Future Trends in Health and Health Care: Implications for Social Work Practice in an Aging Society

Major economic, political, demographic, social, and operational system factors are prompting evolutionary changes in health care delivery. Of particular significance, the “graying of America” promises new challenges and opportunities for health care social work. At the same time, the Patient Protection and Affordable Care Act of 2010, evolution of Accountable Care Organizations, and an emphasis on integrated, transdisciplinary, person-centered care represent fundamental shifts in service delivery with implications for social work practice and education. This article identifies the aging shift in American demography, its impact on health policy legislation, factors influencing fundamentally new service delivery paradigms, and opportunities of the profession to address the health disparities and care needs of an aging population. It underscores the importance of social work inclusion in integrated health care delivery and offers recommendations for practice education.     

Health Education for Social Workers: A Primer

Health education, as a discipline and specialization, is often overshadowed by other branches of public health (e.g., bio-statistics, epidemiology, and policy management). Although social workers have been performing health education for decades, social work students may not know the history of health education as a practice profession and its uses in a social work context. The purpose of this article is to introduce the field of health education to social work students who are currently, or anticipate, practicing health education in their careers. We conclude with implications for social work education and a discussion about the impact of collaborative social work and health education efforts in the reduction of health disparities.     

The Challenges of Health Care Reform for Hospital Social Work in the United States

This article examines the potential impact of the Patient Protection and Affordable Care Act (ACA) of 2010 on the practice of hospital social work in the United States and its implications for social work education and training. It briefly traces the history of hospital social work, outlines some contemporary issues in the health care field, particularly those that create persistent health disparities, summarizes the major provisions of the Act that have implications for social work practice, and discusses how social workers in hospital settings might respond effectively to the changes produced by the legislation.     

Atypical Alliances: The Potential for Social Work and Pharmacy Collaborations in Primary Health Care Delivery

The growing prevalence of chronic conditions is a cause for concern globally, both in terms of its impact on the health of populations and also the strain it is predicted to place on health resources. There is a push to adopt more holistic and collaborative approaches to health care, and for the education of health care professionals to be reformed if these efforts are to be successful. A research project was undertaken in New Zealand in 2010–2011 aimed at exploring the perceptions of health care professionals on competencies in the field of chronic care. This article aims to highlight learning from the project regarding the “atypical alliance” between social work and pharmacy. Based on this, the authors argue that, with the growing expectations for interprofessional collaboration, effective primary and community health care delivery is increasingly dependent on relationships between educators in different health disciplines, between health professionals-in-training, and between education providers and health organizations.     

On the Development of a Model of Supervision for Licensed Social Work Practitioners

This paper presents a rationale for supervision of social work practitioners after licensure based on the mandates of the NASW Code of Ethics, the "nature of the work," the need to maintain boundaries in practice, and the translation of personal troubles into public issues. A model of supervision is proposed that builds on supervison as an interactive and interdependent process but does not assume clinical superiority of the supervisor. Group supervision is proposed as the primary structure because it provides a forum for the identification and development of strategies of client/client system intervention to mitigate against the individuation of personal prolems and promote their exploration as systemic public issues.     

Shared Decision Making in Health Care Settings: A Role for Social Work

Shared decision making (SDM) is a process integral to social work practice, one where the provider/professional and the consumer/patient discuss treatment alternatives based on patient values and life circumstances and make a shared decision about whether and how to proceed with treatment. Evidence-based medicine suggests that for many health conditions, having the choice of several effective treatment options is not uncommon. In these cases treatment should be based on what is best for the individual, since many factors influence an individual's treatment preference, including the psychological, social, cultural, and spiritual history she/he brings to the medical encounter; a history that has long been ignored in somatic health care. This article develops the argument that medical social workers possess the professional knowledge and skill base to provide decisional coaching, and implementing SDM in primary care settings. Of particular importance are the values that guide professional social work practice, including client self-determination, which is the basis of SDM, and the ability to maintain neutrality.     

