and two palliative care units.

RESULTS

Eight pastoral care workers were interviewed (5 Catholic, 3 Protestant, mean age of 58 years). The analysis of the interviews revealed three major themes: (A) Self-positioning in relation to the organization, (B) Offering conversations to patients and relatives, (C) Performing religious rituals. Minor themes were: mediating conflicts between patients, relatives and staff, sensing moods in silence with patients and organizing workshops for staff.

CONCLUSION

In modern hospice care, pastoral care workers routinely address the problem of making death more tangible and of answering the unanswerable question of what comes afterwards. Through this, they support dying residents in hospices and palliative care units in dealing with the inexplicability of death.

Movement Behaviors and Mental Health of Catholic Priests in the Eastern United States

The purpose of this observational study was to examine (a) the proportion of Catholic priests in the United States that have anxiety/depression and meet the Canadian 24-Hour of Movement Guidelines, and (b) the association of meeting these guidelines with the likelihood of anxiety and depression. A sample of (arch)diocesan priests (n = 335) completed demographic and behavior survey, International Physical Activity Questionnaire (IPAQ-SF), and Hospital Anxiety and Depression Scale (HADS). Results indicated that 21.1% of priests surveyed met all three movement guidelines (physical activity, sleep, and screentime) and 7.8% met none. Priests who reported excessive recreational screentime (≥ 3 h/day) were more likely to have anxiety (OR = 3.17) and depression (OR = 2.91), and who were physically inactive (< 150 min/week) were more likely to have depression (OR = 8.89). Data from this study addresses a gap in the literature regarding Catholic priests, movement behavior, and mental wellbeing.

Engaging the AQ10 to Predict Professional Burnout or Poor Work-Related Psychological Wellbeing Among Anglican Clergy in Wales

The ten-item Autism Spectrum Quotient (AQ10) is a self-report instrument originally designed to identify referrals for professional diagnosis for Autism Spectrum Disorders (ASD). Recent studies suggest that this instrument may also be tapping more generalised affective disorders. Working with this interpretation, this study examines the predictive power of the AQ10 to account for additional variance, after personal and personality factors have been taken into account, on the two scales of the Francis Burnout Inventory. Data provided by 220 Anglican clergy serving in Wales demonstrated that 8.6% of the participants recorded six or more red flags on the AQ10 (and so qualified for referral for specialist diagnostic assessment) and that higher scores on the AQ10 are associated with significantly lower levels of satisfaction in ministry and with significantly higher levels of emotional exhaustion in ministry. These data suggest that screening with the AQ10 may be helpful in identifying clergy vulnerable to professional burnout and to poor work-related psychological wellbeing, in addition to its primary purpose of screening for ASD.

Black Pastors' Experiences of Occupational and Life Stress During COVID-19 in the USA

This study sought to identify the occupational stressors Black pastors experience, who serve in Black Church denominations and Black nondenominational churches. A total of 218 pastors completed the survey out of 2786 for a response rate of 10.1%. Black pastors identified their most challenging stressors as member dynamics, financial stress, leading a church to fulfill its mission, and pastor's workload. Black women pastors faced the additional stressor of having their pastoral leadership challenged by male congregants. Black pastors faced more stressors during the COVID-19 pandemic including church closures, transitioning to virtual services, unexpected deaths, and an increased workload with 72.5% of pastors reporting moderate to extreme stress levels. Approximately 77% of pastors acknowledged experiencing from moderate to extreme stress levels during social protests for the deaths of Black people by law enforcement. Black pastors further acknowledged experiencing an additional three to six life stressors outside of their pastoral roles.

Pilot Evaluation of the Online 'Chaplains-CARE' Program: Enhancing Skills for United States Military Suicide Intervention Practices and Care

Chaplains frequently serve as first responders for United States military personnel experiencing suicidal thoughts and behaviors. The Chaplains-CARE Program, a self-paced, e-learning course grounded in suicide-focused cognitive behavioral therapy principles, was tailored for United States military chaplains to enhance their suicide intervention skills. A pilot program evaluation gathered 76 Department of Defense (DoD), Veterans Affairs (VA), and international military chaplain learners' responses. Most learners indicated that the course was helpful, easy to use, relevant, applicable, and that they were likely to recommend it to other chaplains. Based on open-ended responses, one-quarter (25.0%) of learners indicated that all content was useful, and over one-quarter (26.3%) of learners highlighted the usefulness of the self-care module. One-third (30.3%) of learners reported the usefulness of the interactive e-learning features, while others (26.3%) highlighted the usefulness of chaplains' role play demonstrations, which portrayed counseling scenarios with service members. Suggested areas of improvement include specific course adaptation for VA chaplains and further incorporation of experiential learning and spiritual care principles. The pilot findings suggest that Chaplains-CARE Online was perceived as a useful suicide intervention training for chaplains. Future training can be enhanced by providing experiential, simulation-based practice of suicide intervention skills.

