Andrew Todd1

Cardiff Centre for Chaplaincy Studies, Cardiff, UK

One of the distinctive characteristics of chaplaincy is its contextuality. Part of the character and identity of chaplaincy comes from the faith or belief tradition that the chaplain represents. But part of that character and identity is generated in the engagement with the particular context where a chaplain serves. This is consistent with the embedded nature of chaplaincy, which is not the work of someone who visits an organization (such as the hospital) but of someone who inhabits the place where s/he serves. The faith/belief dimension of identity, which can be part of the strangeness of chaplaincy within the organization, is held in tension with an identity that has to do with participation in the life of the organization (whether that has to do with health or social care, or another aspect of social life). This often means that chaplaincy is at the same time both a strange and a familiar presence amongst those served by chaplains.

The contextuality of chaplaincy (together with its distinctiveness) gives rise to a range of questions, some of which are explored in articles in this edition of Health and Social Care Chaplaincy. A fundamental question that is part of chaplains’ self-reflection, and is of particular interest to those who offer educational and professional development for chaplains, is: How does the chaplain engage with their setting? How, for example, do chaplains understand the organizational culture of a health or social care unit or operation? How do they locate chaplaincy practice within the practice of the organization, alongside that of other health and social care practitioners?

The question of how a chaplain engages may be addressed in part by drawing on other disciplines. Some of these, such as organizational theory, ethnography or different approaches to reflective practice, cast light directly on the how question – elucidating the method of engagement. Other disciplines work in parallel to the chaplain’s interest in what is going on in a particular setting. Their own distinctive engagement with the setting casts light on chaplaincy from the side, as it were. So nurses’ research into their own practice and engagement with spiritual care might offer insight into the research task that parallels that in which chaplains engage.

With a method established, the question that follows is: What is the character of chaplaincy’s engagement here? How has the embedding of chaplaincy practice within a particular setting shaped it? What are the professional or socio-political factors at work in the particular engagement of chaplaincy? In part addressing these questions contributes to an emerging “map” of chaplaincy in different geographical and socio-cultural milieux. But chaplains in other locations may also gain insight from the exercise.

Beyond these how and what questions lies the possibility that chaplaincy’s contextual engagement will give rise to interesting critical dialogue, with others who have different positions in relation to the organizations. In dialogue with observers of their context, or other practitioners within it, chaplains may find a helpful and constructive critique of their own role and identity. Equally, on occasion, chaplains may offer their own critique of the other dimensions and practices of the organizations they serve, in a spirit of co-participation and shared endeavour. And of course, such dialogue offers insight, in turn, into the contextuality of the chaplain’s own faith or belief tradition, which has its own cultural texture. Chaplaincy’s engagement with the organization it serves not infrequently generates interesting dialogue with the communities of faith and belief who sponsor chaplains.

General Articles

Martyn Skinner and David Mitchell offer insight into the reflective process by which chaplains and others locate themselves within their context. Their exploration of the reflective cycles of Borton and Rolfe, and how they can work in combination, is earthed in the pastoral practice of chaplains. But it also shows how reflection can be properly “reflexive”, developing the contextual self-awareness of the chaplain. Crucially, this reflexive work is multi-dimensional, allowing chaplains to explore not only how they can be effective and developing practitioners, but also various aspects of the question: Who am I in this context? I respond positively to the combination of “cue questions” that prompt the different parts of the cycle of reflection, which include the very direct (“What? So what? Now what?”) and a wider range of more detailed questions – as well as allowing for reflection to take place with a minimum of prompting.

Julian Raffay focuses his reflection on a particular aspect of healthcare, the Francis Report. This article is very much in the spirit of critical, but also constructive dialogue. Indeed it specifically explores the question of whether chaplains, or indeed others, can offer a theological critique of healthcare practice. Drawing on Jesus’ engagement with the Pharisees (especially in Matthew 23), Raffay offers a theological exploration of regulation in healthcare. While acknowledging the place of regulation, he argues that: “You can avoid the worst with rules but you cannot achieve the best”. In particular, he explores the risks that too heavy a burden of regulation can overwhelm staff, contributing to a depersonalization of healthcare, rather than the good care of, and relationship with, the service-user that is the spirit of the rules. The reflection includes an interesting and helpful reflection on the interaction between standards and values in organizational culture, that has a much wider applicability in any context shaped by “new management”.

