Long Review of a Short Book

Review of: NINE MORE CLINICAL CASES: Case Studies in Clinical Pastoral Care, Counseling and Psychotherapy, by Raymond Lawrence (General Secretary of CPSP)

Reviewer: Robert Munson (Bukal Life Care, CPSP-Philippines)

Raymond Lawrence’s book, Nine More Clinical Cases: Case Studies in Clinical Pastoral Care, is a short book. The main body of it is just 70 pages, with additional pages of introductory material. This is his second book that served as a response to a book by George Fitchett and Steve Nolan

Book by George Fitchett and Steve NolanCritique by Raymond Lawrence
First Book CycleSpiritual Care in Practice: Case Studies in Healthcare ChaplaincyNine Clinical Cases: The Soul of Pastoral Care and Counseling
Second Book CycleCase Studies in Spiritual Care: Healthcare Chaplaincy Assessments, Interventions & OutcomesNine More Clinical Cases: Case Studies in Clinical Pastoral Care, Counseling and Psychotherapy

For both of these critiques, Lawrence chose nine of the cases in the book, and in so doing is critiquing some underlying themes that are found in the clinical pastoral training movement today. This critique should be seen neither as “punching up” nor “punching down.” Lawrence, Fitchett and Nolan are very much respected in pastoral care/spiritual care, within their respective camps These nine cases presumably chosen specifically because the author had strong views on them, both positive and negative. His reasons, however, are his own.

Lawrence repeats in this book a number of themes that are common to several of his works. Among them are:

  • Expressing his preference of the term “pastoral care” over “spiritual care.” Lawrence notes Nolan at least is aware of problems associated with the term spiritual care. Lawrence quotes Nolan on page 65 of, As Nolan writes, “The lack of an agreed and articulated definition for spiritual care means that, as a profession, chaplains struggle to explain clearly the nature of the work.” Lawrence sees value in the use of the term religious care— providing care in terms of sacraments, religious symbols, and faith tradition. But for other care he strongly prefers “pastoral care” which he sees as clinical, non-religious (or at least not limited to a specific religious tradition) and grounded in the broadly understood metaphor of the shepherd as a caregiver.
  • Seeing the clinical pastoral training movement as having degraded in moving away from the ideals of its founder, Anton Boisen, and becoming more attached to his former partner in the movement, Richard Cabot. Interestingly however, Lawrence praised Fitchett and Nolan for bringing back emphasis on case studies as an educative tool. Case studies used in clinical pastoral care was developed through the interaction of Boisen, a theologian by training, and Cabot, a medical doctor.
  • Identifying clinical pastoral care as grounded very much in Freudian psychology. This reviewer would prefer that the author would say smething to the effect of seeing clinical pastoral care as taking seriously the insights found in “psychodynamics” rather than referring so much back to Freud. For many Sigmund Freud is championed as a great innovator in the field of psychology and the “talking cure.” Many others, both inside and outside of religious circles, know him more for what he was wrong about than what he was correct. This reviewer believes that Lawrence’s referencing of Freud and Boisen doesn’t suggest an uncritical return to early 20th century theories of the human mind, but rather presents them as founders of two important movements. Lawrence invites the reader to embrace a thoughtful integration of care drawn from the best of theological and psychodynamic insights.
  • Questioning the long-standing tradition of praying to end the pastoral care visit. Some of this question returns to the conflict between Boisen and Cabot, where Cabot saw physicians as those who heal the body, and chaplains as religious experts who pray. Much of Lawrence’s concern, however, stems from the question of who the prayer is really for. While a pastoral care provider may say that the prayer is for the client/patient, quite often this is not the case— especially in multi-religious and somewhat secularized places like the United States. In these places a prayer may not be welcome, or perhaps only welcome from someone within the patient’s own faith community. Here in the Philippines, however, prayer is almost always uncritically welcomed by the patient. Part of this desire comes from the common presumption here that the pastoral care provider has a special relationship with God that makes his/her prayers just a bit more powerful than their own. (That view may be comforting to the care provider but really is something that shouldn’t be promoted.) Regardless of the wishes of the patient, prayer is all too often done for the benefit of the care provider. This person often prays with the unspoken message, “I don’t think there is very much I can do, but at least I can pray.” This sells one short in the possibility of truly providing critical therapeutic care for the patient. Additionally, praying almost always is used as a signal. The signal is, “Well, I have run out of things to say and I really want to leave, so let’s do a prayer so I can go.” (It should be noted that in a conversation with Raymond Lawrence a couple of years ago, he made it clear that he was not opposed to prayer. But he said that prayer should be requested by the patient, not pushed by the care provider. Also, if prayer is asked for, the care provider should utilize this to draw more out of the patient— “What would you want me to pray for?” “Tell me more about this?” In doing this, the patient actually crafts the prayer and the care provider simply puts the patients prayerful longing into verbal form.)