Predicting Patterns of Social Work Staffing in Hospital Settings

One long-standing problem of social work departments in acute care hospitals has been their diverse patterns of staffing. The lack of a standard or guide has tended to diminish the utilization of social work services in hospital settings. Over a period of six years, the Society Hospital Social Work Directors of the American Hospital Association developed and revised a guide for inpatient staffing. The guide is designed to assist hospital and social work administrators establish an inpatient line staffing plan which is based on the number of hospital beds, the number of patients to be served and the number of functions carried. The logic of the inquiry and the findings can serve as a base for future research in inpatient, ambulatory care and other settings which serve special populations.     

Coaching Within Social Work Field Education

Abstract

Coaching is an innovative approach within the educational supervision process with social work students. Coaching is a rapidly growing field with commonalities to social work supervision and practice. Supervision, evaluation, and coaching all follow the same processes of observing the student's work, and providing feedback and discussion to help the student's learning process. This paper proposes that supervisors and field educators be educated in coaching methods to integrate coaching into educational supervision.     

Health Care Social Work Treatment of Patient and Family Emotion

ABSTRACT

Health care practitioners and researchers alike are beginning to acknowledge the importance of emotion in health. Nevertheless, health care social workers continue to assume most of the responsibility for actually dealing with the emotions of patients and families. Literature exploring social work interventions with emotion are restricted to a single patient population and practice setting. This study conducted a content analysis of pertinent literature, systematically codifying strategies across patient populations and practice settings according to a pragmatic conceptual foundation of the professional emotion treatment process. Analysis yielded a comprehensive conceptually clustered matrix of 45 strategies, establishing an objective and systematic basis for identifying and understanding this professional emotion treatment process for social work educators, practitioners, and researchers alike.     

Communicating With Pediatricians: Developing Social Work Practice in Primary Care

While social work models of interdisciplinary collaboration suggest that communication is important, the research literature on social worker–physician collaboration infrequently considers work with pediatricians or practice outside the hospital setting. A cross-sectional survey was sent to a stratified random sample of social workers to assess their communication satisfaction with pediatricians. The study found that social workers in health settings were more satisfied than those in mental health settings. The implications of this finding for the development of colocated, collaborative care models are discussed.     

Countertransference and Clinical Social Work Supervision

ABSTRACT

Countertransference, once regarded as a major impediment in the therapeutic endeavor, is now generally held to be a potentially useful tool in the treatment and supervisory processes. These therapeutic and supervisory situations comprise aspects of both subjective and objective countertransference. A comprehensive review of the social work and psychoanalytic literature reveals several prevalent subjective countertransference themes in the supervisory situation, such as envy of the supervisee, an attitude of omniscience on the part of the supervisor, and factors relating to the supervisor's position in an institutional setting. Objective counter-transference elements are discussed in relation to reflection, parallel, multidimensional parallel, and triangulation processes.     

Interprofessional Experiences and Attitudes Toward Interprofessional Health Care Teams Among Health Sciences Students

This study examined how the interprofessional experience, including education and practice, affects graduate health science students’ attitudes toward interprofessional practice in health care teams. Data were collected from 227 graduate students, using the Attitudes toward Health Care Teams (ATHCT) scale. Both social work and other health science students had positive attitudes toward interprofessional collaboration with regard to its ability to improve the quality of a patient’s care. The results from hierarchical linear regression analyses demonstrated that female students, older students, and students with longer interprofessional practice experiences had more positive attitudes toward interprofessional collaboration in health care teams. Based on these results, implications for interprofessional education are discussed.     

