This article, "Interprofessional Teams and Relationships," is from the Dictionary of Pastoral Care and Counseling, a valuable resource available with a subscription to the Ministry Matters Premium Library.

 

Interprofessional teams are interdisciplinary in practice and involve pastoral care and counseling specialists working together with men and women from various professions and skills for the good of individuals, couples, families, or groups. This kind of practice most commonly takes place in health care delivery systems such as hospitals or clinics, but can also occur in educational institutions, prisons, parishes, mental institutions, the armed services, or denominational judicatories.

Typically, persons in pastoral care and counseling interface with medical personnel. Physicians in a myriad of sub-specialties work with nurses, patient care personnel, and clergy to form an interprofessional team. Psychiatrists, family practitioners, internists, and oncologists are probably the most frequently mentioned subspecialists in pastoral care and counseling literature. Other hospital personnel frequently mentioned in the literature are occupational therapists, biofeedback specialists, physical therapists, audiologists, art therapists, and social work personnel. Of all medical personnel, nursing personnel seem to have the greatest amount of interface with clergy.

There are a number of settings outside hospitals where interprofessional teams operate: health clinics, social service centers, mental health facilities, wholistic health centers, pastoral counseling centers, day care centers, and parish or judicatory outreach programs. Other professionals that function outside hospital programs on interprofessional teams are psychologists, social workers, marriage and family specialists, and educators.

Cooperation is the watchword in interprofessional relationships. Each profession represented on the team performs a different function. Thus each presents a different perspective by looking at different aspects of a patient or consumer. This hopefully offers a more well-rounded view of each patient that takes into account physical, emotional and spiritual elements. Clergy are the professionals who demand nothing of patients in the health care setting. While others take blood, administer medication, plan activities, x-ray, test, and monitor calls, the clergy person is available for the patient.

The clergy person provides a link with the community outside of the institution as a representative of the church at large. Clergy often have an entrée to the patient unavailable to other team members. If there are patients who do not want to deal with religious professionals they may deal well with other team members.

People still seem to go to clergy more than any other professionals for initial help with personal or emotional problems. One reason is that clergy provide a practical way for people to deal with crisis through the symbols and rituals of the church. Whether a person is facing an operation or the loss of a loved one, when critical changes occur, religious beliefs can help reassure, support, and give needed strength to face whatever difficulty comes.

The religious professional provides this support for both patients and fellow team members. Recent research on hospice teams showed that clergy provided the statistically most significant support to other team members that helps counter burnout. Clergy also report a significant amount of time spent listening to and supporting other team members. Religious professionals often receive support and counsel from other team members, too. The high stress of helping others in crisis requires good support systems for each team member. This sense of fellowship helps forge a team identity that is so essential for the successful function of an interprofessional team.

A good team is built on mutual respect and good communications about team relationships with each other and with the patient. This communication is achieved through writing in a patient's chart, written notes, personal conversations, phone calls, staff meetings, health conferences with the patient present, and sharing times. In this way, team members and patient avoid being isolated from each other, thus reducing loneliness and misunderstandings.

Clergy often play an important role in helping people in crisis understand what is happening to them while encouraging their faith in the type of treatment they are receiving. Again research has shown a significant correlation between belief in a healer, healing team, or an institution and the success of the treatment (Mason et al.; Florell). Religious professionals often take an advocate stance for patients that helps patients have more confidence in their treatment team. Though the clergy person may not be able to answer a patient's questions, he or she may be able to direct them to the appropriate team member who can answer the question.

This referral and consultation function which clergy provide on the team is only one way the religious professional helps people adjust to major changes in life. Pastoral care and counseling specialists also provide rites of passage from one life cycle event to another. Here the clergy use a knowledge of religious fellowship, family systems, and the symbols and sacraments of the church to help people change or recognize a new dimension of life.

The religious professional offers team members and patients his or her services for confession. Because of the meaning many people endow to the office of ministry, many feel they can share their deepest thoughts and feelings without fear of losing confidentiality. The confessional nature of clergy in the team relationship provides an intimacy and closeness that has a very therapeutic effect.

The closeness many interprofessional teams develop is built on a foundation of mutual respect of each discipline. A team must be able to build a sense of fellowship with an identity as a team. To accomplish this, each team member needs to be aware of his or her own needs and what his or her strengths and weaknesses are. Each person must also communicate well within the team. Good listening skills helps team members understand each other and evaluate how effectively they are communicating with patients and each other.

Strong team spirit in team members seems to be based on positive self-esteem and esteem of team members and patients. Obviously, lines are not always sharply drawn between professions. Physicians give counsel on emotional and spiritual issues. Psychologists may investigate people's religious beliefs and values as well as their physical well-being. Nurses may pray with patients and care for their medical needs. Pastoral care and counseling specialists frequently counsel about people's emotional traumas and physical lifestyle. The important aspect of team relationships is that all professionals are pulling together for the benefit of the patient, while holding in dynamic tension their being like each other and their being different from each other.

The religious professional also offers the team a person who provides a number of religious services including worship, religious education, being a leader on moral and ethical issues, and an expert on patients' religious backgrounds. These religious services are paralleled by services in medicine, nursing, psychology, etc. provided by other specialists. The interprofessional team sees the patient from many different dimensions and can provide the best overview of the patient and the most supportive environment for professionals to work in.

 

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