Enhancing Patient-Centered Care Skills Using Pastoral Care Insights
Dharma Rodríguez Pagán, UTHealth Science Center, Dr. Marianne Florian, Institute for Spirituality and Health

In healthcare, patient-centered care (PCC) emphasizes respecting individual patients’ values and needs to ensure that they are heard, supported, and empowered to make informed decisions. Pastoral care is a faith-based approach that offers spiritual and emotional support as a means of finding hope, meaning, and psychological wellbeing. Both pastoral care and patient-centered care perspectives emphasize the centrality of inter-personal relationships, enhancing a sense of mutual respect and listening that sustain health and well-being. Despite their similar commitments to individual needs, a gap persists between these two professional practice approaches. This has unfortunately slowed the flow of information and practical wisdom from one to the other. Studies across various healthcare contexts indicate that medical providers frequently overlook spirituality in clinical practice. Bridging this divide would strengthen the practice of person-centered care by fostering trust and creating opportunities for physicians to reflect and ethically engage with patients’ worldviews. Therefore, to integrate pastoral care resources into patient-centered care, within a biopsychosocial model of health, I first specify two trainable competencies, supported by relevant research in pastoral care and chaplaincy, that clinicians could integrate into their clinical approach. These competencies are (a) setting aside periods of time when patients’ values are the top priority and (b) conducting research-based spiritual assessment. As a pastoral care practitioner, I argue that pastoral care contains useful knowledge and techniques that could meaningfully strengthen patient-centered care in medical contexts. At its core, pastoral care involves creating intentional spaces where patients’ values, beliefs, and experiences are brought to the forefront, fostering a relationship grounded in moral attentiveness and respect for the patient’s beliefs and autonomy. This involves intentionally creating moments during patient encounters to elicit and reflect on patient’s values through active listening, presence, and non-judgmental attention. These practices can be integrated into healthcare settings, acknowledging that time-sensitive must be accomplished, while attending to what matters most to patients. Conducting a spiritual assessment using evidence-based tools such as FICA (which explores Faith, Importance and influence, Community, and how to Address these) or HOPE (which assesses sources of Hope, the role of Organized religion, Personal spirituality, and the Effects on care) provides a space for patients to articulate what is most deeply important to them. FICA offers a concise, structured approach suited for brief encounters. HOPE enables more in-depth exploration of hope, spirituality, and the impact of religion on health decisions, supporting understanding in different health settings. Medical providers can select the appropriate tool based on the individual’s need. Additional consideration of the constraints and objectives of a medical consultation will influence which tool is preferred. By developing two key pastoral care competencies, medical providers become trustworthy witnesses to patients’ humanity and suffering, offering presence and hope. This approach also gives clinicians a framework to engage with spirituality using humility, curiosity, and openness, transforming experiences that might otherwise be shaped by fear, bias, or discomfort into opportunities for learning and connection. This form of witnessing aligns with prophetic tradition, where cultivating curiosity over fear and fostering healing grounded in dignity and shared humanity become the foundation for proclaiming truth with compassion. In this way, pastoral care and research-based spiritual assessment practices enhance patient-centered care by fostering compassion, trustworthiness, and ethical attentiveness, allowing patient’s worldview, identity, need for connection, and values to guide the direction of care while affirming their dignity amid uncertainty. Integrating these two competencies into clinical practice represents a bridge between the classic biomedical model and a more holistic approach that recognizes and supports physical, psychological, social, and spiritual dimensions of care, embodying a practice marked by compassion and creativity.