A Chaplain’s Comprehensive Spiritual Assessment And Military Mission

Introduction

Commanders are under incredible pressure to make sure their Soldiers and their Families are physically, mentally, emotionally, and spiritually fit. Commanders look to their Chaplains to provide spiritual care. But how can effective spiritual care happen given the number of Soldiers and their Families for whom Chaplains are responsible? Since Soldier’s spirituality is seen as a critical aspect of his/her resiliency, the Chaplain must ascertain the level of the Soldier’s spirituality and spiritual/moral injuries which could prove detrimental to the Soldier’s well-being and possibly the Commander’s mission if not identified and addressed.

One answer to the above question is to have a reliable spiritual assessment tool that could measure a Soldier’s spirituality and level of moral/spiritual injuries (see discussion of moral/spiritual injury after the references). At the time (2007), spiritual assessment tools were seldom used in the military. Spiritual Assessments were, however, used throughout Veteran Administration Hospitals. Two reliable validated instruments which could be applied for the purposes of spiritual assessment include the Duke University Religion Index Score (Koenig & Bussing, 2010) and the Berg Spiritual Injury Scale (Berg, 1994). The former measures the level of one’s spirituality as limited, moderate, and high. The Berg Spiritual Injury Score has similar designations related to guilt/shame, anger/resentment, grief, meaninglessness, hopelessness, feeling God/life had treated a person unfairly, and worries and fears about death.

While scores drawing from these instruments could prove invaluable, the authors wanted a more thorough spiritual assessment that could not only identify the level of spirituality but also the pattern, level, and priority of Chaplain care to be given. Moreover, the authors aspired to the acknowledgment of moral/spiritual injuries which needed to be combined with life-loss changes to give insight into the reasons for any moral/spiritual injuries. In 1995, one of the authors developed such an assessment tool called the Multi-Level Spiritual Assessment (MLSA) (Kopacz et al., 2016). In 2007, the authors worked together to revisit the 1995 assessment and created a more comprehensive spiritual assessment or the Searle-Vance Spiritual Assessment for use within the US Army Reserves 98th Training Division. (See Appendix 1 “Spiritual Assessment” after a discussion of moral/spiritual injury).

The Division Chaplain (author) then presented this spiritual assessment tool to the Commanding General as a quality improvement effort within the Army Reserve Chaplain Service and not as a research activity and thus not submitted to the Institutional Review Board (IRB). The Commander agreed to use this assessment only after it was reviewed by his Executive Officer (XO), the Judge Advocate General (JAG), the Equal Employment Opportunity (EEO) Officer, Command Sergeant Major (CSM) and other leaders within the Division. Minor changes were made, and approval was given. The Searle-Vance Spiritual Assessment was consequently included in the Commander’s Master Religion Program (CMPR) which is the plan of ministry presented each year by the Division Chaplain to the Commanding General for his/her approval and assures its successful implementation.

Once approved, the Division Chaplain has the responsibility to implement the plan and provide administrative oversight. As a result, each of the four Brigade Commanders within the Division comprising 18 states and Puerto Rico provided time during Battalion weekend drills for the Soldiers to complete the spiritual assessment. Chaplains in each of the four Brigades were trained to implement and score the assessments. Soldiers were asked to voluntarily complete the spiritual assessment on Saturday morning of the drill weekend so that those who needed immediate attention were given time with the Chaplain along with other Soldiers who desired time with the Chaplain(s).

Searle-Vance Model Methodology

While voluntary, over 90% of the soldiers completed the spiritual assessment because Division and Brigade Chaplains emphasized the fact that the assessment was confidential and would not become a part of the Soldiers’ 201 file, medical files, or permanent records. Chaplains assured the Soldiers that their assessments would be kept in a safe place in the Chaplains’ Offices and reserved for their exclusive use. Moreover, the Chaplains’ genuine interest in the Soldiers and their Family’s well-being communicated the Command’s intent to care for his/her Soldiers. The use of the spiritual assessment demonstrated the Commander’s sincere desire to allow the Soldiers to give voice to their concerns and to find appropriate ways to address them. This approach enhanced the buddy system, unit cohesion, and encouraged Soldiers to see their request for assistance as a sign of courage.

The Searle-Vance Spiritual Assessment tool was administered by pencil and paper as a self-reporting tool offering the Chaplain insight into several areas of the individual’s life that intersected with the Chaplain’s responsibility to provide pastor care. It measures:

the reporting individual’s quantity of spiritual support brought with him/her to the environment of care.