Much like his previous book critique, this book avoids unnecessary wordiness. Generally it makes its point and moves on. Yet it is also written so that if one had not read the book it critiques, one can still understand the case well enough to follow the points well. That is quite useful. Cases also have the advantage of enlivening interest and the imagination where traditional exposition fails.

This book is not a polemic, but invites dialogue. Powell’s well-written Foreward does well in framing this book in this light for the first-time reader of Lawrence’s works. Lawrence sees growth in the clinical pastoral training movement through this sort of dialogue and critique. Page xi of the Introduction sums this up well when comparing two major streams within this movement:

Let the reader decide which is more representative of the authentic clinical pastoral training movement. Let the reader decide which position is more therapeutic. Let the reader determine what posture most accurately speaks for Anton Boisen, the founder of the clinical pastoral training movement. And let the reader decide whether some new direction should be called for at large. But no one is beyond the reach of criticism. Criticism is the lifeblood of the clinical pastoral training movement.

That being said, the Epilogue of Lawrence’s book does serve as a direct challenge to Glenn Fitchett’s work promoting “Evidence-Based Outcomes” as it relates to Clinical Pastoral Care. While I find Lawrence’s arguments weighty, this is another area where some back and forth dialogue is needed in the coming years.


September Updates

SEP 24. New CPE group starts (Celia’s) Doc Paul’s group ongoing.

OCT 25-31. Pastoral Care Week

OCT 27. Pastoral Care Seminar, led by Mr. Edgar Chan.  PBTS.

OCT 28. Bukal Life Care BOT Meeting (tentative)

NOV 21-27. Visit from Dr. Raymond Lawrence, CPSP Gen. Sec.

NOV 23. Case Study Seminar (AM) Case Study Practice (PM)

NOV 24. CPE Supervisor in Training Meeting

NOV 26. Thanksgiving and MOA signing.

What’s New in Summer and Beyond

<For the most part, this is a repeat of a post on the CPSP-Philippines website: http://www.cpspp.org&gt;

A few updates. As Summer is beginning here (Summer starts in March in the Philippines) a number of things are happening.

1.  Clinical Pastoral Care.  CPO (“Clinical Pastoral Orientation”), a shortened-form of CPE intended for professionals and Bible school students, is finishing up in Baguio. CPO has requirements that are approximately 1/4th of a Full Unit of CPE (and according to my calculations, that is 1/2 of the requirements of a Half Unit). It provides a taste of the philosophy and training structure of CPE for those who are curious… and can be taken for school credit in some places.

Additionally, our Foundations of Clinical Pastoral Care book in development has just pased the 100 page mark (finally). It is almost a year and a half in development… but it is rolling now. It seeks to integrate the methodology and insights of the modern CPE and pastoral care movements, with the insights and theological grounding of the historical pastoral care movement. Prayerfully, the first draft should ready by June. This will provide the text basis for CPO/CPC training.

CPO will start again, hopefully, in June or July, but this time in Bulacan. Will keep you updated. <Note: While CPE is certified certified by CPSP-PI in conjunction with the standards of CPSP, CPO is not. It is a training program under the standards of Bukal Life Care… following methodology and quality standards of the CPSP-PI CPE program.>

2.  Clinical Pastoral Education. CPE always seems to be a fluid thing since it is small groups driven by need and opportunity. However, it LOOKS like CPE will be held this Summer at:

  • Three locations in Manila
  • One location in Baguio  (Full unit starts March 16. Half unit starts 2nd week of April)
  • One location in Korea

3.  D.Min. in “Pastoral Counseling and Clinical Pastoral Supervision.”  This program is held in Central Philippines University, in partnership with CPSP and CPSP-PI. The program is new but on-going. We are excited by its potential.

4.  Disaster Response Chaplaincy. CPSP-PI, Bukal Life Care, and Philippines Baptist Theological Seminary, will be holding a 3-day intensive training in Disaster Response Chaplaincy May 13-16 (yes, it looks like 4 days… but the ends are cut off). One of the goals of CPSP-Philippines is to add a sub-specialty for Clinical Chaplains of Disaster Response Chaplain.

