Editorial Religious, Spiritual, Pastoral and Secular? Where Next for Chaplaincy?

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[HSCC 9.1 (2021) 1–10] HSCC (print) ISSN 2051-5553
https://doi.org/10.1558/hscc.42735 HSCC (online) ISSN 2051-5561

ditorial
E
Religious, Spiritual, Pastoral … and
Secular? Where Next for Chaplaincy?
Steve Nolan1
Princess Alice Hospice and the University of Winchester, UK
Email: stevenolan@pah.org.uk

Duncan MacLaren2
NHS Lothian, Scotland
Email: duncan.maclaren@nhslothian.scot.nhs.uk

Introduction
The genius of chaplaincy has always been its ability to evolve and reinvent
itself. This evolution has been ably described (in the United Kingdom, Swift,
2009, pp. 9–95; in the USA, Cadge, 2012, pp. 18–50; in Australia, Carey,
2012, p. 397–407). In the last 20 years, readers of this journal will have been
actively involved with, and personally affected by, chaplaincy’s recent evolu-
tion, specifically, the transition to professional accountability and the move
towards being an evidence-based and research-informed service. Chap-
laincy is no longer the “ministry” many of us thought we were entering and,
because “constant change is here to stay”, we can predict with some degree
of confidence that the evolution of chaplaincy is set to continue.
In fact, the next big change is already underway: the evolution of chap-
laincy from a purely religious ministry to what it must become if it is to
adapt to the “secular age” (Taylor, 2007). What began as a Christian min-
istry is visibly morphing into a secularized form of therapeutic service, at

1. Rev. Dr. Steve Nolan is Chaplain at the Princess Alice Hospice, Esher, Surrey and Vis-
iting Research Fellow at the University of Winchester, Hampshire.
2. Rev. Dr. Duncan MacLaren is Head of Spiritual Care and Bereavement in NHS Lothian,
Scotland.

2 STEVE NOLAN AND DUNCAN MACLAREN

least within the context of healthcare. Whether this is a good thing should
be debated, but as a previous editorial in this journal suggested, some chap-
lains may regard this change “as a betrayal of a long-standing and largely
undervalued religious tradition” (Carey, Swift & Burton, 2020, p. 140). How-
ever, this evolution is in step with wider sociocultural changes that have
impacted Western societies in the post-war period.
Taking the United Kingdom as an example, in the period 1945–1958/9,
church membership grew to the point where, most Sundays of the year,
around one in five Britons were to be found in church (Bruce, 2002, p. 67).
Since then, the change has been radical, multi-factorial and continuous,
with the result that (with notable exceptions) the influence of religion on
public life has been eroded (Taylor, 2007). The impact of this sociocultural
change on chaplaincy has been profound. In 1955, Cox could describe the
hospital as the chaplain’s “parochia in parochia [parish in the parish]” (Cox,
1955, p. 41), and Autton could anticipate an easy acceptance of his priestly
model of chaplaincy, which was essentially Christian, sacramental and male
(and, we might add, white) (Autton, 1966, 1968). Today, the value of pro-
fessional chaplaincy is under scrutiny,3 even as it has become multi-faith,
multicultural and (increasingly) research-informed and non-binary.

Secularization and Diversity
The radical nature of post-war secularization has led some sociologists to
declaim the eventual demise of religion.4 Yet, despite a relentless numerical
decline in, for example, UK church attendance – which is estimated to have
fallen from 3.2 million (6.5%) in 2005 to 2.8 million (4.9%) in 2020 and
is predicted be less than 2.5 million by 20305 – the religious impulse has
proved remarkably resilient. This resilience is apparent in the continuing
growth of minority faiths, the recognition of religion as a “protected char-
acteristic” under equalities legislation, the mainstreaming of spirituality as
a lifestyle choice and the persistence of spirituality in healthcare, these are
all examples of desecularization working alongside the decline of historic

3. The National Secular Society continues to campaign for what it calls the “reform of
chaplaincy” (https://www.secularism.org.uk/chaplaincy).
4. So-called, “secularization theory”, classically stated by C. Wright Mills: “Once the world
was filled with the sacred – in thought, practice, and institutional form. After the Reforma-
tion and the Renaissance, the forces of modernization swept across the globe and seculari-
zation, a corollary historical process, loosened the dominance of the sacred. In due course,
the sacred shall disappear altogether except, possibly, in the private realm” (Mills, 1959, pp.
32–33).
5. See https://www.brierleyconsultancy.com.

