Help All Around: Social Workers Play Crucial Role in Our Well-Being
From aiding immigrants in a new land to assisting pet owners to helping nursing home residents, their impact is vast
When Sylvia (not her real name), a previously vibrant, relatively healthy and independently living 96-year-old broke her hip, it led to one medical crisis after another. Her daughter Victoria flew down to Florida to be with her on two separate occasions but then had to return to her job in New York. While she occasionally was able to speak to her mother's doctors, Victoria says it was an amazing social worker who was supportive and helpful in terms of planning for her mother's future while there was still some hope that she might recover.
The social worker spoke with Sylvia about ways to assess an assisted living facility, a nursing home and hospice services as well as discussing financial concerns. She met with Victoria and her mother's medical team to discuss the possibility of dialysis, since her kidneys were shutting down, and ultimately they came to the decision to make her mother DNR (do not resuscitate) and to only provide comfort care.
The primary focus of social work is enhancing the psychosocial, emotional and behavioral well-being of individuals, families and groups.
"Although I believe that my mother would have wanted that, she had never made a living will," Victoria says. "I struggled with self-doubt and the guilt was awful. Talking with the social worker helped a lot."
When Sylvia passed away, Victoria says the social worker held her in her arms as she cried. When Victoria mentioned she was "feeling like a motherless child," the social worker validated her concerns, helping Victoria to feel understood, seen and comforted. "The social worker even called me in New York the following week to see how I was doing. Although I am in my 60s, losing my mother was devastating. I never could have gotten through the whole thing as well as I did without her expertise, guidance and compassion."
The Role of a Social Worker
As a licensed clinical social worker myself, I know how skilled, empathetic and knowledgeable social workers can help people who are hurting, feeling helpless and in emotional and physical pain.
The primary focus of social work is enhancing the psychosocial, emotional and behavioral well-being of individuals, families and groups. It takes a holistic, person-in-environment approach, looking at an individual's problems and deficits not as personal weakness but as being emblematic of larger sociocultural and structural issues.
Traditionally, social workers have worked with abused children or kids in foster care, victims of domestic or racial violence, patients and their families in nursing homes, and individuals suffering with depression, anxiety, schizophrenia or other mental illnesses.
Social workers help people living in poverty, adults who are incarcerated, folks struggling with addictions, chronic health issues, disabilities or dementia, older adults, students overwhelmed by family discord or learning challenges, families torn asunder by estrangement, divorce or death, and patients in hospitals needing aftercare planning or aid transitioning into a rehab facility. Social workers play critically important roles in all of these situations.
60%-70% of mental health services are provided by clinical social workers.
Many of us work in clinics, inpatient and outpatient psychiatric facilities, and in private practice, where we do psychotherapy with adults, children, teens, elders, couples, groups and families. In fact, although many think of psychologists or psychiatrists as the predominant type of psychotherapists, 60%-70% of mental health services are provided by clinical social workers, many of whom accept Medicare or other health insurance. The American Board of Clinical Social Work reports there are 250,000 clinical social workers in the United States and points out, "Working in both the public and private sectors, including many nonprofit programs, clinical social workers are the mainstay of the American mental health care system."
Victoria was lucky in that her mother was hospitalized in a facility that had adequate social work staff to attend to families' emotional needs as well as to address their more concrete needs for information. Unfortunately, many social service agencies, especially ones dealing with child or adult protective services, are understaffed, with workers having huge caseloads and mounds of paperwork. The most vulnerable human beings need and deserve the best that social work has to offer.
History of Social Workers
Since the late 19th century, when the American social work profession was established to ensure that immigrants and other vulnerable people were able to develop skills that would enable them to climb out of economic and social poverty, social workers have focused on social justice, civil and human rights for all. The challenges for the profession now include promoting diversity, equity and inclusion, addressing systemic racism, and working to eliminate violence and discrimination against marginalized and oppressed groups including people of color, women, and those who identify as LGBTQ. The National Association of Social Workers (NASW) has identified a number of priorities, including voters rights, immigration, economic justice, criminal justice and juvenile justice and environmental justice including climate change.
Some social workers ... specialize in veterinary social work, helping pet owners through challenging situations, connecting them with financial and community resources, doing bereavement counseling.
Other areas that social workers are involved in include:
- International social work, including direct services in communities, refugee camps, orphanages, hospitals and schools
- Justice and corrections social workers work in courts, rape crisis centers, police departments, the legal system and prisons and can be involved with ex-offenders, restitution and victim assistance services
- Occupational and employee assistance programs, corporations, businesses, unions and associations utilize social workers to help them improve productivity, efficiency and morale, to provide mental health services and to advocate for employee’s rights to a fair, safe and secure working environment
- Organizations such as the MPTF (Motion Picture and Television Fund) and the Entertainment Community Fund, formerly the Actors Fund, a national human services agency which provides social services and mental health counseling to performing arts and entertainment professionals, along with affordable supportive housing
Some social workers, such as Margaret Cooney, who works at Friendship Hospital for Animals in Washington, D.C., specialize in veterinary social work, helping pet owners through challenging situations, connecting them with financial and community resources, doing bereavement counseling and running pet-loss support groups.
Others work in libraries, helping patrons access Medicaid, food stamps or other needed services. Still others work in community settings organizing grass roots movements and neighborhood coalitions. There are hundreds of social workers in national, state and local elected offices. The U.S. Department of Veterans Affairs employs more than 13,000 professional social workers.
According to Virginia Commonwealth University, social work falls into three basic categories:
- Macro-level social work calls for a broad, big-picture view of social and systemic injustice. Instead of individuals, the community, which can include a neighborhood, a state, national or even international entity, is the client, and the social worker’s job is to help address the causes of injustice indirectly through research, public policy and program development. An example would be funding a non-profit organization aimed at statewide prevention of domestic violence.
- Between macro- and micro, mezzo-level social work involves supporting individuals and large groups such as a business, medical facility or nonprofit organization.
- Micro-level social work involves working with individuals, families and small groups to identify and meet a variety of needs. It includes helping clients to connect to resources such as government assistance, education and training programs and other social services. Clinical social work includes providing mental health services and psychotherapy in behavioral health clinics, inpatient units, hospital based psychiatric treatment programs and private practice.
At the School of Social Work at Rutgers University in New Jersey, a state where there are many ways social workers can be involved in politics as advocates, scholars or political candidates themselves, case workers and direct service providers have a front-row seat to see the ways in which government policies impact people and communities and are well positioned to give feedback to decision makers and legislators. As researchers, they can use their knowledge and skills to evaluate government programs and report on their impact. More than 100 social workers attend and participate in the annual conference of the Association for Public Policy Analysis and Management.
Could a social worker help you to get through a personally difficult time or, through involvement in large scale projects and advocacy, enable all of us to lead happier, healthier, more productive and less conflictual lives? I say a resounding and categorical, "Yes, indeed."
