Pastoral Narrative Disclosure

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Pastoral Narrative Disclosure (PND) is a contemporary rehabilitation counselling strategy developed by military Chaplain Timothy Hodgson (RAAFSR) and Dr. Lindsay Carey (Public Health, La Trobe University, Melbourne) which involves, firstly, the ‘pastoral’ which embraces the individual holistically, secondly ‘narrative’, which involves the individual’s story as part of their being, and finally ‘disclosure’, which is a more modern term for admission or confession.[1] PND was initially developed as a strategy for military chaplains using a multidisciplinary bio-psycho-social-spiritual approach [2] [3] to address the complex syndrome known as ‘Moral Injury' (MI) occurring among military personnel.[4] [5] More recently however, MI is now also being identified among non-military personnel (e.g., police, firefighters, paramedics) [6] who witness or experience traumatic life and death incidences - and thus PND may prove a useful strategy for chaplains within the police force and other first responder services.

PND comprises eight stages, namely: (i) Rapport, (ii) Reflection, (iii) Review, (iv) Reconstruction, (v) Restoration, (vi) Ritual, (vii) Renewal and (viii) Reconnection (refer Table 1). Greater detail relating to each of the stages is freely and publically available via the journal Frontiers in Psychiatry.[7] It is important to note that PND, as a rehabilitative / restorative process, is being futher developed and "feedback from the wider professional community is being recruited to permit the PND process to be tested for validity in order to ensure therapeutic credibility". Currently PND is the only published systematic strategy for chaplains/spiritual carers that is based upon a holistic 'bio-psycho-social-spiritual model', which moves beyond the importance of moral injury reconciliation,[8] to strive for renewal and reconnection.

Interested chaplains and other pastoral care/spiritual care practitioners are invited/encouraged to consider PND within Frontiers in Psychiatry and provide feedback regarding the PND stages via the following emails: Tim.Hodgson@uqconnect.edu.au and/or Lindsay.Carey@latrobe.edu.au


TABLE 1: Summary of PND Eight Stages [1]
Rapport: Developing rapport/trust between personnel/service member and chaplain, who ensures (caveats permitting) absolute confidentiality.
Reflection: Personnel/service member provides an account either oral, written or by other medium, reflecting upon operational life journey and their morally injurious experience.
Review: Indepth review of personnel/service member’s reflection regarding their morally injurious experience by examination of conscience — considering past thoughts, words, actions, and omissions, particularly with regard to self-accusation/s.
Reconstruction: Reconstruct the moral/ethical issue relating to the event and address feelings of grief, guilt, shame, anger, betrayal, trust and forgiveness.
Restoration: Restoration is sought regarding grievances, which if possible, are heard by the perpetrator or organizational representative.
Ritual: Rituals, either formal or informal, secular or religious rites, expressing regret, naming mistakes, seeking self-forgiveness and/or forgiveness and reconciliation from significant others or a sacred source.
Renewal: Engaging in renewal by personnel/service member making amends and doing activities that are meaningful/purposeful in life by relinking with family, friends, workplace, community, the sacred/divine/God.
Reconnection: Reconnection involves personnel/service member engaging support and resources to reconsider or implement future values, career plans and personal goals relevant for themselves and significant others so as to develop resilience and sustain themselves long term.


References:

  1. 1.0 1.1 Hodgson, Timothy J.; Carey, Lindsay B. (2018). "Chaplaincy, Spiritual Care and Moral Injury: Considerations Regarding Screening and Treatment" (in English). Frontiers in Psychiatry 9. doi:10.3389/fpsyt.2018.00619. ISSN 1664-0640. PMID 30568605. PMC PMC6290645. https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00619/full. 
  2. Carey, Lindsay B.; Hodgson, Timothy J.; Krikheli, Lillian; Soh, Rachel Y.; Armour, Annie-Rose; Singh, Taranjeet K.; Impiombato, Cassandra G. (2016-08-01). "Moral Injury, Spiritual Care and the Role of Chaplains: An Exploratory Scoping Review of Literature and Resources" (in en). Journal of Religion and Health 55 (4): 1218–1245. doi:10.1007/s10943-016-0231-x. ISSN 1573-6571. https://doi.org/10.1007/s10943-016-0231-x. 
  3. Hodgson, Timothy J.; Carey, Lindsay B. (2017-08-01). "Moral Injury and Definitional Clarity: Betrayal, Spirituality and the Role of Chaplains" (in en). Journal of Religion and Health 56 (4): 1212–1228. doi:10.1007/s10943-017-0407-z. ISSN 1573-6571. https://doi.org/10.1007/s10943-017-0407-z. 
  4. "Moral injury" (in en). Wikipedia. 2018-12-28. https://en.wikipedia.org/w/index.php?title=Moral_injury&oldid=875772338. 
  5. Griffin, Brandon J.; Purcell, Natalie; Burkman, Kristine; Litz, Brett T.; Bryan, Craig J.; Schmitz, Martha; Villierme, Claudia; Walsh, Jessica et al.. "Moral Injury: An Integrative Review" (in en). Journal of Traumatic Stress 0 (0). doi:10.1002/jts.22362. ISSN 1573-6598. https://onlinelibrary.wiley.com/doi/abs/10.1002/jts.22362. 
  6. Chopko, Brian; Papazoglou, Konstantinos (2017). "The Role of Moral Suffering (Moral Distress and Moral Injury) in Police Compassion Fatigue and PTSD: An Unexplored Topic" (in English). Frontiers in Psychology 8. doi:10.3389/fpsyg.2017.01999. ISSN 1664-1078. PMID 29187830. PMC PMC5694767. https://www.frontiersin.org/articles/10.3389/fpsyg.2017.01999/full. 
  7. Hodgson, Timothy J.; Carey, Lindsay B. (2018). "Chaplaincy, Spiritual Care and Moral Injury: Considerations Regarding Screening and Treatment" (in English). Frontiers in Psychiatry 9. doi:10.3389/fpsyt.2018.00619. ISSN 1664-0640. PMID 30568605. PMC PMC6290645. https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00619/full. 
  8. Lee, L.J (2018) Moral injury reconciliation. London: JKP