Date of Award


Document Type


Primary Advisor

Dr. Tim Sensing

Secondary Advisor

Dr. Virgil Fry

Committee Reader

Dr. Wes Crawford


This thesis addresses the understanding and practice of spiritual care in a nonprofit hospice. The identified problem this project seeks to resolve is a lack of a protocol to continually assess the spiritual concerns of patients and families on service with this organization. The purpose of this project intervention is to develop a protocol document that assesses spiritual concerns and helps members of an interdisciplinary team offer more informed responses to spiritual care needs. The project has multiple intents in that it will also help address a gap in organizational awareness and seek to enhance current care practices and understandings. This intervention is guided by a practical theology of created space that attends to the questions raised by critical incidents and contexts by cultivating dialogue about experiences, beliefs, perception, and theology. This confessional approach works from the conviction that God is active and present within our experiences and that we are called to participate in the compassionate ministry of Christ. This contextualized theology for pastoral hospice care is influenced by three values: investment, patience, and a posture of benevolence. The goal is to develop a deeper understanding and awareness of four areas: 1) a better grasp of God’s presence and activity, 2) a clearer awareness of our own convictions and perspectives, 3) a more accurate understanding of the critical incident and relevant details, and 4) to discern a better way forward. Richard Osmer’s 4-Question Model is used in this context to substantiate the framework due to its simplicity and accessibility. I used purposive sampling to assemble a design team from the organization’s volunteer program, along with one staff member. A delimitation is that I did not consider medical team member contributions to spiritual care, although this is a necessary next step beyond this intervention. Members of the volunteer team are a comparative sample because they are likely to offer care that is similar to that provided by spiritual care disciplines. The team participated in discussion-based sessions in which their stories and feedback contributed to the writing of the spiritual care protocol document. Sessions consisted of appreciative inquiry, teaching on the theological construct, instruction on existing assessments, open-ended group interviews, and group evaluation. I conclude that 1) there is a place for a confessional approach to spiritual care, 2) further work is needed on engaging dissonant beliefs, 3) this practical theology offers substantial resources for addressing end-of-life concerns, 4) making operative spiritual care definitions explicit encourages involvement, 5) the role of prayer needs exploration, 6) ideographic knowledge is better positioned to create a robust protocol, and 7) this protocol has applicability beyond this hospice organization.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.



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