Significant Change in the North American Spiritual Care Education and Psychotherapy Movement

Since 1920 there have been many new beginnings and significant changes in the associations that have led the spiritual care, counseling, and education movement in North America. The year 2019 marks one of those most significant changes.

In March 2019 the American Association of Pastoral Counselors (AAPC) voted to end its work as an association, work which began in 1963. But the members were not ready to end their work in advancing practices of spiritually focused counseling and psychotherapy. Conversations between the governing boards of AAPC and ACPE: The Standard for Spiritual Care and Education (previously Association for Clinical Pastoral Education) during early 2019 led to an agreement that has set a very positive tone for all the steps taken to date. They agreed to make decisions and choices based upon the values of gratitude and hospitality, transparency, mutual benefit, professional differentiation, and cooperation. AAPC members were invited to join ACPE after ACPE established a Psychotherapy Commission with membership categories and a broad charge to support the new members arriving from the now inactive AAPC.

Out of the 1168 AAPC members in good standing when AAPC ended its charter, 875 chose to accept ACPE’s invitation to membership under the ACPE Psychotherapy Commission umbrella. That large migration in itself was surprising to almost all observers. But it reinforced the core conviction of those leading the integration that spiritual care and counseling practitioners have more in common than difference. We need each other and will find ways to further our historic missions. ACPE (over 2000 individual members of whom about 600 are Certified Educators) has welcomed these new members into full and equal participation in ACPE. The leaders of AAPC and ACPE have written a new future story for their associations and members. As with all future stories, there are hopes and fears, gladness and sorrow, joy and anger. At this time, the positive energy for the future is great. All we know beyond that is that a new future is emerging for both organizations.

How will the integration of these associations affect the future of North American and international spiritual care and counseling movements? Obviously, this question can only be answered through hope and conjecture at this point in time. The Psychotherapy Commission hopes that the blended resources of human energy, intellectual capacity, and deep consciousness will provide a solid foundation for the emergence of spiritually integrated psychotherapy as a discipline and method. We hope that the deep formation of persons for spiritually centered therapy previously represented by AAPC Certification will be continued in new wineskins by ACPE. The ACPE Psychotherapy Commission members hope that the collective wisdom of spiritually integrated counselors and supervisors will merge with the collective wisdom of spiritual care educators producing a vibrant energy for human healing as we move into the 21st century. We hope that our collective commitments to honoring and encouraging diversity will position our movement for maximum impact in the multi-cultural United States and respectful engagement with other cultures internationally. These are audacious hopes. But they flow from the past century of the pastoral care movement’s emphases and successes.

Care of the soul, cura animarum, has always been a curious blend of tradition, contemporary knowledge, and practical wisdom among all spiritual traditions. And, in most traditions, spiritual care practices have appealed to accepted principles in the psychology, sociology, and medicine of that culture as key references for contemporary knowledge. Thus, tensions between science, tradition, and scriptural/theological perspectives frequently come to focus in the practice of soul care. In North America these intersections emerged in unique ways in the education of Christian pastors beginning in the 1920s. In 1923 William Keller introduced seminarians to the needs of their future parishioners through the Summer School in Social Work for Theological Students and Junior Clergy, a supervised clinical immersion program through agencies in Cincinnati, Ohio. In 1925 Richard Cabot, MD and the Rev. Russell Dicks introduced seminarians to the reality of human suffering through the Massachusetts General Hospital in Boston, Massachusetts. That same year, with Cabot’s encouragement, Anton Boisen introduced seminarians to the reality of human suffering at Worchester State Hospital. The thread that tied these dispersed efforts together was the new educational environment in which pragmatism (John Dewey’s influence) required the interface of experience, knowledge, and person in the formation of budding professionals. Similar educational streams were witnessed in medicine and law, and soon thereafter in other professions.

Many seminaries received this new clinically oriented education with great favor, and demand for the services spread. These culminated in the formation of two associations. The Council for Clinical Training of Theological Students, formed in 1930, focused their educational sites in state hospitals and prisons. Many saw this training as the best entry for the slowly emerging profession of chaplaincy. The Institute for Pastoral Care, formed in 1944, focused its training in general hospitals. Many saw this as the best entry for parish clergy. Tensions and appreciation characterized the relationships between persons in these two groups.

