Important Facts About the Spiritual Care Association
1. FACT: SCA is carrying out what thought leaders have voiced for decades.
SCA's innovative approach to standardize and modernize chaplain training, credentialing, certification, and continuing education incorporates the desires and issues raised by chaplains in the field and thought leaders over decades.
As just two examples:
- "Chaplains are inclined to argue among themselves over best practices, once again dividing the occupational group and slowing efforts to professionalize. If members of the occupation cannot agree on how to define and measure their own work, then why should society grant them professional status?" Source: Raymond de Vries, Nancy Berlinger, Wendy Cadge, "Lost in Translation: The Chaplain's Role in Health Care," Hastings Center Report (November-December 2008)
- While chaplaincy leaders and educators in each of these areas could work together to imagine new, more interdisciplinary, and more integrated training models, change is not likely to be easy. Change is important, however, if chaplains are to become more than 'tinkering tradespersons' fulfilling needs seen as peripheral to their organization's main missions." Source: Wendy Cadge, Ph.D., "Paging God: Religion in the Halls of Medicine," Chicago: University of Chicago Press, 2012
Given the fast-moving changes in health care, action was long overdue. It's well known that health care providers and payers are increasingly focused on value derived from quality outcomes. Chaplaincy care had not been able to demonstrate value because defined, evidence-based quality indicators and competencies did not exist (until now).
2. FACT: SCA is raising the profession to be on par with other disciplines, especially in terms of standardization and objective demonstration of competencies.
We greatly respect and appreciate professional chaplains and the work they do in providing meaning and comfort to patients and their loved ones, and their contributions to interdisciplinary teams. We are not saying they are not competent, and we are not questioning their vital role in health care. HCCN has played a major part in education and requirements that have shaped the profession.
However, we are saying that it is time to build upon the field's existing guidelines and research. Moreover, today's health care environment demands that chaplains be subject to uniform training and testing, including demonstration of clinical competencies based on current evidence.
- Standardized training and objective testing conforms to best practices in other health professions and puts chaplaincy on par with other disciplines by replicating their uniform approach and requirements to gauge competencies and define quality care that contributes to enhanced outcomes and value.
- The goal of evidence-based competency guided our development of SCA's knowledge base, testing, and credentialing and certification requirements. The core competencies that will be tested rely on the demonstration of knowledge and skills linked to evidence-based (18) quality indicators and scope of practice-both of which were developed by panels of international experts.
- We have identified common core content areas for education that support the evidence-based documents, as well as lay the groundwork for chaplains' effective participation on interdisciplinary teams.
- SCA's entire system is built so that it can be assured that the professional chaplain can reliably deliver spiritual care that meets the value-added outcomes of the health system.
3. FACT: SCA is basing its requirements for credentialing and certification on current evidence, and is opening the door to allow individuals to become professional chaplains through various pathways while ultimately demonstrating the required degree of knowledge and competency.
- Board certification of chaplains based merely on a required number of hours, faith endorsement, and a subjective process ---- what the candidate says and writes, and what the certifying committee judges as meeting competency ---- does not ensure the delivery of effective care.
- SCA's introduction of a standardized clinical knowledge test and standardized patient exam through a simulated patient encounter eliminates the subjective certification process that has plagued the profession and allows for a true objective demonstration of evidence-based knowledge, clinical competencies, and best practices. Both tests are being developed using subject matter experts and the most rigorous standards, and both will be able to be scored objectively.
- Standardized objective testing conforms with best practices in other health professions by replicating their uniform approach and requirements to gauge competencies and define quality care that contributes to enhanced outcomes and value.
- Many of the requirements in the current certification systems, including Clinical Pastoral Education (CPE), a graduate level theological degree, and faith group endorsement, have never been shown through evidence to have any influence on chaplaincy competence.
- Through our new credentialing and certification process for chaplains, we are opening up the field to include capable and competent chaplains. We will accomplish this through education based on research (evidence) and testing based on knowledge, demonstration of clinical competencies, and skills.
4. FACT: To ensure quality care of patients, SCA is bringing a standardized and evidence-based approach to the education and training of professional chaplains.
Over decades, thought leaders have had reservations about the current education of chaplains. For example:
"A question for the chaplaincy profession is whether designing CPE residency curricula around the certification competencies is an effective way to educate people for professional chaplaincy or whether it is time for a fresh look at education for professional chaplaincy ..."