Where Next for Chaplaincy? 3

religions in the United Kingdom. As a consequence, the contemporary con-
text of professional chaplaincy is that of the secularizing decline of religion
and, simultaneously, the sacralizing growth of spirituality (Heelas & Wood-
head, 2005), overlaid on a bed of increasing religious diversity. Realizing
that traditional chaplaincy needs a broader definition, insofar as it needs
to clarify that its care is not defined by or limited to religious care, some
chaplaincy teams have begun rebranding their service.6
The changes in post-war Britain have also included increased sociocul-
tural diversity, and with that a growing demand for greater equality and
inclusion. Autton’s priestly model of chaplaincy essentially imported the
Anglicanism of his day into the hospital setting, and with it the sense of enti-
tlement that goes with being the state Church. However, as Roman Catholic
and Free Church men and women entered the profession, accompanied by
a gradual increase in those from non-Christian faiths,7 the demography of
the profession has become more reflective of British society – except that
British society has itself become less obviously religious. At the time of the
census in 2001, around 37 million people (72% of the adult population) in
England and Wales self-identified as Christian, and while other religions
accounted for around 6%, those recording no religion totalled 12 million
(15%). Ten years later, 4 million fewer people (59%) identified as Christian,
compared with 6 million more (25%) who claimed to have no religion (ONS,
2015).
These two changes – the redefining of professional chaplaincy as a ser-
vice that is broadly spiritual rather than narrowly religious care and the
shift in the percentage of people identifying as not following any religion
– have opened a space into which chaplaincy must evolve or die. There is
good evidence to argue that people continue to value the roles chaplains
fulfil. Ryan’s study of chaplaincy in Luton (Ryan, 2015) and the case studies
published in this journal (Health and Social Care Chaplaincy, 5.2) point to
the way religiously unaffiliated people value the care of professional chap-
lains. But it is interesting to speculate whether those who identify as non-
religious, and who yet knowingly access religious chaplaincy, are doing
so because they perceive chaplains to be somehow independent of their

6. For example, of the 366 registrants currently listed on the UK Board of Healthcare
Chaplaincy (UKBHC) Register, 33 explicitly include the term “spiritual care” as part of their
title (https://www.ukbhc.org.uk/the-ukbhc-register).
7. The Multi Faith Group for Healthcare Chaplaincy (MFGHC) was formed in November
2002 (under the auspices of the Hospital Chaplaincies Council), with the object of advancing
multi-faith healthcare chaplaincy in England and Wales. The MFGHC subsequently became
the Healthcare Chaplaincy Faith & Belief Group and, in 2018, was reconstituted as the Net-
work for Pastoral, Spiritual & Religious Care in Health.

4 STEVE NOLAN AND DUNCAN MACLAREN

religious institutions. The availability and use of civil celebrants for what
have traditionally been religious activities, such as baby naming, wedding
and funeral ceremonies, speak to a continued demand for (and supply of) a
pastoral/spiritual care that is independent of formal religious institutions.
And the fact that chaplains are requested to conduct these ceremonies may
suggest that they are viewed more as skilled professionals rather than as
religious representatives.