Towards a Holistic Model of Care for Moral Injury: An Australian and New Zealand Investigation into the Role of Police Chaplains in Supporting Police Members following exposure to Moral Transgression

Police members can be exposed to morally transgressive events with potential for lasting psychosocial and spiritual harm. Through interviews with police members and police chaplains across Australia and New Zealand, this qualitative study explores the current role that police chaplains play in supporting members exposed to morally transgressive events. The availability of chaplains across police services and the close alignment between the support they offer, and the support sought by police, indicates they have an important role. However, a holistic approach should also consider organizational factors, the role of leaders, and access to evidence-based treatment in collaboration with mental health practitioners.

"It's Taboo to Talk About It": Korean American Clergy Members' Views of Mental Health

Korean Americans are more likely to seek guidance from church leaders than to use traditional mental health services. Through semistructured key informant interviews with 16 Christian clergy members serving later-generation Korean Americans, the authors explored clergy members' perceptions of the mental health needs of their congregants. Insights from the study suggested that communication and collaboration between mental health professionals and church leaders may be helpful in addressing the Korean American community's emotional and mental health needs.

Competencies in Pastoral Counseling: The Lived Experiences of Filipino Diocesan Parish Priests

Pastoral counseling has been a significant part of the priestly ministry in the Philippines. Nonetheless, literature about Filipino priests' lived experiences and competencies in counseling is almost non-existent. Using Interpretative Phenomenological Analysis (IPA), the researcher explored the lived experiences and competencies of Filipino diocesan parish priests in their role as pastoral counselors. The study was framed in Phenomenology, the Philippines Psychology Act of 2009, and the 2009 competencies of the Association for Spiritual, Ethical, and Religious Values in Counseling (ASERVIC), a division within the American Counseling Association (ACA). Data were collected using a semi-structured interview, and the analysis yielded seven (7) themes under three (3) clusters. The findings revealed that the participants lack the prerequisites to be rightfully called pastoral counselors. As priests continue to attend to people in need of counseling, the researcher calls on church leaders, the Psychological Association of the Philippines (PAP), and the Professional Regulation Commission (PRC) to address the practice of pastoral counseling in the country.

Spiritually Well, Mentally Well? Examining the Early Life Religious Antecedents of the Impact of Spiritual Well-Being on Mental Health Among United Methodist Clergy in North Carolina

Research has consistently shown that the seeds of religiosity are planted and begin to take form during early life socialization, but little attention have been given to these dynamics among clergy members. In this study, we consider whether early life religious exposure may amplify the beneficial effects of spiritual well-being (having a "thriving" spiritual life) for mental health and burnout for clergy. Drawing from a life course perspective, we use longitudinal data from the Clergy Health Initiative, which sampled United Methodist Clergy in North Carolina (n = 1330). Key results suggest that higher frequencies of childhood religious attendance were consistently associated with lower depressive symptoms and burnout. The beneficial associations between spiritual well-being and lower depressive symptoms and burnout were also stronger for clergy with greater church attendance in childhood. The accumulation of "religious capital" for clergy who were raised in religious households with regular service attendance appear to accentuate the positive effects of spiritual well-being, which encompass a greater sense of closeness to God in their own lives and in ministry. This study identifies the importance of researchers taking a "longer" view of the religious and spiritual lives of clergy.

Examining the Relationship of Clergy Distress, Spiritual Well-Being, Stress Management and Irritation to Life Satisfaction among Black Pastors in the USA

This study sought to determine the level of clergy distress and other psychological characteristics of Black pastors and their relationship to life satisfaction through a convenience sample of 2786 Black pastors in historically Black Protestant denominations and nondenominational Black churches. The response rate equaled 10.1% (283/2786) while the survey completion rate equaled 77% (218/283). These 218 Black pastors were serving as either senior pastors (86.3%) or co-pastors (13.7%). This study found clergy distress in Black pastors did not differ based on gender or age but differed by church size and denomination. Clergy distress (r =  - .187, p = .023) and irritation (r =  - .293, p = .003) possessed significant relationships with satisfaction with life as expected, but stress management (r = .039, p = .641), spiritual well-being in daily life (r = .140, p = .140), and spiritual well-being in ministry (r =  - .064, p = .475) did not, which was surprising. Notably strong relationships existed between stress management and spiritual well-being in daily life (r = .469, p = .003) and stress management and irritation (r =  - .359, p = .003). These two important relationships may offer some guideposts for Black pastors in developing strategies to combat the impact of both clergy distress and irritation. The study concludes with implications for Black pastors and suggestions for future research.

