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).  

What a Fortnight!

Sis had the flu and now she has pneumonia.  It's been a rough two weeks for her and, while she is on oral meds at home, she is still coughing and exhausted.  We have reassurances from school that she'll catch up--they'll adjust her assignments and excuse the absences with a doctor's note.  Right now, she's too tired even to contemplate work.  She's not even going to see her horse often, so you know she doesn't feel well.

And right in the middle of that, Bud started throwing up and missed a few days of school himself.  We thought he might be getting the flu, too, but we were all tested and are negative.  It just must have been some virus that thankfully we didn't all catch.  Now he's just jealous that his sister doesn't have to go to school, even if she's sick.

What else?  I think I have a whole list of things to mention (pardon the repeat from my email in some bullet points, Lambeth!)

• Did I ever even talk about Halloween?  Sis was Dean, from the tv show "Supernatural," one of the demon-and-monster fighting brothers in a show that crosses "X-Files" and "Buffy."  Bud was Dipper, from the animated show "Gravity Falls;" he's a code-breaking sleuth.  We went to the office Halloween party and then, night of, they had friends over for pizza and trick or treating and a huge candy swap at the end.  I love that they still want to trick or treat as teenagers AND that are neighbors don't seem to care about their age.
• About the same time, I had my own party:  a hygge party, based on the Scandinavian idea of coziness.  I had a few close friends over for a casual night of comfy clothes, Frito chili pie, hot buttered rum, almond cake, candles, fairy lights, and conversation.  And we all thoroughly enjoyed it.  I didn't rush around preparing, nor did my friends expect any sophisticated entertaining--we actually curled up on the couches under various afghans! I even gave them all fluffy socks and little candles.  Delightful!
• Our cat Hermione has developed arthritis.  She moves awkwardly and slowly, preferring little cat stairs to get on the bed or couch.  And she is always looking for warmth and so sleeps behind my knees in the bend in my legs, sits next to anyone on the couch, follows the sun patches around the house through the day, or curls up in her special heat-generating "poofs" (which have a layer of that silver-ish, heat-reflecting material they give to marathoners and people in crisis.)  Though, she can still "high tail" it for food or to chase the other female cat, Eris. To help Hermione out a bit, we're now giving her CBD oil, the non-hallucinogenic substance in marijuana (as opposed to TCH.)  They say it has a physical effect sort of like a warm bath; she does seem a bit more physically relaxed.  She has definitely relaxed a bit about Eris, so that Eris can now sleep on the big master bed during the day and was even curled up not too far from Hermione the other day (though definitely not touching.)  And our new Romeo is settling in, spending his days with Sis, who curls up in a big, soft, pink, fluffy blanket.  He even sleeps with her (which is good because Hermione won't let him on the bed in our room.)  he'll miss her when she's well, though at least he will have the blanket.
• We have a new street!  After a few years of widening pot holes and deteriorating asphalt, the street has been re-paved.  It's lovely, though we still don't have curbs.  I've got my fingers crossed for curbs so that the water doesn't erode my yard where it meets the road as it has for a few years now, creating a wider and deeper ditch that I have to specially mark so people don't trip (especially on Halloween!)  Good thing people don't walk around much, I suppose.  Because we won't ever get sidewalks!
• I am taking two classes at seminary (though, online) come springtime as I begin work on my MA of Religious Studies in order to become a board-certified chaplain.  One class is the history of Christianity, which will look at the different iterations (Ethiopian cave churches, Roman catacombs, evangelical tent revivals) from the early church to present.  I think it will have a lot of archaeology, which I especially like.  Second is "There's Something about Mary," which examines the different Marys of the Bible in a socio-historical and also (oh, the lingo) a "womanist biblical hermeneutics"!!!!!  The final project is to examine a contemporary representation of a Mary--I'm thinking Andrew Lloyd Webber's hippy Magdalene or the almost-Booker prize winner Colm Toibin's Testament of Mary, which depicts the Virgin as a depressed, isolated, and bitter older woman resenting her son's disciples.   I love school.  And I'm really excited to become a "real" chaplain.  Somebody needs to be there at hospice for people who aren't mainstream Christians (the Catholics have hospice covered!)--who are members of other religions, no religions, a mixture, unchurched, spiritual but not religious, atheists.  And I think I'm that somebody to offer solace and comfort (but not answers.)
• In preparation for our Thailand trip, I'm reading a book on the Buddha which answers a question I've often wondered:  why is there no single Buddhists sacred text the way there is the Bible or Koran?  Apparently, stories of Buddha were preserved orally and only written down later (hundreds of years later), but by competing sects who slightly altered the narrative, so that they don't really agree on a particular canon.  Add to that, even those manuscripts don't survive well--I think I read that the oldest extant Pali canon manuscript is only a few hundred years old.  Nothing like Dead Sea Scrolls.  And Buddhists don't quite see the texts as "in the beginning was the Word;" textual exegesis just isn't as central to the religion.  
• I watched the funeral of Bush 41 yesterday.  Solemn rituals and big, dramatic occasions always get to me, even if I wasn't quite mourning the late president.  The eulogies were informative--and entertaining in the way they lectured  #45 on character and charity and bi-partisanship.  I slightly remember Bush 41--I paid much less attention to politics then, but it was also less emotional, polarized, us vs them, angry.  I remember first getting riled about politics when Republicans kept trashing and attacking the Clintons, though if I think hard on it, I remember people not liking Reagan (though, much of that grew up afterwards.)  It's been downhill, civility-wise, since then.  Though I think it has also gotten dirtier--just look at Wisconsin GOP stripping the governor's office of power now that a Dem has defeated Republican governor Scott Walker--they didn't feel like he needed his power stripped when he was in office!  It's just ugly and there are few political remedies.  

