Chaplaincy Thoughts, or How To Start

**This is an info dump based on my possibly misinformed knowledge.  It is true to the best of my knoweldge but definitely do check up on all of it.  This is to give you and idea of what is involved.  And I focus exclusively on healthcare chaplaincy (though some of the same training can be extrapolated to university/education chaplains, movement chaplains, prison chaplains, even corporate chaplains etc.)  Military chaplaincy is its own thing with different rules and requirements.

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I realize that I am asked, quite frequently, about how to become a chaplain.  And so I've decided to write some of this up.

For the most part, I am talking about professional chaplaincy, where you as the chaplain get paid to do chaplain work.  There are spiritual care volunteers and chaplain volunteers but there are few standardized requirements for them.  

Because of the separation of church and state, there are no federal or state guidelines for licensing chaplains like there are for doctors, nurses, social workers, lawyers, teachers, etc.  

There are a few professional organizations that are most respected in the field and dominate most of the official recognition of quality professional chaplains:

APC: The Association of Professional Chaplains (https://www.apchaplains.org/) sets out certification standards as well as professional ethics and competencies.  They grant Board Certified Chaplain (BCC) status to those who pass their requirements.  See  https://www.apchaplains.org/bcci-site/becoming-certified/ for details on how to be certified.

ACPE: The Association of Clinical Pastoral Education (https://acpe.edu) which trains and certifies the educators who train chaplains as well as sets the curriculum for training student chaplains at numerous sites across the nation.  Essentially, this organization will oversee the units of Clinical Pastoral Education (CPE) that every professional chaplain and student chaplain takes.  See https://acpe.edu/education/cpe-students 

Nehsama: Association of Jewish Chaplains (https://najc.org/)

National Association of Catholic Chaplains (NACC; https://www.nacc.org/)

Spiritual Care Association (SCA; https://www.spiritualcareassociation.org/) has its own path to certification

**There is controversy about whether you go the APC/ACPE or the SCA route.  I've taken CPE units from both "sides."  I'm completing certification through APC/ACPE.  

First caveat:  many of your decisions on becoming a chaplain will be based on your denomination's requirement for endorsement.  Endorsement helps with becoming a board-certified chaplain.  There are the mainline Protestant denominations, Catholicism, various branches of Judaism, the Unitarian Universalists, plus humanists, pagans, and atheists.  There might even be an interfaith denomination that will endorse you.  The organizations endorse you, essentially saying that you are a member in good standing who has completed the requirements for endorsement.  

For many denominations, the path to chaplain endorsement resembles the path towards (and sometimes up to and including) ordination.  If you are in a denomination that does not ordain anyone (such as Latter Day Saints and Quakers), there are probably other paths to endorsement for you to be supported by your denomination.  If you are in a faith that doesn't ordain women, like Catholics, there are other paths to endorsement for you.  And there are national organizations that will endorse humanists, pagans, Buddhists, etc.

In my Unitarian Universalist denomination, there are essentially two paths--one is the traditional path of ordination (complete with Master of Divinity, psychological ministerial assessment, usually one unit of CPE, one internship, a complete ministerial packet, and a committee interview) and the other is the path of community minister which does not require ordination (I believe you still need an MDiv but not the other steps above; you are the endorsed by the UU Society of Community Ministers.)  ONLY after you have made progress on the path to endorsement can you apply to be BCC.  You will then need to finish the BCC requirements.  Many people pursue this concurrently; indeed, my CPE residency (3 units of CPE at the same place PAID!) counts as my internship for ordination.  It's not all one and then all the other.

To become board-certified, you need an MDiv (or the 72-hour graduate school hours in an equivalent topic), an endorsement, 4 units of CPE, a packet, 2000 work hours (which can be completed after you are provisionally approved) and an interview with the BCC committee.

NOW, you can be a chaplain without being BCC.  Indeed, hospice organizations will often take people on as chaplains who have had 2 units of CPE and not much else (requirements vary).  Other healthcare organizations usually want BCC but will allow people with 4 units of CPE to work as chaplains (oftentimes without the other requirements).

Why an MDiv?  

This advanced degree or its equivalent gives the student a firm grounding in theology, ethics, pastoral counseling skills, scripture, other major religions, current social justice issues in ministry, preaching, etc.  While MDivs are often geared toward congregational life (as is ordination in most denominations), they do give you the background to do the work.  And, perhaps even more than that, the knowledge to do the CPE work which involves theological reflection, self-reflection, knowledge of a variety of faiths and cultures, familiarity with scripture and rituals, etc.  Many seminaries now offer certificates or pathways which focus on chaplaincy.  This is what I did, taking multiple chaplaincy-oriented classes while finishing my MDiv:  theories and methods of chaplaincy; theologies of chaplaincy; bereavement; pastoral counseling; and spiritual care for LGBTQ+ people. Hartford International University (formerly Hartford Seminary) also has a specific program in Islamic Chaplaincy, the first one in the country.  

So what is CPE?

