This blog post is by Ann Fairchild, LCSW and member of the Oncology Advisory Council for MyLifeLine.org.
The Oncology Advisory Council is comprised of professionals in the field of Oncology including Oncology Doctors, Nurses and Social Workers. This group provides advice and guidance on our program offerings to people affected by cancer, vets our cancer resources to ensure the information we are providing is from solid and appropriate resources and offer education and awareness about the trends in the area of Oncology, so we may better serve the patients, friends and families using MyLifeLine.org.
“I wish I had known you were here sooner.” That was an oft heard heartbreaking message I heard from patients and family members as an Oncology Social Worker. Here is the deal: (start eerie music..) Oncology Social Work is shrouded in mystery in many cancer treatment centers. I could have neon posters, flyers and brochures promoting Oncology Social Work (OSW) services and they were too easily passed over for the medical information available in a resource room. That was my rude awakening when I was lucky to score a full-time job in a physician practice in Austin in the late 1980′s. Cancer treatment was just moving out of inpatient settings for many patients, and physicians discovered the need to have a Social Worker on site to address the issues that often fall through the cracks in a medical setting. I quickly developed a lot of humility recognizing that people were not at the oncology clinic to visit me! The much more urgent medical needs trumped my offerings for good reason.
Who needs an OSW, anyway?
At the risk of academic boredom, Social Work theory views a person within the multiple systems that define their lives. We view a person’s constitution as a result of their communities, homes, families, schools, spirituality, job status, financial situations, friends, etc. When making an assessment, a SW cannot separate a person from his/her environment. This is the most important distinction one can make about how a social worker can be of help in a medical setting. Cancer can devastate one’s life upon diagnosis. Even if a person is feeling well, most of the treatments they will undergo will create challenges in their day to day lives.
There are significant emotional reactions as well, for a patient and their loved one. There are practical concerns like managing to continue in ones role prior to diagnosis: Will I be able to work? Will I be able to take care of my children? Will I be able to stay in school? How will my family cope with my illness? How will my illness affect my financial situation? Will I be disabled? Will I be disfigured? Am I eligible for any support services? What if I cannot drive myself to treatment? What if I have no insurance? Should I apply for disability? Will my doctor discontinue treatment if I cannot pay? These are concerns that can be addressed by an OSW. As well, a good part of my practice is spending time with caregivers and loved ones of patients. Matter of fact, there was a consensus among the couples I worked with that posited that the cancer experience is harder on the caregiver/loved one than it is on the patient.
Can we talk about that Elephant in the Room?
“I am not satisfied with my doctor but I am afraid if I change doctors he/she will be mad.” “I intend to live to 100, but just in case, can we talk about what my disease will be like at the end?” “I want to create a legacy project for my infant daughter, should I not survive.” “My sex drive is on a road trip somewhere, how can I get it back?” “I am so exhausted, I am thinking of quitting treatment.” “Would you help me write my will and get power of attorney documents?” “My friends say I look great since finishing treatment…. Why don’t I feel so great?”
Oncology Social Workers are counselors. Most have a master’s degree in Social Work and a tremendous amount of expertise in therapy and counseling. Due to heavy caseloads, most OSW’s focus on brief format counseling and group work which is most compatible with people with cancer. The shock, anxiety, fear and grieving can be addressed by an OSW. Should more significant needs arise, your social worker can refer you to a professional in the community. Good news is that most OSW’s salaries are covered by the physician practice so there are no charges for OSW services.