The role of social case worker in health care
Health settings usually include services in three broad levels of health care application:
prevention, treatment and rehabilitation. It is recognized that individual social workers may practice exclusively within one setting or cross the boundaries of all three in response to diverse client, family and community needs.
Prevention: Aims to reduce the incidence of disease or dysfunction in a population through modifying stressful environments and strengthening the ability of the individual to cope. Prevention involves the promotion and maintenance of good health through education, attention to adequate standards for basic needs and specific protection against known risks. Preventive activities include public and client education regarding emotional self-care and healthy relationships, building community knowledge and skills (community development), social action, and advocacy for social justice.
Treatment: aims to reduce the prevalence (number of existing cases) of a disorder or dysfunction and includes early diagnosis, intervention and treatment. Treatment activities
are focused on individuals experiencing acute symptoms, emotional trauma, relationship
problems, stress, distress or crisis and include assessment, risk management, individual,
couple, family and group counselling, intervention or therapy and advocacy. Social work uses relationship as the basis of all interventions.
Rehabilitation: aims at reducing the after effects of disorder or dysfunction, and involves the provision of services for re-training and rehabilitation to ensure maximum use of remaining capacities by the individual. Rehabilitation activities focus on clients who are disabled by mental illness and may include individual, couple, family, and group interventions to build knowledge and skills, provision of specialized residential, vocational
and leisure resources, and advocacy to ensure the development of needed services and
to change community attitudes.
Specific to their employment setting, social workers deliver the following professional services:
Counseling: social workers counsel patients and their families. They explain the nature of an illness and advise the patient and family on how to effectively deal with symptoms and treatment. A medical social worker also serves as a grief counselor to help patients and families deal with the trauma of experiencing a chronic or acute illness.
Care Planning: Families and patients often do not know where to turn to get medical care. A medical social worker assists patients and families in finding and arranging services such as in home care, nursing home care and counseling.
Financial Assistance: Acute and chronic illnesses are expensive. Families may not be able to financially provide for the care of an ill family member. If the ill person is a parent, financial support for the care of dependents must also be dealt with. Medical social workers refer and assist patients in obtaining financial assistance, food assistance and health care coverage through city, state and federal programs.
Assessment: when doctors or nurses suspect that a patient is severely mentally ill, is a drug addict or is a victim of abuse, they enlist the services of a medical social worker. The experienced opinion of a medical social worker is highly regarded by hospital staff. The medical social worker evaluates the patient and reports back to the hospital staff. Together, hospital staff and the medical social worker collaborate to find the best approach to helping mentally ill, mentally incompetent, drug-addicted or abused patients.
Advocacy: At times, a medical social worker serves as a patient advocate. The medical social worker acts as an intermediary between patients and the medical community. They are the voice for people who have communication barriers or cultural differences that make effective communication challenging. Without the medical social worker, these types of patients often fall between the cracks—their health and emotional needs unknown.
Legal Assistance: There are situations where a medical social worker must take legal action to protect a patient. When a medical social worker encounters situations where parents are unable or unwilling to care for their sick child or encounter cases of abuse, legal action must be taken. In these cases, a conservator, a power of attorney or a public guardian may need to be appointed.
Direct Services to individuals, couples, families and groups in the form of counselling, crisis intervention, therapy, advocacy, coordination of resources, etc.
Case Management – coordinating inter-disciplinary services to a specified client, group or population.
Discharge Planning: Discharge planning typically involve the following dimensions:
Helping patients to understand medical prognosis and its implications for activities of daily living
Helping patients cope with emotional reactions to a perceived threat to their life style and independence
Helping patients adjust to anew and sudden dependence on family, friends and other care givers
Helping patients overcome natural anger, anxiety and fear about their current predicament
Helping patients decide about appropriate service for continuing care
Supporting the patient’s decision
Facilitating communication among members of the hospital team to ensure comprehensive care that includes the psychosocial aspects
Supervision and Consultation- clinical supervision/consultation, maintaining quality and management audits and reviews of other social workers involved in mental health services.
Program Management/Administration – overseeing a mental health program and/or service delivery system; organizational development
Teaching – University and college level; workshops, conferences and professional in-services
Program, Policy and Resource Development – analysis, planning, establishing standards
Research and Evaluation
Social Case Work in Hospitals
Practice in hospitals is a major component of social work in health care. The functions of social work include:
1. Assess the patient’s psychological and environmental strengths and weaknesses.
2. Collaborate with the team in the delivery of services to assure the maximum utilization of the skill and knowledge of each team member.
3. Assist the family to cooperate with treatment and to support the patient’s utilization of medical services.
4. Identify with a cadre of other professionals to improve the services of the hospital by an interdisciplinary sharing of knowledge.
5. Serve as a broker of community services, thus by providing linkage of patient need with appropriate resources.
6. Participate in the policy making process
7. Engage in research to assure a broadening of the knowledge base for successful practice.