In response to an earlier article that we distributed re this ongoing debate about terminoloty (submitted by Dean Dyk), Jeffrey Funk replied: 

Thanks for the question about spiritual care versus pastoral care. I remember many discussions back in the 90s about whether to call our department Pastoral Care or Spiritual Care.

I know there is a tendency for facilities to want to use a term (in this case “spiritual”) that they think everyone understands. The problem with this thinking is that when it comes to spirituality, there is a wide variance of understanding among people as to what that word means and involves. I think it also confuses the issue of who can provide this type of care. Therefore, I think it is important that we define these terms so that people can understand that there really is a difference, and the differences are significant.

First, Spiritual Care comes under the large umbrella of the basic spiritual support that anyone can provide to help someone deal with his or her spiritual journey in order to experience wholeness and wellness. Because we all tend to have a basic understanding of what’s involved with spiritual care—even though there can be some significant differences in what that means—this is consistent with those who make the claim: “I can provide spiritual care” (such as: social workers, nurses, technicians, church members, and so forth). Yes, there is no doubt that anyone can provide this basic spiritual support. It doesn’t require a specialist. And, of course, this basic spiritual support does form part of the care provided by professional chaplains. However, because a Board Certified Chaplain (BCC) is a specialist in spiritual care, s/he will tend to understand better the spiritual issues at hand and will go deeper than this basic type of spiritual care.

Second, Pastoral Care is a step up from basic spiritual care. By definition, the word “pastoral” implies the giving of spiritual guidance by a clergy member of a faith group that holds to a specific religious worldview. This level of care is provided by someone who has had some theological education and pastoral experience and is often the faith leader for a particular faith group. This type of spiritual support is usually provided by and for those who share similar beliefs and practices. Such pastoral care often forms a part of the care provided by a professional chaplain. Basically, I see Clergy as general practitioners in the pastoral care they provide, whereas I see a BCC as a specialist (a professional expert) in the provision of pastoral care within the healthcare setting.

Clergy—as “pastoral” caregivers—are general practitioners in the provision of pastoral care at the bedside. They certainly know a lot about caring for the spiritual needs of the hurting, but their bedside ministry is usually not a main part of their focused experience and expertise. By definition, a specialist is someone who is qualified by advanced training (in other words, it goes beyond basic theological education) plus certification by a specialty examining board to practice in a specific area of expertise—in my case healthcare chaplaincy. A specialist is someone who has special knowledge and strengths and skills needed for the specialty task of spiritual support at the bedside.

So, spiritual care is more general and pastoral care is more specific. This is good because otherwise what would define what the pastor or chaplain provides as being unique from what anyone else can provide? I tend to like this terminology because it comes from a rich tradition that reflects the caring and healing role of our Good Shepherd, Jesus. It emerges from religious traditions, which are historically Christian in focus. The main problem for the general public is that it may sound too religious or too Protestant. I think that was one of the key reasons my one facility wanted to change the name of the Pastoral Care Department to the Spiritual Care Department because they thought spiritual care was more inclusive. But there is another option.

Finally, there is Chaplaincy Care. This is the emotional, spiritual, religious, pastoral, and ethical care provided by a BCC. It is the specialized spiritual support provided by a specialist in healthcare chaplaincy. This professional chaplain not only has theological education and pastoral experience, but also has received extensive and intensive specialized clinical pastoral education in chaplaincy care at the bedside, has been peer reviewed for the competency of this chaplaincy care, is held to a code of ethics for the service provided, and is endorsed by his or her faith group for this type of specialized ministry. It’s a level of skilled care—expertise, proficiency, know-how—that no one else can provide.

Because of these distinctions in the meaning of the three phrases, I prefer calling what we do as chaplains as “chaplain services” or “chaplaincy care” rather than spiritual care or even pastoral care. It tends to imply to others—who don’t have my specialty training and credentials—that they can’t necessarily be or do what I am or do. That’s not being arrogant; it’s simply recognizing that we are specialists in a specialized ministry in a specialized setting.

What do you think?