The Gap in Mental Health Service Utilization Among United Methodist Clergy with Anxiety and Depressive Symptoms

Clergy are tasked with multiple interpersonal administrative, organizational, and religious responsibilities, such as preaching, teaching, counseling, administering sacraments, developing lay leader skills, and providing leadership and vision for the congregation and community. The high expectations and demands placed on them put them at an increased risk for mental distress such as depression and anxiety. Little is known about whether and how clergy, helpers themselves, receive care when they experience mental distress. All active United Methodist Church (UMC) clergy in North Carolina were recruited to take a survey in 2019 comprising validated depression and anxiety screeners and questions about mental health service utilization. Bivariate and Poisson regression analyses were conducted on the subset of participants with elevated depressive and anxiety symptoms to determine the extent of mental health service use during four different timeframes and the relationship between service use and sociodemographic variables. A total of 1,489 clergy participated. Of the 222 (15%) who had elevated anxiety or depressive symptoms or both, 49.1% had not ever or recently (in the past two years) seen a mental health professional. Participants were more likely to report using services currently or recently (in the past two years) if they were younger, had depression before age 21, or "very often" felt loved and cared for by their congregation. The rate of mental health service use among UMC clergy is comparable to the national average of service use by US adults with mental distress. However, it is concerning that 49% of clergy with elevated symptoms were not engaged in care. This study points to clergy subgroups to target for an increase in mental health service use. Strategies to support clergy and minimize mental health stigma are needed.

Relationships Between Perceived Importance of Chaplain Presence and Health Professionals' Emotional Well-Being in the United States

Hospital-based chaplains receive specialized training to provide spiritual support to patients and healthcare staff during difficult health transitions. However, the impact of perceived chaplain importance on healthcare staff's emotional and professional well-being is unclear. Healthcare staff (n = 1471) caring for patients in an acute care setting within a large health system answered demographic and emotional health questions in Research Electronic Data Capture (REDCap). Findings suggest that as perceived levels of chaplain importance increase, burnout may decrease and compassion satisfaction may improve. Chaplain presence in the hospital setting may support healthcare staff emotional and professional well-being following occupational stressors including COVID-19-related surges.

Work-Related Psychological Wellbeing and Conservative Christian Belief Among Methodist Circuit Ministers in Britain: Distinguishing Between Emotional Exhaustion and Satisfaction in Ministry

Drawing on data provided by 803 Methodist circuit ministers serving in Great Britain, the present study was designed to test the association between conservative Christian belief and work-related psychological wellbeing as operationalised by the balanced affect model proposed by the Francis Burnout Inventory. After taking into account the effects of personal factors, psychological factors, contextual factors, and experience factors, holding conservative Christian belief was associated with a higher level of positive affect (satisfaction in ministry) but independent of negative affect (emotional exhaustion in ministry).

Mental Health Awareness and Counseling Practice of Jamaican Clergy: An Exploratory Study

Clergy play a vital role in mental health care in Jamaica but little is known about their mental health awareness and practices. Thirty five Anglican and Baptist clergy were compared to 24 helping professionals and 67 community members using purposive sampling. Clergy's awareness exists with spiritualized beliefs about the etiology of mental illness as well as with effective and unethical counseling practices. Findings indicate the need for more training in mental health sensitization and practice.

Standardized Spiritual Screening Increases Chaplain Referrals Through the EMR: A Nurse-Chaplain Collaboration for Holistic Acute Healthcare

The use of a concise standardized spiritual screening process to identify spiritual practices and needs of patients is essential for holistic nursing care. This interprofessional initiative resulted in the development of a spiritual screening tool that substantially increased Pastoral Services referrals to the patients who needed them and represents a significant opportunity in the delivery of holistic nursing care. Acute care settings may benefit from the adoption of a standardized chaplain referral process housed in the EMR and completed on the frontlines by trusted nursing staff providing patient and family centered care. This standardized spiritual screening process not only triggered essential services of Pastoral Services, but also helped identify and address important spiritual needs of hospitalized patients.The ability to design a tool responsive to the evolving, spiritual needs of patients can be challenging. Through collaboration with chaplains, nurses can be instrumental in creating instruments informed by available evidence in the empirical literature. Furthermore, engaging patients as a source of data during instrument design helps to ensure the content validity and practical usefulness of an instrument. Healthcare organizations might choose to implement and further evaluate/refine the new Spiritual Screening Tool and referral process developed as a result of this initiative.

