1. Social Worker Roles and Healthcare Settings
Chapter 2
Handbook of Health Social Work, 2nd Edition
Created by
Teri Browne

2. Social Worker Roles and Healthcare Settings
Chapter Objectives:
Describe a biopsychosocial approach to health care and the professionals who deliver it.
Define the role of the social worker on the health-care team.
Outline the tasks of health social workers related to the delivery and design of healthcare.
Discuss professional issues and challenges related to teamwork and recommendations for effective collaboration.

3. Social Worker’s Bio psychosocial Approach to Healthcare.
Biopsychosocial Model:
Addresses the biological, social, environment, psychological and behavioral aspects of illness.
Expands on the traditional medical model of health care by focusing primarily on the biological causes of disease.
Considers the nonmedical determinants of disease in collaboration with biological components.
E.g. the biopsychosocial model of health takes into account patient’s ability to purchase recommended medicine for diabetes when creating a treatment plan for patients rather than focusing only on laboratory results and physical status.

4. Social Worker’s Bio psychosocial Approach to Healthcare.
Biopsychosocial Model:
For the purposes of this chapter, the term biopsychosocial is used to indicate an approach to health service delivery that addresses the psychological and social aspects of health and treatment that includes behavioral and environmental factors.

5. Limits of the Medical Approach: Psychosocial Issues Related to Health
Health Social Workers directly address the social , behavioral and emotional concerns of the individuals and their social support network as well as develop and administer policies and programs and conduct research that are attuned to the psychosocial needs of individuals.

6. Limits of the Medical Approach: Psychosocial Issues Related to Health
Social Illness and Problems:
Illnesses and problems are psychosocial rather than biological in nature.
Examples:
Child or elder abuse
Violence including sexual assault and family violence.
Substance abuse
Cutting
Bulimia and suicide attempt.

7. Limits of the Medical Approach: Psychosocial Issues Related to Health
The current health-care environment in the United States emphasizes cost containment through:
Shorter hospital stays.
Briefer medical interventions.
The provision of fewer comprehensive services with fewer personnel.

8. Limits of the Medical Approach: Psychosocial Issues Related to Health
Bateman and Whitaker( 2002) assert that social workers are needed in medical settings to address increased home care needs and in primary care settings addressing medical issues on a preventive level to decrease morbidity and the need for hospitalization

9. Health Settings and the Social Worker’s Place within Them
Direct health services are provided in various settings such as:
Public and private hospitals
Outpatient clinics
Neighborhood health centers
Ambulatory surgery centers
Physician’s Offices
Mobile care units
Skilled nursing facilities
Military settings
Correctional facilities
Schools
Health maintenance organizations

10. The Social Worker’s Role on Health Teams
Social workers are essential to the delivery and design of optimal health care.
They work on health teams comprised of direct patient-care professionals and as administrators overseeing program planning and implementation.
Tasks include:
goals of the profession of social work.
helping clients problem solve and cope with life stressors.
Linking individuals with resources, services, and opportunities;
Promoting effective and human service systems.
Developing and improving social policy.

11. Hands-On Practice: Social Workers as Part of Health-Care.
Health social work tasks:
Interventions
Collaborations
Coordination
Advocacy
Supervision or administration
Activities of health social work include:
Assessment
Design, implementation of intervention.

12. Health Social Work Assessment
Social Workers evaluate the strengths and needs of individuals and members of their social support network as part of a social work assessment to identify assets and potential barriers to care.
Social workers help health-care teams assess psychological and social issues such as domestic violence, and socioeconomic barriers to the attainment of quality health care, among other issues.

13. Health Social Work Intervention
Social Workers provide assistance and develop and implement interventions to address identified needs. This process includes:
Explaining the disease
Treatment
Facilitating communication
Social workers are the health professional who process the “knowledge necessary to assess social services needs and to secure and coordinate community-based services (Berkman, 1996, p.545).

