Competencies Introduction

There are many ways to provide spiritual care. This blog will focus on one of those paths and specifically on the competencies that must be demonstrated for board certification. The purpose of my blog is to provide you, the reader, with insights you may find helpful as you prepare for the board certification process. The prerequisites are typically: A Master’s degree from an accredited school, two Clinical Pastoral Education (CPE) units for associate certification or four units for board certification, an endorsement from your faith group, and the minimum required hours of work experience.

The next step in board certification is to demonstrate competency in broad skills related to spiritual care. Board certification was first coined in 1916 to separate doctors working in specialization from the rampant increase in “snake oil salesmen.”[1] In the 1920’s clergy organizations started certification processes focused on clinical integration, education, diversity, and research.[2] The largest chaplain certifying group, The Association of Professional Chaplains (APC), partnered with The Association of Clinical Pastoral Education (ACPE) in the 1960s and 1970s to begin offering the first certification for chaplaincy. During the 1980s the insurance industry started to prefer working with physicians who were board certified over those without this designation. Because of this, there was an increase in physicians pursuing board-certified status. Concurrent with these changes in the 1990s, the APC created an affiliate organization known as Board of Chaplaincy Certification Incorporated (BCCI). This company has solidified the process and standardization for chaplaincy competencies over the last 30 years.

“Today’s patients and administrators ask not only for compassion but also for competency.”[3]

Batholomew Rodrigues wrote this over two decades ago and the relevance still holds. Competencies give standards and accountability that are desperately needed when chaplaincy finds itself at a place of unsteady ground with rapid changes in healthcare. With over twenty different certifying organizations there is little to no agreement on what competencies must be demonstrated.[4] An important point of these blogs is that board certification is not always required. This is why the emphasis here is on demonstrating one’s skills by pursuing certification. One study noted that 37% percent of job ads for hospice chaplaincy positions required certification, ranking it last in the list behind ordination, education, and experience.[5] Board certification may not be right for you, but considering and demonstrating the components of the competencies addressed in the board certification process could be very valuable to all practitioners. These blogs will address the four sections by breaking down the 29 competencies over the next five posts. It is important to let you know that I am not affiliated with any certifying body and have not been certified myself.

Anton Boisen is credited as the originator of CPE. As a Presbyterian minister in the early 1900s and noted the lack of spiritual care available when he was sick. In these early stages, the programs focused on people as living human documents and were the training grounds for seminarians to apply theology to personal relationships between the student and the care recipient. In the 1980s and 1990s, the individualism of this approach was incorporated into broader contexts.[6] Social location, sex, race, and other contexts were being addressed. Connecting the academic study of religion to the practice of spiritual care has been a key goal of this work. The CPE model was simple: theory and practice. Miller-McLemore recounts some of these challenges that caused her to coin the term “living human web” to describe pastoral care in complement to Boisen’s work.[7] In the history she gives there are important points for the reader assessing their competencies.

Theological studies in the early 1900s become abstract and less practical. The next step was to integrate modern psychology into theological knowledge. Out of this came pastoral theologies that bridged the gap between abstract theology and the lived experience. In the late 1900s, theology expanded drastically coinciding with political and academic changes. Liberation movements and theologies gained momentum with the universities and the public, which in turn shifted the emphasis of pastoral care outward. Studies of congregations showed that the role of the pastor was moving into a place of organizing and leading as a facilitator for the networks of care. These interlocking changes became part of the human web. Miller-McLemore ends her history by noting that empathy remains the most constant trademark of pastoral care. This brings you to the next steps.

The development of the competencies is not pedantic or just following trends for the sake of relevancy. Parsing out what makes for true spiritual care has been the work of many theologians who are passionately trying to demonstrate what care for the soul looks like. At present, the sections of the competencies are Integration of Theory and Practice (ITP), Professional Identity and Conduct (PIC), Professional Practice Skills (PPS), and Organizational Leadership (OL). This little historical review of chaplaincy gives context for why these competencies have been developed as they have. We can begin to see why these areas are important for defining a milestone in the continued pursuit of competent chaplaincy. You are stepping into a river that has been moving and will continue to do so.

“What have been some of the more challenging competencies in your chaplaincy work to this point?”

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[1] Christine K Cassel and Eric S Holmboe. “Professionalism and Accountability: The Role of Specialty Board Certification,” Transactions of the American Clinical and Climatological Association vol. 119 (2008): 295-303; See also; Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982).

[2] Kelsey B. White, et al., “Mapping the Healthcare Chaplaincy Workforce: A Baseline Description,” Journal of Health Care Chaplaincy 27 (2020): 255.

[3] Larry Van De Creek, ed., Professional Chaplaincy and Clinical Pastoral Education Should Become More Scientific: Yes and No (Oxford: Taylor & Francis Group, 2003), 142.

[4] Wendy Cadge and Shelly Rambo, Chaplaincy and Spiritual Care in the Twenty-First Century: An Introduction (Chapel Hill, NC: University of North Carolina Press, 2022), 32.

[5] Emily Cramer, and Kelly Tenzek, “The Chaplain Profession from the Employer Perspective: An Analysis of Hospice Chaplain Job Advertisements,” Journal of Health Care Chaplaincy 18 (2012.): 140.

[6] Cadge, Chaplaincy and Spiritual Care, 218.

[7] Bonnie Miller-McLemore, “The Living Human Web: A Twenty-Five Year Retrospective,” Pastoral Psychology 67, no. 3 (06, 2018): 308.