New Networks
The call from Humanists UK that non-religious people should have access
to pastoral support analogous to the support religious people are able to
access from chaplains may be seen in this twofold context: at one level,
as a response to unmet pastoral (and spiritual) need; at another level, as
an appeal for inclusivity.8 The urgency for inclusion motivated the launch,
in 2016, of the Non-Religious Pastoral Support Network (NRPSN) and, in
the same year, the impulse to address the needs of non-religious patients
inspired the appointment of Jane Flint (a Humanist) to the chaplaincy team
at the University Hospitals of Leicester NHS Trust as the first ever non-
religious pastoral carer (Mulholland, 2017).9
   The alignment of the NRPSN with the Network for Pastoral, Spiritual &
Religious Care in Health (NPSRCH) – newly reconstituted, in 2018, from
the Healthcare Chaplaincy Faith & Belief Group (HCFBG, formerly, the
Multi Faith Group for Healthcare Chaplaincy) – through the role of Simon
O’Donoghue (formerly Head of Pastoral Support at the NRPSN) as Chair
of the NPSRCH, may be seen as an astute strategic move by the NRPSN.
Certainly, O’Donoghue has played a significant role in the NPSRCH, co-
authoring two of the Network’s key documents: Fit for the twenty-first cen-
tury? The state of inclusion for acute NHS chaplaincy pastoral spiritual and
religious care services in England (O’Donoghue, Hardy & Mutlow, 2020)
and Endorsement of NHS pastoral, spiritual, and religious (chaplaincy) staff
and volunteers: A practical guide (O’Donoghue & Jones, n.d.). Significant
in the latter document is the direction, suggested by the Network, for the
development of professional chaplaincy; specifically, the idea that (as is the
norm in Scotland) Trusts might appoint “generic” chaplains without any

    8. In discussing this call by Humanists UK for greater inclusion of non-religious people,
it is important to note that we are not endorsing a common misconception that regards
Humanists as sole representatives of the “non-religious”. Humanists UK is a particular voice,
and those self-identifying as “non-religious” make up a widely diverse group.
    9. This milestone was followed, in 2018, by the appointment of Lindsay van Dijk as the first
non-religious head chaplain, in the Buckinghamshire Healthcare NHS Trust (Burgess, 2018).

© Equinox Publishing Ltd 2021

Where Next for Chaplaincy? 5

endorsement from a faith or belief community: “a generic chaplaincy role
is one in which a religion- or belief-specific occupational requirement has
not been deemed necessary” (O’Donoghue & Jones, n.d., p. 7).

Endorsement
Traditionally, chaplains have required some form of endorsement from their
faith (or, latterly, belief) community,10 and it should be noted that, despite
this apparent departure from the traditional requirement by the NPSRCH,
the NHS makes clear, in the same document, that “for the protection of the
public … who are often vulnerable”, chaplaincy staff and volunteers should
maintain a recognized status with the appropriate religion or belief group
(O’Donoghue & Jones, n.d., p. 7). However, this requirement is not univer-
sal. Whereas for some in the United Kingdom, the suggestion proposed by
the NPSRCH may seem radical, chaplains in other nations are not neces-
sarily required to seek such endorsement. For example, membership criteria
for Spiritual Care Australia, the certification/registration body for all Aus-
tralian chaplains, makes no mention of faith community endorsement,11
and, as you can read in the article by den Toom and co-workers (2021)
in this issue, Dutch chaplains also have a route to certification that does
not require endorsement from a faith/belief group. Perhaps more signifi-
cant is the position of the newly launched professional chaplaincy body
in the United States, the Spiritual Care Association,12 an initiative of the
New York-based HealthCare Chaplaincy Network, which explicitly rejects
endorsement by a faith/belief group as a requirement for certification. On
its website, the Association states that its “credentialing and certification

10. For example, it is a requirement of registration with the UKBHC that a candidate
shows, “evidence of a recognised or accredited status within a mainstream faith com-
munity or belief group” (https://www.ukbhc.org.uk/for-professionals/registration/
registration-criteria). Similarly, in the United States, Board Certification requires, “[d]ocu-
mentation of current endorsement (or acceptable language in accordance with the appli-
cant’s spiritual/faith tradition) received or reaffirmed within last 12 months” (https://bcci.
professionalchaplains.org/content.asp?pl=25&sl=110&contentid=110).
11. See https://www.spiritualcareaustralia.org.au/membership/membership-criteria.
However, the situation in Australia is complex in that there is no consistency between the
states. While the national position is that Spiritual Care Australia does not advocate for
faith/belief endorsement as part of their membership criteria, in the state of Queensland,
for example, health services do require faith endorsement (in the main, because chaplaincy
positions there are paid for through the churches). I am grateful to Cheryl Holmes, CEO,
Spiritual Health Association, for this detail.
12. See https://www.spiritualcareassociation.org.

