Kaplun: Understanding the spiritual-care model

Mount Sinai Hospital street view

The CJN’s story on the changes that Mount Sinai Hospital in Toronto made to its chaplaincy program may have left some readers thinking that patients will receive a reduced level of care (“Mount Sinai ditches chaplaincy for ‘spiritual care’,” July 4). Yet, as someone who was directly involved in the recruitment process when the University Health Network (UHN) made the progressive paradigm shift from a chaplaincy to a spiritual-care model nearly 10 years ago, I can attest to the fact that this model provides an enhanced level of care for patients, their families and clinical staff.

A large part of the misunderstanding stems from the fact that many people don’t understand the differences between the more traditional faith-based chaplaincy model and the non-denominational spiritual-care model.

Traditional chaplaincy services are provided by either public or religious institutions. Either way, the services stem from a singular faith group: chaplains work primarily with people of their own faith.

Spiritual care providers (SCP) can come from any faith group, but are expected to provide pastoral care to anyone in the institution they serve.

Baycrest defines spiritual care as follows: spiritual care attends to a person’s spiritual or religious needs as he or she copes with illness, loss, grief or pain and can help him or her heal emotionally as well as physically, rebuild relationships and regain a sense of spiritual wellbeing.

This is a good start, but doesn’t explain the education, credentials and experience required to serve as an SCP, or who benefits from the service in a non-religious institution such as a hospital.

While requirements for being an SCP differ from institution to institution, during my tenure at the UHN, they were required to: be ordained, or otherwise recognized, by their own faith group; have a master’s degree in divinity; and have a set number of units of clinical pastoral education. These qualifications make SCPs an integral part of the clinical team. They are often assigned to specific departments, making them experts in that form of care – something that was not possible with the traditional chaplaincy model.


I distinctly recall having lunch with two of the UHN’s spiritual care providers, one Buddhist and the other Jewish, when their pagers went off within seconds of each other. “What’s the emergency?” I asked. I was informed that it was Ash Wednesday and a Catholic patient had asked for ash. I was bemused. “How does a Buddhist and Jew deal with that request?” I asked. “Oh,” came the succinct response, “we call the Archdiocese of Toronto, who will send a member of their clergy to look after the patient’s religious needs.”

In a religiously diverse country such as Canada, it would be impossible for a hospital to have all religions represented on staff. The spiritual-care model, however, ensures that patients of all faiths have their spiritual and religious needs met.

I vividly recall a memorial service I attended at the Toronto General Hospital a number of years ago. It was an annual interfaith service designed to remember the patients who died during their stay. As we waited for the service to begin, over a dozen individuals surrounded one of the spiritual care providers. Each took a turn to physically embrace him and share a few words.

It was clear that emotions were running high, but I had no inkling as to why. After the service, I was informed that, at the family’s request, the SCP sat in the operating room during the 10-hour transplant procedure performed on their loved one. The painful loss of their cherished family member didn’t diminish their appreciation of his service, which many would view as going above and beyond.

The spiritual care model doesn’t replace religious care; rather, it complements it, while providing a more holistic service that is inclusive of patients, their families and clinicians.