The Role of Social Work in Pediatric Pulmonary

Susan Horky, LCSW

Pediatric Pulmonary Division

University of Florida

Which of these is a social worker?

What does a social worker do?

What comes to mind when you think “Social Work” or “social worker”?

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Overview

What does a SocialWhat does a SocialWorker do??Worker do??

What does a SocialWhat does a SocialWorker do??Worker do??

Social Work Social Work in pediatric healthcarein pediatric healthcare

Social Work Social Work in pediatric healthcarein pediatric healthcare

CasesCasesCasesCases

http://www.socialworkers.org/pubs/choices/default.asp

http://www.socialworkers.org/pressroom/events/anyGivenDay1007/default.asp

http://www.youtube.com/watch?v=IkQzfv8o3n8

What does a Social Worker do?

• concrete services• resource information• case management• discharge planning• advocacy/policy• social welfare/child protection

BSW, MSW

MSW,LCSWPhD

• psychotherapy• research• medical social work• administration

MSWsmay do someor all of these

Medical S

ocial W

ork

Early

1900

s

2007

History of Social Work

1920

s

Child Guidance/Psychiatric Social Work

Child Welfare/Social Policy Child Welfare/Social Policy

1890

s

History of Social Work- Child Welfare

• Providing food/shelter

• Job training

• Child labor laws

• Public health

• Federal programs for the poor

History of Social Work - Medical

“to make medical care effective”

• Financial needs/resources

• Psychosocial support

• Adherence

History of Social Work-Child Guidance/Psychiatric Social Work

Child G

uidance Model:

• Psychiatris

t sees child

• Social w

ork works with fa

mily

1930s1930s

WWII- Social W

orkers

do more th

erapy:

• Psychiatris

ts at war

• Psychiatris

ts doing meds

1940s1940s

Some Social Workers

trained in

psychoanalysis

1950s1950s

HealthHealth

Top Ten Social Work Rules1. Start where the patient is

2. The relationship is everything

3. Don’t judge a book by its cover

4. There is no big book in the sky

5. Concrete help may lead to counseling

Top Ten Social Work Rules6. It takes two to tango

7. People are doing the best the know how

8. People bring their solutions, we figure out what the problem is

9. Emotions always underlie behavior

10.Don’t just do something, sit there!

Social Work in Pediatric Pulmonary

• Setting: Primarily Clinic

• Roles:– Psychosocial Assessment

• Child and family functioning• Concrete needs• Emotional needs

– May depend on roles of other team members

Social Work in Pediatric Pulmonary (cont’d)Interventions:

• Support to child and/or family members

• Ongoing psychotherapy or referral for same (child or family members)

• Behavioral interventions • Child behavior• Parenting• Adherence

• Groups

Social Work in Pediatric Pulmonary (cont’d)

• Assistance with concrete issues

• Community resources: WIC, Food Stamps, SSI

• Case Management: Agencies involved with child: school, after-school, outside therapist

• Conveying families’ views to team

• Discharge planning (has varied over time)

• Child protection

PPC

• Adjustment to illness

• Parenting issues

• Support

• Life stresses

• Relationships

• School

• Work

• SSI

• Insurance/Housing

• Transition/Voc Rehab

Goal is for Adaptation:

Adaptation is achieved when the family’s

POWER > LOAD

LOAD:

• Chronicity• Unpredictability• High Costs• Extensive Daily Care• Pain/embarrassment

(physical appearance)• Multiple providers• Isolation

POWER:

• Healthy family dynamics:– Open communication– Mutual respect and support– Good differentiation– Shared problem solving and decision making– Role flexibility– Enhancement of personal growth

More Power:

Knowledge of disease process and health care system

Finding meaning in the illness Financial

Security

Sharing the

Burden

Case taken from: Gropper, RC. Culture and the Clinical Encounter. Yarmouth, Maine: Intercultural Press, 1996

Case taken from: Gropper, RC. Culture and the Clinical Encounter. Yarmouth, Maine: Intercultural Press, 1996

Case taken from: Gropper, RC. Culture and the Clinical Encounter. Yarmouth, Maine: Intercultural Press, 1996

Case taken from: Gropper, RC. Culture and the Clinical Encounter. Yarmouth, Maine: Intercultural Press, 1996

Case taken from: Gropper, RC. Culture and the Clinical Encounter. Yarmouth, Maine: Intercultural Press, 1996

Case taken from: Gropper, RC. Culture and the Clinical Encounter. Yarmouth, Maine: Intercultural Press, 1996

Case taken from: Gropper, RC. Culture and the Clinical Encounter. Yarmouth, Maine: Intercultural Press, 1996

Case taken from: Gropper, RC. Culture and the Clinical Encounter. Yarmouth, Maine: Intercultural Press, 1996

Mental Mental HealthHealth

Medications Resources

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