14. Health Social Work Intervention
Health social workers can help patients gain needed resources by providing case management services that refer and link patients and their families to services and other resources.
Health social work dual focus:
Enhancing social institutions responses to human needs.
Enhancing the social functioning of individuals.

15. Health Social Work Intervention Administration
Social workers ensure that the social context of health is addressed in patient care and program planning.
Social workers in health care as mediators between the health-care system and consumers and involve advocating at the systems level for improvements in the delivery of care.

16. Social Work as a Part of the Design of Healthcare
The dual focus of social work are:
Enhancing the social functioning of individuals.
Responds of social institution to human needs.

17. Social Work as a Part of the Design of Healthcare
Health social workers design and implement community health programs and initiatives.
Social workers also may provide education to individuals, groups and communities on different health issues.
Health social workers are involved in preventive services and provide linkages to services via outreach programs.
On a maco-level, social workers are involved in research that directly and indirectly influences public policy, community, public health and clinical practice.

18. Survey of Social Work Professionals
Social workers roles include:
Case management and Patient advocacy
Assessment of Need
Needs-based care
Public health
Multilevel intervention
Administration and design of health care

19. Collaborating with other Professionals
Social workers may work on teams that are:
Multidisciplinary-
Each professional works autonomously with little interaction.
Interdisciplinary
Professionals interact with one another to provide services but maintain clear professional boundaries dictated by distinct terminology and intervention planning.
Transdisciplinary
Close collaboration among professionals, common terminology and goal setting

20. Challenges to Professional Collaboration
Challenges include:
Professional of health care teams may not have equal voices in the care planning process.
Professional roles may not be clearly stated.
Professional perspectives and ethics may clash.
Workplace change
Reduction in resources
Increase in cost and decreased hospital stays.
Co-opting by other professions of tasks that historically have fallen under the rubic of social work
Ambiguity of roles and tasks and different disciplines may not understand one another’s lexicon and procedures.

21. Health Social Work Recommendations
Cowles(2003, p.21) lists specific objectives that are essential to maximal team collaboration:
Role clarity and flexibility
Mutual respect and trust
Consensus on group norms, values, commitment and purpose
An egalitarian attitude; a sense of equal importance
A sense of group bond and interdependence rather than autonomy
Open communication and sharing

22. Health Social Work Recommendations Continued……
Cowles(2003, p.21) lists specific objectives that are essential to maximal team collaboration:
Flexible leadership and decision making.
Flexible membership composition based on case needs.
A stable core membership
A sense of both group and professional identity.
Ability to negotiate and reach consensus
Goal focus and goal clarity
Record keeping of meeting
Attention to both the task and maintenance functions of the team
A systems perspective.

23. Health Social Work Recommendations Quality Assurance
Social workers role in quality assurance:
To obtain resources and the commitment from hospital administrations to provide comprehensive services
To continually collect data that substantiates that they are the professionals best trained for such responsibilities
Deliverance of services in the most cost effective manner.

24. Health Social Work Recommendations Fiscal Advantages
Social workers:
Conserve institutional resources
Linking patients with insurance and resources
Planning and linkage to outpatient resources
Increased service provision through outreach and program planning and mediating conflicts between patients and providers
Enhance revenue through the creation of new programs and services
Improve the productivity of the medical team by participating in employee assistance programs that support team members.

25. Health Social Work Recommendations Advocacy
Social workers:
Must advocate for themselves as active members of health teams
By creating literature that informs other professionals and consumers about the role of health social workers
Provide team training about the social work activities and roles.
Provide evidence of the effectiveness of social work services.
Be visible parts of health settings by volunteering to be part of tasks forces and committees.

26. Treating the Whole Person: Social Work’s Primary Role.
Social work function in biopsychosocial approach to healthcare.
Romano(1981) suggests:
Social work occupies a unique position in that it has feet in:
Health and mental health
Hands in the social sciences
Its viscera in clinical intervention skills
Head and heart in a commitment to the issues of the quality of life of disabled persons in society (p.15)