Social Work 564: Social Work Practice in Hospitals, Rehabilitation,

Long Term Care and Hospice Settings

 

Winter Quarter 2006

Instructor: Gunnar Almgren

Friday; 1:30 - 4:30,  SW 38

Office, SW 127L, Office Hours – Fridays 11:30 to 1 PM or by arrangement with instructor

206-685-4077; mukboy@u.washington.edu

 

General Course Description

 

This health care practice course teaches health care theory, knowledge and practice skills used by health care social workers in hospitals, rehabilitation, hospice and long term care settings. In an interactive classroom environment the course approaches health care practice from a biopsychosocial, ecological, contextual, multi-cultural, interdisciplinary and lifespan perspective. Health care disparities, cross-cultural and contextual health care practice, family systems issues, increasing incidence of chronic illness, and co-occurring medical and mental health illness are actively addressed.  Students will engage in skill building around theory based interventions aimed at the individual, family, organization and larger cross-cultural community. Students will explore multicultural applications of ethical decision making, brief individual and family interventions, discharge planning protocols, rehabilitation models, end of life care models used in hospitals, rehabilitation centers, hospice programs and long term care centers. Special emphasis will be on interdisciplinary collaboration and consultation and review of medical terminology, common medications, and frameworks for biopsychosocial assessments and interventions will be incorporated. Students will bring in cases for discussion and consultation.   

 

Although the most of the course content will be delivered through instructor lead lecture and discussion, periodically there will be guest speakers introducing specialized content..

 

General Course Objectives

1.       Understand the history of social work in the field of hospital based health care practice and how health care policy and advocacy have affected change over time.

2.       Explain and utilize the spectrum of theories and approaches addressed around practice interventions in health settings identifying linkages between application of methods and theory.

3.       Demonstrate a clear knowledge and support of the application of strengths and empowerment perspective in working with clients and their families, in health care practice.

4.       Demonstrate advanced skill in recognizing and addressing cross-cultural differences in responses to health, illness, and disability and demonstrate an ability to work with diverse populations in health care settings.

5.       Demonstrate a commitment to social justice in addressing the disparities and inequalities that exist in health care.

6.       Recognize and incorporate bio-psychosocial variables in the assessment and design of treatment strategies associated with specific categories of illness and disability (e.g. transplantation, chronic illness, etc.).

7.       Describe the general characteristics of particular settings and contexts of health care delivery, the influence of these on social work practice and methods of intervention.

8.       Demonstrate an ability to engage in multi-level health care practice with individuals, families, groups, communities and organizations.

9.       Apply knowledge of human development over the lifespan to enhance interventions.

10.   Demonstrate how core social work skills are applied across a variety of health care settings, including the establishment of helping relationships, psychosocial assessment, advocacy, resource mobilization, management of loss, grief and painful emotions.

11.   Demonstrate the ability to document assessments and intervention plans in a medical chart. 

12.   Demonstrate the ability to apply brief treatment approaches in health practice settings.

13.   Demonstrate an understanding of the importance of skilled interdisciplinary collaborative practice in health care settings and the role that social workers can have as teacher and consultant with interdisciplinary colleagues..

14.   Discuss the legal and ethical principles influencing the social workers role in health care practice  including limits to confidentiality, liability, charting, right to treatment, advanced directives etc.

15.   Recognize the impact of empirically based practice in affecting client outcome and the role that research can have in informing practice and increasing professional knowledge in health care.

16.   Demonstrate a commitment to the core values and ethics of the social work profession as evidenced in classroom discussion, course assignments and practice interventions.

17.   Complete the course with a more sensitive understanding of the reactions you, families, friends and clients have to health care problems, illness and disability in life.

