Social Work and Health Care Policy, Practice, and Professionalism

Dr. Joan Borst, a social work professor, is an associate professor at Grand Valley State University. She has an extensive professional history working in a wide range of health care settings and a variety of experiences with people who care for and live with chronic illnesses such as HIV/AIDS and cancer.

Introduction

PART I: SOCIAL WORK, HEALTH CARE AND POLICY

From Social Problem to Social Policy

Values

Social Change

The Influence of Policy 

Understanding Policy

The Roles of the Social Worker in Health Care Policy

Witness to Human Needs

Being Political

United States Health Care Policy

The United States Veterans Administration

The Social Security Act of 1935

Changes in Health Care Policy

The Second World War

The Civil Rights Movement

Healthy People 2010

The Emergence of Chronic Illness

Life Expectancy

Summary

References

Chapter 2 – Health Care Policy and Social Injustice

Disparities

Age

Gender

Race and ethnicity

Economic class

Sexual Orientation

Socio-Cultural Access Issues

Challenges to Policy

Worthy/Unworthy

Complexities of Culture

Racism

Funding

Delivery

Competence

Social Injustice in Health Care Policy

Eugenics in Germany

Eugenics in the United States

The Tuskegee Study

Deinstitutionalization

Summary

References

Chapter 3: Health Insurance

Public Health Care Insurance

Medicaid

Medicare

Common Insurance Related Terms and Policies

Managed Care

Health Savings Accounts [HSAs]

Diagnostically Related Groups [DRGs]

Health Insurance Portability and Accountability Act [HIPAA]

The Future of Health Care Policy

Nationalization of the Health Care Debate

Summary

References

Chapter 4 – Health Care: A Field of Practice

Social Work Roles

Advocate

Communicator

Mediator

Researcher

Evaluator

Recorder

Educator

Health Care Settings

Inpatient

Additional Forms of Inpatient

Rehabilitation

Assisted Living

Nursing Homes

Hospice

Outpatient

Ambulatory Clinics

Physician’s Office

Home Health Care

Public Health

Summary

PART II: SOCIAL WORK, HEALTH CARE AND PRACTICE

Chapter 5 — Social Work Foundation

Social Work Language

The Foundational Concepts of Social Work

The National Association of Social Workers Code of Ethics
Cultural Competence

Evidence-Based Practice

Strengths Perspective

Liberal Education

Critical Thinking

Ecological Systems Theory

Generalist Perspective

Practice Models

The Medical Model

The Biomedical Model

Biopsychosocial Model

Social Determinants of Health Model

Application of Theory

Summary

References

Chapter 6 – Cultural Competence

The Concept of Culture

Personal Culture

Community Culture

Cultures and Health Care

Race

Ethnicity

Gender

Sexuality Orientation

Religion

Age

Economics

Privilege

Diversity

Stereotypes and Stigma

Ways to Understand

Generalizations

Asking the Patient

Building Competence

Self-awareness

Cultural Awareness

Knowledge Acquisition

Skill Development

Summary

References

Chapter 7 — Engagement and Assessment

Process of Engagement

Personal Strengths

Professional Skills

Assessment

Forms of Assessment

Interviews: Lessons Learned

Cultural Guides

The Power Differential

Vulnerability

Environment

Taking Notes

Listening

Confidentiality

Empowerment

Thoughtfulness

Treatment of Colleagues

Unspoken Cues

Home Visits

Safety

Teamwork

Unhurried

Follow-through

Flexibility

Alternative Forms of Assessment

Genogram

Ecomaps

People in Crisis

Immediate and Concrete Action

Limited Time

Empathy

Education

Families

Summary

References

Chapter 8 — Chronic Illness: Grief, Loss, and Coping

The Advent of Chronic Illness

Chronic Illness

Types of Chronic Illness

Quality of Life

Spirituality

Family and Care Givers

Roles for Social Work in Chronic Illness Care

Prevention

Adherence to Treatment

Strengths and Barriers

Adaptation Skills

Psychosocial Coping

Loss Due to Illness

Physical Losses

Emotional Losses

Social Losses

Personal Space

Socialization

Community Mobility

Palliative Care

Summary

References

Chapter 9 – The Health Care Team

History of Social Workers on Health Teams

Role of the Social Worker on the Health Care Team

Values

Theories

Ecological Systems

Strengths Perspective

Cultural Competence

Patient Cultures

Professional Cultures

Professional Social Work Expertise

Facilitate Interdisciplinary Communication

Contribute Professional Social Work Culture

Identify Adjustment Barriers

Supply Expertise Regarding High Risk Groups

Support Patient Self-Determination

Learning the Language

Improved Communication

Community Referrals

Credibility with Patients and the Team

Cultural Advocate

Types of Teams

Team Settings

Inpatient Settings

Outpatient Settings

Challenges of a Health Care Team

Summary

References

Chapter 10: Caregivers, Family and Friends

The Support System

Support

Communication Difficulties

Practical Assistance Difficulties

Responses to Care Giving

Physical Response

Emotional Response

Social Response

Burn-Out

Time and Logistical Challenges

Financial Complexities

Secondary Trauma

Life’s Purpose and Meaning

Policy Issues

Social Work Response

Assessment

Emotional Support

Self-Care Support

Financial Support

Summary

References

PART III: SOCIAL WORK, HEALTH CARE AND PROFESSIONALISM

Chapter 11 — Ethical Considerations

Ethics

National Association of Social Workers Code of Ethics

Human Rights

Ethical Conflicts

Cultural Differences

Value Differences

Informed Consent and Confidentiality

Technological Advances

End of Life

Rationing

Resolving Ethical Conflicts

Summary

References

Chapter 12 — Supervision

Supervision

Receiving Supervision

Other Professional Supervision

Cost Savings

Preparation

Assessment of Practice

Job Satisfaction

Giving Supervision

Good Supervision

Establishing Goals

Topics for Supervision

Stress

Burnout

Secondary Trauma

Preparation

Self-Care

Conflicts

Healthy Boundaries

Benefits of Supervision

Summary

References

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