The Role and Value of Chaplains in an Australian Ambulance Service: A Comparative Study of Chaplain and Paramedic Perspectives

Chaplains are embedded in several ambulance services across Australia, however as Australia's religiosity is currently in decline and questions are being asked about retaining chaplains, little is actually known about their role and value within Ambulance services. The aim of this paper is to present the key findings from interviews with chaplains about their role and value of being ambulance chaplains. These findings are then compared with those of paramedics derived from an earlier phase of this study. Thirteen chaplains participated in semi-structured interviews, and data were analysed using framework analysis. The results indicated that ambulance chaplains provided paramedic-centred emotional and spiritual care through proactively and reactively supporting paramedics in their work. Chaplains saw value in their relational approach which facilitated trust and access, did not seek to 'fix' or diagnose but instead offered physical and emotional presence, and promoted supportive conversations. Chaplains and paramedics valued operationally trained and equipped ambulance chaplains who provided a relational, around the clock, 'frontline' staff support presence in paramedic workplaces, regardless of the paramedic's personal religious/spiritual beliefs.

Relationships Between the Number of Chaplain Visits and Patient Characteristics: A Retrospective Review of a Large Suburban Midwest Hospital, USA

It is critical to understand the characteristics of patients who receive spiritual care through chaplain visits. This study evaluated 2373 records from chaplain visits provided to 1315 patients over a three-month period (March-May 2021) at a large suburban teaching hospital, Midwest, USA. Approximately 70% of patients received one chaplain visit. However, data revealed that when patients were admitted emergently, or received visits for reasons related to self-harm or suicidality, the frequency of chaplain visits significantly increased. This study suggests a need for spiritual care services for patients with emergency or mental health conditions. Furthermore, it highlights the need for further training and resources for chaplains to increase clinical competencies in providing specialized spiritual care support to specific patient populations.

Supporting chaplains on the frontlines of the COVID-19 pandemic: A mixed-method practice-based pilot intervention study

During the coronavirus disease 2019 (COVID-19) pandemic, chaplains have played a pivotal role in patient, family member, and staff care. However, little empirical attention has been given to (a) the potential toll of frontline spiritual care on chaplains' mental health and occupational functioning as well as (b) the development of interventions that can help ameliorate these risks and promote resilience. Using a mixed-method practice-based design, we conducted a pilot study (n = 77) to evaluate a novel spiritually integrated support group intervention for chaplains across multiple industries, which consisted of five Zoom-based sessions cofacilitated by psychotherapists. Participants completed pre- and postintervention measures of traumatic stress, burnout, spiritual/moral struggles, flourishing, resilience, and overall experience in the group. Qualitative findings elucidated the salience of peer support, therapeutic group processes, and key intervention components that warrant further study. Quantitative results indicated significant (a) decreases in burnout and spiritual/moral struggles from pre- to postintervention as well as (b) increases in sense of resilience and flourishing. Findings of this pilot study offer preliminary evidence for the use of a spiritually integrated group model to decrease isolation, address moral and spiritual distress, and promote resilience among chaplains. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Chaplains' perspectives on standardizing spiritual assessments

Chaplains are an integral part of mental health treatment within the Veterans Health Administration (VHA) and over the past decade, efforts have been made to integrate chaplain services into behavioral health treatment. One unique duty of chaplains is to conduct spiritual assessments, which are characterized as collaborative discussions with veterans to understand their overall religious and belief system, identify spiritual injuries, and how to integrate one's spiritual values into medical care. Although spiritual assessments in Veterans Affairs Medical Centers have evolved throughout the years to adopt a more structured approach, spiritual assessments can vary depending on site, clinical setting, and medical center. The present study sought to examine chaplains' perspectives on standardizing spiritual assessments and incorporating empirically validated measures into the assessments. Thematic analysis was conducted on two focus groups of chaplains from a large VHA medical center. Overall, chaplains appeared interested in standardizing spiritual assessments, with an expressed desire to maintain their current conversational format. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Prevalence of Sexual Grooming Behaviors in a Large Sample of Clergy

Following the exposure of child sexual abuse (CSA) within the U.S. Catholic Church, it was postulated that many of these cases went unreported because sexual grooming was involved. The present study examined the prevalence of sexual grooming behaviors of clergy through the lens of the content-validated Sexual Grooming Model (SGM). The study used archival data from a victim survey of 10,667 cases of alleged CSA within the U.S. Catholic Church. Results revealed the accused clergy frequently used tactics in the gaining access and isolation, trust development, and desensitization stages of the SGM. From the limited data available for the victim selection and post-abuse maintenance stages, the findings showed these tactics were relatively less common. Overall, clergy who were alleged to have committed CSA used tactics consistent with sexual grooming in general, although there were unique aspects of sexual grooming given their institutional role and position.

Hospital chaplains' communication with patients: Characteristics, functions and potential benefits

OBJECTIVE

Hospital chaplains communicate with patients concerning spirituality/religion, but many aspects of their interactions have received little attention.

METHODS

Telephone qualitative interviews of ~1 h each were conducted with chaplains and analyzed, drawing on grounded theory.

