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Spiritual AIM and the work of the chaplain: A model for assessing spiritual needs and outcomes in relationship

Published online by Cambridge University Press:  10 March 2014

Michele Shields*
Spiritual Care Services Department, University of California San Francisco Medical Center and Benioff Children's Hospital, San Francisco, California
Allison Kestenbaum
Center for Pastoral Education, Jewish Theological Seminary, New York, New York
Laura B. Dunn
Spiritual Care Services Department, University of California San Francisco Medical Center and Benioff Children's Hospital, San Francisco, California Department of Psychiatry, University of California San Francisco and UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California
Address correspondence and reprint requests to: Michele R. Shields, Director, Spiritual Care Services, UCSF Medical Center and UCSF Benioff Children's Hospital, 505 Parnassus Avenue, San Francisco, California 94143-0208. E-mail:



Distinguishing the unique contributions and roles of chaplains as members of healthcare teams requires the fundamental step of articulating and critically evaluating conceptual models that guide practice. However, there is a paucity of well-described spiritual assessment models. Even fewer of the extant models prescribe interventions and describe desired outcomes corresponding to spiritual assessments.


This article describes the development, theoretical underpinnings, and key components of one model, called the Spiritual Assessment and Intervention Model (Spiritual AIM). Three cases are presented that illustrate Spiritual AIM in practice. Spiritual AIM was developed over the past 20 years to address the limitations of existing models. The model evolved based in part on observing how different people respond to a health crisis and what kinds of spiritual needs appear to emerge most prominently during a health crisis.


Spiritual AIM provides a conceptual framework for the chaplain to diagnose an individual's primary unmet spiritual need, devise and implement a plan for addressing this need through embodiment/relationship, and articulate and evaluate the desired and actual outcome of the intervention. Spiritual AIM's multidisciplinary theory is consistent with the goals of professional chaplaincy training and practice, which emphasize the integration of theology, recognition of interpersonal dynamics, cultural humility and competence, ethics, and theories of human development.

Significance of Results:

Further conceptual and empirical work is needed to systematically refine, evaluate, and disseminate well-articulated spiritual assessment models such as Spiritual AIM. This foundational work is vital to advancing chaplaincy as a theoretically grounded and empirically rigorous healthcare profession.

Review Article
Copyright © Cambridge University Press 2014 

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