• 

  Tulip stitch

  Even in the midst of all that, I have had time for my favorite hobbies.  I've crocheted blankets for a friend and a local fun-run raffle, even learning a new stitch, the tulip stitch.  I've been tangling as part of several online challenges, including Gratitangles 2018 and now 12 Days of Zentangle.  I love my meditative drawing practice.  I've also been reading more and have a book for downstairs, a book for upstairs before bed, and a book for the bathtub.  I've recently read a mystery featuring Fidelma, Irish nun-detective in 7th-century Ireland; the fifth and sixth Outlander books; a page or two of The Case for God, which is slow reading; the Buddha biography by the same author; and others I can't quite recall.  
• We've also been watching a lot of tv, with two sick kids.  They are working their way through a dozen or more seasons of Supernatural.  We enjoyed British comedian Sue Perkins's exploration of the Mekong River and especially love her on the Great British Bake Off (I think we are currently watching the newly-released season 3.)  Sis has started Outlander, though without the abusive sex parts.  Bud has a few animated series he's following, including Hilda-something.  I caught up with Grantchester, the Arrow, and can't wait to watch the second season of Mrs. Maisel.  We only have one tv plugged in right now and also use it for video games--they are all playing the new Pokemon game.
• I will delve into this at a later time:  I found proof that my ancestors on two branches of my family tree owned slaves. I have two partial names and the reference to four others. I always suspected as much, with many family members serving in the Confederacy and relatives having been in the south a century or more before the war, but learning it for fact has me overwhelmed and sad. I'm not quite sure what to do with this knowledge now....but I will do something. And acknowledging it has to be the first step.  I've joined a FB group, Coming to the Table, which connects descendants of both slave owners and enslaved peoples.  It's been informative, especially the resources page about reparations, financial and otherwise.  
• Sadness:  on our drive to the doctor's office on Tuesday, I hit an owl which flew up in front of my car. I never saw it coming, though I was going the speed limit; we just felt the thump and then I saw the round-faced, speckle-winged bird above my left headlight, flapping backwards. We pulled over but couldn't find it.  So it didn't die right there but somehow managed to leave.  My friends think this is a good sign; I'm a bit more pessimistic.  What chance does a bird, even a big one, have against a car?  Why did it have to be a beautiful bird of prey? I'm so sad.  (And no, I'm not ready to debate why it's sadder that something I like and is beautiful died vs. something ugly or not liked, like a snake. I know it's subjective and hypocritical.)
• Illusionists:  On Saturday, leaving Sis at home with what we then thought was the flu, we went to see a magic show on Broadway for Bud's Christmas present.  What a great show!  We especially liked the card tricks of Shin Lim, the mind-reading of Colin Cloud, and the sleight-of-hand of Darcy Oake.  In fact, Bud and I were both picked for separate tricks.  Colin Cloud read my mind!  He had me flip through a book and choose the top word on the left-hand page and remember it; he asked the same of two other audience members.  And then he "read" the word from my mind, "professional."  It really was astounding; and while I know there's a trick, I don't know what it is.  During his turn (we were seated very close to the stage in the second row), Bud was given an empty bottle in a box-inside-a-box to hold and then he chose a card out of a deck; later, of course, the card was in a corked glass bottle in the box-inside-a-box!  Now, the main "tell" that this was sleight of hand is that Oake did the same trick on Penn and Teller using the SAME CARD (5 of hearts) that Bud "chose."  I'm guessing it's a force of some kind but honestly neither Bud nor I saw it.  After the show and lunch at a nearby ramen place (Zen Ramen, not Sapporo because that dear old place has closed, forced out by raised rents), we went to Tannen's, the premiere NYC magic shop down by Macy's.  Bud had a great time conversing with the different magicians and seeing some of their tricks.  He bought a trick, a book, a beautiful Momento Mori deck, and a special card trick mat.  
