Reprinted with permission of the organization People Living With Cancer

Introduction

For people diagnosed with cancer, an oncology social worker is an important member of the health-care team. An oncology social worker provides services, such as counseling, education, and information and referrals to community resources, including support groups. An oncology social worker often acts as a liaison between people with cancer and the medical team, and helps people find ways to navigate the health-care system. He or she works with the medical team to make sure people with cancer get the information they need to make informed choices about their care, and the support needed to manage the day-to-day challenges of living with cancer.

Taking Care of the Whole Person

An oncology social worker is a professional who has specialized training in how a diagnosis of cancer affects a person and his or her family and friends. An oncology social worker understands that there are many aspects of a person’s life outside of cancer, and that cancer affects each person in a different way. The oncology social worker’s expertise is a comprehensive view of the person living with cancer that is respectful of each individual’s ethnicity, spirituality, family situation, unique strengths and challenges, and it is his or her job to represent a person’s interests and needs to the medical team.

For most people, a cancer diagnosis brings with it new feelings and experiences. Talking to a professional who has helped other people manage similar situations may help a person find ways to improve quality of life, manage fears, and find hope. A social worker talks to people about the different aspects of adjusting to the cancer, and helps find strategies to adapt to, and manage health-care concerns. This can happen through individual, couples, and family counseling; support groups; and referrals to community agencies that have additional support programs.

A Bridge to the Medical Care Team

An oncology social worker has advanced training in cancer treatment, as well as in how treatments affect people living with cancer. Many people with cancer find that information that may have been easy to read and absorb in a textbook is much more difficult to understand when it pertains to their own health. A social worker helps gather the information people need to make decisions about their care. He or she may arrange a family meeting with the medical team, at which people’s care and treatment options may be discussed. A social worker can also refer people to additional educational resources and to community organizations that have information about cancer and treatment.

New Roles and Responsibilities

People may wonder how their parents, children, friends, and coworkers will react to their cancer, and how they will feel about that reaction. People may also wonder if there will be changes in their ability and desire to keep up with the many responsibilities of their life, such as a demanding job, taking care of young children, or helping an older parent. A social worker can arrange a meeting to talk about how those roles and responsibilities might change, and about what kind of support he or she wants and needs while going through treatment…Click here for the rest of this article

Army National Guard Specialist Chuck Ross

The Veteran’s Administration employs more than 4,400 MSWs to assist veterans and their families with individual and family counseling, patient education, end of life planning, substance abuse treatment, crisis intervention, and other services.

Please click here to read the article Leaving the War Half a World Away which is the story of Army National Guard Specialist Chuch Ross pictured above. When Mr. Ross returned home from the Iraq war experiencing symptoms of post traumatic stress disorder, he turned to social worker Dr. Rick Selig for help.

Below are links to additional articles about veterans affairs and social work.

• - About Post Traumatic Stress Disorder (PTSD) and Brain Injury in Iraq’s War Veterans
• - Help for Spouses of Combat Vets With Post Traumatic Stress Disorder From People Who Know
• - When the Soldier Doesn’t Return: The Needs of American Families of Down Warriors in Iraq
• - What It’s Like to Help Disabled Veterans as a Veterans Health Administration Social Worker
• - Love, Honor, & Obey: Working With Military Men and Their Families
• - How Social Workers Help Veterans and Their Families
• - Help for World War II POWs: The Former POW Living History Project
• - Retired Army Colonel and Dean of the University of Maryland, Baltimore School of Social Work, Jesse J. Harris, PhD, Honored by the Maryland Legislature

By Sharon Covington, LCSW-C

Introduction

A woman once told me of the painful dilemma she experienced following her miscarriage. She had been longing to be pregnant, hoping for years to hear the words, “You’re going to have a baby.” When it finally happened, her spirits soared. But the elation quickly turned to despair when she started to bleed. The confirmation that there was “only an empty sack” was the final blow. She grieved intensely for many months over the loss of this precious baby. Also hurting, her husband felt powerless to help her. She poignantly reflected that she did not want to stop mourning, as it was her only tie to her baby. Resolving her grief would mean letting go of the biological child she might never have.

A miscarriage is an event full of dilemmas and conflicting emotions. If you are involved in the organization called RESOLVE (the National Infertility Association) and have had a pregnancy loss, you may wonder where you fit in. Having conceived, are you part of the fertile world or do you belong to the infertile world, not having given birth to a live baby? Others may try to minimize your pain by saying, “At least you can get pregnant.”

