4/4/2007 Vol. 4, No. 5

Professional Practice

Dr. Diane Bridges on the art of spontaneous ritual

The Anniversary

The phone rang and the distressed voice said shakily: “I’ve got to see you, Reverend. I think I’m losing it.”

Within half an hour Phil was sitting in a comfortable chair in my office pouring out his heart and soul.

He and his wife had suffered through seven miscarriages, and one month after this last tragedy, he felt he was losing his mind. He could no longer cope. He wondered if he should have a vasectomy or if his wife should have a tubal ligation. Should they try again?

As a materially successful young couple, they had the world by the tail. The only treasure they lacked was a child.

The grief was enormous. Tears flowed freely. I listened quietly and intently and at one point responded: “Phil, I don’t think you’ve ever buried those children. You’ve never ritualized their deaths. You’ve not had an opportunity to hand them over to the Lord. Perhaps that’s what you and Helen need to do.”

He looked confused and thoughtful and said he would suggest this to his wife.

I did not hear from them for months until one day the phone rang. Helen was weeping while she said: “Diane, this is our tenth anniversary and we think we need you to come over. We need to say goodbye to our children today.”I went to the house that day with my prayer book and seven white carnations.

We chatted and listened to some soft music and when the time seemed appropriate we went to the nursery, which was fully decorated, in anticipation of new life. We brought along the lovely red anniversary roses and the white carnations. After some moments of silence, we spoke prayerful goodbyes …naming each child. As we did this, we placed a white carnation for each among the red roses in the vase. We handed each child back to its Creator with painful tears, acknowledging the grief of these loving parents.

At the conclusion of our time in the nursery, I spoke to them about their courage and the power of their married love which had carried them through so much already. I blessed them and their children. The two of them then renewed their marriage vows in the nursery on this very memorable 10th anniversary of their love.

As chaplains, we often find ourselves in challenging situations which require an immediate and sensitive response. I was fortunate to have known this couple and to have shared some of their tragic history, but I was somewhat taken aback to have to carry through on my own suggestion in such a surprising moment. The prayer book and the carnations seemed like good "props" for the time, but ultimately it was all about hope. Hope for healing, hope for renewed grace and strength in this couple's marriage, hope that their children were safe in the arms of their compassionate Maker and hope that their Spiritual Guides would continue in the journey of recovery with them. It was truly a privilege to share in this extraordinary anniversary. Blessed be God for all our sacred trusts.

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Advocacy

Responses on not doing the right things right

What About Spiritual Care?
The Dialogue Continues

Editor’s Note: Because of the importance of the findings of Tracy Balboni's study to the profession of chaplaincy, we have chosen to post the replies to Rev. Handzo's response here and not in TalkBack. It is our hope that others will continue to respond to Mr. Jacobs and Rev. Handzo's questions and concerns.

I am amused—though not surprised—by the Balboni findings. I marvel that we speciously satisfy as many spiritual needs as we do. In order to deliver spiritual care, chaplains would probably have to intend it. Instead most healthcare chaplaincy continues to labor under older models of “religious care,”or even worse, “religious activities.”This is by no means entirely our fault.

Chaplains in faith based institutions often feel as if their care must follow party lines. They, as well as other healthcare professionals, color outside those lines at merciless and swift peril of their employment. Chaplains in secular institutions often feel marginalized as “religious artifacts,”nice to have, but not central to the real business of a hospital. Many smaller hospitals continue to assume that clergy volunteers will fill anyone’s—everyone’s—spiritual need. Chaplains in government institutions must often respond to the political pressure of sectarian interest groups with access to those in power.

Screening and assessment models for spiritual care abound. But when chaplains define the spiritual dimension in patient care by issue: hope, fear, awareness, meaning, dignity of life, identity, trust, the ability to give and receive, respect, self-responsibility, grief, even ethics: we are frequently told we are usurping ground from medicine, psychology, social work, or rehabilitation. “Aren’t chaplains supposed to pray and hold bible studies…how about those Sunday services?”

Any chaplain who also has experience in congregational ministry knows what it means to be told to “get back in the pulpit.”Chaplains will be able to substantively deliver spiritual care when the institutions that employ us learn the difference between a spiritual need and a religious one, and commit to delivery of the former.

The last decade has seen much fine writing on spiritual vs. religious care, not the least by published by JCAHO. Sadly, I have had to read those articles to administrators, prelates, politicians, and even a surveyor, to defend my own department’s modes of operation.

