Scottish Journal of Healthcare Chaplaincy

Vol 9 No 2 October 2006


It is hard to believe that seven years have passed since the present editors agreed (were persuaded!) to take over the nurturing of the fledgling Scottish Journal of Healthcare Chaplaincy. Its first few editions had already appeared, distinctive in its cover featuring the celtic design in terracotta and grey inspired by the late Ruth Scott. The vision behind it had already been articulated by John Swinton, who in his appeal for articles in the then ‘SACH News Sheet' of March 1999 wrote,

‘It is vital that the journal authentically represents people ‘on the ground' as they work out their theology and practice in the complicated messiness of health care practice.'

We remember the sense of trepidation and responsibility with which we approached the task of helping the journal to take forward that vision. Would we be able to maintain the standard which had been set? Could we generate a flow of articles sufficient in number and quality? Would we have the nerve to ask contributors to alter or rework material they submitted, or would that seem like cheek? We need not have worried about the latter. To our mild surprise, contributors took us and our suggestions seriously, and so the confidence of two rooky editors increased accordingly. But we remember also the sense of excitement at becoming involved in the early years of a venture whose time had surely come, and being in a position to help the journal establish itself and grow in respect and reputation.

It is safe to say that both have indeed grown over these last years. As the journal approaches its first decade of life, it becomes clear that its existence has co-incided with an unprecedented period of change and innovation in health care chaplaincy. In his article ‘Healthcare Chaplaincy in Scotland and the UK:A look back to the future' David reflects on this slice of recent history, between the creation of SACH amid turbulence and controversy, up until the recent drawing together of SACH, CHCC and AHPCC in improved communication and co-ordination. Out of many developments during this period he highlights two as having ‘catapulted healthcare chaplaincy and spiritual care forward in Scotland' : the publication of HDL (2002)76, which pushed spiritual care further up the healthcare agenda than seemed possible only a few years previously, and the creation and staffing of the Healthcare Chaplaincy Training and Development Unit.

The events, debates and developments of this period have been well reflected in the pages of the journal, in the variety and quality of contributions from chaplains, academics and health professionals. As each successive issue has gone to the printer, we have had an impression that there is a growing confidence abroad in the world of chaplaincy and spiritual care – not in the sense of knowing exactly where the future will take us, but rather, confidence in the worth and distinctiveness of what we offer, even as we try to articulate these things. There is the courage to explore, for ourselves and for the healthcare community, what we do, and how and why we do it. Confidence and courage too, such as it takes to put pen to paper (or fingers to keyboard) and write for publication.

In our time we have addressed concerns current and topical in the world beyond chaplaincy, such as organ donation and retention in the wake of the events at Alder Hey (4:1); Severe Acute Respiratory Syndrome, or SARS ( 6:2); Asylum seekers (4:2). (This topicality is reflected in the current edition, in which three contributors write about their perspectives on the issue of HIV/AIDS). We have devoted space for consideration of developments of importance and concern within chaplaincy, such as HDL 76 (6:1) and Agenda for Change (8:1). We have broadened our vision and understanding of chaplaincy by looking to Europe and learning of, for example, the relationship between psychiatry and pastoral care in Greece (7:1); the experience of a chaplain working with young people affected by HIV in St Petersburg (5:2); the traditions and problems of healthcare chaplaincy in Bulgaria (6:2). And we have explored through many different contributions, the ways in which the role of the chaplain can be better understood, and the contribution of the chaplain measured and articulated.

We have had extensive discussion of the concept of spirituality in the pages of the journal, and no doubt we will return to this again and again, since it is fundamental to the practice of chaplaincy. Part of our task as chaplains is to continue to give voice and meaning to this elusive but vital aspect of human existence, to go on defining and refining, and to make sure that it is neither lost sight of in the world of healthcare, nor subtly domesticated or dealt with in too mechanical and simplistic a fashion. Writing in SACH Soundings of Dec 2005, and commenting on the predicted prevalence of depression as a major public health issue in our society, Chris Levison writes

‘The main cause of future ill health is going to be an inner cause, and if we do not look to the inner life, to the spiritual aspect of our humanity, then we are in danger of a vast increase in depression and related problems.'