6 STEVE NOLAN AND DUNCAN MACLAREN

process does not require faith group endorsement” (emphasis added).13 The
Association’s rationale is unadorned: “Board certification of chaplains based
merely on a required number of hours, faith endorsement, and a subjec-
tive process does not ensure the delivery of effective care” (Hall, Handzo &
Massey, 2016, p. 6). Crucially, the Association contends that “[Faith group
endorsement] is not an evidence-based indicator of the person’s compe-
tency as a chaplain, and can bar an otherwise highly qualified chaplain from
becoming certified” (Hall, Handzo & Massey, 2016, p. 9).

Professional Chaplaincy Issues
In the United Kingdom, the launch of the NRPSN, and to some extent the
reconstitution of the NPSRCH, has focused attention on a number of issues
that have been widely circulating within professional chaplaincy for some
time. These include the following issues.

    • Language: what do “spirituality” and “spiritual care” mean when
      they no longer simply refer to religious experience and religious care?
      Does the concept of “spirituality” have any currency in a pluralis-
      tic context or should it be abandoned, and if so, what alternatives
      are appropriate? Is the term “chaplain” anachronous, and if so, what
      other name (if any) effectively communicates the role? Is it possible
      to speak meaningfully (and theologically) about spiritual care using
      non-religious language? Is there a meaningful replacement for the
      term “non-religious”? Does the title “Chaplain” need to be revised,
      and if so, what alternative title could communicate the chaplaincy
      role?
    • Authorization: given the variety of beliefs chaplains now serve (his-
      torical religions, new religions, non-religions), should chaplains
      continue to be authorized by a “community of belief”, or can a pro-
      fessional body provide sufficient authorization? What kind of rela-
      tionship is appropriate between a chaplain’s “community of belief”
      and their professional body? Does chaplaincy embody an emerg-
      ing mode of spirituality, based not on exclusive forms of religious
      identity, but rooted in common human experience – an “inclusive”
      spirituality?
    • Training and qualification: what level of training should chap-
      lains have? What knowledge and skills should a chaplain be able to

  13. See https://www.spiritualcareassociation.org/requirements-for-board-certification.
html.

© Equinox Publishing Ltd 2021

Where Next for Chaplaincy?       7

      demonstrate? Should chaplain training follow a competency model
      or a personal development model? What recruitment criteria should
      be used for chaplains from new and non-religions?
    • Practice: if spiritual care can be offered independently of religious
      care, what difference is there between chaplains and social workers
      or counsellors or other sorts of “talking therapists”? What distinc-
      tive contribution do non-religious chaplains make to patient care?

Health and Social Care Chaplaincy
A number of these issues have been addressed in the seven articles published
within this special issue of HSCC in response to our call for papers. David
Savage, a founding member of the NRPSN and author of Non-religious pas-
toral care: A practical guide (Savage, 2019), opens this collection. Writing in
the United Kingdom, Savage (2021) makes a humanist case for equality and
inclusion. Drawing on statistical data, Savage argues that, notwithstanding
the fact that many religious chaplains present themselves as being avail-
able for people from “all faiths and none”, those who have sincerely held
non-religious beliefs feel ill-served. Savage’s argument is that non-religious
people should be able to receive pastoral care from “like-minded” pastoral
carers in the same way that Christians do from chaplains, who are predomi-
nantly Christian.
   Scottish chaplain, Duncan MacLaren (2021), suggests that the kind of
inequity of access to spiritual care Savage addresses may actually be a fea-
ture of the “multi-faith” model practised by English chaplains. The nations
that make up the United Kingdom operate different models of spiritual care
provision. In Northern Ireland, chaplains are denominational, largely visit-
ing patients of their own denomination. In Scotland, as MacLaren describes,
chaplains have developed a “generic” model. However, while the multi-faith
model risks inequity of access, MacLaren argues that the generic model
threatens the chaplain’s religious or belief identity. He suggests a potential
way out of this bind using the example of how the “talking therapies” have
navigated their path to professionalization.
   Three studies by Dutch scholars consider aspects of chaplaincy as it is
practised in the Netherlands. Niels den Toom and colleagues (2021) con-
sider the meaning of “spirituality”, insofar as it relates to chaplaincy. They
contend that the term is conceptually unclear and fails to do justice to the
plurality and richness of what professional chaplains actually do. Working
with the definition of chaplaincy care as published in the Professional Stan-
dard of the Association of Spiritual Caregivers in the Netherlands (VGVZ),
den Toom and colleagues argue that chaplaincy should be conceptualized

