CPE Quality Indicators

Twelve Indicators of CPE Supervisor Adequacy and Excellence

  1. 1. Conducting Verbatim Seminars
  2. This set of intricate skills, broad knowledge, caregiving experience, the flexibility of employing immediate dynamics, and pervasive educational focus is the very heart of clinical pastoral educator identity. Consistent group practice of well-led communal exploration of actual patient care events presented in writing for 75 to 90 minutes each, two to four times per week, constitutes the primary tool that differentiates the ACPE from the formative education of other fields and associations. The term “verbatim processing” in this context means “group interpersonal exploration of the cognitive, emotional, and intersubjective aspects of a single actual spiritual care conversation”. There are many supervisory functions that make excellence, and even adequacy of the leadership of this group practice so essential for professional chaplaincy education. For example, in leading a verbatim session, does this educator:
    • Validate students’ conveyed empathy, insightful questions, genuine support, and astute interpretations in the patient dialogue presented in the group?
    • Confront patterns of superficializing, intellectualizing, minimizing, and other avoidance of intimate spiritual care and processing it in a group?
    • Identify and interpret aspects of issues not noticed by the presenter or the group members?
    • Summarize and focus aspects of group feedback to the presenter for use of them in subsequent efforts at spiritual care?
    • Amplify pertinent peer feedback that may be unnoticed or minimized?
    • Facilitate interpersonal engagement between peers to emphasize potential learning?
    • Recognize and interpret parallel processes?
    • Move the group interaction from content discussion to processing thoughts and feelings?
    • Use mini-didactic input and brief conceptualizing without pedantic lecturing?
    • Rein in serious distractions such as peer projection, hostility, scapegoating, and extra-group interruptions?
    • Terminate sessions diversely, i.e., pithily, provocatively, emphatically, complimentarily, smoothly, summarily, or otherwise memorably?
  3. 2. Individual Supervision
  4. Classic CPE includes a major mentoring component, using the two-person arena of student and mentor to optimize the depth of disclosure of more sensitive material in a trusted dyad to further the integration process. Does this educator relinquish the power of mentoring and delete it from the program, possibly because they find it too intimate, complex, emotion-focused, or difficult? Or do they:
    • Establish and maintain with every student, a viable supervisory alliance of some level of trust, shared thinking, good questions, and open dialogue about the student’s needs, goals, hopes, dreams, identification of care issues and problems in learning.
    • Partner with each group member to devise a learning contract with the peer group that guides the initial individualized learning experience and lends itself to change as the program unfolds and the student learns?
    • Keep a major focus on each student’s emotions as the energy that fosters behavior change in improving spiritual care relationships?
    • Receive and honor students’ disclosed earlier life memories as relevant to current interpersonal behavior and care relationships?
    • Help clarify peer-group learnings of each student as they emerge?
    • Describe each student in specifics relevant to learning issues, to document them in final evaluations for subsequent educators and clinical education efforts?
    • Prescriptively name in immediacy, relevant concepts that increase the student’s understanding of people, human interpersonal dynamics and spiritual care issues
    • Catch the student feeling what is not yet fully conscious at key moments to improve their self-understanding for better spiritual care relationships
    • Assist the grief of students from prior losses that emerge in relationships with patients and peers
    • Confront student learning issues or patterns of “resistance” (communication patterns that may serve the student in social contexts but not in the crucible of clinical learning)
    • Support students during emotionally charged times of need
  5. 3. Open Agenda Group Facilitation
  6. Some group time without agenda is facilitated to minimize contamination of the clinical learning group with interpersonal issues that arise in the highly charged arena of verbatim processing and the interaction among students in or outside the formal group time. Open agenda sessions also use the relationships among group members to learn about people, personality characteristics and styles, conflict management, and student issues that may need therapeutic attention in another form of care. Such open time is a unique curriculum component that is easily misunderstood and sometimes neglected by educators wary of its power and possible long-term student attitudes about CPE itself. It requires specific skills of the educator but provides some of the most memorable events of learning in most all ACPE programs. Here are a few of the functions and interventions that can help learning occur in open agenda time:
    • Cultivating authenticity (the experience of feeling like your emotions, thinking, and verbal expressions are courageously and surprisingly congruent)
    • Promoting students’ new awareness through their courageous, partially intentional vulnerability, in self-disclosure and feedback
    • Prescriptively interpreting immediate observed behaviors and dynamics
    • Confronting incongruencies between apparent feelings, words, and behaviors
    • Connecting student issues with patient needs
    • Reining in discussion vs. engagement (moving from content to process)
  7. 4. Didactic Instruction: Arranging Relevant Interdisciplinary Teaching
  8. Every clinical pastoral education student gradually develops frameworks of understanding people and their troubles, partly by group learning sessions led by a variety of professional or self-help practitioners who are excited by what they do to help troubled people. The educator retains the responsibility and creativity of recruiting and scheduling these didactic session presenters as a small but vital part of an ACPE program.
  9. 5. Maintaining an Active Practice of Spiritual Care
  10. Educators are people who are fascinated by the human dialogue and have been successful as caregivers, and who also generate interest in helping others learn and gain competence. Neglecting this aspect of education, direct patient care, contributes to caregiving excellence gradually losing its soulfulness, reduced identification with student experiences, transforming into interpersonal distancing, overly patterned care, and eventual institutionalization of once lively human care movements.
  11. 6. Group Formation, Leadership, and Termination
  12. The educator facilitates the initial formation of the group life beginning with their first group meeting; responds to and stimulates the group learning events; moderates and confronts harmful or useless directions of the group dynamics, and brings the group life to an optimal close at its end. This includes ample use of conveyed empathy, clarification, challenge, interpreting dynamics, brief instruction, focusing, structuring, and a host of other leadership and clinical supervisory skills to maximize group cohesion, members’ personal growth, and development of a variety of conceptual and spiritual care skills.
  13. 7. Group Peer Evaluation and Final Descriptive Writing
  14. As a peer supervisory program, a unit of ACPE education ends with a final group evaluation experience of writing and describing one another’s strengths and weaknesses as caregivers and professionals as they see them. This includes writing about one another descriptively, sharing the writing, and processing responses to one another’s views. The educator manages, facilitates, and moderates this process, focusing on and emphasizing what is most relevant to each student’s potential career as a caregiver. The educator then writes a concise but concrete and substantive narrative of each student’s use of the program, and progress as a caregiver and professional colleague thus far, using the ACPE’s intended outcomes, educational objectives, and their own frameworks of understanding characteristics and skills for caring for people in highly vulnerable situations such as hospitalization.
  15. 8. Ethical Boundary Keeping
  16. The educator adheres to an official strict code of professional ethics of the ACPE/APC/AAPC or NACC and oversees the learning of that code by all students and their compliance with its principles.
  17. 9. Familiarity with Various Human Care Disciplines
  18. All patients and many parishioners are “in treatment”, i.e., under the care of one or many professional caregivers. CPE students often need perspectives on those disciplines and some knowledge of what perennial ways the issues they care for are challengingfor the human spirit. To continue moving to a more integrated team spiritual care practice the clinical spiritual care movement needs educators who are continuing to expand their understanding of various medical, ethical, religious, nursing, and other forms of care with whom they practice in team relationships.
  19. 10. Engaging Cultural Dynamics in Student Relationships