Advocacy begins at home. Department Heads: be clear with your institution. It is time to rewrite policies, manuals, scopes of service, job descriptions…the entire keyed infrastructure your institution requires from you. Be clear with your staff about their role. Can we really afford to be saddled with sectarian chaplains when they do not even meet the basic spiritual needs of their own supposed patient populations? And be clear with yourself. Can you admit that what you are doing is simply not working?

Balboni and Ferrell have done us a great favor by dropping at our feet a study that says: the religious constraints we have been asked to labor under simply do not meet the basic spiritual needs of patients. If we cannot use that to open a conversation with our selves, our staffs, and our institutions, then maybe it is time to get back in the pulpit.

The Rev. Dr. Howard W Whitaker, BCC
Director of Pastoral Service
Greystone Park Psychiatric Hospital
Morris Plains, NJ

It is extremely difficult to confront the skeletons in one’s closet, especially, perhaps, when the skeletons may very well raise the specter of professional inadequacy. So often I have heard from other chaplain colleagues something along the lines of “don’t rock the boat.”After all, this reasoning may go, most of our denominational endorsing agencies just want us to do our annual paper work and most of our administrators really don’t have a clue what we do, so why draw attention to how we do what we do? After all, the reasoning may continue, I am accountable to God!

I want to thank George Handzo for opening our collective closet and bringing one of our profession’s skeletons into the light. This skeleton is named QUALITY. Is what we do actually meeting the spiritual needs of none, some, most or all our patients? How do we know if we are meeting the spiritual needs of our patients? If we are unable to address the spiritual needs of all of our patients, what is in place to see they are addressed? When we ask the question of the “quality”of our work, it always brings up the fear that we may be missing the mark and that some outside standard is setting that mark. But standards and best practices are being developed and so is peer review. So let’s step up to the plate of quality and let’s find out if and how we may be missing the mark and do something about it. Once we identify some of the areas where we as a profession (or we as individual practitioners) may need additional work, then we can begin to address these shortcomings with more appropriate opportunities for professional development.

Respectfully,
Mark LaRocca-Pitts, PhD, BCC
Athens (GA) Regional Medical Center

Patients who report that their spiritual needs have not been met while they were hospitalized is truly hard to process. Press-Ganey scores related to the questions like , "Did you feel that your spiritual needs were met?" often are more about whether people felt cared about by staff at an emotional level. In our institution those scores showed up to be average until a patient care initiative was begun, and without the number of chaplain visits changing, that score improved remarkably.

As Pastoral Care providers, if we are to be judged for the provision of care, we should probably insure that patients who were asked those questions actually had a contact with a chaplain, requested a chaplain visit, or had contact with someone from the Pastoral Care Department. Some of that is dependent upon whether the patient intake process includes questions related to spiritual needs and whether the referral process is in place and working. As the size of institutions vary, so varies the chaplains per unit ratio, and the ability to provide intentional visits rather than visits based upon referrals.

Our hospital uses lay Pastoral Care Volunteers whose purpose is to stop by newly admitted patients to insure that they have been asked questions pertinent to their spiritual needs. The notion that someone may say their spiritual needs have been met or not met is then dependent upon their response to the volunteers. The fact that someone from the Pastoral Care Department has asked the question in and of itself, signifies that our department has an interest in the spiritual well-being of each patient, and that has more than once been met with surprise and appreciation, even if patients ask nothing further of the chaplains department

George Burn
Mount Nittany Medical Center
State College, PA

One has to look within and do a self examination of self and then ask themselves "How do I treat my fellow people that I meet minute by minute, day by day and then if they are treated to the best of my ability - I can honestly say I am doing the best job that I can and....... even with this assessment, there is always room for improvement. Ask anyone who you are working with, "do you think I am being honest with you?" If yes, you are doing your best, but I believe we delude ourselves sometimes and that is not always the case, and there is the problem. The answer to any problem lies within.

The Rev. Rose Marie Martino
St. Jude's Episcopal Church
Wantagh, NY
and
Winthrop University Hospital
Mineola, NY

To read the article to which this dialogue refers, please go to:
http://www.usatoday.com/news/health/2007-02-14-spiritual_x.htm?csp=34&POE=click-refer

Do you have thoughts about advocacy you’d like to share with your colleagues? Send an e-mail to info@PlainViews.org.