This ‘spiritual aspect of humanity' is the base from which we set out, and to which we constantly return, as chaplains. It must inform our thinking not only about our day to day practice, but also about developments within chaplaincy and within health care. Which of them nourish the spiritual, within us, within the various healthcare settings in which we operate, and which do not? For example, is there a tension between moves in the direction of chaplains becoming ‘healthcare professionals', with all that this implies, and our calling to ‘notice dimensions of human experience that other professionals frequently do not.' (Swinton 2005)? Is there a danger of compromising the sense of being in some ways on the outside, and thus able to notice things, by becoming ever more comfortable, accepted and at home in the world of professional care givers?

Still on the subject of spirituality, the editors would have liked to see the concept being aired and explored more extensively through contributions from adherents of diverse faith communities, and we hope that in future the multi faith dimension of the journal may be strengthened.

And so, in the spirit of change, we move on, and hand over to Iain Macritchie and Janet Foggie with great confidence that they will take the journal forward into its tenth anniversary year, and beyond, from strength to strength. We have found our time as editors rewarding, and would like to thank the members of our inspirational editorial board, without whose hard work and creative suggestions we could not have done what we have done. We have also been heartened by the solid support of the SACH executive and members, and they and you have our gratitude. Special thanks to all our contributors, especially to Noel Brown, whose ‘Orere Source' has become such a valuable resource. You have all borne patiently with our suggestions to nip, tuck, trim, expand, and occasionally to embark upon complete re-writes, as well as with our panicky e mails as the Deadline Draweth Nigh. It has all been in the best of causes.

Georgina Neslon, joint editor.


SWINTON, J (2005 )in the foreword to COBB, M (2005) The Hospital Chaplain's Handbook. Norwich. Canterbury Press.

Full Text


Spiritual Perspectives on HIV – Scotland and beyond

Editorial note: In this article we hear from three chaplains who describe ongoing work in the field of HIV/AIDS. They describe ways in which those living with or affected by HIV/AIDS, and their communities, both in Scotland and the wider world, can be helped to face the emotional, physical, practical and spiritual challenges involved. Each contribution in its own way speaks about the re-creation of hope and fullness of living. The Editors

3rd Day People
Marion Chatterley

Pages 3-6

Abstract: A diagnosis of HIV no longer implies a rapid progression to AIDS and to inevitable death. From the perspective of her work in Edinburgh, the author describes how the work of chaplaincy has changed in response. It now seeks to offer ongoing spiritual and pastoral support, in a variety of settings, to those living with HIV, and to their various communities within Scotland.

Keywords : HIV/AIDS; spiritual care; pastoral care; chaplaincy

Marion Chatterley is a priest in the Scottish Episcopal Church, and a chaplain with Waverly Care.


'Life on the ocean wave!'
Spiritual Care, Mental Distress and HIV
Cameron Langlands

Pages 6-8

Abstract: The Tidal Model is a holistic approach to healthcare. It focuses on the personal journey, using the metaphor of a sea voyage. The journey may at times feature storms, breakdown, rehabilitation and recovery. This article describes how the model may be creatively used by chaplains and other members of the healthcare team working with those coping with mental distress and HIV.

Keywords : HIV; Tidal Model; spiritual care; chaplaincy; holistic care

Cameron Langlands is head of the department of pastoral and spiritual care, Gartnaval Royal hospital, Glasgow


Sacred Starfish
The Church of Scotland's HIV/AIDS Project:
Marking a (Real) Difference

John McMahon

Pages 9-11

Abstract: The Church of Scotland's HIV/AIDS Project is concerned with practical, person centred care of those affected by HIV/AIDS in many parts of the world. It aims to offer solidarity and practical support, through partnership with those at the grassroots. The author describes his recent experience as part of a Partners' Consultation Conference held in Limuru, Kenya.