 

 

Students with Disabilities

 

The School of Social Work and the University at large are committed to ensuring facility and program access to students with either permanent or temporary disabilities through a variety of services and equipment. The Disability Resources for Students Office (DRS) coordinates academic accommodations for enrolled students with documented disabilities. Accommodations are determined on a case-by-case basis and may include classroom relocation, sign language interpreters, recorded course materials, note taking, and priority registration. DRS also provides needs assessment, mediation, referrals, and advocacy as necessary and appropriate. Requests for accommodations or services must be arranged in advance and require documentation of the disability, verifying the need for such accommodation or service. If you would like to request academic accommodations due to a disability, please contact DRS Office 448 Schmitz 206-543-8924 (V) 206-543-8925 (TTY). If you have a letter from Disabled Student Services indicating you have a disability that requires academic accommodations, please present the letter to me so the two of us can discuss the accommodations you might need for the class.

 

 

Teaching methods

There will be a combination of teaching approaches including lecture by the instructor and guest professionals in the field, large and small group discussion, case discussions, role-plays, experiential exercises, video, and field visits.  You are encouraged to suggest methods that are conducive to your learning.

 

Readings

The course readings will be available via electronic reserves:  https://eres.lib.washington.edu/eres/coursepage.aspx?cid=4388&page=docs , and via  hardcopy in the library reserves. Students may download and/or duplicate a single copy for their own personal use.  

 

Plan for Course Evaluation

Course content and teaching will be evaluated through the use of short evaluation instrument and with the University faculty evaluation form on the last day of class.  You are also strongly encouraged to express your opinions and suggestions about any aspect of the course during class or calling me at any time.

 

Expectations

Basic expectations for this course include completing weekly reading assignments, attending class regularly, participating actively and thoughtfully in class discussions and exercises, and completing assignments on the designated dates. Throughout the quarter, I am available by appointment to meet with students for questions and guidance regarding learning and individual assignments.

 

Assignments and Grading

 

There are two assignments in the class, the first involves your active participation and share of the facilitation of a field case seminar group, typically to be conducted during the second hour of the class every week.  This will be a peer rated assignment worth 30 percent of the course grade. A more detailed description of this assignment will be handed out in class. The second assignment, worth 50 percent of the course grade is a case study to be drawn from your practicum, although more detailed description of this assignment will be handed out in class, the case study is brief terms is the equivalent of a brief scholarly article written for publication in a social work practice journal. The remaining 20 percent of the course grade is based upon presence in class and the instructor’s appraisal of a quality of participation in class that contributes to your learning and the learning of others.

 

Assignment

Due Date

Proportion of Course Grade

Field Case Seminar

Peer Ratings Due March 15th

30 Percent of Grade

Case Study Paper

March 15th

50 Percent of Grade

Class Participation

Weekly

20 Percent of Grade

 

COURSE OUTLINE

 

Note: Although this is the intended outline of the course, the availability of guest speakers for particular weeks may dictate some changes. Where that occurs I will let students know at least a week in advance.

 

Week 1 January 6th

 

Course Introduction and Presentation of Course Constructs and Frameworks.

 

*Cowles L. (2003). Social Work in Hospitals (143-185). Social work in the health field. NY: The Haworth Press.

.Mizrahi T, Berger C. (2001). Effect of a changing health care environment on social work leaders: Obstacles and opportunities in hospital social work. Social Work. 46(2). 170-182.

Diegielewski SF. Acute health care settings (151-169). The changing face of health care social work.  NY: Springer Publishing.

Subramanian K. (2000) The Nature of Social Work Services in a Large Public Medical Center Serving an Impoverished Multicultural Population. Social Work in Health Care 31 (2): 47-63.

Almgren G (1998). Primary Care as a Context for Mental Health Practice. In Schamess and Lightburn (Eds.) Humane Managed Care? NASW Press.

 

Week 2 January 13th

Family and Crisis Interventions on Surgical and Critical Care Units in Hospitals.  (Secondary/Tertiary) Exemplars:  Surgical Services.  Intensive  Care, Coronary Care.

 

Schulman N and Shewbert A(2000). A model of crisis intervention in critical and intensive care units of general hospitals (412-430). In A. Roberts (Ed).Crisis Intervention handbook: assessment, treatment, and research. Oxford; NY: Oxford University Press.

Sulman J, Verthaege V. (1994). Social work practice with myocardial infarction: Patients and families in an acute care hospital (39-59).  In  MJ. Holosko and PA Taylor (Eds). Social work practice in health care settings.  Toronto: Canadian Scholars Press.

