SOCIAL WORK IN HEALTH CARE: A CURRICULUM PROPOSAL FOR A HEALTH CARE CONCENTRATION IN THE GRADUATE PROGRAM OF THE DIVISION OF SOCIAL WORK AT CALIFORNIA STATE UNIVERSITY, SACRAMENTO A Project Presented to the faculty of the Division of Social Work California State University, Sacramento Submitted in partial satisfaction of the requirements for the degree of MASTER OF SOCIAL WORK by Kassy Mason Jocelyn Merino SPRING 2013 SOCIAL WORK IN HEALTH CARE: A CURRICULUM PROPOSAL FOR A HEALTH CARE CONCENTRATION IN THE GRADUATE PROGRAM OF THE DIVISION OF SOCIAL WORK AT CALIFORNIA STATE UNIVERSITY, SACRAMENTO A Project by Kassy Mason Jocelyn Merino Approved by: __________________________________, Committee Chair Dale Russell, Ed. D., LCSW __________________________________ Date ii Student Name: Kassy Mason Jocelyn Merino I certify that this student has met the requirements for format contained in the University format manual, and that this project is suitable for shelving in the Library, and credit is to be awarded for the project. __________________________, Division Director__________________________ Robin Kennedy, Ph.D. Date Division of Social Work iii Abstract of SOCIAL WORK IN HEALTH CARE: A CURRICULUM PROPOSAL FOR A HEALTH CARE CONCENTRATION IN THE GRADUATE PROGRAM OF THE DIVISION OF SOCIAL WORK AT CALIFORNIA STATE UNIVERSITY, SACRAMENTO by Kassy Mason Jocelyn Merino There is a need for an emphasis in medical social work in graduate programs. Students who have not had this educational training are not adequately prepared to work as medical social workers. 14 current medical social workers at Sutter General Hospital and Sutter Memorial Hospital were evaluated. The survey included questions to assess how effective their Master of Social Work program was in preparing them for medical social work. The study confirmed that participants with an emphasis in healthcare found their courses to be beneficial upon entering the medical field. ________________________, Committee Chair Dale Russell, Ed.D., LCSW ________________________ Date iv TABLE OF CONTENTS Page List of Tables ……………………………………………………………………… viii Chapter 1. STATEMENT OF THE PROBLEM………………………………………… 1 Background of the Problem ………………………………………………. 2 Statement of the Research Problem ……………………………………….. 4 Study Purpose…………………………….………………………………... 4 Theoretical Framework ………………….………………………………… 5 Definition of Terms ……………………..………………………….….…... 9 Assumptions ……………………………………………………………….. 11 Social Work Research Justification ………………………………..…..….. 11 Study Limitations ………………………………………………………….. 13 Statement of Collaboration ………………………………………………... 13 2. REVIEW OF THE LITERATURE …………………………………………… 14 Impact of Illness and Disease on the Whole Person ………………………. 15 Importance of Social Work Roles in the Healthcare Setting…..................... 19 Knowledge and Skill Set…………………………………………………… 23 Impact of Healthcare on GDP and Concerns of Cost…………………........ 25 Challenges of Evidence Based Research…………………………………... 26 Value and Effectiveness of Social Work in Healthcare……………………. 27 Agency and Policy Involvement………………………………………….... 29 v Other Challenges of Social Work in the Healthcare Field………………… 30 Implications of a Health Emphasis in a Social Work Graduate Program ..... 33 Access............................................................................................................ 34 Knowledge of Emerging Trends…………………………………………... 34 Population-Specific Knowledge…………………………………………. 36 Field Instruction……………………………………………………………. 36 Research…………………………………………………………………… 37 Current Programs and Courses Available…………………………………. 38 Conclusion………………………………………………………………… 38 3. METHODS…………………………………………………………………….. 40 Study Design ………………………………………………………………40 Sampling Procedures ……………………………………………………… 41 Data Collection ………….. ……………………………………………… 41 Instruments ……………………………………………………………… 42 Data Analysis Plan ………………………………………………………… 42 Protection of Human Subjects …………………………………………….. 43 Conclusion…………………………………………………………………. 44 4. STUDY FINDINGS AND DISCUSSIONS…………………………………… 45 Overall Findings …………………………………………………………… 45 Specific Findings …………………………………………………………. 46 Interpretation to the Findings …………………………………………….. 50 Proposed Curriculum……………………………………………………… 52 vi Summary …………………………………………………………………. 53 5. CONCLUSION, SUMMARY, AND RECOMMENDATIONS …………….. 54 Implications for Social Work ……………………………………………. 55 Recommendations …………………………………………………………. 56 Limitations ………………………………………………………………… 57 Conclusion ………………………………………………………………… 57 Appendices………………………………………………………………………… 59 Appendix A. California State University, Sacramento Master of Social Work Program (MSW) Guidelines for a Concentration in Health Care Setting…….. 60 Appendix B. Human Subjects Approval Letter…………………………………... 65 Appendix C. Letter of Consent …………………………………………………... 