Global Under Menu
Home > Publications > APC Forum > APC Forum Resource Reviews April 2022

APC Forum Resource Reviews April 2022

APC Forum, April 2022, Vol. 24 No. 2

Assessing and Communicating the Spiritual Needs of Children in Hospital:  A New Guide for Healthcare Professionals and Chaplains
Alister Bull (London and Philadelphia: Jessica Kingsley Publishers, 2017, 146 pages, E-book, softcover)
This book will rock your understanding of spirituality! Bull writes, “If spirituality is a maze, then connectedness is a map” (127).  Essentially, the writer makes the case from the beginning of the book that the “assessor” of childhood spirituality must find a way to hear the child tell his or her story.  Bull references cards and board tools (play and storytelling) where a child can use a card to represent his/her feelings about family, nurse, school, diagnoses, distaste for treatment, and computer games.  Kids will share their feelings, but only in a caring, trusting relationship, and even more importantly, the feelings are best understood in the context of “connections.” 
Why is the distinction important?  In the traditional sense, a chaplain or other healthcare worker runs the risk of bringing a pre-set understanding of God, faith, and spiritual beliefs and then using that paradigm to understand a child’s faith.  Bull makes the strong case that children have to be given the opportunity to tell their story and their feelings related to the important concept of “connection to self, world, family and hospital” (how each child is connected or disconnected to school, siblings, God, faith community, friends, nurses, other hospital patients, etc.).  Essentially, once the connections or disconnections are understood, the chaplain or healthcare worker can rightly assess what a child may need.  For example, a child may become emotionally detached as the nurse brings medicine, shots, or treatments.  The connection between the patient and the nurse is challenged, and the child needs comfort, reassurance, and listening support as he shares fears and anxiety related to medical treatments.   
Bull uses the concept and technique “Zone of Proximal Connectedness (ZPC)” to describe the manner in which a clinician (chaplain, child life specialist, nurse) attends to the story and words and feelings of the child so that the story becomes the basis for a spiritual assessment.  Assessment grows out of story (connections-based), and Bull advocates for clinicians to remove all assumption and projections so that the child can be clearly heard and understood. 
This book is a short 130 pages, yet hospital chaplains and healthcare clinicians will find it to be a slow read as they encounter heavy doses of childhood developmental theories and references to past classics on “children and spirituality.”
However, it would be an excellent resource for a chaplain who works in any type of pediatric or children’s healthcare environment.  Chaplains who are researching “spiritual assessment” would find this book fascinating because it deals with the concepts of “understanding connections” and “story telling” which are foundational to professional chaplaincy work.  I look forward to discussing this book and its material with some of our Children’s Hospital Child Life Specialists and Nurses.  I also look forward to talking with chaplains in the area of pediatrics to see if they would read the book and be open to discussing the contents. 
Reviewed by George M. Rossi M.A. M.Div. BCC, Clinical Chaplain, Pastoral Care Services, Medical University of South Carolina, Charleston, SC.


Sex Difference in Christian Theology: Male, Female, and Intersex in the Image of God
Megan K. DeFranza (Grand Rapids, MI: Eerdmans, 2015, 331 pages, softcover, Ebook)

Megan DeFranza, PhD, the author of Sex Difference in Christian Theology: Male, Female, and Intersex in the Image of God, is passionate about helping Christian communities “navigate controversial conversations about biological sex differences, gender, sexually, religion, and medical ethics.” Her motivation, she explains, is “toward the common good; toward a world in which all God’s children—especially the marginalized—know they are safe, valued, healthy, and loved” (

DeFranza reports that “1 in every 2,500-4,500 children is born intersex” (5). One researcher states that a conservative estimate is that as many as 50,000 intersex individuals may live in the United States (45). DeFranza describes a number of types of intersex conditions, which reveals how complex the discussion can become and the need for ethical consideration when an individual is identified as intersex.

For many years in the mid-20th century, the prevalent medical opinion was that nurture trumped nature, and that an intersex infant who had had medical interventions and was raised as a boy would be a boy, or vice versa; this simplistic solution caused much suffering for intersex children. Being intersex can easily result in shame, secrecy within families, extensive painful surgery, and psychological/medical intervention that feels like abuse. Families have had to pack up and move to another city to enable an intersex child to switch genders with no controversy or shame. In other situations, an intersex person is unaware of their condition until they reach puberty and find they don’t have the hormonal changes associated with their identified gender, which was based on their external genitalia. One solution of many suggested for these difficulties is that intersex should identify as a third gender so they do not have to conform physically and psychologically to societal norms regarding two genders.

As the title of the book suggests, the majority of the writing explores theology and philosophy related to sex and gender beginning with Aristotle and Plato, thus covering centuries. For example, Aristotle viewed females as defective males who had to strive toward masculine perfection as much as males did. The same is true with the intersex, who have been regarded as defective males or females throughout history. Intersex people have existed for a long time, often referred to by the term hermaphrodite. This analysis of the definitions of male,female, and hermaphrodite or eunuch in Western culture over the centuries is necessary to comprehend the effects on the current understanding of gender and sex.