If you have had difficulty conceiving and then miscarried or if you have had repeated miscarriages, the dilemma grows. You continue to grieve for the wished-for child, while grieving at the same time for the baby you have lost. You feel you are so near and yet so far. For some, the pain is too great to consider trying again. For others, the hope generated from having conceived can be addictive, keeping them in treatment indefinitely. They struggle with the decision over when to stop trying and move on. Unlike other experiences that get easier to handle with repetition, having recurrent miscarriages makes it harder. It becomes especially difficult when you find support from family and friends diminishing with each loss, even though you need it more than ever.

New Technologies

Diagnostic and therapeutic technology available today make the miscarriage dilemma even more complex. During in vitro fertilization (IVF) eggs are retrieved and united with sperm in a laboratory, so that you know conception has taken place within hours of the event. When the embryo transfer fails to result in pregnancy, it can feel like a miscarriage.

With fertility treatment called gamete intrafallopian transfer or GIFT, the procedure is similar to IVF, but allows fertilization to occur naturally inside the woman’s fallopian tubes.

A third procedure called zygote intrafallopian transfert or ZIFT is similar to GIFT but the woman’s eggs are fertilized in a laboratory before they are inserted into her fallopian tubes.

With any pregnancy loss following IVF/GIFT/ZIFT, there is profound sadness and grief. And yet you may be instructed to undergo another cycle almost immediately. This can thwart your chance to grieve.

In addition, the new technologies used in early pregnancy often facilitate bonding and attachment to a developing baby. Blood tests can confirm a pregnancy before you have missed a period. Sonography enables you to see a heart beating or your tiny baby moving before others are even aware of the pregnancy. This visualization helps to confirm and make the pregnancy a reality. Finally, amniocentesis and chorionic villi sampling can provide information about your baby, including its sex, even before you are wearing maternity clothes. Each unique detail strengthens your feelings about your baby and can make a miscarriage feel like a death.

Grief and Loss After a Miscarriage

Yet miscarriage is enigmatic. Even though it can feel like a death, there is nothing tangible to mourn. There are no burials or memorial services to facilitate grieving. You may find yourself suffering intense emotions, often in isolation, as others may not understand the impact of your loss. The manner in which you grieve is highly individualistic and follows no predictable course; there are no instructions to follow. Much depends upon your own personality and life experiences.

Grief can feel like a tidal wave that sweeps over you with force and fury. Shock, anger, rage, guilt, blame, sadness and depression can engulf you, growing and cresting with time. It peaks somewhere between one to six months following a miscarriage. Nevertheless, swells of grief can be triggered long after the waters have settled. Difficult times include your first menstrual period, due date, Mother’s/Father’s Day, holidays, the anniversary of your miscarriage. It can be especially painful when a friend with whom you were pregnant delivers a healthy baby. As years pass, seeing this child can continue to trigger feelings as you recall what your child might have done at this age. Your triggers are unique and relate to memories and dreams about your baby. For some, triggers may be a song, holiday or time of the year, while for others it may be walking into the doctor’s office or passing a hospital.

Another aspect of the dilemma relates to the difference between men and women and the way they deal with grief following a miscarriage. A woman is usually more attached to the developing baby. The loss of the baby can feel like a loss of a part of herself, shattering her self-esteem and self-image. Her emotions may be more apparent as she tearfully needs to continue to talk about the experience. She may take longer than her spouse to heal emotionally from the miscarriage…Click here for the rest of this article.

By LeslieBeth Wish, Ed.D, MSS

Introduction

Few of us are immune to holiday stress. It doesn’t help that Thanksgiving and Christmas are so close together. For many people, it’s like getting a second wham of anxiety and disappointment before you recover from the first one at Thanksgiving.

Because our American culture still promotes the image of the happy family with the white picket fence, we often assume the ideal family exists–even if we know that these families, too, have holiday difficulties. Holiday movies increase our disappointment. Oh, they might start out with family feuds, misunderstood children and unacceptable mates, but all these issues get resolved by the end of the film.

In reality, most families have a few issues that are unresolved. What may be stressful to one family may not be to another, yet despite the differences, the top holiday stresses are familiar to most of us. What can you do to make the holidays a happier time? Everyone’s situation is unique, but here are the top problems and solutions. (All names and identities cited below have been changed.)