66 Appendix D. Survey ……………………………………………………………… 67 References …………………………………………………………………………. 71 vii LIST OF TABLES Tables Page 1. Graduate Program Participants Attended for MSW……………………….. ….46 2. Participants that Attended a MSW Program with a Health Concentration…….46 viii 1 Chapter 1 STATEMENT OF THE PROBLEM In today’s modern society, there has been significant advancement within the medical field. As people are living longer with both acute and chronic illness, there are increasing emotional, psychological, environmental and spiritual factors that are contributing to a person’s overall quality of life as it relates to their experience with an illness. While physicians and nurses have maintained steady roles working with patients in these aspects, their roles have been limited to what they can provide as long-term intervention. Because of the extensive education and training received on these concepts, it has become more understood that social workers can be a vital part of a patient’s experience in both inpatient and outpatient care (Auerbach, 2007). Throughout the graduate level social work program at California State University, Sacramento, the researchers concluded that concepts and interventions, such as education around specific disease information, relevant resources and case management for the physically and mentally ill have not been of focus in our courses, therefore they felt inadequately prepared for the roles as medical social workers during the required internship. Although the courses that focus on the generalist perspective gave the researchers a general overview of social work theories, practices and intervention methods, it can be difficult to apply many concepts discussed in practice courses to the medical placements. In the researchers current medical placements, along with familiarizing with the role expectation of the social worker, it was also necessary to assimilate to medical terminology, the effects of illnesses, and become familiar with the 2 medical staff and system wide hierarchy. The researchers began to look at other graduate level social work programs that did emphasize education of social work in the healthcare field. Due to the personal experience with attempting not only to developed skills as clinicians, but also establish the skills necessary to work within a medical system, the researchers found it imperative to create guidelines for a curriculum with an emphasis in medical social work for future students pursuing this field. The study will be analyzing surveys taken by current medical social workers to determine what courses they found beneficial in their master’s of social work program. The study will also examine whether the skills and knowledge they are currently practicing were learned in the field or in the classroom setting. After reviewing relevant literature on the role expectations of a social worker in the health care setting, as well as studying concepts and experiences current medical social workers found valuable during their education, the researchers will conclude the study with creating a guideline for a curriculum for future students of a graduate level social work program seeking an emphasis in medical social work. Background of the Problem Physician’s roles were released from the responsibility of assessing home, work, and other life situations as it pertained to a patient’s medical care during the turn of the twentieth century. During this transition the role of social workers was introduced into the healthcare field (Cowles, 2003). Ida Cannon and Dr. Richard Cabot were the first to establish a social work department in 1914 in Massachusetts General Hospital. Social workers evaluated the patient and family dynamics and their adjustment to the presenting 3 illness as well as assisted physicians in recognizing how social and environmental conditions could contribute to the spread of disease (Gregorian, 2005). Since the field of social work was introduced almost 100 years ago, the role of the medical social worker continues to focus on addressing family and patient psychosocial factors. As the expansion of health centers increased the role of social work was developed in practices such as psychiatric, public health agencies, nursing homes, rehabilitation centers, health maintenance organizations, community clinics, private practice, hospice agencies, and veteran administration (Cowles, 2003). Signs of role confusion began early in the career of medical social work as Dr. Cabot saw the role of social workers as the liaison to remove barriers and to bridge the gap between the community and the hospital setting. Meanwhile, Ida Cannon had a different view, Ida viewed her role as providing the patient and their family direct service in treating the