Arndt Büssing describes spirituality as a complex and multi-layered construct (Büssing 2021). Each spiritual care encounter presents the chaplain with unknowns. The encounter is shaped by whatever it is that the patient or client presents and requires the chaplain to be both grounded, flexible, and creative simultaneously as they respond.
The complexity of the situations of the people requiring care is only part of the complexity of the chaplaincy role, and this may be the least ambiguous part of the role. There are two aspects to role clarity: first, the SCP’s own understanding of their role, and second, the organisation’s understanding of their role. This second point for clarification highlights the need to navigate highly complex organisational matrices with multilayered constructs of possibilities and limitations that come with the role, many of which are not within their individual control.
Much has been written on the place of liminality in the chaplain’s work, and the place of mystery and presence when working with spirituality, but in focusing on these implicit aspects, little attention has been paid to that which can be understood more explicitly, and to those things which can be done to reduce some of the ambivalence and uncertainty around the role.
Role clarity is essential to mitigate role confusion, conflicts of interest, power imbalances, and unclear limits and permissions and enable emergent possibilities to open. Key factors around role clarity in spiritual care include understanding the reason and purpose of the role, acknowledging levels of training and experience that define the scope of practice, and recognizing possibilities and limits. A further factor in role clarity is differentiating between broad spiritual care and more narrow and specific religious care, as well as being willing to critically assess and evaluate the spiritual care provided. To this list, we could add the ability to identify requests for complex spiritual care encounters from the many other claims made during a SCP’s time.
Most encounters begin momentarily in a confused space as we gather our initial impressions and information and decide where to go next. For this reason, I find the Cynefin sense-making framework invaluable.
Most spiritual care encounters begin with a phone call or a referral, or when someone comes into the office or attends a worship service, we encounter them in their space: a workspace, residential home, hospital ward, exercise yard, or tea room. Initially, we are listening for the ‘edge,’ the inquiry, the unresolved dilemma, or whatever is frontmost in a person’s mind at this time. Most encounters begin momentarily in a confused space as we gather our initial impressions and information and decide where to go next. For this reason, I find the Cynefin sense-making framework invaluable (pronounced ku-nev-in).
The Cynefin framework was developed to assist strategic and organisational decision-making (Mark and Snowden, 2006). The framework has been successfully employed in a number of other situations and used to help with medical triaging. The genius of the Cynefin framework is the key insight that different types of problems or situations presenting as such require different and non-interchangeable approaches and responses.
The four categories of the framework are clear, complicated, complex, and chaotic, each of which requires a distinct response:
- Clear (straightforward as cause and effect are clear)—sense -> categorise -> respond;
- Complicated (requires expertise, but cause and effect are related)—sense -> analyse -> respond;
- Complex (co-creative, working with patterns and correlations)—probe -> sense -> respond;
- Chaotic (first aid as there are no discernible patterns)—act -> sense -> respond. (Mark and Snowden 2006)
An example of a clear spiritual need (sense, categorise and respond) occurs when the staff or patients know what they need and simply request it, such as an inquiry regarding the use of the quiet room, a service time, or a request for a Bible, prayer beads, or something similar. If departmental procedures are in place with these everyday items or information on hand, requests are easily addressed.
A complicated spiritual need (sense, analyze, and respond) may be a request for Holy Communion, end-of-life prayers, or rituals. After hearing the request, it is essential to understand or analyze it in order to provide an appropriate response and refer to the person with the precise expertise to conduct the service or ritual. These requests are directed to the chaplaincy or spiritual care department for them to make the necessary phone calls and set up the visit. Such requests are highly specific and can only be met by a representative of a particular faith.
The heart of spiritual care and chaplaincy lies within the complex and multilayered constructs described by Büssing and should be referred to the specialist SCP or chaplain for further assessment. The approach for complex requests is to probe, sense, and respond, leading to a conversation that often continues with “Are you able to say more about that?” or “It sounds like…” or “did I catch that correctly?” There is no clear answer or solution to these needs, as there is no simple cause-and-effect relationship between events and possible solutions because the needs are interrelated and interleaved with other people, events, histories, and possibilities. There is a need to work slowly and at slant, carefully separating layers of need from other things and being willing to refer on to others when needed.
Chaotic cases, as described in the Cynefin framework, are often emergencies, requiring multiple interventions by many interdisciplinary professionals to arrest the descent into further chaos. The response to chaotic situations is to act, sense, and respond. For example, recently, I heard a man and woman arguing in an escalating manner about their child. Although I considered talking with them, sensing that there was a spiritual need, I acted. I called security and waited for them to arrive before assessing the spiritual need or distress that needed addressing for either person. Once a chaotic situation settles, spiritual care needs will default to one of the three categories clear, complicated, or complex.
Spirituality includes a person’s wider relational network; because of this, it includes caregivers and family, who may be experiencing even greater complicated, complex, and chaotic needs. Furthermore, as each person experiences events from differing perspectives and timelines, it is possible across a relational network to have clear, complicated, complex, and chaotic needs presenting simultaneously, in which case it is important for the SCP or chaplain to notice whose needs are coming into focus and being addressed, and whose ongoing needs recede into the distance and remain unaddressed.
The Cynefin sense-making framework helps SCPs and chaplains reduce some of the ambiguity and confusion around their role in order to conserve capacity for the truly complex spiritual care they provide. If this is possible – then it is surely worth considering.