Demand-focused spiritual care

We have been thinking a lot at the Lab about what it would mean and require to build an approach to spiritual care based on demand. What does this mean? 

Who receives spiritual care?

First, it means thinking about spiritual care first from the perspective of care recipients. Who are care recipients? Where are they? Where do they access spiritual care and/or chaplaincy? How do they experience interactions with chaplains? The information we gathered about these questions through a national survey with Gallup in March 2022 and fifty follow up interviews is sobering. 

  • People in the United States do not have a consistent understanding of the term “chaplain.” Interviews suggest that people see the explicitly religious dimension of chaplains’ work (not the more general sense of presence that chaplains talk about) as what distinguishes them from other care providers.
  • Between 18% and 44% of the public report interacting with a chaplain based on their understanding of the term.  Some people understand the term to include local religious leaders and / or people  who supported them through transformational experiences.
  • The largest percentage of people interact with chaplains through healthcare organizations, and there are few patterns by gender, race, religious affiliation, or other individual factors in who interacts with chaplains 
  • Many of those who interact with chaplains are not sure when or if they would do so again.

Who employs chaplains and how do they structure them?

Second, it means thinking about spiritual care from the perspectives of organizations like the military, healthcare organizations, higher education, prisons, etc. that employ chaplains. Our research finds that employers want chaplains to receive more and better training in crisis intervention, moral injury, and religious diversity. 

Third, it means thinking about delivery systems. Most people meet chaplains through organizations – mostly healthcare organizations – they are in for other reasons. We get lots of calls about people looking to start direct to consumer spiritual care or chaplaincy (mostly apps) but there are few cost-effective proofs of concept. Direct to consumer approaches require people to pay for spiritual care, another revenue engine, or philanthropic investments. We know the delivery systems through which people receive religious and spiritual content writ large are changing and the business models needed to sustain these new approaches have mostly not been built.

What we think

We engaged some of the country’s leading chaplains, scholars and educators in a conversation about demand-focused spiritual care last month (as part of a broader project that connects chaplains to the work of covenantal pluralism). It was a hard conversation. The experts are much more used to talking about how chaplains are trained – what we call supply-side questions. Our research names many challenges in training, however.

  • It is organizationally complicated
  • There are no clear guideposts or delineated paths focused on specific skills in training.
  • There are few agreements between educators and employers about what chaplains need to know (or space for consistent conversation about these questions)
  • There is little standardization of chaplaincy coursework or training in theological schools 
  • Training is lengthy, expensive, and – therefore – not accessible to some people and groups. 

The Lab has done a lot to support chaplains since it launched in 2018 and has focused almost entirely on chaplains (i.e. supply), not on care recipients (i.e. demand). If we want everyone in the United States to have access to spiritual care, we need to think hard about revolutionizing our approaches to spiritual care so they are built based on demand and on sustainable business models. 

Supply, demand, and the gap in between

We release today a gap analysis that names what we see as the gap between the demand for spiritual care and how chaplains are trained and deployed. It identifies six gaps:

  1. The public has limited and inconsistent knowledge of who chaplains are and what they offer: their value proposition is unclear to potential care recipients, some existing care recipients, and some of the organizations that employ them.
  2. The business model is based on service provision through organizations focused on other things.
  3. Opportunities to serve people who are ill/suffering and their caregivers (as two distinct groups with different needs and experiences) may not be fully realized.
  4. Chaplaincy training / certification does not operate as a well coordinated network. We estimate that half of the competencies for the MDiv are not relevant to chaplains. Training is costly and time consuming.
  5. Educators and employers are not regularly in conversation and there are not mechanisms to address existing gaps in training around crisis intervention, moral injury and religious diversity.
  6. Endorsers are gatekeepers with little to no transparency and mechanisms for change.

We invite you to join us in this conversation about how to build strategies to close these gaps. Read the working papers on supply and demand. Attend our webinar on April 27 at 2 PM to discuss our analysis, invite one of us to speak to your class or group, and / or share your feedback here. The future of this work may depend on it.

Wendy Cadge, PhD is Founder and Director of the Chaplaincy Innovation Lab. She is also Barbara Mandel Professor of Humanistic Social Sciences and Dean of the Graduate School of Arts and Letters at Brandeis University. 

Photo of Wendy Cadge, who will address the World Health Organization conference on October 2021