RESULTS

We interviewed 21 U.S. chaplains. Chaplains have relatively unique characteristics, having relatively more time to spend with patients, and less rigid and less medicalized agendas, while gaining respect/trust as religious figures. Chaplains can thus provide several critical beneficial functions - e.g., obtaining key information from patients/families that can help with decision-making and with diagnosis and treatment, and conveying medical providers' points of view to patients/families. Consequently, chaplains can serve as mediators between patients/families and providers; and also overcome staff biases and "labelling" of patients, and pursue or encourage psychological interventions, in part because psychotherapists are often unavailable.

CONCLUSION

While past research suggested certain ways how chaplains might benefit hospitals, these professionals can aid these institutions and improve patient care in additional vital, tangible ways.

PRACTICAL IMPLICATIONS

Hospital administrators, chaplaincy departments, doctors, nurses and others should more fully recognize, encourage and facilitate these functions. Targeted improvements in practice and education can help achieve these goals. The findings suggest, too, several specific questions for further investigation.

Well-Being and Help-Seeking Among Assemblies of God Ministers in the USA

This study examined Assemblies of God pastors in the USA (n = 874) on role identity, well-being, religious coping, and attitudes toward seeking professional counseling. Overall, 14.1% had depression at moderate or higher severity based on the PHQ-9 scale (score of 10 or above), with an additional 25.7% in the mild category (score of 5-9). On the Clergy Spiritual Well-Being scale, 9.2% had poor spiritual well-being in everyday life, while 18.1% showed poor spiritual well-being in ministry (score below 15 on each respective subscale). About 20% of the sample scored in the high range (above 10) on the Clergy Occupational Distress Index. Male role norms, occupational distress, and positive religious coping were predictive of help-seeking attitudes. Those who were married, younger, more highly educated, female, or had more close friends had more positive attitudes toward seeking counseling.

Advancing interprofessional education in communication

OBJECTIVE

The objective of this training project is to develop and host Interprofessional Communication courses to improve interdisciplinary communication in oncology care. The initial national course was held in a virtual format and included pre- and post-course participant data. The curriculum was developed with support from the National Cancer Institute.

METHODS

A virtual two-day course was held to equip nurses, social workers, and chaplains with vital communication skills in oncology practice, so that they could return to their home institutions and teach communication skills to other healthcare professionals, with the intention of making improved communication a quality improvement goal. Fifty-two participants were selected through an application process to attend the virtual course in two-person interprofessional teams (e.g., nurse and chaplain, or social worker and nurse). The Interprofessional Communication Curriculum was based on the National Consensus Project for Quality Palliative Care's eight domains of quality palliative care. The six online modules developed by the investigators were presented in lectures, supplemented by discussion groups, role plays, and other methods of experiential learning.

RESULTS

Pre- and post-course results identified areas of communication, which are a priority for improvement by oncology clinicians. Participant goals identified specific strategies to be implemented by participants in their settings.

SIGNIFICANCE OF RESULTS

The need for communication training was clearly demonstrated across professions in this national training course. Participants were able to apply course content to their goals for quality improvement in cancer settings.

Examining admission and formation outcomes for Catholic clergy applicants with the MMPI-2-RF: A prospective study

Psychological evaluations of clergy applicants to the Catholic Church are an important gatekeeping mechanism during the admission process. However, limited research exists on the validity of assessments for this evaluative purpose and none have examined the predictive utility of the MMPI-2-RF to determine if an applicant will be accepted to formation, or if they ultimately ordained. This study fills that gap in the literature by investigating the predictive validity of MMPI-2-RF scales in 147 male applicants evaluated as part of their application for seminary or diaconate formation programs in a mid-sized Catholic diocese in the United States. Group analyses (e.g., Kruskal-Wallis tests) with admission status as the independent variable and MMPI-2-RF scales as the dependent variables yielded significant differences, most notably, those participants not admitted had higher mean scores on F-r, Fp-r, EID, RC7, THD, RC8, RC1, MLS, NUC, and JCP than the other three groups. Relative risk ratios were estimated for all MMPI-2-RF scales, indicating that higher scores are generally associated with a lower likelihood of admission and, ultimately, ordination. Limitations and future directions of research are also discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Staff-Care by Chaplains during COVID-19

The aim of this study was to understand how chaplains delivered spiritual care to staff during the Covid-19 pandemic. The researchers analyzed data collected from an International Survey of Chaplain Activity and Experience during Covid-19 (N = 1657). The findings revealed positive changes that emerged and new practices evolved around the use of technology as useful tools for maintaining contact with staff.

