Mara Selvini Palazzoli (1916–1999) was best known for being an original member of the Milan Family Center Team and is credited for helping to advance systemic therapy.
Michael A. Patchner and Lisa S. Patchner
The complicated nature of illness and health care delivery along with the complexity of insurance and health policy demand team-based health care. As a consequence, social workers have become engaged in team-based health care with numerous other professionals within multiple settings. Through the engagement of client-centered practice social workers experience systems that weigh the provision of direct services against macro quantitative accountability. This has resulted in newly defined roles and expectations for social workers who are well trained for both micro and macro practice. In multiple health care settings, social workers are partners in team-based models of care where patient-centered practice is a component within larger public and private delivery systems.
Mary Raymer and Dona J. Reese
Hospice social workers are essential members of the interdisciplinary team that provide biopsychosocial and spiritual care to terminally ill patients and their significant others during the last 6 months of life. Hospice philosophy emphasizes symptom control, quality of life, patient self-determination, and death with dignity. Hospice social workers must be skilled in providing evidence-based interventions including direct client services; collaboration with the interdisciplinary team; community outreach; developing culturally competent services; and advocating for policy change on the organizational, local, and national levels.
Terry Altilio and Dana Ribeiro
Palliative care is a burgeoning specialty in medicine, nursing, social work and chaplaincy which privileges patient-centered, family-focused care provided across settings. Rather than a singular focus on a disease or an organ of the body, clinicians serve persons with serious illness with an approach that honors the whole person, their priorities, values and goals. In contrast to hospice care, palliative care is accessible at any point along the continuum of illness and is often provided concurrently with disease-modifying or potentially curative therapies as in the treatment of many persons with various cancers. Palliative care clinicians often work in interdisciplinary teams who collaborate with primary teams such as oncology or cardiology to identify and respond to the physical, psychological, social and spiritual needs of patients and their families. Palliative care programs are extending beyond the confines of acute care settings to venues such as outpatient clinics, home and extended care facilities. Signal events have contributed to the history, evolving role and presence of social work in this specialty. Palliative social work brings values and skills that reflect a whole person in environment perspective that is elegantly congruous with the palliative approach to care.
Social workers are uniquely prepared to benefit from and provide cross-boundary leadership for several kinds of collaborative practice. Examples include teamwork, new practice relationships with service users, inter-organizational partnerships, and community-wide coalitions structured for collective impact. All are needed to respond to adaptive problems without easy answers, and to dilemma-rich, “wicked” problems. Among the family of “c-words” (for example, communication, coordination), collaboration is the most difficult to develop, institutionalize, and sustain because it requires explicit recognition of, and new provisions for, interdependent relationships among participants. Notwithstanding the attendant challenges, collaborative practice increasingly is a requirement in multiple sectors of social work practice, including mental health, substance abuse, school social work, complex, anti-poverty initiatives, international social work, workforce development, and research. New working relationships with service users connect collaborative practice with empowerment theory and serve as a distinctive feature of social work practice.
The concept of health profession centrism and its effects on interprofessional education is important to Social Work practice. Profession centrism is concerned with a student’s professional socialization and their ability to work effectively with other health professionals and clients. This cultural frame determines the salience of curriculum content, core values, practice rituals and customs. It determines the meaning and etiology of symptoms and what constitutes health and treatment success. The interprofessional education (IPE) agenda is often seen as “soft curriculum” content and put to the side for the rigors of health sciences. Paradoxically, it is these issues of communication, ethics, role definition, and working as a team that creates problems among health professionals which compromise safety and efficiency in patient/client care. Learning to minimize profession centrism is a critical education and training objective for health social workers.