Through a series of nine questions, each with five available answers, and a structure of Low Thresholds, the Chaplain can grasp the amount of spiritual support over three support systems:

Perceptual: self-thought, concepts, ideas related to spiritual life;

The structure of Low Thresholds permits the conversion of compiled raw scores into the percentage above/below the Low Threshold per support system and the combination of the three. This allows for the ranking of these support systems around the percentage above/below the relatively Low Threshold.

2. the reporting individual’s frequency of resolution in such spiritual issues as guilt, grief, anger, hopelessness, meaning of life, doubt, fear of death, and unfairness of life.

Each of the eight spiritual issues asks, “how often do you …,” or “do you feel …” about the particular issue. The available five answers are the same for all eight elements. The self-reporting responses of “very often” and “often” allow the Chaplain to explore these potential spiritual injuries with the reporting individual. If there are multiple items with “very often” and “often” responses, the Chaplain is able to prioritize his/her related pastoral care per score and the responding individual’s input. Some of the issues additionally ask for the main source of the concern with such available answers as Faith-Group, Family, God, Life, Military, or None of the Above/Not Applicable.

3. the reporting individual’s amount of loss and life change in six areas of life (spiritual, personal, marital, household, vocational, and financial) over the previous two years. The totaled scores for each area are converted to a percentage above/below the average for each area of life. The combination of all scores is also converted to a percentage above/below a High Threshold. By virtue of these scores, the Chaplain is able to rank the areas of the responding individual’s life to provide appropriate pastoral care, especially if the comprehensive score exceeds the High Threshold.

An individual’s reported sources of spiritual often help complement what is exhibited in the ranking of spiritual support systems. If the highest-ranking support system for the individual is faith-group, the selected sources of spiritual help are usually faith-group, group smaller than a congregation, pastor/priest/rabbi/imam/monk/spiritual advisor, or sacraments/ordinances/creeds.

An individual’s reported values can often be used in conversation between the Chaplain and individual to explore and encourage the use of those values in accomplishing, for example, the team’s care plan in the medical environment of pastoral care, or the unit’s mission in the military environment of pastoral care.

An individual’s faith-group preference, at the very least, allows pastoral care to assure this preference is properly recorded on such constructs as “dog tags” in the military arena, or the Faith-Group on record in the medical arena.

In practice, the spiritual assessment tool provides a way to best manage Chaplain assets to perform and provide pastoral care by

triaging the reporting individuals into groups for timely application of the appropriate Chaplain skillsets to the identified needs of the individuals in the environment of care. The individual with the reported least amount of spiritual support and the greatest amount of unresolved spiritual issues and/or loss/life changes may need the Chaplain’s pastoral care more than the individual with the reported greatest amount of spiritual support and the least amount of unresolved spiritual issues and/or loss/life change. The individual with the reported greatest amount of spiritual support may still need the Chaplain’s pastoral care if there are one or two identified spiritual injuries wanting to be addressed by the individual. Or this same individual with the greatest amount of spiritual support may need the Chaplain’s pastoral care if there is an extensive amount of loss/life change and if the related expressions of grief are not addressed.

The six patterns of spiritual support refer to the configuration or combination of three support systems––the Perceptual/Devotional/Faith-Group. The levels of spiritual support refer to the amount of spiritual support provided by these three support systems. The priority of spiritual support refers to order of priority or power attributed to each of these three support systems.

3. employing the selected values of the reporting individual toward achieving a mutual plan of care for the individual which is supported by the Chaplain in the institutional environment of care; and

The responding individual may be so willing to accept the Chaplain’s invitation when the request is wrapped in artful observation. For example, “I noticed on the spiritual assessment that you acknowledged an exceptional amount of loss/life change over the past two years; would you be willing to share with me how your faith or faith-practices have supported you in all of this?”

Such is the tool that we believe can maximize the artful skills of the Chaplain for the positive benefit of the reporting individual in their environment of care.

Vignette

For example, in the case of Soldier X, the spiritual assessment appeared very good. The Soldier had a positive pattern which meant he had Above Threshold scores for all three parts of his spiritual support system: Perceptual/Devotional/Faith-Group. His level of support was extensive with his priority of support being Faith-Group.

The Soldier’s Spiritual Injury score was well below the threshold as was his Loss and Life-Change Score. However, within these below threshold scores, there was reason for concern. Though his spiritual injury score was significantly below threshold, he felt guilt/shame very often which seemed contrary to his spiritual support system.