Williams MI, Hill G, Jackson M.  (2000). (Abstract only available) Acute myocardial infarction at a university hospital: effect of race on short-term mortality. J Assoc Acad Minority Physicians. 11(4):50-54.

Delva D, banoost S, Bijttebier P, Lauwers P, Wilmer A. (2002).  Needs and feelings of anxiety of relatives of patients hospitalized in intensive care units: Implications for social work.  Social work in Heqlth Care. 35(4).21-20.

Kerson TB, Kerson LA. Heart Disease. In Understanding chronic illness.  NY:The Free Press.

 

 

Week 3 January 20th

 

Discharge Planning and Brief Interventions on Medical/Surgical units in Hospitals.  (Secondary) Exemplars: Chronic Illness, Geriatrics

Cummings SM, Jackson DR. (2000). Hospital Discharge Planning (191-224). In RL Schneider & AJ, Lisor (Eds). Gerontological Social Work: Knowledge, service settings and special populations. CT: Brooks Cole.

Sulman J, Savage D, Way S. (2001). Retooling social work practice for high volume, short stay. Social Work in Health Care. 34 (3/4). 315-332. 

Holliman DC., Dziegielewski & Priyadarshi, D (2001). Discharge planning and

         social work practice. Social Work in Health Care 32(3),1-19.

Hammer DL, Kerson TS (1998). Discharge planning in a community hospital: A patient whose symptoms the system could not manage (227-241). In Kerson TS (Ed). Social Work in Health Settings. NY: The Haworth Press.

Cummings, SM. (1999). Adequacy of discharge plans and rehospitalization among hospitalized

         dementia patients. Health and social work, 24(4), 249-259.

 

Week 4 January 27th

Ethical Decision Making in a University Teaching Hospital (Tertiary Care). Exemplars: Liver, Kidney Transplants, Life Support Decisions

 

Landau R. (2000). Ethical dilemmas in general hospitals: Social workers’ contribution to ethical decision making. Social Work in Health Care 32(2). 75-92.

Foster L and McLellan L (2002). Translating Psychosocial Insight into Ethical Discussions Supportive of Families in End of Life Decision Making. Social Work in Health Care 35 (3): 37-51.

Holosko MK, Taylor PA. (1994) Social work practice with organ transplant patients (441-452). In Social work practice in health care settings. Toronto: Canadian Scholars Press.

 

Jones, Jill B., & Egan, Marcia. (2000). The transplant experience of liver recipients: Ethical

         issues and practice implications. Social Work in Health Care, 31 (2),65-88. .

International Federation of Social Workers. (2002). Ethics in social work, statement of

         principles.

Wolfe WA. (2003). Achieving equity in referrals for renal transplant evaluations with african-american patients: The role of nephrology social workers. Social Work in Health Care, 37(2). 75-87.

 

Week 5 February 3rd

Ethical Decision Making in Pediatric Hospital Based Social Work Practice – (Secondary Care): Exemplars – Family Systems, Chronic Illness and Craniofacial Anomolies

 

Biester D, Belsor-Friedrich (1998). Historical overview of health care delivery models for children and their families (251-267). In M Broome, K Knaft, Pridhauk, Feethaus S (Eds) Children and families in health and illness. Hoursand Oaks, CA: Sage Publications.

Patterson J (1995). Promoting resilience in families experiencing stress. Pediatric Clinics of North America. 43:1. 47-63.

*Marion R. (1995). Syndromes, genetics, and the craniofacial complex (8-14). In JT Goodrich and CD Hall (Eds). Craniofacial anomalies: Growth and development from a surgical perspective. NY: Thieme Medical Publishers.

*Meling TR, Tveten S, Due-Tonnessen BJ, Skjelbred P, Helseth E. (2000). Monobloc and midface distraction osteogenesis in pediatric patients with severe syndromal craniosynostosis.  Pediatr Neurosurg 33. 89-94.

Hartman A, Depoy E, Francis C, Gilmer D (2000). Adolescents with special health care needs in transition: Three life histories. Social Work in Health Care 31(4). 43-57.