Unrealistic Expectations of Happiness, Joy and Acceptance

The holidays are supposed to be a joyous time. If you have unresolved issues, hopes run high that the festivities will propel family members to act with greater kindness and emotional responsibility. Unfortunately, holiday time is not necessarily the best time to try to settle grievances or have one of those long, heart to heart talks with a family member. In fact, you might end up with nothing more than a lot of words and raised hopes—with little followup after the holidays are over.

The first thing to do is to lay the groundwork for a renewed relationship long before the holidays. Start by sending e-mails or birthday and anniversary cards. You want to send the message that you care about them and that you have changed.

It’s usually not a good idea to play a game of history where you review your past complaints. A long family meeting where you air your past anger won’t necessarily result in changing other family members’ behavior or attitudes about you. More effective change usually comes from your acting differently—and surprising them with the new you. Acting unpredictable in a positive way is a potent strategy for shaking up family members’ old views and treatment of you.

For example, if you’ve been regarded as the wayward child, you can demonstrate your maturity by telling the family about your life changes and speaking to each relative about things that are important to each of them. Even though it can take months for attitudes and behavior to change, when you act in a different and positive way, the family is more likely to notice you’ve changed.

Of course, if there is a timely hot topic that has to be addressed, then speak to other family members about ways to coordinate a strategy. For example, a common issue is how to care for a close relative who has dementia or Alzheimer’s disease. Some families divide up the tasks of researching doctors, nursing homes and other care facilities in the area. Family members then use e-mails to remain in touch.

Rigid Rituals

Rituals sustain the family emotional glue. They provide an easy format to recall and chart family growth, connection and cooperative decision-making. In addition, the holidays give families an opportunity to celebrate “who we are and why we matter.”

Later, as you mature, these family events provide a forum for testing your maturity, feelings and assumptions about yourself and others. You can assess family members with your own eyes and come to different or refined conclusions about how your family operates. You can forge your own identity and role as well as establish resources in the family through selected people.

However, rituals are often unresponsive to change. Family ruts are easy to get into. For example, mother always sits here, father there. It’s amazing to see the power of even these simple acts. Yet, not everything can stay the same. Family members are lost and added through death, marriage, birth and feuds. Life demands flexibility. Rather than complain about a ritual, recruit the key person in the solution. Be prepared to provide a reason and ideas.

For example, no one wants to hurt Cousin Dee’s expectations about hosting the Thanksgiving feast. However, now the family is too large to fit into her dining room. If you have a better idea, discuss it with other members, including the person whom Cousin Dee responds to with the least defensiveness. Then, have this person seek Dee’s advice about some related issue such as how to arrange the seating order or what chairs to use.

If you are that designated person, act perplexed about the best way to accommodate the growing family. You might mumble about moving chairs or using the kitchen. You might even say things such as: “Gee, it’s too bad Cousin Tina hasn’t offered to have the Thanksgiving meal at her house. Then we could have the next day brunch all day at your house, where it’s more fun and casual. Do you think Cousin Tina would want us messing up her new carpet?” Of course, you’ve already cleared it with Cousin Tina. The goals are to get creative and positive and to turn the key family members into key players in the solution.

Finally, take advantage of changes in the family to forge new traditions. Use events such as births, marriages, remarriages or college graduations as springboards for new gift giving, different homes for the celebration or more flexible seating arrangements around the dining table. These changes might prompt innovative ways of sharing the holiday. For example, you can divide up Christmas into Christmas Eve, Christmas morning and Christmas dinner. (more…)

By Terry A. Altilio, MSW, LMSW

Introduction

Pain is unique in that everyone has pain at some time or another and in fact it is essential to survival. Pain signals that the body is or has been injured and thereby warns us to take action. People who do not feel pain do not receive this signal and cannot protect themselves from further physical harm. Most of the time pain dissipates as healing takes place and we continue on the path of our lives.

As people grow from child to adult, they experience pain and are taught through their families, their cultures, and their spiritual beliefs how to think and act when in pain, what to expect from others, and the meaning of pain in their lives. While pain is a very personal and subjective experience, sometimes the impact expands beyond the individual to family, to work life and other areas of pleasure and fulfillment.

Physical and Emotional Factors

Over the years, research and clinical experience has led pain experts to believe that pain is not just physical but rather involves interrelated variables such as our unique history, the meaning of pain, motivational factors and emotions.

