A research report prepared by the prestigious group at King’s College London gives guidance (introduced by Desmond Tutu no less) on spiritual care for black and minority ethnic communities; it particularly focuses on sub-Saharan Africa (that means the countries south of the Sahara – basically the non-Arab parts of Africa) , but is widely applicable and adaptable for the UK situation.

There is a very useful chapter on spiritual care assessment.

Also nice is the recognition in several places that social workers have the skills to respond to spiritual care needs. Margaret Holloway’s fellow traveller model of thinking about spiritual care is highlighted (Margaret is Professor of Social Work at Hull University, and is a Department of Health lead on social work in end-of-life care). this is about practitioners travelling with patients and their families on their spiritual journey at the end of life.

This is (as adapted by the KCL team and shortened by me):

1. Joining (requiring spiritual awareness): Every team member should be …sufficiently spiritually aware to recognise the spirituality of the service user and to identify those people for whom spiritual concerns are important.

2. Listening (requiring spiritual sensitivity): …All team members should be able to ‘hear’ what the service user is saying and pick up the clues as to what they mean as well as what they are not saying (level 1)…[more skilled team members should be able to make] a preliminary assessment of the nature and significance of the spiritual issues is made through ‘active listening’.

3. Understanding (requiring spiritual empathy): …the staff member providing spiritual care needs to be able to understand and convey empathy with the kind of spiritual issues and dilemmas that may concern the service user, as well as the high points of spiritual experience, and understand how spiritual resources might be utilised…[the assumption is that you have to be pretty spiritually aware of your own journey to do this]

4. Interpreting (requiring spiritual exploration): …the traveller [patient] may enter a dark valley or rocky or hazardous terrain in which s/he is reliant on the knowledge, experience and expertise of the guide. The spiritual care provider will be willing to make her/ himself vulnerable through choosing to travel with the other person…This kind of depth work needs to be conducted with great care; often (but not always) a professional spiritual care provider will be the most appropriate person to engage with service users at this level.

One would like to see a similarly flexible approach to social work skills in palliative care, rather than the crude adherence to psychological care chracarteristic of NICE guidance.

The report on the web: http://www.kcl.ac.uk/content/1/c6/07/39/29/Spiritualcarerecommendations-Fullreport.pdf