American Academy of Pediatrics (1995). Informed Consent, parental permission, and assent in pediatric practice (RE9510). Pediatrics 95:2. 314-317.

Hyun I. (2000). When adolescents :mismanage: their chronic medical conditions: An ethical exploration.  Kennedy Institute of Ethics Journal 10. (2) 147-163.

 

Week 6 February 10th

 

Crisis Intervention and Parent Adjustment to a New Diagnosis or Death of a Newborn in a Children’s Hospital.  (Secondary/Tertiary Care) – Exemplar: Pediatric Critical Care, Perinatal Loss.

 

Taksa JL. (1997). Premature babies in the intensive care nursery (53-68). Kerson TS (Ed).  In Social Work in Health Settings. NY:The Haworth Press.

Dungan SS, Jaquay TR, Reznik KA, Sands EA. (1995). Pediatric critical care social work: Clinical practice with parents of critically ill children. Social Work in Health Care. 21(1).69-80.

Desai PP, Mg JB, Bruant SG. (2002). Care of children and families in the CICU: A focus on their developmental, psychosocial and spiritual needs. Critical Care Nursing Quarterly. 25(3).

*Mahan CK, Calica J. (1997). Perinatal loss: Considerations in social work practice.  Social

      Work in Health Care. 24 (3/4):141-152.

Hirsch V. (1995). Relating trauma theory to perinatal loss. NAPSW FORUM. Autumn (8-11).

 

 

 

 

 

 

Week 7 February 17th

 

Physical Medicine and Rehabilitation (PM&R)   (Long Term and Restorative Care):  Exemplars: Spinal Cord Injury

 

*Diegielewski SF.  (1998). Long-term health care and restorative health settings (170-190). The changing face of health care social work.  NY: Springer Publishing.

 

Holosko MJ. (1994). Social work practice in a multi-disicplinary physical rehabilitation setting.(468-488).  In Social work practice in health care settings. Toronto: Canadian Scholar’s Press.

*Introduction: Developing Your Knowledge and Practice of PM&R  (Questions and answers).

*Kirshblum SC, Groah SL,  McKinley WO, Gittler MS, Stiens SA. (2002). Spinal cord injury medicine. 1. Etiology, classification, and Acute Medical Management. Arch Phys Med Rehabil. 83( Suppl1):S50-S57.

McKinley WO, Gittler MS, Kirshblum SC, Stiens SA. Groah SL,   (2002). Spinal cord injury medicine.2. Medical complications after spinal cord injury: Identification and management.. Arch Phys Med Rehabil. 83( Suppl 2):S58-S64.

*Gittler MS, McKinley WO, Stiens SA. , Groah SL, Kirshblum SC (2002). Spinal cord injury medicine. 3. Rehabilitation outomes. . Arch Phys Med Rehabil. 83( Suppl 3):S65-S71.

Stiens SA, Kirshblum SC, Groah SL,  McKinley WO, Gittler MS, (2002). Spinal cord injury medicine. 4. Optimal participation in life after spinal cord injury: Physical, Psychosocial, and economic reintegration into the environment.. Arch Phys Med Rehabil. 83( Suppl 4):S72-S81.

*Groah SL, Stiens SA, Gittler MS,. Kirshblum SC,  McKinley WO (2002). Spinal cord injury medicine. 5. Preserving wellness and independence of the aging patient with spinal cord injury: A primary care approach for the rehabilitation medicine specialist. Arch Phys Med Rehabil. 83( Suppl5):S82-S90.

*+General SCI Anatomy and Physiology

Hirschwald JF. (1997). Rehabilitation of a quadriplegic adolescent: Regional spinal cord injury center. In TS Kerson (Ed) Social work in health settings. NY: The Haworth Press. 

Hanna WJ, Rogovsky E. (1993).  On the situation of African-american women with physical disabilities. In M. Hagel (Ed). Perspectives of disability. CA: Health Markets Research.

Gilson SF. (2000). Disablity and aging (367-391). In R. Schneider, N Kroph, Kisora (Eds). Gerontological Social Work. NY, Brooks/Cole/Thomson Learning.

