Self-reflections of health care chaplain fellows: Development in self-attunement and compassion during engagement with Compassion-Centered Spiritual Health (CCSH)

Clinical Pastoral Education (CPE) prepares health care chaplains to address the spiritual and emotional needs of diverse patients and staff by cultivating self-awareness, interpersonal and clinical skills, and resilient compassion. Some health care chaplains engage in structured fellowship activities after CPE to expand and improve their expertise in clinical spiritual care. We conducted a retrospective investigation of recurring consult case reflections from chaplain fellows (n = 10) enrolled in a 2-year Compassion-Centered Spiritual Health (CCSH) fellowship program. We compared the fellows' first and last 10 reflections to identify changes in the fellows' reported activities and in the language that they used to reflect on their attunement during the consults. In the last 10 reflections, fellows attributed patient distress to a wider array of sources and were more likely to report using mindful grounding and cultivating a warmhearted presence with patients. When reflecting on their self-attunement, fellows used fewer discrepancy words (e.g., would) and more positive emotion language in the final 10 reflections. These results suggest that fellows diversified their activities with patients and used less dichotomous thinking to discuss their attunement as they became more experienced. This research provides insight into the cultivation of interpersonal and intrapersonal skills essential for high-quality chaplaincy care.