🧪 Case Study 1.3: First Visit With a Veteran in a Clinic Waiting Room

🧪 Case Study 1.3: First Visit With a Veteran in a Clinic Waiting Room

Case Scenario

You are a volunteer veterans chaplain serving in a community clinic that partners with multiple local agencies. The clinic has a waiting room with steady foot traffic. Some patients are older veterans with mobility issues. Others are younger veterans coming in for follow-up care, paperwork, or referrals.

You are introduced to Mark, a veteran in his late 30s. He is sitting alone, slightly angled away from the room, scanning the hallway. His foot bounces. He keeps his hands folded tightly. His face is neutral, but his body looks tense.

A nurse quietly tells you, “He’s here for an appointment and he’s been waiting a while. He’s kind of shut down.”

You approach calmly. Mark glances up, then looks back down at his phone.

You say, “Hi, I’m Haley. I’m one of the chaplains here. Would it be okay if I sat for a minute?”

Mark shrugs. “Whatever.”

You sit with a respectful distance and open posture.

After a few seconds, Mark says, without looking at you:
“I don’t really do the whole ‘chaplain thing.’ I’m just here to get this appointment done.”

Then he adds, quieter:
“People keep telling me I should talk to someone. I’m fine.”

Beneath the Surface

This first encounter is not about “getting a deep story.” It is about earning trust.

Possible dynamics at work:

• Hypervigilance: scanning, foot bouncing, body braced for threat or conflict.

• Distrust of helpers: “chaplain thing” may feel like pressure, religion, or being analyzed.

• Shame/avoidance: “I’m fine” can be a protective phrase that avoids vulnerability.

• Identity protection: veterans may fear being seen as weak, broken, or unstable.

• System fatigue: waiting, paperwork, delays, and bureaucracy can intensify irritability or shutdown.

• Spiritual distance: he may have faith, may have anger at God, or may have no interest—your job is not to assume.

Organic Humans lens: Mark is a whole embodied soul. His body language is part of the story. His agency matters. Your care should honor his dignity and choice.

Ministry Sciences lens: Stress often reduces trust and increases defensiveness. Your approach should reduce demand and increase safety.

Chaplain Goals in This Moment

Your goals are simple and professional:

1. Confirm consent and reduce pressure.

2. Offer a safe, brief presence without performance.

3. Use one or two gentle questions that don’t demand details.

4. Clarify role (not therapy, not benefits, not pushing religion).

5. Offer optional support (listening, brief prayer, Scripture) only by permission.

6. End with dignity and a next-step option.

What the Chaplain Should Do

Step 1: Confirm role and reduce pressure

A good reply might be:

“Thanks for telling me that. No pressure. I’m not here to push anything. I’m here to offer support if you want it—sometimes just listening, sometimes a brief prayer if someone asks.”

This communicates: You are safe. You are not a project.

Step 2: Offer choices

Give Mark control over the pace:

“Would you prefer I just sit quietly for a minute while you wait, or would it help to talk about what today is like for you?”

Choice lowers defensiveness and honors agency.

Step 3: Ask a small, respectful question

Keep it simple and non-invasive:

• “Waiting can be frustrating. How are you holding up right now?”

• “Is today mostly stress, or mostly fatigue?”

• “What would be most helpful in the next five minutes?”

These questions avoid combat details and avoid prying.

Step 4: Reflect without diagnosing

If Mark says, “I hate waiting. Crowds get on my nerves,” you might respond:

“That makes sense. Sounds like being here takes a lot out of you.”

You are naming weight without labeling him.

Step 5: Offer optional spiritual support

Only after some trust, and only as an option:

“If you ever want it, I can offer a short prayer for strength and peace. If not, I’m still glad to sit with you.”

Step 6: Close with dignity

As he gets called back:

“Thanks for letting me sit with you. If you see me again and want a few minutes, just say so. No pressure.”

This is how trust begins.

Sample Phrases to SAY

These phrases build trust and protect boundaries:

• “No pressure. I’m here if you want support.”

• “You’re in control of what we talk about.”

• “You don’t have to tell details to be understood.”

• “Would you like me to listen, or would you prefer quiet?”

• “That sounds heavy. I’m glad you didn’t have to carry it alone for these few minutes.”

• “If you’d like prayer, I can do a short one. If not, that’s completely fine.”

Sample Phrases NOT to Say

These phrases often break trust quickly:

• “Tell me what happened over there.”

• “You must have PTSD.”

• “Everything happens for a reason.”

• “At least you made it home.”

• “God won’t give you more than you can handle.”

• “You just need to forgive yourself.”

• “Let me explain why God allowed this.”

• “You should come to my church.”

• “I promise I won’t tell anyone.” (Never promise secrecy without limits.)

What Not to Do (Mandatory)

Do not do these in early veteran encounters:

1. Do not pry for trauma details.
   Early curiosity can feel like interrogation.

2. Do not over-thank or perform admiration.
   Respect is quiet. Don’t turn them into a symbol.

3. Do not preach at pain or rush spiritual solutions.
   A chaplain is not a platform speaker.

4. Do not debate politics or current events.
   Redirect to the person’s experience and well-being.

5. Do not slide into therapy language or trauma treatment.
   You can be trauma-aware without trying to treat trauma.

6. Do not undermine clinic staff or policies.
   You are serving inside a system. Stay aligned.

7. Do not promise confidentiality without limits.
   If safety concerns arise, follow required pathways.

Boundary Map Reminders

Scope-of-Practice

• You are not medical staff. Do not interpret symptoms, meds, or diagnoses.

• You are not mental health therapy. Do not do trauma processing protocols.

• You are not a benefits/legal counselor. Avoid “how to win your claim” advice.

Consent and Agency

• Ask permission before sitting, praying, quoting Scripture, or discussing faith.

• Respect “no” without judgment.

Confidentiality With Limits

• Be honest: you keep privacy, but safety concerns may require escalation.

• If Mark mentions self-harm, threats, abuse, or imminent danger, follow clinic policy.

Documentation and Team Communication

• If your setting requires notes, follow policy.

• Don’t “freelance” communication. Know who you report to.

Pace and Safety

• Public waiting rooms limit privacy. Avoid sensitive questions.

• If a deeper conversation begins, ask about moving to a more private location if available and approved.

If the Conversation Turns Toward Crisis

If Mark says, “Sometimes I think everybody would be better off without me,” your job changes:

• Stay calm.

• Take it seriously.

• Ask a simple safety-oriented question within policy, such as:
  “Are you thinking about harming yourself today?”

• Do not promise secrecy.

• Notify the appropriate staff member immediately and follow the clinic’s crisis protocol.

Reflection + Application Questions

1. What did the chaplain do in this scenario that helped reduce pressure and build trust?

2. Write two consent-based opening lines you could use in a waiting room setting.

3. Which “NOT to say” phrase are you most tempted to use when nervous? What will you say instead?

4. How does the Organic Humans idea of “whole embodied souls” change how you interpret Mark’s body language?

5. What are two ways to stay within scope-of-practice when a veteran is frustrated with the system?

6. In a public space, what is the wisest level of spiritual conversation, and when should you seek privacy or referral?

7. What would you do if the conversation turned toward self-harm language in your setting? (List 3 steps.)

8. What does “presence without pressure” look like in your posture, tone, and pacing?

References

• The Holy Bible, World English Bible (WEB): Psalm 46; Matthew 11:28–30; James 1:19; Romans 12:15.

• Bonhoeffer, D. (1954). Life Together. Harper & Row.

• Doehring, C. (2015). The Practice of Pastoral Care: A Postmodern Approach (Revised and Expanded). Westminster John Knox Press.

• Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., & Maguen, S. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29(8), 695–706.

• Pargament, K. I. (2011). Spiritually Integrated Psychotherapy: Understanding and Addressing the Sacred. Guilford Press.

• Shay, J. (2014). Achilles in Vietnam: Combat Trauma and the Undoing of Character. Scribner.

• Reyenga, H. (2025). Organic Humans. Christian Leaders Press.