A Long Way to Go Understanding the Role of Chaplaincy? A Critical Reflection on the Findings of the Survey Examining Chaplaincy Responses to Covid-19

This contribution reflects on some of the most prominent findings in the survey on the chaplaincy response to the COVID-19 pandemic. The finding that chaplain respondents had difficulty understanding their own role prior to the first wave is of concern. If chaplains cannot articulate their own role, it is not surprising that those around them are also unclear. Chaplains are not the only ones to blame for the confusion around their role though.

Scared but Powerful: Healthcare Chaplains' Emotional Responses and Self-Care Modes during the SARS-Cov-19 Pandemic

Drawing from both the qualitative free-text responses and quantitative responses to an international survey of 1657 chaplains serving during the SARS-Cov-19 pandemic, we explore chaplains' emotional responses to the pandemic and how emotion connects to self-care. This paper reports on the modes of self-care practiced by chaplains, including modes reported as unavailable due to pandemic restrictions. Lastly, we explore how effective spiritual care leadership may mediate chaplain emotions and ultimately chaplain self-care.

"The Most Effective Experience was a Flexible and Creative Attitude"-Reflections on Those Aspects of Spiritual Care that were Lost, Gained, or Deemed Ineffective during the Pandemic

This paper presents and discusses data from three of the qualitative questions in the international COVID-19 survey: What was the most important aspect of spiritual care that was lost during the pandemic? What was new to you during this pandemic? What are the new ways of delivering spiritual care you have experienced? Of these new experiences, what do you think was the most effective?

What Did Chaplains Do During the Covid Pandemic? An International Survey

Chaplains' unique contribution is to healthcare is to respond to the spiritual, religious and pastoral needs of patients and staff. This is their sole purpose, to provide a presence and space to meet individual need and promote healing, even when cure isn't possible. Their value is priceless to families in desperate times. However, despite growing evidence for their impact, chaplains are commonly undervalued and misunderstood by their organisations, and the global pandemic revealed the consequences of this confusion. Whilst some chaplains were applauded as heroes along with their fellow health colleagues, others were seen as little more than an infection risk. A survey was designed to capture and learn from the full range of chaplain experiences of the impact of the pandemic across the globe. In June 2020, 1657 chaplains responded from 36 countries. They all experienced considerable disruption to their usual practice, with enforced social distancing having the biggest impact. Out of necessity they embraced technology to maintain contact with patients and families, and shifted focus of their support to staff. Whilst some chaplains were viewed as essential employees by their organisations, most were not. Despite the majority thinking that their organisations understood what they did, chaplains themselves were neither clear or unclear about their role during and post pandemic. More surprisingly, they felt similarly unclear about their role before the pandemic. This paper concludes that in general chaplains lack leadership skills, and confusion about their role will persist until this changes.

"Essential Not Optional": Spiritual Care in Australia during a Pandemic

This paper focuses on the impact of COVID19 in Australia. Three areas were investigated: professionalism, contrasting hospital and aged care services and "business as usual"? Impact was low overall, the timing being pre-second wave impact. Two areas of weakness were highlighted: depleted spiritual care teams due to standing down non-professional staff and uncertainty about the role of Chaplains in the care of other staff. Further study of second wave impact is recommended.

Remembering

This reflection heightens the value of the role of chaplain during the time of the pandemic.

Clergy Attitudes About Ways to Support the Mental Health of Sexual and Gender Minorities

This pilot study explored clergy members' attitudes about ways to support the mental health needs of sexual and gender minorities (SGM; e.g., lesbian, gay, bisexual, and transgender people). Participants (N = 86, 46% female, 26% SGMs) were US clergy members from a variety of religious faiths but mostly were leaders in Christian faith communities in the greater Chicago area. Clergy participants completed quantitative and qualitative items asking what types of resources (e.g., workshops, websites, consultations, or testimonies) and delivery format (online or in-person) they perceived as most helpful in supporting the mental health of SGM members in their faith communities. The results demonstrated that clergy members found all listed resources to be helpful to varying degrees, although suicide and homelessness prevention were prioritized above other resources. Clergy members also prioritized resources related to supporting gender minorities to be more informative, relative to resources for supporting sexual minorities. Finally, clergy member preferred information to be delivered in-person instead of online. The degree of openness to LGBTQ health promotion resources did not vary by clergy religious denomination.

The COVID-19 Context Calls for a Broader Range of Healthcare Chaplaincy Models: An Exploratory Translational Study Utilizing Evolutionary Psychology and Social Neuroscience Loneliness Research

Shifts in chaplain requests from patients and families and lack of engagement by staff in now traditional support forms in the COVID-19 context suggest that new insights and resourcing are needed. This exploratory translational study suggests that the evolutionary psychology of R. I. M. Dunbar and the social neuroscience of J. T. Cacioppo, his collaborators, and successors and their concerns for human loneliness have potential for use in development of effective healthcare chaplaincy practice in the COVID-19 context.