 

Week 8 February 24th

 

Chronic Illness, Intimate Partnerships, and Sexuality

[READINGS TBA]

 

Week 9 March 3rd

 

Social Work Practice with people living with Cancer;  Social Work Practice in Palliative and End of Life Care: Exemplars: Oncology. Palliative Care,  Advanced Directives

 

Parle, Michael & Maguire, Peter. (1995). Exploring relationships between cancer, coping and

         mental health.In Psychosocial resource variables in cancer studies. Haworth Press.27-50.

 

CANCER

 

Ishibashi , A. (2001).  The needs of children and adolescents with cancer for information and social support. Cancer Nursing, 24(1):61-66.

Walsh F (1998). Coping and resilience in chronic illness and family caregiving (207-236). Strengthening family resilience. NY: Gilford Press.

Cwikel, Julie G. & Behar, Lynn C. (1999). Organizing social work services with adult cancer

         patients: Integrating empirical research. Social work in health care, 28(3),55-76.

Shields G, Schondel C, Barnhart L, Fitzpatrick V, et.al. (1995). Social work in pediatric oncology: A family needs assessment. Social Work in Health Care. 21(1): 39-54.

Kerson TB, Kerson CA.  Cancer (35-70). In Understanding Chronic Illness. NY: The Free Press.

Haushalter LS (1997). Adult oncology” Helping a terminally ill woman to plan and cope (307-330).  In  TS. Kerson.(Ed).  Social work in health settings: Binghampton NY: The Hayworth Press.

Safford F (1997). Advance Directives: Choices and challenges. In Gerontology for health professionals. NASW Press.

Mass S. (1990). A Crisis Intervention Model for dying patients and their families (275-290).  In H and L Parad. Crisis Intervention. Book 2: The Practioners sourcebook for brief therapy. Milwaukee: Family Service America.

  .

END OF LIFE CARE

*Cowles L. (2003). Social work in hospice care:  (281-315). In Social work in the health field: A care perspective.  NY: The Haworth Press.

Chochinov, HM. (2002). Dignity-conserving care – A new model for palliative care: Helping the

         patient feel valued. JAMA, 287(17),2253-2260.

Koenig, Barbara A. & Gates-Williams, Jan. (1995). Understanding cultural difference in caring

         for dying  patients.In Caring for patients at the end of life (special issue). West J Med:

         163:244-249.

Aronheim, Judith C. (1994). Artificial feeding: What’s involved? Choice in dying news,3(2),1-2

Miller, Pamela J. (2002). Take some time to look inside their hearts: Hospice social workers

         contemplate physician assisted suicide. Social work in health care, 35(3),53-64.

Groopman J (2002). Dying Words, How Should Doctors Deliver Bad News. The New Yorker, October 28th, 2002: 62-70.

 

Week 10 March 10th     

 

Grief and Bereavement, Spirituality, Self-care

Moos N (1995) An Integrative Model of Grief. Death Studies 19: 337-364.

Gilliam B and James R (2001). Personal Loss: Bereavement and Grief. In Crisis Intervention Strategies. Brooks Cole L.A. Calif.

Worden W (1991) Excerpt –The Four Tasks of Mourning and Normal Grief Processes. Grief Counseling and Grief Therapy. Springer: New York.  Pp. 11-36.

Perry B (1995) The Child’s Loss—Death Grief and Mourning: General Guidelines for Caretakers of Children Experiencing Death. Baylor College of Medicine. Houston. TX

Crisis Management Institute. Parental Grief and Its Impact Upon Children. CMI Salem Oregon.

Parry J (1994). Death Review: An Important Component of Grief Resolution. Social Work in Health Care 20 (2): 97-107.

Kleinman A (1988). Illness Unto Death. In The Illness Narratives: Suffering, Healing, and the Human Condition. Basis Books: Pp. 146-157.

Jenny M Young; Paule McNicoll  (1998) Against all odds: Positive Life Experiences of People with Advanced Amyotrophic Lateral Sclerosis. Health & Social Work 23 (1): 35-43.

Zapf M (2005) The Spiritual Dimension of Person and Environment: Perspectives from Social Work and Traditional Knowledge. International Journal of Social Work 48 (5): 633-642.