Source: George Fitchett, D.Min., Ph.D., Alexander Tartaglia, D.Min., Kevin Massey, BCC, Beth Jackson-Jordon, Ed.D. & Paul E. Derrickson, BCC (2015) Education for Professional Chaplains: Should Certification Competencies Shape Curriculum?, Journal of Health Care Chaplaincy, 21:4, 151-164, DOI: 10.1080/08854726.2015.1075343
- Currently, there is no consistent, standardized curriculum to educate chaplains, and there is a wide variation of training by CPE supervisors.
- Many of the requirements in the current board certification systems, including CPE, have never been shown through evidence to have any influence on chaplaincy competence. Nor has there been any evidence that someone who becomes certified without traditional CPE performs any worse as a chaplain than someone who has traditional requirements.
- With the emergence of the evidence-based Quality Indicators and Scope of Practice documents, it becomes possible to develop curriculum that teaches to these evidence-based standards, and bring standardization to the field.
- The current level of evidence in the field reasonably indicates that requiring two CPE units, rather than four, for board certification is sufficient to allow someone to take the new objective testing for certification. The test results, not the amount of training hours, prove whether the chaplain can demonstrate competency of knowledge and care.
- The new CPE model is being offered by HCCN, which is an Association for Clinical Pastoral Education, Inc. accredited CPE center. It opens the door to allow individuals to get uniformly educated ---- and become professional chaplains while ultimately demonstrating the required degree of knowledge and competency to provide reliable, high-quality spiritual care.
5. FACT: SCA is not requiring faith group endorsement because it is not an evidence-based indicator of the person's competency as a professional chaplain who provides high-quality spiritual care regardless of religion or beliefs.
- Faith group endorsement is not an evidence-based indicator of the person's competency as a chaplain and is an exclusive practice that has failed to truly embrace diversity.
- Faith group endorsement is a relationship between a chaplain and his or her religious/spiritual/existential community. It is largely a Christian structure that is not practiced by most non-Christian groups. This reality has often meant that otherwise qualified and competent persons who are not from a tradition that endorses chaplains have either been denied the opportunity for certification or have had to compromise their own tradition in order to obtain an endorsement from another group in order to qualify.
- SCA recognizes that if a hospital/hospice/other health care provider/other setting or specific faith group requires that the chaplain have faith group endorsement, SCA respects that the chaplain will need to obtain such endorsement (this is separate from SCA's credentialing and certification process).
6. FACT: SCA's requirements for certification are subject to change as new evidence becomes available.
- SCA's requirements for credentialing and certification, and all of the other components on which the model rests, are open to continuing research and development by the field.
- Because of the nature of the testing process, it is easy to add and subtract content, and we would fully expect to do that as the evidence demands.
7. FACT: SCA is collaborating with many of the existing chaplaincy associations.
After introducing SCA in April 2016, we reached out to all of the chaplaincy and pastoral counseling membership associations in North America to invite them to collaborate with us in moving the field forward. Our goal is for groups with a vested interest in quality health care to weigh in on various issues, most especially on the advocacy front.
- 11 chaplaincy/pastoral care organizations have expressed a desire to participate with SCA. We have invited them to apply components of the SCA model for their own members, and we are in ongoing communications with them on this and other aspects of the new association.
- In addition, recognizing that chaplaincy should not be placed by itself in a silo, we are also in continual communication with 145 professional/nonprofit organizations representing various health professions and disease states.
This push for collaboration is consistent with HCCN's well-established history of leading and funding major initiatives in the field. From research studies to course development, we have provided input and funding to other chaplaincy associations for decades. Most evident of this, under the initiative and financial support of HCCN, the Common Standards for Professional Chaplaincy were developed and adopted in 2004.
8. FACT: SCA recognizes that the essence of professional chaplaincy care is both an art and a science, and the SCA model incorporates both attributes of the profession.
Increasingly, all health care services are being judged ---- and funded ---- by the value of what they add to the system. The normal bar for proposing a quality measure is that it is evidence-based. That is why SCA has introduced:
- Measurable indicators that would support the delivery of spiritual care.
- A standardized curriculum with core content areas that are multi-dimensional.
An objective evaluation of a chaplain's competency of knowledge and care via both a standardized clinical knowledge test and a standardized patient exam through a simulated patient encounter, which will highlight a practitioner's communication and other skills and "human touch"; this two-fold assessment encompasses both the art and science of chaplaincy care.
Here is a two-page document that reinforces and supplements the above points. Also, you may find useful our recent report "Time to Move Forward ─ Creating a New Model of Spiritual Care to Enhance the Delivery of Outcomes and Value in Spiritual Care" which you can find here.