Healing the Wounded Healer? A Survey of Jewish and Protestant Correctional Chaplains

This article explores how working with incarcerated female Jewish and Protestant inmates affected correctional chaplains personally, professionally, and in their religious lives. The researcher interviewed a group of 10 correctional chaplains who work with female Jewish inmates, and a comparison group of 10 chaplains who work with female Protestant inmates in the Northeastern and Midwestern United States. The research found significant positive benefits for both groups, including a tendency to be less conservative in their views regarding the criminal justice system and more compassionate views towards inmates and humanity in general. Noted in both study groups was a high prevalence of trauma history prior to their employment as a correctional chaplain.

The Psychosocial Aspect of Burn Patient Recovery as it Informs Chaplain Interventions

This article provides an understanding of how the psychosocial and spiritual aspects of burn patients informs the chaplain's interventions. It was developed by taking existing literature, using it in a clinical burn care setting, and then developing an experiential model of spiritual care. It has been attempted to point out to the reader where the literature supports the discussion and when the model uses the author's experience to expand on that literature.

Love, Judgement and HIV: Congregants' Perspectives on an Intervention for Black Churches to Promote Critical Awareness of HIV Affecting Black Canadians

We assess participants' experience of Black Pastors Raising Awareness and Insight of Stigma through Engagement (Black PRAISE), an intervention for Black churches to promote critical awareness of HIV affecting Black Canadian communities. We used a community-based participatory approach to implement Black PRAISE among six churches in the Greater Toronto Area and Ottawa, in October-November 2016. For the intervention, congregants received a booklet with validated HIV-related information, attended a sermon on compassion and justice, viewed a short film on HIV-related stigma, and completed baseline and follow-up surveys to evaluate the effectiveness of the intervention. We then conducted in-depth interviews with 18 pastors and congregants from the six churches to explore how they experienced the intervention. Three major themes emerged from an iterative exploration of the thematic content of the interviews: the beneficial impact of the intervention; reconciling the moral and theological issues of their faith with the social reality of HIV and stigma; and perspectives on future stigma reduction efforts. Participants spoke approvingly about Black PRAISE and supported stigma reduction but acknowledged uncertainties about their capacity to actualise their commitment. The main overarching lessons from Black PRAISE are as follows: first, our results support a community-based participatory approach to productively engaging Black congregations in stigma reduction and health promotion; second, promising or successful interventions incorporate multiple components to promote critical awareness about the specific health issue for Black life and wellbeing; and third, interventions are more likely to succeed if they support critical reflection on the underlying conceptual issues, implicit assumptions and belief systems among the professional and lay stakeholders.

[Religious faith in patients in psychiatric care]

The place of the chaplain in psychiatric units is still frequently challenged. Caregivers' mistrust of this person of faith is based on the impact religious words and discourse may have on the patient'sdelirium However, when the chaplainand caregivers cometogether and clarify their approaches, relations improve.The cleric,inhis practicewith patients, lends ahuman ear while taking into accountthe suffering. He is also areceptacle for themetaphysical and religious questions expressed by patients.

"My Hands Are Tied": Abortion Restrictions and Providers' Experiences in Religious and Nonreligious Health Care Systems

CONTEXT

Abortion is generally prohibited in Catholic hospitals, but less is known about abortion restrictions in other religiously affiliated health care facilities. As religiously affiliated health systems expand in the United States, it is important to understand how religious restrictions affect the practices of providers who treat pregnant patients.

METHODS

From September 2016 to May 2018, in-depth interviews were conducted with 31 key informants (clinical providers, ethicists, chaplains and health system administrators) with experience working in secular, Protestant or Catholic health care systems in Illinois. A thematic content approach was used to identify themes related to participants' experiences with abortion policies, the role of ethics committees, the impact on patient care and conflicts with hospital policies.

RESULTS

Few limitations on abortion were reported in secular hospitals, while Catholic hospitals prohibited most abortions, and a Protestant-affiliated system banned abortions deemed "elective." Religiously affiliated hospitals allowed abortions in specific cases, if approved through an ethics consultation. Interpretation of system-wide policies varied by hospital, with some indication that institutional discomfort with abortion influenced policy as much as religious teachings did. Providers constrained by religious restrictions referred or transferred patients desiring abortion, including for pregnancy complications, with those in Protestant hospitals having more latitude to directly refer such patients. As a result of religiously influenced policies, patients could encounter delays, financial obstacles, restrictions on treatment and stigmatization.

CONCLUSIONS

Patients seeking abortion or presenting with pregnancy complications at Catholic and Protestant hospitals may encounter more delays and fewer treatment options than they would at secular hospitals. More research is needed to better understand the implications for women's access to reproductive health care.