Keywords : Church of Scotland HIV/AIDS Project; (COSHAP); partners' consultation conference, Limuru; spiritual needs.

John McMahon is the Lead Chaplain for NHS Lothian Primary Care and Mental Health

Full Text

Community nurses, spirituality and bereavement care
Paul Lyttle

Pages 12-17

Abstract: The study aimed to explore the perceptions of community nurses (health visitors and district nurses) in delivering a bereavement service to older people. It also aimed to gain an understanding of how bereaved older clients perceived bereavement visiting by community nurses. Qualitative semi-structured interviews were carried out with ten bereaved older people and twenty community nurses. Analysis of the interviews identified key concepts. A quantitative survey was carried out by questionnaire to two hundred and fourteen community nurses and achieved a return rate of one hundred and forty-three (66.8%). Community nurses interviewed stressed the importance of continuity of care, using intuition, and the importance of a client led service within the nurse/client relationship. They also identified, as helpful, having had a personal experience of grief. Bereaved older people interviewed identified key concepts of continuity, friendship and rapport within the client/nurse relationship. They had mixed perceptions regarding their own abilities to cope with grief as well as the impact of visits received from community nurses. Some bereaved older people perceived community nurses as skilled assessors of their grief. Community nurses surveyed by postal questionnaire demonstrated variations both in practice and in the administration of practice related to bereavement care. Friendship and rapport with the client group was found to be important as was spirituality, community nurse educational preparation and the role of voluntary organisations. Professional dichotomies in bereavement care were found to be present.

Key words: Bereaved older people, bereavement, community nurses, education, spirituality

C.Paul Lyttle is lecturer at Bell College, School of Health Studies, Dumfries Campus

Full Text

Chaplains working in a hospice palliative care team recount
the spiritual challenges at the end-of-life

Caroline McAfee, Barbara Cochrane, Mary Waldron, Felicity Hasson, W. George Kernohan

Pages 17-24

Abstract: As part of an on-going review of service provision for Hospice adult patients, six chaplains were interviewed to elicit their views and experiences of meeting spiritual needs within a multidisciplinary palliative care team. Interviews were taped: transcribed and common themes were identified. The chaplains highlighted many positive aspects of their work, recognising their role as one of service to the patients. They emphasised the importance of teamwork, both within the chaplaincy service and throughout the wider palliative care team. Negative aspects of working in palliative care were also identified, such as compassion fatigue. Chaplains need special coping skills and ongoing support in their work. They must recognise and obtain resources for patients from other world faith communities.

Key Words: Chaplaincy, Hospice, Spiritual Care, Standards, Support, Team working

Caroline McAfee is Senior Chaplain, Northern Ireland Hospice,
Barbara Cochrane is Director of Medical and Care Services, Northern Ireland Hospice, Mary Waldron is Research Assistant, Institute of Nursing Research, University of Ulster, Felicity Hasson is Research Fellow, Institute of Nursing Research, University of Ulster, George Kernohan is Professor of Health Research, School of Nursing and Institute of Nursing Research, University of Ulster, Newtownabbey

Full Text

The Relative Prevalence of Various Spiritual Needs
Kevin J. Flannelly, Kathleen Galek, John Bucchino, Adam Vane

Pages 25-31

Abstract: An announcement was placed in a chaplaincy newsletter inviting chaplains from the United States and Canada to participate in a survey about the spiritual needs of their patients. A total of 167 chaplains responded to the invitation and completed an on-line questionnaire. The questionnaire listed 28 spiritual needs that fell into seven categories. Chaplains were asked to rate how often they encountered patients with each of the needs, using a scale of 1 to 6, with 1 meaning “a few times a year” and 6 meaning “many times a day.” The responses of chaplains indicated that the seven categories formed a hierarchy of needs. The most common, or prevalent, of the seven spiritual needs were the need for love and belonging, and the need to find meaning and purpose, which chaplains encountered between “many times a week” to “a few times a day.”