Another critical and reflective dialogue is offered by Heye Heyen, Evert Jonker and Martin Neal Walton. Here another therapeutic practice, Logotherapy, is examined for the insight it offers to chaplaincy (as well as the reverse). Logotherapy, rooted in the work of Viktor Frankl, shares a number of concerns about people with chaplaincy. For example, in the search for healing, both areas of practice pay serious attention to the spiritual, understood as a vital dimension of the human person. Equally important to both are questions of meaning and the importance of meaning-making for the person accompanied by the chaplain or logotherapist. Interestingly, one of the ways in which, the authors suggest, Logotherapy challenges chaplaincy is in relation to truth. Logotherapy offers a framework in which the search for truth is important for both the client and the therapist, even if their understandings of truth differ. This is a significant insight for chaplains working in a pluralist context, and working with multiple understandings of truth, including their own. This article offers a fascinating conversation between “neighbours” therefore, each of which is negotiating the same plural context.

Research Articles

The article by Emily Wood, Julian Raffay and Andrew Todd explores how, within the context of healthcare, good conversations can be developed in which service-users and carers are full participants in shaping chaplaincy services, alongside chaplains and other staff. This approach, known as co-production, is not only the focus of the research out of which this article arises, but also integral to the methodology of the research. Full findings of the research will be explored in another publication. This paper seeks to draw out from the experience of undertaking co-produced research the implications for other research projects and for the co-production of the design and delivery of chaplaincy services. Some findings are shared in order to illustrate the lessons learned. They indicate the value of discussion about chaplaincy provision that identifies what service-users are actually concerned about – which may be different from chaplains assumptions! One of the striking features of the research is that working together in a co-produced way, while it has limitations because of institutional practices, demonstrates the real value of spiritual care being an underpinning dimension of holistic healthcare, but one which requires the mutuality of co-production for that value to be fully realized.

Liidia Meel introduces readers to a different geographical and political context for health and social care, that of Estonia. The article is a direct engagement with that context that establishes an initial overview of the socio-cultural factors that are shaping the development of contemporary clinical pastoral care in Estonia. The overview, drawing on a range of data is effectively done, including appropriate population analysis. This gives rise to proposals not only for further research, but also for practice. These include proposals to do with practitioners’ engagement with language and other facets of culture and their negotiation of a secular and diverse context, involving inter-religious cooperation. Economic and political factors, including the particular challenges of funding chaplaincy (and other therapeutic practices), are also addressed, including from an historical perspective. Given this close engagement with the context, it is not surprising that the article considers the “presentation” of chaplaincy to the context. It argues that membership of, and alignment with, the European Network of Health Care Chaplaincy is a vital aspect of this “presentation”. That theme, of how chaplains present within a socio-cultural setting, is nonetheless striking and of use to those in other contexts.

A further geographical context is addressed by Emily Hill, Richard Egan, Rebecca Llewellyn and David McBride in their article on New Zealand Defence Forces and Spirituality. At the heart of the research were interviews with 12 chaplains. Questions were designed to address chaplains’ engagement both with spirituality within the contemporary New Zealand context and with different facets of the military environment. Interestingly chaplains’ responses indicate a positive acceptance of spirituality, in which Māori culture played a significant role. Engagement with the military context included an emphasis on relationship and an acknowledgement of the possibility of role tension around the purpose of the military, alongside a determination to offer a faith perspective in this setting. One of the original features of the article is the aim of researching military chaplaincy as spiritual care. This makes for an interesting inter-contextual dialogue, that includes comparison of these New Zealand chaplains, not only with other military chaplains, but also with other health and social care chaplains. This is a carefully done international comparison, which reveals interesting points of commonality as well as of distinctiveness. For example, the chaplains’ engagement with a plural religious/spiritual context presents an interesting, and distinctively New Zealand, perspective that complements that of chaplains in other countries.

Review Article

Steve Nolan’s review article is a thoroughly inter-disciplinary one, addressing a particular context of health and social care, that of care for the dying person. His review of Allan Kellehear’s, The Inner Life of the Dying Person, is a properly critical appraisal of this sociological engagement with this world. This involves a careful unpacking of Kellehear’s position and its effect on his sociological method. The book is revealed as one which argues for a re-empowering of the dying person and their lay carers and a de-professionalisation of dying – part of a wider aim of building “healthy, compassionate communities”. But it is also revealed as one in which these good and laudable aims shape the interpretation of the perspectives of dying people. This is revealed especially in Nolan’s subtle treatment of the interaction between the concepts of denial and acceptance, in the light of Kellehear’s work on “resistance” to death. As Nolan argues there is much here for the chaplain working with dying people, who (as he also argues) is well-placed to realize Kellehear’s relational approach.

In Conclusion

I am grateful to the editors for their invitation to be the guest editor for this edition. I have found the opportunity to read and be in dialogue with contributors both enjoyable and stimulating. I hope that readers will have the same experience!

Edition 4.2 will be edited by John Swinton, and will focus on the theme of dementia and mental health care. Do contact John if you would like to contribute to that theme, or indeed encourage others to do so too.


1. Guest Editor, the Revd Canon Dr Andrew Todd is the Director of the Cardiff Centre for Chaplaincy Studies, which is sponsored by Cardiff University and St Michael’s College.