Low Health Literacy and Older Adults: Meanings,Problems, and Recommendations for Social Work

Many older adults struggle to manage their health care problems. Low health literacy exacerbates such struggles and contributes to a variety of adverse health behaviors and outcomes. Addressing how health literacy impinges on the lives of older adults is a neglected area of social work practice and knowledge. This article explores seven areas: defining health literacy, the problem and prevalence of low health literacy among older adults, health inequalities and health literacy, a brief literature review, neglected issues in the literature, suggestions for macro and micro social work interventions to improve health literacy for older adult populations, and conclusion.     

社会工作的尝试与实践——氓进流动人口生殖健康项目掠影

介绍社会工作理念和方法在世界卫生组织资助的昆明市西山区“促进流动人口生殖健康项目”中的尝试与实践。社会工作理念和方法的引入显著提高了流动人口生殖健康促进活动的针对陛和有效性。通过为流动人口提供生殖健康服务、求职谋生及城市生活适应服务、婚姻家庭服务、法律服务和青少年服务等,促进这个社会群体的能力提高、行为改变、心理稳定和社会及家庭关系改善,从而促进社区问题的解决。     

Interdisciplinary Relationships between Chaplains and Social Workers in Health Care Settings

As professional members of interdisciplinary teams in health care settings, chaplains and social workers must be prepared to interface with each other in a competent manner and to work cooperatively in caring for the needs of patients and their families. This article shares the results of a combined qualitative and quantitative research study (N = 403) that focused on determining chaplains' perceptions of their professional collaborative relationships with social workers. The findings indicate that chaplains have an overall positive perception of their interdisciplinary relationships with social workers. However, the results suggest areas that should be addressed in order to maintain and improve their functioning as colleagues who each play a critical role in providing holistic treatment.     

Understanding the Critical Role of Social Work in Safety Net Medical Settings: Framework for Research and Practice in the Emergency Department

Social workers in Emergency Departments (ED) provide counseling, community resource linkage, and discharge planning. The ED is a critical intervention point for patients with multiple unmet medical, psychological, and social needs, and little or no other contact with service providers. In part because of its role as a medical safety net for underserved populations, use of the ED has steadily increased over time. There is limited research examining the utility of social services in the ED. This article provides a brief history of hospital social work and a literature review of ED social work research with the goal of advancing current research and practice agendas.     

社会工作的尝试与实践——促进流动人口生殖健康项目掠影

介绍社会工作理念和方法在世界卫生组织资助的昆明市西山区“促进流动人口生殖健康项目”中的尝试与实践。社会工作理念和方法的引入显著提高了流动人口生殖健康促进活动的针对性和有效性。通过为流动人口提供生殖健康服务、求职谋生及城市生活适应服务、婚姻家庭服务、法律服务和青少年服务等,促进这个社会群体的能力提高、行为改变、心理稳定和社会及家庭关系改善,从而促进社区问题的解决。     

Investigating Factor Structure of an Instrument to Measure Social Work Students' Preparedness for Managed Care Environments

Abstract

This study investigated the factor structure of an instrument to measure social work students' perceptions of preparedness to enter managed care environments. Exploratory statistical procedures to reduce data through principle component analysis identified nine factors with eigenvalues greater than 1.0. These factors include: perceived understanding of agency financial agendas, managing personal risk and liability, perceived understanding of agency documentation requirements, awareness of ethical and value conflicts in documentation, classroom preparation for documentation, understanding the fit between client advocacy and managed care agendas, worrying about law suits in employment settings, perceived understanding of managed care gatekeeping and service authorization, and perceptions of field preparation for documentation. Recommendations are made for utilizing this brief self-report instrument in training students for managed care settings.     

Experiences of Social Workers in Primary Care in Ireland

This article presents the findings of research conducted with social workers in primary health care teams in Ireland. Data from questionnaires and from a focus group were analyzed. The findings draw attention to the nature of the role of the primary care social worker, including both the satisfying and challenging aspects of this role. It was evident that the participants liked the generic nature of their role and the fact that they worked with non-mandated clients. However, they encountered challenges related to resources, management structures, and interdisciplinary work. The findings shed light on an area of social work that has been under-researched.