The imago Dei of Genesis 1:26 is the foundational theological concept. DeFranza describes the difficulties theologians in centuries past have had with seeing females as being made in the image of God because they differ from a human male. The intersex are similarly misjudged. Because of the theological impact of being thought “not human,” and thus not made in the image of God, De Franza explains, “the simplistic binary model is no longer sufficient. It is dishonest to the diversity of persons created in the image of God” (67). She recounts an instance of one intersex woman being told that she was not eligible for Christian baptism because she was neither male nor female, as well as other tales of rejection by the church.

Scriptures that are explored in depth are Matthew 19:12, in which Jesus describes eunuchs after his comments on the importance of the marriage bond. Interpretations of these words are explored in detail. Another scriptural discussion is of Galations 3:28, which avers that Christians are neither male nor female, but “all one in Christ Jesus.”

DeFranza points out that some scholars suggest that Jesus would not have fulfilled “ancient ideals of masculinity” because he did not marry and have children (246). Perhaps Matthew 19:12 is Jesus’ response to a jeer that he was a eunuch, one of many insults he responded to in scripture (he was also called a glutton, a drunkard, and a blasphemer) (246). Other scholars have hypothesized an intersex Jesus as the perfect representation of God, as Mollenkott does here:

I cannot help making a connection to the Genesis depiction of a God who is imaged as both male and female and yet is literally neither one nor the other. A chromosomally female, phenotypically male Jesus would come as close as a human body could come to a perfect image of such a God. . . . [I]ntersexuals come closer than anybody to a physical resemblance of Jesus. (248)

This was a startling concept for me, and I’m sure for many!

The book is thoroughly researched and academic, so it is not a book to sit down with for entertainment purposes. The concepts it explores are deep and take time to synthesize well. However, DeFranza is a methodical writer and always ties together the previous section of writing with the next to show the connection between ideas. In the introduction, she provides descriptions of the content of each chapter, which is very helpful for the reader.

I recommend this book for all who need education regarding the topic. If you would like a visual introduction, you can watch the testimonial of an intersex person with commentary by DeFranza at DeFranza has also produced an award-winning film titled Stories of Intersex and Faith. You can view a trailer at I also recommend Jeffrey Eugenides’ Middlesex: A Novel, which relates the experiences of an intersex narrator.

Reviewed by Tamara R. Flinchum MDiv BCC, chaplain at AnMed Health in Anderson, SC.

Spirit in Session: Working with Your Client’s Spirituality (and Your Own) in Psychotherapy 
Russell Siler Jones (West Conshohocken, PA:  Templeton Press, 2019, 275 pages, soft cover, e-book, audiobook). 
Rev. Dr. Russell Siler Jones has done the impossible: creating a cogent, practical, accessible introduction to improve spiritually-informed healing that is a delight to read.  This book will be invaluable for seasoned professionals, beginners and anywhere in between. Jones brings to bear on this complex subject a substantial academic and professional experience, yet his writing is personal and authentic, simple without being simplistic.  The book is never heavy handed, pompous or overbearing, as so many books on spiritual aspects of healing can be.  What is impressive is that this book could be a resource for those who consider themselves “not religious” to explore religion with respect and intelligence.  
We are invited to expand our awareness of how spiritual issues and concerns are presented and how they affect healing and health.  He helps us to tap into the spiritual/religious themes that emerge naturally from comments people make and to make the conversations more healing.  For example, he gives 15 examples of questions that can lead into conversations about religion and spirituality (62).   Jones invites us to learn to use our own spirituality without imposing our individual values and beliefs on others.  He helps us to open up and explore many avenues into this holy ground.  With his help, we can become more sensitive, more aware, more curious and more effective. 
The numerous verbatims and case studies are my favorite parts of this book. They are vibrant, real and informative, giving real life examples to help us deepen our conversations around the religious and spiritual resources and barriers. He includes chapters on Working with Harmful Spirituality where Jones acknowledges spirituality can be dysfunctional.  Also there is a chapter on Working with Spiritual Struggles.
In this work, spirituality, religion, and faith are explored, deepened and illustrated by stories from people who are struggling and seeking.
This work can be a resource for anyone seeking to deepen and sustain exploration of spiritual dynamics from a diverse perspective.  While it is marketed for therapists, it is a rare and essential book for anyone in pastoral care and chaplaincy.  We work at the edge of suffering and service with people from many backgrounds, and we need more practical language to explore all spiritual resources.
The theological reflections which are sprinkled throughout the book are lyrical, suggestive and evocative; though Jones is Christian, that designation does not define him.     The alternation between theory and praxis grounds the abstract into the concrete and practical. 
This would be an excellent text for chaplains, for clinical pastoral education, for any congregational and non-profit staff members and congregational members and for clergy involved with deepening religious maturity. 
Reviewed by Rev. Cathy Hasty MDIV THM BCC, Certified Educator ACPE LPCS-NC AAPC Diplomate, Charlotte, NC. Contact her at

< back