© Equinox Publishing Ltd 2021

8 STEVE NOLAN AND DUNCAN MACLAREN

less in terms of “spirituality” and more in terms of “meaning” and “world-
views”, which for these scholars embraces the existential, ethical, spiritual
and aesthetic dimensions.
   As a profession, Dutch chaplains are committed to the understanding
that their work is not determined by, nor is it limited to, their relationship
with a religion. As Nelleke ten Napel-Roos and associates (2021) discuss,
this inevitably raises the question, already highlighted, about endorsement
– at least for those chaplains unable or unwilling to be endorsed by a faith or
belief community. Until recently, Dutch spiritual care givers working with-
out such endorsement were excluded from full membership of the national
professional association (VGVZ). However, as Napel-Roos and colleagues
explain, this changed in 2015 when the VGVZ established a Council for
Non-Commissioned Spiritual Caregivers and began assessing candidates
with regard to their “spiritual competence”. However, although this move
did open the door to full membership of VGVZ for non-denominational
chaplains, Napel-Roos and co-workers find the concept of “spiritual com-
petence” problematic. Nonetheless, “spiritual competence” is an intrigu-
ing concept, which may prove of interest to other professional bodies in
rethinking their processes of accreditation.
   Whatever value “spiritual competence” may have, the basic qualification
for Dutch chaplains is a Master’s degree. In their paper, Gaby Jacobs and
colleagues (2021) argue that, as a profession like other professions, chap-
laincy is reducing the focus on its worldviewing competencies. In light of
this, they wonder what this implies for those who wish to be trained in
humanist chaplaincy. As colleagues at the University of Humanist Studies
in Utrecht, they describe the Master’s course in humanist chaplaincy at
their university and propose changes aimed at making humanist chaplaincy
“future-proof”.
   A key element of future-proofing chaplaincy will be the way the profes-
sion understands and is able to present itself to colleagues, commission-
ers and the public. Key here will be the question of how “spirituality” is
defined. Given that the contemporary landscape of belief is plural, for any
definition of spirituality to gain wide acceptance it must be meaningful to
religious believers, spiritual pilgrims, freethinkers and non-believers. Writ-
ing from an Australian perspective, where 30% of the population identify
as having no religion, Christopher Turner (2021) develops a definition of
spirituality that he terms “natural spirituality”, effectively a spirituality
without metaphysics (a materialist spirituality?). To do this, he draws on
Epicurus, Spinoza and Nietzsche to argue that, at a cellular level, all life has
a non-religious spiritual, homeostatic “will to live”, and that this is nurtured
by spiritual care that takes place intersubjectively, when two people meet

© Equinox Publishing Ltd 2021

Where Next for Chaplaincy? 9

with the intention “to listen deeply with and to one another”. Readers will
decide whether Turner’s account of non-religious spirituality/spiritual care
has meaning for clinical practice; however, he does offer one of the few
attempts to define this evasive concept in a way that aspires to a degree of
much needed philosophical rigour.
The final article in this collection offers “three short case studies” from
an Israeli setting. More vignettes than full case studies, Roni Almog and
colleagues (2021) offer examples of non-religious spiritual care that resonate
well with Turner’s definition of “natural spirituality”. Although short, the
cases illustrate the role intuition and creativity play in the act of offering
spiritual care. To some extent, these cases return the focus of this special
issue to the question of what it is that traditionally religious chaplains have
to offer when their client group is largely non-religious. The answer to this
may lie in the, as yet unresolved, prior question of what it is we are talk-
ing about when we talk about spirituality/spiritual care. The studies in this
special issue do not provide a conclusive answer to either of these questions;
however, they do contribute to the ongoing debate.

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© Equinox Publishing Ltd 2021

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