Working in Clinical Chaplaincy, I have encountered many models for assessing human needs, both religious & spiritual, humanistic and also psychological assessments; all thoroughly studied and executed in the provision of spiritual and religious care, yet many are too much or too little when it comes to the ever changing face of spiritual and religious needs and expression in contemporary multicultural Australia.
The biopsychosocial model is a modern humanistic and holistic view of the human being in health sciences. Currently, researchers think the biopsychosocial model should be expanded to include the spiritual dimension as well. However, “spiritual” is an open and fluid concept, and it can refer to many different things.
As I developed my own model of integrating somatic awareness and neurobiological factors into presence-centered spiritual care, I started to play with simple and easy to remember maps (both for myself and for educating caregivers) as I searched for the "map maker" within each of my clients, and that was broad enough to cover all possibilities and align to clinical language in healthcare settings.
Above is one example, a brief notepad scribble to support a new caregiver to quickly identify identity, support, needs and life expression in the patient no matter what medical specialty or scenario, based on the traditional Biopsychosocial-spiritual framework, and inclusive of all living factors.
You can note the words in the illustration above....
ATTUNE relating to their body/somatic presentation,
WONDERING about their psychology, identity and coping,
FOLLOWING their social history, community and needs
HOLDING their expression of spirituality, faith, and worldviews.
These principles for assessment are useful for any caregiver whether a spiritual worker or not to follow and are highly influenced by Values-based Reflective Practice by Dr Ewan Kelly, and the work of Mary Koloroutis, Michael Trout in See Me as a Person: Creating Therapeutic Relationships with Patients and Their Families. Softcover, 464 pages. (2012).
Attuning, wondering, following, and holding are core principles of any caregiving role, and allow for a holistic response to patient needs through the established therapeutic connection; in utilising these values, people feel more open, competent, and hopeful.
Author Mary Koloroutis invites us to cultivate more meaningful connections in our professional relationships, which when integrated into our professional identity help resource ourselves both at work and at home.
Try these four simple practices:
Attuning
We cannot connect meaningfully with others unless we are tuned in to ourselves. When we pause and take a breath, we make space for greater connection with others. Attuning is the practice of being present in the moment and “tuning in” to ourselves and then others. When we attune to patients, we meet them exactly where they are and remember that what might be routine for us is often life-altering for them.
Try this: Before entering a patient room, pause, take a mindful breath and as best you can, slow down. Then connect with the patient/family with a focus on their state of being (physical, emotional, mental, and spiritual).
Wondering
We all bring with us preconceived ideas and expectations about others. Wondering is the practice of bringing an open-hearted curiosity toward others by recognizing and suspending assumptions and judgment. It is the practice of being genuinely interested and understanding that only patients can tell us about themselves. Their input is critical to quality care.
Try this: Be curious about what your patient will teach you. Be curious about your patient’s backstory and how it is impacting their interactions and responses to care. You may not actually hear their backstory – the point is to remember they have one.
Following
When we are watching a movie, we follow the story as it evolves. Similarly, when we practice following patients, we are listening, focusing on their emerging story, and paying attention to what they are telling us that matters most to them.
Try this, Next time you are with a patient or family member, listen to and validate the person with empathic sounds and attuned body language. Pay attention to what they say is most important to them and integrate that into their care.
Holding
When we hold an infant, we instinctively cradle them in our arms. Holding a patient is the same thing but from a psychological perspective. It is the practice of intentionally creating a haven that protects the dignity of an individual. It is the practice of speaking with respect for them as persons.
Try this: Next time you are caring for an angry or distressed patient, experiment with remembering that anger is a normal human response to illness. It comes from feelings of fear and powerlessness. Acknowledge their feelings, remain a sturdy, compassionate presence, and take kind actions to ease their suffering.
Healthcare professionals are all guided by a shared purpose to reduce suffering and bring more heartwarming connections to our skilled work. These four practices of attuning, wondering, following, and holding are critical skills that make a significant impact on the care of our patients and clients, and our own sense of joy in our work.
You can align these principles into your own therapeutic identity and assessment framework through embodied awareness, cultivating curiosity, having an experimental attitude, and creatively exploring the mystery of an individual's spiritual expression; allowing you to transform your spiritual and holistic assessments into responsive, open spaces of genuine connection.
If you would like to explore these concepts within experiential activities for learning, contact me about Reflective Practice sessions for your team.
Links to original works: