Abstract This article explores the history of spiritual assessment tools as a lens through which to consider the place of spirituality and religion in American healthcare. While precise definitions of spiritual assessment have evolved with the concept, the phrase generally refers to the process of evaluating someone’s spiritual needs and resources and addressing those needs in the context of clinical healthcare. We trace the diffusion of spiritual assessment tools from their origins in chaplaincy and pastoral counseling in the 1970s through nursing, medicine and social work in subsequent decades. While engaging with patients around religion and spirituality began as the professional jurisdiction of chaplains, spiritual assessment tools were designed – in part – to enable professionals in other fields to talk with patients about these topics. As such they are both a mechanism of diffusion – a set of questions healthcare professionals who advocate for greater attention to spirituality and religion teach their colleagues to ask – and a symbolic representation of how that diffusion is taking place and where there have been conflicts and bumps along the way.

Note: this article featured in the APC Best Papers of 2015 bibliography.