Education & Research

Dr. Brent Peery on helping others with guilt

Not All Guilt Is the Same

Guilt is ubiquitous among the parents with whom I work in a children’s hospital. We parents often adopt for ourselves an admirable but unrealistic job description. We aim to care for our children in such a way that they are kept safe from all harm. When our child requires hospitalization for illness or injury, failure is implied. Disturbingly, parents often feel a deep sense of guilt even when no reasonable cause and effect can be established between them and their child’s ailment.

Frederick Buechner observes, “It is about as hard to absolve yourself of your own guilt as it is to sit in your own lap.”[1] Most people who struggle with guilt are going to need the assistance of another to resolve the struggle and experience absolution.

For centuries persons have turned to clergy for help with their guilt. To be sure there has been and continues to be great variation in the effectiveness of clergy in providing that help; from healthy guidance to ignorance to outright abuse. Be that as it may, very often chaplains are the members of the interdisciplinary healthcare team to whom patients and families turn for help in managing their guilt.

It is important to recognize guilt can be both a healthy and an unhealthy emotion. Healthy guilt helps a person realign his or her behavior and/or thoughts to be congruent with his or her beliefs and values. When changes have been made, the person experiences some relief. This leads to more satisfying ways of living. Unhealthy guilt is more existential. It points to no particular reform of action or thought through which relief from guilt might be experienced. Instead, it is a general feeling of shame for being. The latter is what I encounter most among parents.

So how does a chaplain respond to guilt in a patient or family member? First, he or she needs to assess whether the guilt is healthy or not. The key question to answer is, “Is this feeling rooted in some sort of violation of this person’s values or beliefs?”If so, the chaplain’s interventions are most helpfully aimed at helping them acknowledge the violation, engage in rituals of absolution appropriate to their beliefs, and develop strategies for avoiding violations in the future.

If the chaplain determines the person’s guilt is of the unhealthy or existential variety, he or she may need to focus intervention toward education and reassurance. Help the other to understand not all guilt is the same. Not all guilt is healthy. Not all expectations placed on us by ourselves or others are reasonable. Laudable and worthwhile are our efforts to keep our children from all harm. Our world is too dangerous for us to always be successful.

[1] Buechner, Frederick. Wishful Thinking: A Theological ABC. New York: HarperCollins, 1973. 35.

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Spiritual Development

Rev. Jill M. Bowden on being part of a Beloved Community

Bridges

Whenever I lead Sunday worship, I like to facilitate the Children’s Time in the service as an opportunity to begin to discuss the topic for the day's sermon. In laying the groundwork for the children in the presence of the adults, I like to imagine their participation at the dinner table if the conversation comes around to the days’sermon.

One Sunday my topic was cultural and religious symbols. I said, "Today after you go to your Religious Exploration classes the adults are going to talk about symbols. Can you tell me what a symbol is?" One firecracker, with flaming red hair and an impetuous streak jumped up waving both arms and shouted, "I know, I know! When you bang them together, they crash!" Time stopped; what I had planned to say and do was gone. I remembered a time when I had been that child –when everyone laughed and I felt abashed. To the eager young face in front of me, I cried, "You are right! That is exactly what they do!”In that second I redeemed my internal child from years of embarrassment because of my own impetuous streak.

Unitarian Universalist educator Sophia Fahs said that we had to wait for the children to be ready to learn, and then we had to be ready to meet them each one, where they stood at that moment in their lives. To encourage a child is to be encouraged –joy in learning is contagious. Their questing natures and curious probing puts the world together in thrilling new ways that may –that must –point the way to what we Unitarian Universalists call The Beloved Community.

Jesus of Nazareth, visionary, prophet, child of God, teacher, said to those who would have kept the children from intruding on his rest, "Let the little children come to me, for theirs is the kingdom of heaven." He led the way. And what do we do for ourselves? We are all people on a journey –a journey of life-long learning and life-long discovery. Ideas are fragile things –they live or die in the readiness of the person who hears them first to entertain the possibility that they are not laughable, even when they are.

We all stand in a Beloved Community –the realization of the dreams of those who came before us –dreams for a free land, for a democratic (if flawed) government, for relative safety. Those who lead serve as the bridge that carries the next generation forward. As we do so we realize that we have reached the river’s edge and the bridge leading across to our own Beloved Community. We wait for those who come along to be ready and then we facilitate their crossing into that fulfillment. We send the next generation forward into our Beloved Community ready to dream their own dreams and build their own bridges into the future.