Because guilt/shame have been associated with depression, suicidal ideation and attempts, it was important for the Chaplain to examine his Loss and Life Changes more closely. In 21A of the Loss and Life-Change Score, the Soldier indicated there had been a change in his devotional practices which was his number one source of spiritual help.

In 21B, the Soldier checked the box that said he had thoughts of suicide and/or thoughts to harm another person(s) over the past two years. In this same section, the Soldier also showed that there had been a change in his personal time schedule.

Why suicidal ideation and/or thoughts of harming himself and/or others? In 21C, Soldier X revealed there was increased emotional distance in his home and/or family. 21D stated there had been a change in the place where the Soldier and Family lived, and 21F indicated there had been a change in the Soldier’s financial state.

Because this spiritual assessment had given the Chaplain a window into the Soldier’s life in a short period of time, he became a priority for the Chaplain to meet and talk. As both Chaplain and Soldier know in the military, any hint of suicide or harm to others will be met with the question of whether or not the Soldier has a plan. In this case, the Soldier did not have a plan and was relieved to know someone read his assessment and was concerned enough to pay attention to his answers.

Discussions ensued. As a devout Christian, he felt guilt and shame, especially over his emotional distance from his wife. His recent move to a new location along with its financial challenge added to his stress. The Chaplain listened intently to the Soldier’s story, especially as he rarely talked about his private life.

The Chaplain then explored the change in the Soldier’s personal time schedule and devotional practices. As the stress of an estranged relationship, relocation, and financial problems could negatively impact his stated number one and two spiritual helps (prayer/meditation and sacraments), these practices which had historically given the Soldier strength and hope were discussed and encouraged.

Moreover, since his priority of spiritual support was his Faith-Group, the Chaplain asked about and supported his frequent participation in his Faith-Group and his attendance at his worship services. These practices along with his spiritual helps could reaffirm his stated values of faith in God, personal salvation, and his marital relationship.

Because integrity is critical for this Soldier and for his Christian faith, the reaffirmation of his faith was necessary to address his guilt and shame and to defuse its effects of depression, suicidal ideation, and harm of self and/or others. Discussion of his emotional distance from his wife, relocation, and financial problems opened the door to find ways to address these issues before they became insurmountable and truly life threatening.

Without this spiritual assessment, it is unlikely that the Chaplain could have ascertained the needs of this Soldier and addressed them in a timely manner. Usually, questions like, “how are you,” are greeted with “I am fine.” Issues are suppressed, depression begins, and thoughts of suicide can occur. The morale of the unit can be affected and, thus, so too the success of any mission.

Fortunately, the 98th Training Division leadership embraced the work of the Chaplains and their spiritual assessment in order to take care of their Soldiers and their Families. Stories similar but different from Soldier X were many in the five years that this spiritual assessment was field tested. No adverse side effects were reported.

Conclusion

Within 15 minutes, Soldiers can complete the Searle-Vance Spiritual Assessment tool. Within another 15 minutes, a Chaplain can have a window into a Soldier’s concerns and ways to address them. Because of the comprehensive nature of this spiritual assessment, the Chaplain can ascertain the individual’s concerns to explore in depth and thus have a more effective Chaplain conversation. As the above vignette demonstrates, this intervention is critical, especially with Soldiers who might be experiencing thoughts of harming self or others.

Since this spiritual assessment tool has been successfully field tested in a broad geographic area, one might reasonably posit the potential for broader military dissemination, as well as within the Veterans Administration Hospitals. At the present time, there is no way to ascertain a Soldier’s spiritual well-being spanning the course of his/her military service and later within a VA Hospital. This spiritual assessment could be used to provide a seamless transition and the consistent care needed for Soldiers and their Families from military to civilian life.

The limitation of this spiritual assessment tool is that although it was a way to improve and enhance the quality of the US Army Reserve Chaplaincy’s care of Soldiers and their Families, the spiritual assessment is not validated. Given the unique and beneficial results of the Searle-Vance Spiritual Assessment, it behooves its use within the US Reserve and Active Duty as an IRB-approved formal study with the intent to validate. At one point, the United States Army Reserve Leadership attended one of the 98th Training Division Spiritual Assessment training events for Chaplains and decided to use it throughout the Reserve Command. However, its leadership changed, and the spiritual assessment was not utilized within this larger area. As a suggestion, this broader use of the spiritual assessment could be revisited and used within the Reserve Command and/or Active Duty as a formally approved study. Data from this study could prove essential for the better care of our Soldiers and their Families.