5.  CPSP-PI Standards and MOA. CPSP-Philippinesstandards have been disseminated for utilization by chapters, training centers, and CPE programs. They closely follow the standards set by CPSP. The Memorandum of Agreement between CPSP and CPSP-Philippines has been written up and is presently being reviewed by both parties. Hopefully, the final version will be done soon for signing. The MOA will ensure equivalency of programs and reciprocity of certifications between the organizations.

September/October Activities

–Staff meeting.Thursday, September 11. 11am. Review of visioning
meeting and plans of action.
-CPSP planning meeting. September 17, 1pm
–Baguio Chapter (CPSP). September 18-19. 8am and onward.
-Video and Discussion, “Healing the Shame that Binds You.” Thursday,
September 18, 6:30pm.
-Korea trip and training. October 4-13
-Parents Congress. Saturday, October 11..
-Pastoral Care Conference (Pasig City). October 17-19.

CPE Graduation, May 2014


The CPE (Clinical Pastoral Education) Summer 2014 team. They completed 1/2-unit from late March to early May 2014. The team is from left to right: JM (on first unit), Alexis (advanced unit), Sr. Annette (on first unit), Celia (supervisor), Sr. Isabella (on first unit), Cori (advanced unit), and Rob (on first unit). Also thanks to Becky and Jehny in assisting the training.

Bukal Life Care is a CPSP-certified training center for Clinical Pastoral Education. Our next training starts on June 2nd, 2014. If you have any questions, contact us at 0933-302-0373, or email us at info@bukallife.org.


November 2013 Updates… Updated

1.  Keep those in the Visayas in prayer who are in the process of weathering the Supertyphoon Yolanda. Some in this area have also had been through a major earthquake recently.

2.  Thanks to Sr. Angie in leading a dental/optical mission to Bagulin, La Union. Thanks also to Ptr. Mateo for hosting our team. Thanks for resource assistance from Aquashine and Dr. Alex Alcantara. And thanks to all of the team volunteers for the sacrifice of time and skill.

3.  BOT meeting is planned for November 15th 11am to 1:30pm. Tentative location is Cafe Will in Baguio City.

4.  Mid-November… Half unit of CPE anticipated led by Joyce Gray.

5.  Mid-January… Half unit of CPE anticipated led by Celia Munson.

6.  Mid-January… CPO will begin at PBTS led by Joyce Gray.

7.  Mid March… CPSP Annual meeting in the US. At least two expected to attend from our group. Maybe more.

8.  Late March… CPE Summer intensive (full unit) expected to start.

9. Also note: We have been asked to do crisis care in multiple locations. Please pray with us in how or if we can help in these place.

September 2013 Updates

1.  Clinical Pastoral Education.  Batch 3 completed in mid-August, with 3 graduates. Batch 4 started on September 9th with 6 trainees. One is working on first unit, the others are working on 2nd or 3rd. Batch 5 (the final batch for 2013 is expected to start November or December.

2.  BOT meeting. October will be our annual board meeting. Actual date TBD.

3.  Farrell Symposium. The Annual Farrell Symposium is tentatively scheduled for October 25th at Philippine Children Medical Center in Quezon City. Speakers are expected to be Dr. Cesar Espineda and Chaplain Barbara McGuire.

4.  CPSP. Congratulations to Padi Pinit Caytap as the convener of the newest CPSP Chapter— Resurrection. That brings the number of chapters in the Philippines to 5. A 6th is in the process of being formed in Manila.

5.  Sunflower Children Center. In August we had a nice visit with Fr. Acosta and staff at Sunflower Children Center. They do a wonderful job in helping children in greater Baguio. 6 of our team were able to join a training on DSM-5 as it pertains to children. It was hosted by Sunflower. We look forward to continued opportunities to support each other.

That’s enough for now. But keep checking!



August 2013 Updates

Some Updates:
-Aug 13. “Growth Groups” class starts at PBTS, 8 weeks duration. Taught by Joyce.
-Aug 17. Start of Batch 2013-4 Half unit led by Celia.
-Aug 19. Final Unit Evals for CPE 2013-3
-Aug 19. North Central Luzon ( NCL) CPSP Chapter Meeting.
-Aug 27. Benguet CPSP Chapter Meeting
-Aug 29. CPSP BOT and Conveners Meeting.
-Sep 5. Baguio CPSP Chapter Meeting