CPE Educators need to be aware of how diverse students and peer groups are deeply informed, shaped, and impacted by culture and social systems, just as they have been so shaped themselves. Educators have not only demonstrated cultural humility and cultural competence in their educational theories and practices, but also in assessing cultural dynamics of individuals and groups and how they inform learning and clinical practice. They have become aware of their own biases and prejudices (and being able to tolerate the discomfort that may create), expanded to a degree of their own knowledge about and awareness of cultures other than their own (a lifelong process), and have mastered a few interventions appropriate for teaching and caring for diverse persons from different cultures. They have learned the difference between passionate values and beliefs on one hand and biases and prejudices on the other.

In addition, Educators have a developed understanding of how systems of oppression impact individuals and groups and have learned some strategies to help transform unjust systems to gradually become more appropriate for the learning and teaching of spiritual care.

  1. 11. Program Accreditation and Management
  2. The educator carries the responsibility for the structure, curriculum, functioning, and ongoing development of the CPE program and maintaining its authorization to grant credit by the government-approved Association for Clinical Pastoral Education. This includes establishing and maintaining written policies, procedures, curriculum, and descriptions of every aspect of the program, regular consultation with an interdisciplinary committee, and maintaining working relationships with administrators and leading interdisciplinary practitioners, local clergy and church bodies, and the ACPE accreditation commission.
  3. 12. Maintaining Competence and Certification
  4. Clinical supervision requires a flow of human processes that resist being stuck on any of them – observation, thinking, memory, affect, emotional awareness, imagination, intuition, conceptualization – all used together to engage and decide what to cast light on in the immediate complex group dynamics to further someone’s learning and the health of the group culture. Such a flow of functions stands unique with the profession of ACPE supervision as combining psychology, theology, and the use of one’s own personality to help people improve their care of troubled people. This competence does not maintain itself. It is gained with years of practicing it with groups of one’s peers and needs to be maintained by employing one’s vulnerability in openness to feedback on one’s supervision. Competence will inevitably wane with aging, inactivity, and impairment. Maintaining excellence in it is far more difficult than maintaining certification.