• Thanksgiving:  did I mention Thanksgiving at all? We watched the parade in our jammies that morning, particularly liking that there were two female hosts (bye, Matt Lauer!!!)  And we liked the performance by the Prom cast, complete with kissing lesbian leads (it's about a girl who can't take her girlfriend to the prom so she enlists help!)  We bought tickets on the spot, to support the show and NBC for fairing the no-doubt controversial scene.  In the afternoon, we had Mama Teacher and her son over for muffalettas, snacks, conversation, and video games, since they were celebrating on a different day, just like we were. We all played MarioKart--and had a great time.  (Sis actually came down with a fever on that Thursday night but the clinic said on Friday that it was NOT the flu.  Harrumphf.)  We went to Goo's on Saturday, because he had been working at the hospital the other days.  I made Chex mix, the sweet potatoes, the green bean casserole, the cranberry-horseradish relish, and a lemon pie.  Goo did everything else, including a lovely charcuterie.  And Mama and her parents spent the day arranging and rearranging post-its in order to organize our trip.  In the evening after dinner, the kids and Goo played video games, including this fast one where you drum to the rhythm prescribed by the game, while making little characters dance to the music.  Very Japanese.
• BTS--Bud and I are still very much enamored of Kpop band BTS.  He practices their dance moves and I enjoy listening to the music in the car.  And we watch videos together sometimes.  When we were in NYC, for the magic show, we even went to the Line store, which sells BT21, a line of animated characters drawn by the members of BTS.  Bud got a few items, like J-Hope's horse character pillow and a key chain, and I even got a Koya (Koala, by RM) headband.  Yes, it's a cult.
• Reiki--and no, I didn't think of Reiki next because it is a cult (ahem)--I had my second Reiki  on Sunday, with the same teacher and students as last time.  This section added some words and hand signs, which really did make it seem more like an occult thing than the hands-on meditation did.  But there was also more references to Buddhism--"the light in me sees the light in you," connecting to your higher Self or buddhahood, and forget what else.  The next session has crystals and angels, but I think I'll stop here; crystals and angels and the Reiki grid which can create continuous Reiki without your participation just takes it all a few steps too far for me.  Hands on meditation that contributes to relaxation and peace, I can handle (though, true practitioners would see it more as aligning the chakra energy wheels than simple meditation.)  And I'm looking forward to using it with hospice patients, as just another modality for care and comfort.  I did try it on the kids when they were sick (mainly because they didn't want me to tell my teacher that they had said no!) and both were relaxed afterwards, as you would be lying still with your mom's hand on your head or shoulders or chest.  I did it on myself a few days later, when my neck was stiff from too much driving, and it did release the tension, just like mindfulness meditation releases tension in my mind.  It's all from the same place, I think.  
• In fact, I'll be going back to my PT soon to have her use her own therapy techniques (a unique combo of Western medicine and less scientific treatments) on the almost softball-sized scar tissue that has grown up in my lower abdomen and pelvic region from all the scars.  After consulting both my GI doctor and GYN and going through their tests, as well as talking at length with my caring and supportive GP, I decided that surgery isn't the answer for scar tissue which is pulling and pushing and causing regular discomfort; it'll just make more scar tissue.  I'm trying PT to try to break down some of the adhesions and meditation (particularly self-compassion from Kristin Neff) to assist my anxiety about the discomfort when it arises.  I hope it helps.

Whew, I think that's it for now.  I've blown through 30% of my laptop battery and a full hour of quiet between Mama's departure for work, Bud's departure for school, and now Sis's late arising.  Time to get up and get to the rest of my list . . . .