Do you have thoughts about spiritual development you’d like to share with your colleagues? Send an e-mail of any length to info@PlainViews.org.

EthicsWalk

EthicsWalk addresses spiritual care as an ethical enterprise. It explores why relationships between spiritual care providers and those they serve need protection, and examines what that protection entails. PlainViews invites our readers to share their responses to each EthicsWalk column, which will be published in the following issue.

If you’d like to respond to EthicsWalk, please send a comment of no more than 100 words. You can use the e-form below (click on "hearing from you," link) or submit your commentary to the editors in the body of an e-mail (or as a Microsoft Word attachment) sent to Info@PlainViews.org. Please put the phrase “EthicsWalk” in your subject line.

We look forward to hearing from you.

Subprimes: A Financial Opiate

Financial health for many patients is as fragile as physical, psychological, emotional and spiritual well being. All are linked. The latter four are addressed daily by spiritual and other health care providers. The first is among the American Discussion Taboos. This column confronts an epidemic ravaging the financial health of many Americans: sub prime mortgages. Disproportionately damaging to populations whose vulnerability is heightened by illness, age, disability, and racial or ethnic minority status, regulation of subprimes is a justice issue for people of faith.

Home ownership remains the strongest opportunity for American families to build wealth, establish economic security and enter or remain in the economic middle class.[1] As home values rose in 2000, subprime lenders began providing mortgage loans for people with impaired or limited credit histories. Predatory lending practices soon emerged, blemishing the industry. Today, more people are losing homes than acquiring them through their involvement in the subprime market. [2]

The majority of subprime loans are taken out to refinance property. Refinancing represents the greatest danger to home ownership. Its usual impetus is securing funds for health care, compensation for job loss, or paying for education. Equally pernicious is the desire to “cash out”a portion of rising home equity to consolidate debt, buy a car, or just take a vacation.

Subprimes are usually marketed by mortgage brokers who make their money “placing”mortgages with a “lender.”Unlike similar professionals, brokers acknowledge no fiduciary duty to the consumer-client and are unregulated in many states. They push subprimes with seductive, temporary two or three year “teaser”rates, frequently fail to escrow taxes and insurance, and often don’t disclose loan origination and prepayment fees until the closing, at which time emotional involvement and practical considerations block most buyers from backing out. “Informed consent”is absent in abusive subprime sales.

Borrowers may be approved, with minimal screening, based on the value of the property, not their ability to pay. During the “teaser”period, almost anyone feels capable of meeting the loan terms. Thereafter, the rate rises every six months based on a complex formula. In short order, payments outstrip what the borrower can afford and exceed the rates of conventional mortgages.

Subprime borrowers become self-defining. Once perceived (by self and lenders) as less worthy of conventional financing, and caught in the cycle of excessive fees and charges, families find it difficult to escape. The result is an accelerating succession of ‘flipped’subprime loans, culminating in foreclosure and Chapter 7 bankruptcy.[3]

Predatory lenders claim that their product permits low income and credit challenged borrowers to enter the American wealth stream. The assertion is false. The majority of subprimes are used to refinance existing mortgages, not to acquire new property.[4] And, most people obtaining subprime loans could qualify for conventional or government insured mortgages were not unscrupulous mortgage brokers soliciting and steering vulnerable populations to the sub-prime market.[5]

Owning a home is the American Dream and home equity is the strongest predictor of economic security. Subprimes promise the dream but are the financial equivalent of prescribing opiates to patients. Occasionally after non-narcotic drugs have been tried, the opiate is necessary. But its use is closely monitored and patients are weaned to conventional treatments as soon as possible. Vulnerable people deserve the same carefully controlled processes for their financial healing. Justice here demands knowledgeable advocacy.[6]

Footnotes:

[1] Center for Responsible Lending (www.responsiblelending.org). Data and analysis on subprime mortgages obtained from materials provided at this site and in testimony by the center’s president, Michael D. Calhoun before the U.S. House Committee on Financial Services, Subcommittee on Financial Institutions and Consumer Credit, March 27, 2007.

[2] From 1998 -2006, subprime loans have led or will lead to a net loss of homeownership for almost one million families. Net homeownership loss occurred in subprime loans made in every one of the past nine years.