During the 1950s another emphasis emerged among clergy interested in depth training in counseling and psychotherapy, both within congregational structures and in community settings. By 1963 the differences became sufficiently pronounced that the American Association of Pastoral Counselors was established, rooted both in training institutes and in seminaries. The formation of AAPC coupled with the need for more coherence in clinical pastoral education created the impetus for the formation of the Association for Clinical Pastoral Education in 1967. The Council, the Institute, a Lutheran Clinical Pastoral Education (CPE) group, and a Southern Baptist CPE group merged around common principles. Late in 1967, AAPC made overtures to the newly formed ACPE to determine whether at least some functions such as training programs, accreditation, conferences, and publications could be jointly sponsored. ACPE rebuffed that overture although soon cooperative ventures in continuing education and publishing were developed. The point the Commission wishes to highlight is that, from the earliest days, both AAPC and ACPE recognized common principles and concerns that could be better addressed together than separately.

Historically, another story line developed in relationship to but separate from the AAPC-ACPE story. Chaplaincy developed into a profession during World War II and then expanded during the post-war period in the context of general and mental health hospitals. Associations formed to support the growth of chaplaincy including the Chaplains Section of the American Protestant Hospital Association in 1946, the Association of Mental Health Chaplains (sponsored by the American Psychiatric Association) in 1948, the National Association of Catholic Chaplains in 1965, the Canadian Association for Spiritual Care/Association Canadienne de soins spirituels (CASC/ACSS) in 1965, the College of Pastoral Supervision and Psychotherapy (CPSP) in 1990, and Neshama: Association of Jewish Chaplains in 1990. While these many organizations might be viewed as creating divergence based upon specialty and faith tradition, the Commission thinks that the trend line actually arcs toward integration.

In 1978, the Council on Ministry in Specialized Settings was formed as an umbrella organization for pastoral care and counseling-focused organizations in order to seek cooperation and advocacy. In 1996, the Association of Professional Chaplains emerged from their APHA roots and then integrated the AMHC organization into the Association for Professional Chaplains (APC) in 1998. While CASC/ACSS members have maintained their own training programs and standards in both CPE and counseling, most other organizations (APC, NACC, NAJC) have looked to ACPE as the primary provider of their clinical pastoral education and have dialogued with ACPE as to the common standards and outcomes needed for the profession. ACPE has continued to bridge the historic dynamic tension between education for ministry and education for professional recognition. About 50% of its training units annually are single units, mostly for those in preparation for congregational leadership, while about 50% are residency units, mostly for those seeking chaplaincy vocations.

The integration of AAPC members into ACPE takes place among the ongoing changes that impact medical and mental health care in the United States. Many of these forces are economic. But others are scientific and technical. As one example, new knowledge paths in brain science increasingly change care routines for trauma survivors. Some of the forces are also social as many in the younger generation are less connected to religious structures so that the traditional paths toward recognition as spiritual caregivers and psychotherapists no longer work for many. And at the same time, there is apparent widespread interest in the spirituality of human experience and substance. The work of spiritual integration is substantial even as our supporting organizations evolve and refocus.

The year 2020 may mark another epochal change. Leaderships of ACPE, APC, NACC, NAJC, and CASC/ACSS are in deep discussions as to how a single organization or umbrella organization could serve the long-term best interests of all. The dynamics have shifted from ecclesial tensions to economic challenges, from polarities of theories to shared values among faiths, from the importance of uniqueness to the essentiality of community. ACPE has received a new class of members with creativity and respect knowing that spiritually centered counselors and psychotherapists have more in common with ACPE Certified Educators than differences. Ministries are different but values are held in common. Education and training models diverge, but service toward spiritual integration and compassion remain the same.

How will the ACPE-AAPC integration affect the international spiritual care movement? The Commission members think that our success in integrating those with passion for spiritually centered clinical education and those with passion for spiritually integrated counseling will continue moving toward a new and deeper center. But that center will hold in the midst of the many diversities among us. Together we can explore cultural similarities and differences in the formation of caring persons through intensive and extensive supervision in professional functions. Just as North American spiritual care associations are seeking to learn with and from each other, we anticipate that the larger diversity and needs of our world will be welcomed. The core of our practices is deepening. The center is strengthening as more join in this important developmental process. Perhaps new maturity is emerging in a discipline devoted to being present to those who are suffering, to nurturing forgiveness where there is brokenness, to offering liberation where there is bondage.

Yes, 2019 marks another essential developmental moment in the spiritual care movement in North America. Gratitude and hospitality, transparency, mutual benefit, professional differentiation, and cooperation are core values that have served us well. We look forward to what this next era will bring.

Members of the ACPE Interim Psychotherapy Commission:

Steven Ivy

Joann Heaney-Hunter, Chair

Wally Fletcher

Kathleen Gallivan

Russell Jones

J. Bernard Kynes, Sr.

Robert Renix

Doug Thorpe

Beth Toler

Linda Wilkerson

(Permanent Commission to be elected Fall 2019.)