Key Words: chaplaincy, pastoral care, religion, spirituality, spiritual needs

Kevin J. Flannelly is the Associate Director of Research at The HealthCare Chaplaincy in New York.
Kathleen Galek is a clinical psychologist and researcher at The HealthCare Chaplaincy. John Bucchino is the Director of Pastoral Care and Education at Lenox Hill Hospital in New York.
Adam Vane is the CEO of Paragon Global, LLC, a consulting firm in New York City.

Full Text

Standards for NHSScotland Chaplaincy Services:
Scoping, Standards and Consultation

Chris Levison and Katy Bullock

Pages 31- 35

Abstract: A scoping group established by NHS Quality Improvement Scotland and the Healthcare Chaplaincy Training and Development Unit, (HCTDU, now part of NHS Education for Scotland (NES)) was asked to scope awareness and provision of Spiritual Care in NHS Scotland. The group produced a report covering a survey and literature research. Following a seminar May 2005 in which this report was discussed along with some current research, a further group began work on chaplaincy service standards. A consultation conference held on 27 th June 2006 brought much support and many comments on the standards document. Despite some hesitation in trying to measure things spiritual, these standards should be a useful audit tool and an aid for future work on competencies and help development towards national standards or good practice statements on spiritual and religious care in NHS Scotland.

Key words: Spiritual Care, chaplaincy, scoping study, national standards, service standards, competencies.

Chris Levison is Healthcare Chaplaincy Training & Development Officer/Spiritual Care Adviser, NHS Education for Scotland, Katy Bullock is Senior Project Officer, NHS Quality Improvement Scotland.

Full Text

Healthcare Chaplaincy in Scotland and the UK: A look back to the future
David Mitchell

Pages 36-39

Abstract: As the Scottish Journal of Healthcare Chaplaincy heads toward its 10 th anniversary year retiring joint editor David Mitchell reflects on the changes that have taken place in the arena of healthcare chaplaincy during that time. Looking at Scotland and the wider UK scene the author acknowledges the considerable developments, changes and frustrations that have impacted on chaplaincy and have guided its course to the present day. Acknowledging the fears of individual chaplains, faith communities and belief groups, the author outlines a positive vision for the future that could allay these real fears. A vision that sees the development of standards, competencies and professional registration as a clear strategic direction and one earthed in the professional chaplaincy organisations. The author concludes that the continuing development of healthcare chaplaincy in Scotland is a model that could have a positive and guiding influence on the development of chaplaincy throughout the UK.

Key words: Chaplaincy, professional organisations, professional registration, standards,

David Mitchell, joint editor

Full Text

Book Reviews

Pages 40-44

New Journeys Now Begin: Learning on the path of grief and loss

Gordon T.

ISBN 1-905010-08-7

Wild Goose Publications, The Iona Community


Coming In: Gays and lesbians reclaiming the spiritual journey.

Mattmann, U

ISBN 1-901557-98-7

Wild Goose Publications


Social Perspectives in Mental Health: Developing Social Models to Understand and Work with Mental Distress

Tew, J.

ISBN 1- 84310-220 x

Jessica Kingsley Publishers


Life After Darkness

Weild, C.

ISBN 1-85775729-7



Integrating Spirituality in Health and Social Care: Perspectives and practical approaches.

Greenstreet, W (ed.)

ISBN 1-85775-646-0



Religions, Culture & Healthcare: A Practical Handbook for use in Healthcare Environments

Hollins, S.

ISBN – 10 1 85775 755 6

Radcliffe Publishing Ltd


Healthcare and Spirituality

Kliewer S. P. and Saultz J.

ISBN 1-85775-622-3


Full Text


Abstracts from the Pastoral Care and other Healthcare Journals

Page 45-52

The Rev. W. Noel Brown is a recently retired hospital chaplain and former ACPE supervisor. He is the Convenor of the Standards Committee of ACPE and the Convenor of the Research Committee of the Association of Professional Chaplains. He is also the Editor of The Orere Source, a bi-monthly publication of his abstracts from the pastoral care and healthcare literature. There are over 16,000 abstracts in the database.


Full Text