Boundaries and Dual Relationships Within Chaplaincy Care
Reflections Following a Case Review
DOI:
https://doi.org/10.1558/hscc.22614Keywords:
Chaplaincy care, boundaries, supervision, dual relationships, multiple relationshipsAbstract
This article explores the related issues of boundaries and dual relationships within health and social care chaplaincy. The article begins by noting a tension between an understanding of pastoral care as having unstated and flexible boundaries and the clear statements from professional bodies that boundaries help the effective functioning of caring and supportive relationships. In a discussion of boundary-setting issues in relation to the expectations of both patients and chaplains, the article touches on the use of social media, before looking in more detail at dual relationships. The article argues that, while chaplaincy boundaries may need to be flexible, an awareness of normal practice is vital, so that any extending of boundaries is done consciously. In relation to this, a number of trigger points are suggested. The article recommends that individual chaplains discuss boundaries within supervision, and that teams have clear policies and protocols which articulate expectations around team working. It further recommends that the profession develops more guidance around dual relationships, and that formal supervision standards are set and audited.
References
American Counseling Association (ACA) (2014). Code of ethics. Alexandria: ACA. Retrieved 7 March 2022 from https://www.counseling.org/resources/aca-code-of-ethics.pdf
American Psychological Association (APA) (2017). Ethical principles of psychologists and code of conduct. Washington DC: APA. Retrieved 7 March 2022 from https://www.apa.org/ethics/code/ethics-code-2017.pdf
Association of Professional Chaplains (APC) (2000). Code of ethics. Hoffman Estates: APC. Retrieved 7 March 2022 from http://www.professionalchaplains.org/Files/professional_standards/professional_ethics/apc_code_of_ethics.pdf
Australian Psychological Society (2007) Code of ethics. Retrieved 9 March 2023 from https://psychology.org.au/getmedia/d873e0db-7490-46de-bb57-c31bb1553025/18APS-Code-of-Ethics.pdf
Berry, J. (2014). A safe space for healing: Boundaries, power and vulnerability in pastoral care. Theology & Sexuality, 20(3), 203–213. https://doi.org/10.1179/1355835815Z.00000000050
Boyde, A., & Lynch, G. (1999). Establishing the therapeutic frame. In G. Lynch (Ed.), Clinical counselling in pastoral settings (pp. 64–78). London: Routledge. https://doi.org/10.4324/9780203360842
British Association for Counselling and Psychotherapy (BACP) (2018). Ethical framework for the counselling professions: Glossary. Lutterworth: BACP. Retrieved 7 March 2022 from https://www.bacp.co.uk/media/3101/bacp-ethical-framework-2018-glossary.pdf
British Association for Counselling and Psychotherapy (BACP) (n. d.). BACP register guide to supervision. Lutterworth: BACP. Retrieved 7 March 2022 from https://www.bacp.co.uk/membership/registered-membership/guide-to-supervision
British Psychological Society (BPS) (n. d.). Supplementary guidance on the use of social media. BPS. Retrieved 7 March 2022 from https://cms.bps.org.uk/sites/default/files/2022-08/Supplementary%20Guidance%20on%20the%20Use%20of%20Social%20Media.pdf
Ceroni, L. (2019, November 15) Evidence brief: Navigating dual relationships in mental health care settings. Evidence Exchange Network. Retrieved 9 March 2023 from https://kmb.camh.ca/eenet/resources/evidence-brief-navigating-dual-relationships-in-mental-health-care-settings
Chaplaincy Accreditation Board (CAB) (2017). Code of conduct for healthcare chaplains. Mahon: CAB. Retrieved 7 March 2022 from https://www.ireland.anglican.org/cmsfiles/pdf/Information/Resources/hob/2017001-Chaplaincy-Accreditation-Board.pdf
Churchill, H. (2021) The Churchill framework. Association of Christians in Counselling and Linked Professions. Retrieved 9 March 2023 from https://www.acc-uk.org/public/docs/The_Churchill_Framework.pdf
Cobb, M. (2005). The hospital chaplain’s handbook: A guide for good practice. Norwich: Canterbury Press.
Cooper-White, P. (2004). Shared wisdom: Use of the self in pastoral care and counseling. Minneapolis: Fortress Press.
Doehring, C. (2015). The practice of pastoral care: A postmodern approach (revised and expanded ed.). Louisville: Westminster John Knox Press.
Handzo, G., Flannelly, K. J., Murphy, K. M., Bauman, J. P., Oettinger, M., …, & Jacobs, M. R. (2008). What do chaplains really do? I. Visitation in the New York Chaplaincy Study. Journal of Health Care Chaplaincy, 14(1), 20–38. https://doi.org/10.1080/08854720802053838
Harrison, G. (2017). The practice of psycho-spiritual care. In G. Harrison (Ed.), Psychospiritual care in health care practice (pp. 20–45). London: Jessica Kingsley.
