Whole Person Healing

August 13, 2011
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According to Christina Puchalski, M.D., F.A.C.P., director of the George Washington Institute of Spirituality and Health (GWish) and professor of Medicine in the GW School of Medicine in Health Sciences (SMHS), what hospital patients report wanting more than anything else during their stays is “to feel love and connected.”

While that connection, she says, doesn’t happen enough, Puchalski is optimistic that there is a rising commitment to making it happen more. And the proof is in the turnout of GWish’s third annual Spirituality and Health Care Summer Institute, July 25- 29.

“Spirituality and health is a groundbreaking, interdisciplinary field of which you all are a part,” said GW President Stephen Knapp, Ph.D., in his welcoming comments on the institute’s third day. “The summer institute is symbolic of how much GWish has grown and its leadership in the field.”

This year’s institute, which focused on interprofessional spiritual care, brought together 63 physicians, social workers, nurses, chaplains, pharmacists, administrators, and educators — a marked swell from last year’s 43 attendees.They came from 23 states and DC, as well as from seven countries including Ghana, the Netherlands, Canada, Singapore, Italy, Saudi Arabia, and South Korea, to learn how to better integrate spiritual care in outpatient and inpatient clinical settings.

“The numbers show the importance of spirituality and health as an aspect of whole person care,” said Puchalski. “There is a growing recognition — both nationally and internationally — that healing is about something bigger than the technical aspects of care.”

Among the institute’s 16 presenters and three keynote speakers were GW’s Benjamin Blatt, M.D., professor of Medicine and medical director of the Clinical Learning and Simulation Skills Center and Standardized Patient program, SMHS; James L. Griffith, M.D., professor and interim chair of Psychiatry and Neurology and director of the Psychiatry Residency program, SMHS; Mikhail Kogan, M.D., assistant professor in the Division of Geriatrics and medical director of the GW Center for Integrative Medicine, SMHS; Lorenzo Norris, M.D., assistant professor of Psychiatry and Behavioral Sciences, SMHS, and director of the GWU Hospital’s Psychiatric Consultation-Liaison Service; Ed O’Donnell, adjunct assistant professor of Clinical Management and Leadership, SMHS; Bette Peabody, Master of Arts candidate in Art Therapy/Counseling, Columbian College of Arts and Sciences; and Catherine West, senior research scientist at the Center for Health Care Quality, the School of Public Health and Health Services.

The first day of the institute, which featured keynote speaker Carolyn Jacobs, Ph.D., dean and Elizabeth Marting Truehaft Professor at the Smith College for Social Work, addressed the role of participants’ own spirituality in the context of their call to serve and patient relationships. Puchalski discussed the “two worlds” of a practitioner — spiritual and scientific — and how to navigate the tension between the two. Citing emerging research, she encouraged practitioners to engage in a daily reflective practice like meditation or journaling, which have been shown to avoid “burnout.”

“Before you can be compassionate to your patient, you must first be compassionate to yourself,” she said.

On the second day, the participants were introduced to the Interprofessional Spiritual Care Model, a way to assess, diagnosis, and treat patients’ spiritual needs in the context of their physical and emotional needs. The following day, they were given a chance to practice what they had learned by working in interprofessional teams to diagnose and treat “patients” who were played by trained actors, also called standardized patients.

“Spiritual distress can present in many different ways, usually as pain or difficulty sleeping,” said keynote speaker Ann Berger, M.D., M.S.N., chief of Pain and Palliative Care Service at the National Institutes of Health (NIH) Clinical Center. “It often happens after treatment but before the patient really feels well. This is when we need to intervene.”

Berger, a breast cancer survivor, also discussed the difference between healing and cure, saying that healing is an ongoing process. “Healing is maintained after the treatment ends,” she said. “There is a strength that comes up from these experiences that you have for the rest of your life.”

Playing audio clips from interviews with cancer patients at NIH Clinical Center, Berger reminded practitioners of the profound influence they have on their patients. “We become their family,” she said. “There’s never nothing more we can do — we can always be present. We are always doing something by being there.”

During the institute’s final two days, participants concentrated on building leadership capabilities in order to affect change in each of their places of work. Shirley Otis-Green, M.S.W., senior research specialist at City of Hope, presented the final keynote address on applying quality improvement concepts and goal-setting techniques to spirituality and health. Participants also took tips from panelists who had developed quality improvement programs in spirituality and health and later discussed in small groups how they might do the same.

“Our goal of the summer institute is to not only provide you with knowledge, but to also teach the skills and the leadership needed to be able to integrate that knowledge into practice,” said Puchalski. “It is our hope that when you go back, your clinics will become more holistic, compassionate, and ready to meet all the needs of patients and caregivers."

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