This is THE hands-on training program for students working to become chaplains.  It is also the program that many clergy are required to take, at least one unit, to become congregational clergy (i.e. with no intention to be chaplains).   Overseen by ACPE or SCA--and offered at hundreds of different sites and organizations (like Sankofa)--one unit of CPE includes:

• 300 clinical hours
• 100 educational hours
• IS: individual supervision between chaplain intern and their supervisor educator, every other week
• IPR: interpersonal group where the cohort of chaplain students discuss the work together, every week. (This is the part of CPE that often causes the most agita and stories--it can be very emotionally intense. Or not).
• Didactics--condensed learning sessions focused on particular topics, often with guest speakers (for instance, these might be on geriatrics and dementia; pediatric chaplaincy; power and authority in chaplaincy; charting; working with humanists, atheists, and "nones").  
• Journal entries--often completed and submitted before each IS 
• Verbatim--approximately 5 or so presented each unit
• Theological reflection--approximately 1-2 for each unit
• Other activities as required by your educator (on-call or overnight hours, presenting didactics, Sim Lab experiences, research projects, attending rounds, joining hospital committees)
• intriguingly, it does NOT include a syllabus with a lot of texts or readings, which really surprised me.
• these units can be extended units (over a long period of months, like 7+ months, less than part time a week, about 15 hours) or intensives (approximately 10 weeks, essentially full time 40 hours a week) or regular units (about 16 weeks, part time or 25 hours a week).
• So much about the unit depends entirely on the program and tone the educator sets and on how the various students in the cohort get along.  

Chaplain interns are often in their first unit or in an independent unit; these are at levels I or II (this has been altered somewhat but I was grandfathered into the older system).  These are unpaid positions for which some students do get seminary credit (and some schools do pay the CPE fee which is around $900 give or take).  

Chaplain residents are working three units together at one place, with each unit building on the last; these are often paid positions.

(There are Chaplain Fellows, which is a lot like a post-doc but I am not going that route--they are few and far between and I can't relocate).  

You can do 4 independent units, hopefully reaching Level II around the second or third unit, or you can do an internship and then become a resident.  My denomination will only accept the residency as my denominational internship if all three units are at Level II.  

The main learning activity of CPE is the "clinical method" which is a cycle of action-reflection-action. This is experiential learning par excellence.  And each educator organizes their units differently, based on their institution, their pedagogical preferences, and specialties.  See the book How to Get the Most Out of Clinical Pastoral Education by Gordon Hilsman.

My residency included one unit focused on research in chaplaincy complete with a research proposal and also includes a unit focused on BCC competencies; these are addressed in the didactics or learning sections of our class day.  I am assigned to a variety of units, mostly Emergency Department and Palliative Care.  I attend Palliative Care rounds.  I am also a member of the community care and frequent visitor team which helps with community connections. I belong to the employee resource group on LGBTQIA+ and Allies and have hosted a Pride table.  I have been a peer supporter.  I have taught inspiration groups on the behavioral unit.  I have done on-call overnights.  I am oranizing weekly meditation sessions, published blurbs on various religious holidays for employees, and helped with hospital-wide holidays like Ash Wednesday, Blessing of the Hands for Nurse's Week, a table for Spiritual Care Week, escorting the Easter Bunny around to the units.

A few other notes:

How is a chaplain different from a death doula?  Even less that chaplains, death doulas have many routes to being a death doula.  There is not a single program or organization that trains or certifies death doulas.  The field is relatively disorganized.  Death doulas often work as independent consultants/practitioners without the structure of an institutional system (either the hassle or the protection!).  They set their own schedules, fees, and services.  I took an introductory class with the International End-of-Life Doulas Association (INELDA https://inelda.org/ ) and found that they are much more engaged in physical symptom management and relief (like bed positioning, massage, etc) than chaplains whose work is almost never physical (I do adjust the odd pillow and fetch water when allowed). I think they mentioned that they learn the disease progression of some 30-plus common illnesses and how to help, in consultation with the medical team. They also have the freedom to use alternative modalities that aren't often seen in hospitals--Reiki, aromatherapy, somatic therapy, etc etc. They do not have to belong or be endorsed by a denomination or have an advanced degree.  I seriously considered being a death doula, having read about it in The New York Times, but decided I like the protection and structure of an institutional position and the learning connected to the endorsement and certification processes. 

How is a chaplain different from a social worker?  My answer to this is broad, general, and based on my own understanding.  Social workers are licensed professionals who have completed graduate-level degrees and some kind of board examination.  They do work in healthcare especially as case managers (working with disposition after discharge, so contacting care facilities and insurance) or in palliative care with patients and their families, on community care teams doing outreach.  Depending on the institution, they may be focused on the details of papework and "fixes" or do more counseling.  As chaplaincy continues to professionalize, we are having to specify how we function differently.  I believe that social workers are more focused on helping people navigate pathways to specific outcomes (the right nursing home, setting up medical equipment, signing DNR/DNIs, stopping smoking, getting into rehab).  Chaplains are not so specific and our outcomes are broader (patient explores emotions, patient receives Sacrament of the Sick).  This is a huge debate around evidence-based chaplaincy (like Chaplaincy Innovation Lab, Transforming Chaplaincy, and SCA).