Health and Care Professions Council (HCPC) (2017). Guidance on social media. London: HCPC. Retrieved 7 March 2022 from https://www.hcpc-uk.org/globalassets/resources/guidance/guidance-on-social-media.pdf
Idler, E. L., Grant, G. H., Quest, T., Binney, Z., & Perkins, M. M. (2015). Practical matters and ultimate concerns, “doing,” and “being”: A diary study of the chaplain’s role in the care of the seriously ill in an urban acute care hospital. Journal for the Scientific Study of Religion, 54(4), 722–738. https://doi.org/10.1111/jssr.12235
Justice, J. A., & Garland, D. R. (2010). Dual relationships in congregational practice: Ethical guidelines for congregational social workers and pastors. Social Work and Christianity, 37(4), 437–445.
Katherine, A. (1991). Boundaries: Where you end and I begin. Hazelden Publishing.
Kelly, E. (2008). Meaningful funerals: Meeting the theological and pastoral challenge in a postmodern era. London: Bloomsbury.
Kelly, E. (2012). Personhood and presence: Self as a resource for spiritual and pastoral care. London: T&T Clark.
Lusk, C. T. J. (2002). Boundary issues for hospital chaplains. SCI Psychosocial Process, 15, 210–212.
Lyall, D. (2001). Integrity of pastoral care. London: SPCK.
Mathers, J., & Bloomfield, I. (1978). Counselling and consultation. Contact, 60(1), 19–24. https://doi.org/10.1080/13520806.1978.11759381
National Advisory Group on the Safety of Patients in England (2013). A promise to learn – A commitment to act: Improving the safety of patients in England. Retrieved 7 March 2022 from https://www.gov.uk/government/publications/berwick-review-into-patient-safety
Newitt, M. (2010). The role and skills of a hospital chaplain: Reflections based on a case study. Practical Theology, 3(2), 163–177. https://doi.org/10.1558/prth.v3i2.163
NHS England (2017). Social media and attributed digital content policy. Retrieved 7 March 2022 from https://www.england.nhs.uk/wp-content/uploads/2018/04/social-media-policy.pdf
Nursing and Midwifery Council (NMC) (n. d.). Guidance on using social media responsibly. London: NMC. Retrieved 7 March 2022 from https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/social-media-guidance.pdf
Plaut, S. M. (2010). Understanding and managing professional–client boundaries. In S. B. Levine, C. B. Risen, & S. E. Althof (Eds.) The handbook of clinical sexuality for mental health professionals (2nd ed., pp. 21–40). Routledge.
Risen, C. B. (2016). Boundary Crossings in Clinical Practice. In S. B. Levine, C. B. Risen, & S. E. Althof (Eds) The handbook of clinical sexuality for mental health professionals (3rd ed., pp. 22–31). Routledge.
Rumbold, B. D. (1986). Helplessness and hope: Pastoral care in terminal illness. London: SCM.
Scopelliti, J., Judd, F., Grigg, M., Hodgins, G., Fraser, C., Hulbert, C., Endacott, R., & Wood, A. (2004). Dual relationships in mental health practice: issues for clinicians in rural settings. The Australian and New Zealand Journal of Psychiatry, 38(11–12), 953–959. https://doi.org/10.1080/j.1440-1614.2004.01486.x
Spiritual Care Australia (SCA) (2017). Code of conduct for spiritual care practitioners. Retrieved 7 March 2022 from https://www.spiritualcareaustralia.org.au/public/103/files/documents/Code_of_Conduct_Final_V2_Approved_May_2017.pdf
Spiritual Care Australia (SCA) (2020). Professional development and supervision requirements of SCA members. Retrieved 7 March 2022 from https://www.spiritualcareaustralia.org.au/public/103/files/SCA%20Supervision%20Guidelines.pdf
Swift, C. (2001). Speaking of the same things differently. In H. Orchard (Ed.), Spirituality in health care contexts (pp. 96–104). London: Jessica Kingsley.
UK Board of Healthcare Chaplaincy (UKBHC) (2014). Code of conduct for healthcare chaplains. Cambridge: UKBHC. Retrieved 7 March 2022 from https://www.ukbhc.org.uk/wp-content/uploads/2019/12/Encl-4-ukbhc_code_of_conduct_2010_revised_2014_0.pdf
UK Board of Healthcare Chaplaincy (UKBHC) (n. d.). Supervision. Cambridge: UKBHC. Retrieved 7 March 2022 from https://www.ukbhc.org.uk/for-professionals/supervision
UK Council for Psychotherapy (2019) Code of ethics and professional practice. Retrieved 9 March 2023 from https://www.psychotherapy.org.uk/media/v11peyoh/ukcp-code-of-ethics-and-professional-practice-2019.pdf
Winnicott, D. W. (1973). The child, the family, and the outside world. Penguin Books.
Zur, O. (2014). Not all multiple relationships are created equal: Mapping the maze of 26 types of multiple relationships. Independent Practitioner, 34(1) 15–22. Retrieved 7 March 2022 from https://drzur.com/media/multiple_relationships_26types.pdf