[3] Lehman Brothers projects that “cumulative defaults may run as high as 30%”on sub-primes made in 2006.

[4] Estimates are that since 1998, only 9% of subprime loans have gone to first-time homebuyers and hence led to increased homeownership. CRL Issue Paper, No. 14, March 27, 2007.

[5] Subprimes are disproportionately made in communities of color. They constitute 52% of mortgages in African American communities and 40% in Latino. For white communities, they are 19%. Appendix B, Michael D. Calhoun testimony.

[6] On March 8, 2007, federal financial regulators issued the Proposed Statement on Sub-prime Mortgage Lending, a strong national anti-predatory lending recommendation currently before Congress. It advocates requiring an evaluation of the borrower’s ability to repay the debt by its final maturity at the fully indexed rate, assuming a fully amortized repayment schedule, rather than basing the loan on the value of the borrower’s property at the time the sub-prime is made as well as full disclosure of fees and costs. Similar measures are before a number of state legislatures. More information at www.responsiblelending.org.

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CaseConference

We post an ethical or situational concern that has arisen in a facility where one of our readers works. It has no identifiers included. It gives you only the facts of the case. Then, you can respond to that concern. This is an ongoing dialogue, with comments added as they come in. In the following issue, assuming it has been resolved, we give you the outcome from the facility where the incident took place.

We are always looking for cases. Please send any cases that you would like considered for inclusion to: info@plainviews.org We will ensure that it is stripped of any identifiers. For further guidance about how to write up a CaseConference, please refer to the CaseConference Archives, Vol. 4, No. 3 "How to Submit a Case for CaseConference." (Click HERE)

We hope that this will help to inform not only those who are dealing with the issue, but will enable all of our readers to learn from the experiences and perhaps mistakes of others.

PLEASE NOTE: Due to unanticipated continuing responses to both the case and the resolution of the case, added responses can be viewed in the archives. Click HERE.

The chaplain began by asking the adolescent to tell her about her mother. What was she like? What did they enjoy doing together? This gave the girl an opportunity to share her story but also gave the chaplain some insights as to how to respond.

The chaplain heard that the young lady and her mother were very close. Her father had left them when she was only 6 months old and was never heard from again. The two of them enjoyed attending church services each Wednesday and Sunday. They enjoyed shopping together and in fact, one of the last things they were able to do together was shop for school clothes. Her mother loved to entertain her daughter’s friends by inviting them over for special meals that sometime took hours for her mother to prepare. This young woman loved her mother’s cooking and was hoping to learn some of her culinary secrets.

After listening, the chaplain said, “You truly love your mother. I believe that you love her so much, that the thought of your mother spending eternity in hell alone is more than you can bear.”(The young lady began to cry.) The chaplain went on to suggest that the girl, out of her love for her mother, was trying to take her own life in order to be with her mother. Additionally, the chaplain suggested to the girl that her mother may have been frustrated and angry that God was not able to spare her life and that God probably understood her frustration and anger. The chaplain also suggested that by taking care of her and her friends (by fixing gourmet meals and shopping for school clothes) her mother showed how much she loved her and that when one shows that kind of love especially to one's child, God forgives even those who are most angry with God.

The girl's attitude seemed to change almost immediately. She was released into the care of her grandparents a few days later.

Case #17

A fourteen-year-old young lady was admitted through the emergency room to the Adolescent Psychiatric unit of a hospital after attempting suicide by an overdose of drugs.

Four months before admission, her mother had died of cancer. Since that time, the adolescent's behavior had greatly deteriorated. She was skipping school more than she was attending. Her grades had fallen from a B average to failing. She became promiscuous, started on street drugs and alcohol, became belligerent in speech and abusive emotionally and physically, and began running with a wild crowd. Her attitude towards life had greatly changed from the church-going adolescent she had been six months earlier. She appears to have lost all desire to live.

She has been living with her maternal grandparents since her mother’s death. They no longer feel they are capable of caring for her and want her placed in foster care.

She shares with the chaplain that she and her mother had attended church constantly, asking God to heal her mother, but her mother died anyway. A few weeks before her death, the mother called her daughter into her room and said that she was angry with God for not healing her. The mother said that she decided to reject God and “follow the devil instead.”The adolescent told this to their pastor. The pastor told her that it was "too bad" and that her mother was "now in hell."

What else would you want to know before making a spiritual assessment?

