CHAPLAIN CREDENTIALING (CERTIFICATION) ASSESSMENT
Date Review Completed
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Month
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Name of the Candidate
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First Name
Last Name
Name of the Reviewer
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First Name
Last Name
Rate the following to determine whether the candidate met the requirements: 5-Strongly agree; 4-agree; 3-neutral; 2-disagree; 1-strongly disagree.
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CC:1.0- Identified significant turning points, past hurts, disappointments, and successes in one's life which impact one's personal, pastoral, and professional identity as well as the awareness of one’s strengths and limitations.
CC:1.1- Articulated the ability to provide meaningful pastoral care to others in crisis and describe one’s feelings, attitudes, values, and assumptions.
CC:1.2-Demonstrated discussions an awareness of one’s faith development and its integration into one’s theory of pastoral care.
CC:1.3-Identified potential ethical issues in the practice of ministry and the role as an advocate for clients/patients, families, and staff.
CC:1.4-Discussed one's self-care plan for spiritual, emotional, and physical well-being.
CC: 2.0-Articulated a clear pastoral care theory which describes one's approach in addressing spiritual and human development issues.
CC:2.1-Demonstrated the ability to center self and confidently engage individuals while setting aside personal and religious agendas and utilizing one’s professional authority as appropriate.
CC:2.2-Discussed the ability to conduct a spiritual/pastoral assessment and develop an appropriate pastoral intervention.
CC:2.3-Articulated the ability to consult, collaborate, and communicate with healthcare and other professionals.
CC:2.4-Described one’s ability to establish a meaningful pastoral relationship with persons from diverse cultural and theological backgrounds.
CC:3.0-Demonstrated the ability to assess systemic principles and/or group dynamics in relating to and providing pastoral care.
CC:3.1-Communicated the ability to identify human development and spiritual issues while providing meaningful spiritual care to others, which contributes to the well-being of others. This could include but are not limited to psychological or emotional issues such as grief and loss, domestic violence, and anger.
CC:4.0-Demonstrated competency in oral and written communication, which reflects graduate-level work. Use of APA, Turabian, or a similar format.
CC:5.0-Presented in a manner that reflects professional behavior, including appropriate attire and a confidential setting for the review.
Comments:
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Candidate's Score
Based on the Candidate's Score, Choose One: (A Fee is assessed for each review. Review CPEI's Certification Guidance for Non-Approval Status).
70-56: Passed without comments
55-40: Provisionally passed with specific comments: The applicant must schedule a follow-up meeting with the Certification Committee within one year to address their concerns.
39-Below: Did not pass with comments
Recommendation to Address if Provisionally Passed:
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