1. Oncology Social Work –Helping Patients and Caregivers Along the Continuum
January 20, 2016
Penny Damaskos, PhD, LCSW, OSW-C
Oncology Social Work—Helping patients and caregivers along the continuum

2. Talk Outline Review the role of oncology social work
Review of social work interventions along the disease continuum
Society funds
Overview of programs offered

3. Role of Oncology Social Work
Primary function is to assist patients and families in coping with the psycho-social issues that result from a cancer diagnosis
Emotional adjustment to the diagnosis
Assist with practical issues to help patients through the diagnosis
Assist family members and support system
Assess strengths in all systems to provide support as needed

4. Role of Oncology Social Work
We provide resources
Within the hospital
Patient Financial Services
Philanthropy assessment and distribution
Community settings
Temporary housing
Help them to mobiles resources around employment issues
Disability
FMLA
Other entitlements

5. Role of Oncology Social Work
Collaborate with
Medical/surgical teams, nurses, patient representative, psychiatry, chaplain, Integrative Medicine Service, PFS
Case management for discharge planning
Home care assistance
Hospice care
Skilled nursing facilities—physical rehab

6. Role of Oncology Social Work
We work with adult and pediatric populations all along the disease continuum
In both inpatient and ambulatory settings
We help patients and families communicate with
Medical team
Families, friends and caregivers

7. Oncology Social Work Interventions Along the Disease Continuum
Oncology Social workers intervene to assist patients and family members at every stage of the disease
Each stage can present a new crisis for the patient and/or family
Important to have understanding of cancer diagnosis and treatment plan
Important part of our clinical assessment is to explore the patient’s understanding and thinking about their diagnosis

8. Stages of the Cancer Experience
Diagnosis
Initiation of Treatment
Effects of Treatment
End of Treatment
Survivorship
Recurrence- living with metastatic disease
End of Life

9. Self referrals from patients and caregivers Additional staff
How We Get Referrals
From medical team
In person—through Interdisciplinary team meetings/rounds
Electronic referrals
Adult Health Screen and Distress Screening
Self referrals from patients and caregivers
Additional staff

10. Crisis Intervention Model (CIM) and Cognitive Behavioral Therapy (CBT)
Primarily use both CI M and CBT approaches to help cancer patients
Crisis Intervention Model:
Addresses the perception that the event is threatening which triggers a response that is characterized by disequilibrium
disorganization in thinking, behavior and perceptions

11. Crisis Intervention and CBT
In oncology social work, crisis intervention is used to help individuals regain equilibrium after a cancer diagnosis and the treatment is cognitive behavioral therapy
Through cognitive behavioral approaches patients are able to change their behavior and thinking about the crisis
Both approaches help the patient move from destabilization to stability in a short period of time

12. Crisis Intervention in the Oncology Setting
Equilibrium is achieved through:
Individual counseling
Problem solving, task oriented
Psycho-educational support groups
Family/couple counseling

13. Cognitive Behavioral Therapy
C BT increases awareness of inaccurate or destructive thinking
Helps in understanding of difficult situations and to respond to them in a more effective way
Emphasis is on the present “here and now”
Guidance/directive role of the therapist
Rachman (1997)

14. Financial Support/Emotional Support
The connection between financial support and emotional support:
When some of the practical stressors are addressed, especially at the start of treatment or at progression of disease, this can allow patients to address the emotional impact the diagnosis has on their lives.
The level and type of support we offer is unique to NYC area hospitals and other cancer centers

15. Financial Support
With the financial assistance provided by the Society, oncology social workers are able to facilitate financial support to adult and pediatric patients that helps them sustain access to treatment
Transportation/parking
Housing
Emergency funds

16. Support to Patients: What is the Process?
Financial need is assessed through the Patient Financial Assistance office (PFS)
Social Work provides paperwork and PFS determines financial need according to established criteria
Generous guidelines take into account the impact cancer has on multiple areas of life and that life has on cancer
“Double whammy” factor
Super storm Sandy, global financial crisis, increasing unemployment AND Cancer

17. Support to Patients
Once financial assessment is completed and it is determined that the patient is eligible for funds
The social worker and medical team evaluates the patients most pressing needs and allocates the funds
The top three areas are transportation, housing and parking assistance

18. MSK Society Funds Provided to Patients
2014
Individual Patients/ Quarter*
Total Funds Q1
311
125,372 Q2
313
129,885 Q3
305
118,463 Q4
309
117,569
TOTAL
1,238
491,289
* Incl both peds and adults

19. MSK Society Funds Provided to Patients
2015
Individual Patients/ Quarter*
Total Funds Q1
335
134,097 Q2
317
129,222 Q3
324
141,039 Q4
370
159,785
TOTAL
1,346
564,143*
* Incl both peds and adults
* 14.8% increase over 2014

20. MSK Society Funds Provided to Patients
Individual Patients/ Quarter*
AVG Funds/ Individual
2014
1,238
$400
2015
1,346
$419
* Incl both peds and adults

21. Social Work Programs and Groups
Multiple programs offered through Social Work Department
Collaborate with nursing, physical therapists, nutritionists
On treatment, survivorship, chronic cancer, bereavement
In person, on line (virtual)
Specific populations: geriatric, young adults, Spanish speaking, childhood cancer survivors

22. Groups--General Disease specific breast, prostate, lymphoma, etc
Population specific
caregivers, children, young adults
At point of diagnosis
Post-surgery (breast group)
On treatment (inpt, outpt)
Post-treatment– Resources for Life after Cancer
Advanced disease

23. Counseling, resources, workshops, online support group
Kids Express Program
Help adults talk with children about cancer at every phase of the continuum
Counseling, resources, workshops, online support group
CLIMB program specifically for children to be able to express their feelings in a weekly meeting with art and discussion
Separate group for adults

24. Educational meetings several times a year Spanish and in English
Caregivers program
On line support groups
Several times a month
Educational meetings several times a year
Spanish and in English
Caregivers newsletter

25. Educational panels/meetings “Drop in” monthly group
Bereavement Program
Educational panels/meetings
“Drop in” monthly group
Time-limited support groups
Spouses
Young adult spouses
Adult children
Parents who have lost children

26. 65+ programs
Bi-monthly series of educational lectures specifically geared for geriatric populations
Cognitive functioning
Stamina
Nutrition
Meditation

27. Post Treatment Resources for Life After Cancer
Ongoing informational programs
Specific topics that address long standing side effects
Highlights resources here through integrative medicine, chaplaincy, psychiatry/behavioral psych, physical therapy, nutrition, sexual health
Support groups
Individual counseling

28. Social work provide support to staff inpatient and out patient
Staff Support
Social work provide support to staff inpatient and out patient
Groups, informational meetings
The Schwartz Center Rounds
Building Resilience program
Clinical, patient-oriented programs are sometimes attended by staff

29. The Society has provided support to key programs over the years
Programmatic Support
The Society has provided support to key programs over the years
Pediatric programs
Kids Express
Social Work student fellows
57 fellows trained since inception in 1997
11 fellows hired by MSK; 7 of them hired in the last 6 years
Dream Team
Social work liaison to this program
On treatment and in survivorship

30. Thank you for your support!