What is your spiritual assessment given the information already presented?

What would you advise the rest of the team in terms of how they should relate to her?

What would your plan of care be?

What outcomes would you expect?

Please check the archives below for comments made about previous CaseConferences.

Send your comments about CaseConference to info@PlainViews.org.

Reviews

Sarah Masters reviews the film

Inside Mecca

In this visually absorbing and spiritual film, you will journey with three Muslim individuals, an Indonesian businessman, a female American physiologist, and a male South African radio announcer from their respective homes to Mecca on the sacred pilgrimage, the Hajj.

The viewer has an inside seat as each individual prepares for the journey in three distant locales and experiences the physical stress of the journey to Mecca, the performance of rituals amongst two million Muslims and the attainment of a life-altering spiritual connection..

Each of the three pilgrims shares his or her struggles with cultural differences. The South African encounters racism and the American encounters sexism, yet by the end of their travels each feels a tremendous sense of belonging and faith.

The National Geographic film Inside Mecca is rich with description of the history of the pilgrimage and the beliefs underlying each ritual performed during the Hajj over a period of days. Visually, the camera follows the routes taken by the three pilgrims and peeks into tents and staging areas, markets and towns within and around Mecca.

The narrative is both instructive and moving and the filmmakers achieve an exceptional degree of access to all filmed sites in the most sacred place of Islam.

_____________________

Completed: 2003
Running Time: 60 Minutes
Director: Anisa Mehdi

If you are interested in purchasing this film, you can do so on Amazon.com. The cost of the film is $14.99 for a DVD. You can also rent the film by downloading for $1.99.

Sarah Masters is the Managing Director of the Hartley Film Foundation, a non-profit foundation dedicated to cultivation, support, production and distribution of the best documentaries and audio meditations on world religions, spirituality, ethics and well-being.

Book Review

Rev. Dennis E. Snider reviews

The Unwanted Gift of Grief:
A Ministry Approach

A well titled book, this is a good read which goes beyond a primer with a depth and sensitivity blanketed by a sense of authenticity. The writing style of Chaplain VanDuivendyk is open and honest, revealing the universal truth that while pain and grief touches each of us, the way one deals with it makes a considerable difference. A powerful image is that we are invited by God to grieve and be comforted.

He writes in a way that allows the reader to open oneself to one’s own very personal and often hidden experience. That grief is a process unfolding in as many different ways as there are experiences. Using a subtle yet firm style, the author points out the importance for each person to recognize that there is no fixed time frame in which one must move through grief. “Move at your own pace not another’s expectations. Yet at the same time, continue to move toward the light and new life. Move away from worshipping the past but honor the past. Love life and others more because of the past.”(p.103)

This text doesn’t seek to proclaim the “only”way to approach this topic. The author takes the time through words and images to draw the reader inside his approach to ministry presenting not perfect answers, but possibilities. Utilizing helpful stories and illustrations Tim clearly points out that grief is not a cookie cutter process, nor does he seek to lift one up.

While not forcing his own theology, VanDuivendyk centers on a Judeo Christian foundation of God with us in our journey through the pain of grief. He reminds us that while it may be difficult to see while trudging through the mire of grief, one need not journey alone. As such, the reader is drawn to look at grief and all it holds through one’s own lens. Throughout his writing is the inescapable reminder that one must journey through the pain of grief.

He writes to those dealing with grief as well as persons called to walk alongside. Utilizing a subtle yet provocative methodology the book is a reminder that as professionals, we continue to learn. That experience is a wonderful teacher and reinventing the wheel is not necessary. The author lifts up a central tenet of chaplaincy and pastoral care in general: the art of listening as one walks with those in grief, without becoming enmeshed.

This is a text which drew me into my own experiences of grief and the privilege I have had as I journeyed with others. All the while allowing me the space to reflect upon my own professional practice.

In reading the pre-publication reviews the bar was set high for VanDuivendyk. Having finished the text, I can honestly say I was not disappointed. This is not simply another batch of paper bound together filled with warm fuzzies, but with openness, learning, caution and hope.

There are many feelings which this text elicits. Perhaps the strongest for me is found in the word “genuine.”In approach, theory, theological integrity and feeling, this text is genuine. A good read for professionals and lay.

VanDuivendyk, Tim P. The Unwanted Gift of Grief: A Ministry Approach, Haworth Pastoral Press, New York, 2006, pp 192.

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