The Sacred and Stressed: Testing a Model of Clergy Health

In many ways, clergy and religious leaders are an ignored, yet high-risk population. A clergy member unable to cope with challenges in his or her own life may be ineffective at helping church members to cope with their stress. In the present study, we developed and tested an operational model of clergy holistic health, including occupational demands, and personal and job-related resources. Data were collected from clergy (N = 418) and analyzed using correlational and regression-based techniques. Results from the present study provide support for the demands-control-support model (Johnson and Hall in Am J Public Health 78(10):1336-1342, 1988). Specifically, our findings suggest that clergy mental health may be improved by (a) an increase in the work-related social support needed to take advantage of job control followed by (b) an increase in job control. Furthermore, the present findings expand on previous research by identifying spiritual well-being as an important outcome that may be impacted by job-related demands. The present findings also underscore the value of contextualized or occupation-specific measures, given the stronger correlations that were observed between the occupation-specific measure of perceived job demands than the general measure of perceived job demands.

Male Chaplains and Female Soldiers: Are There Gender and Denominational Differences in Military Pastoral Care?

In this study, 15 United States Army chaplain men described the practices they engaged in when providing pastoral support to women soldiers. Many engaged in creating safe spaces for women and themselves, particularly in regard to avoiding perceptions of impropriety. Other clergy did not consider gender a factor in counseling. Some chaplains placed limitations on the amount of support they would give. This study did not determine the degree to which chaplain men were effective.

Prisoners Helping Prisoners Change: A Study of Inmate Field Ministers Within Texas Prisons

Research on incarcerated offenders trained to help prisoners change is rare because programs that equip inmates with practical capacities for helping others rehabilitate in prison hardly exist. An exception is the Field Ministry program in Texas, which enlists inmates who have graduated from a prison-based seminary to work as "Field Ministers" and serve other inmates in various capacities. We hypothesize that inmate exposure to Field Ministers is inversely related to antisocial factors and positively to prosocial ones. We applied manifest-variable structural equation modeling to analyze data from a survey of a random sample of male inmates at three maximum-security prisons where the Field Ministry program operated. We found that inmates exposed more frequently to the Field Ministry and for a longer time period tended to report lower levels of criminological risk factors and aggressiveness and higher levels of virtues and predictors of human agency as well as religiosity and spirituality.

Lived Experience, Transparency, Help, and Humility: Four Characteristics of Clergy Responding to Mental and Emotional Problems

Many individuals who experience mental and emotional problems prefer support from clergy instead of formal mental health services. Because clergy are often sought out by those with mental illnesses, it is essential to understand their perspectives about mental and emotional problems and identify the individual characteristics that influence these perspectives. This study utilized qualitative data from a conversation among pastors in an online social networking group to examine the characteristics of clergy who held affirming attitudes toward professional mental health services. Thirty-five pastors participated in the discussion, generating more than 140 comments over 13 days in response to the question: "If the church is where we are to come for healing, how do we handle people who are depressed, suicidal, suffering from PTSD or anxiety?" Thematic analysis was conducted, and results suggest four characteristics common among clergy: personal experiences with mental and emotional problems, transparency in sharing their stories, personal help-seeking, and humility. These four characteristics may influence clergy members' present-day understanding and responses to mental and emotional problems. Implications for spiritual care professionals and mental health professionals are presented.

Knowledge, Attitudes, and Beliefs of Catholic Clerics' Regarding Mental Health in Lebanon

Arabic speakers rarely seek the help of professional mental health providers while they heavily rely on religious leaders. However, little is known about the knowledge, beliefs, and attitudes of clerics regarding mental illness. A standardized questionnaire was administered to 115 Christian religious men. Clerics appeared to have an informed, scientifically based understanding of the causes of mental disorders and of the importance of medications in effective treatment. However, several stigmatizing attitudes were identified. Contact with the patients significantly reduced the discrimination. Fear of the unpredictable highlights the need to develop and implement targeted approaches that outreach clergy.

The Priority List: An Evidence-Based Approach to Selecting Patients for Chaplain Visits

This paper examines three methods chaplains have historically used to identify patients they should see: rounding, referral, and protocol-based systems. Mercy Health is in the initial stages of adopting an expanded protocol-based system known as "the priority list." Central to the idea is the proposal and testing of clinical indicators that patients would benefit from chaplain support. Practical steps are offered for other pastoral departments in the development, implementation, and interpretation of their own lists.

Experience of Stress and Burnout among Pastors in China

A quantitative survey was conducted among a convenience sample of 164 church ministers in China to test a model relating experience of stress, clergy burnout, and clergy health. Results indicated that respondents experience relatively low levels of stress and burnout. The burnout score was 2.73 on a seven-point scale. Stress from family was a significant predictor of overall burnout. The experience of emotional exhaustion was a significant predictor of the occurrence of adverse health symptoms.