For example, the pain that results from a marathon run is filtered through feelings of accomplishment and pride and has a meaning that is infused with the months of training that preceded the race.

This experience is essentially different from pain caused by recurrent migraine headaches that are unpredictable, disruptive of work and family life, and bring to mind a flood of sadness and anger left over from an adolescence interrupted by the same pain problem.

Acute Pain

The two kinds of pain that people experience are acute and chronic pain. Acute pain is of recent onset and short duration and the response is often one of anxiety and an emergency fight or flight reaction. We have all experienced acute pain and usually expect that it will go away when the injury heals. Depending on the nature of the pain and our health behaviors, we may or may not seek medical attention. (more…)

College Student AnxietiesSocial workers in college counseling centers see increasing numbers of students each year for problems ranging from homesickness and test anxiety to eating disorders and suicidal thoughts.

While many people think of college as an ideal time of life when young adults are meeting academic challenges, experiencing personal growth and enjoying social activities like football games and parties; college can also be a time of depression and overwhelming anxiety, confusion about identity and dealing with losses and traumas such as parental divorce or date rape.

Life can feel complicated and lonely as students move into a new and shifting environment without the emotional skills or support to deal with many of the changes they are facing. For returning adult students there may be additional financial and caretaking issues with which to contend.

How Social Workers Help

An effective social work therapist in the college counseling center setting is able to evaluate, diagnose, and provide treatment for a range of life and emotional issues. Clinical social workers engage in assessment of student problems and emotional status, provide crisis intervention, individual and group counseling, make referrals for medical and psychiatric services and engage in consultation with friends, family and other caregivers on campus.

Working with young adults requires openness to changes in cultural trends and surface presentations of students while also connecting with them about timeless issues such as understanding life events, developing coping strategies and finding meaning in their struggles. In the case of suicidal or high risk behaviors, a social worker’s role may involve developing a safety plan to prevent harm.

In addition to counseling services, social workers also engage in education and prevention activities as well as activities designed to create a more caring and emotionally responsive environment. Social workers present workshops and classroom presentations for students on topics such as stress management, depression, and relationship communication. Faculty, staff, and peer helpers are also trained to identify and refer students experiencing emotional distress.

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The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.

Reviewed by NASW Office of Social Work Specialty Practice Staff

What Are Assisted Living Residences?

Generally, assisted living residences provide a combination of housing and supportive services for seniors who do not require round-the-clock skilled nursing or medical care but do require more personal care and health services than independent living provides.

Assisted living facility settings vary widely — from small homes to big apartment buildings. Many are stand-alone assisted living residences, while others are connected to independent housing and/or a nursing home on the same campus.

Accommodations and services also vary. Some residences provide apartments with kitchenettes, while others offer private or shared rooms. In one residence, services may be limited to housekeeping and personal care, such as help with bathing and dressing; meanwhile, another may also offer other services such as physical therapy or transportation. Typical services include meals that are served in a common dining room, personal care, housekeeping, and activities.

Explore Your Options

We encourage you to explore the whole spectrum of long-term care options. Do you still live at home? If so, before deciding on assisted living, find out whether you could get home care, housekeeping, or other services — and what they would cost. These services could help you stay in your own house or apartment. Your own home is familiar, and it’s where you have the most freedom to lead your life as you want.

Maybe you are still able to live independently but want the companionship that communities offer. If so, here’s another option to consider: independent living, also called retirement communities, congregate living, or senior apartments. Independent living typically provides seniors with recreational, educational, and social activities. Although such residences may also provide laundry, linen, meal service, and transportation, they almost never offer any personal care of health services. (more…)

This user-friendly, comprehensive search tool includes areas of expertise, hours of operation, languages spoken, payment options, and more. The Finder has more than 3500 licensed social workers listed.

Easton (Mass.) Journal, March 4, 2005

By Cathy Knipper, Correspondent

Doll Statue On Tour To Counter Unrealistic Body Image Expectations

She is the one who every girl hopes will be at her birthday party. Her clothes are stylish, she always looks so together, everyone wants to be like her. Her name is Barbie, but the image she promotes is not all that pretty, and it is one that the professionals and volunteers of the South Shore Eating Disorder Collaborative (SSEDC) hope to shatter with their “Get Real Barbie” tour.

The SSEDC is a group of clinicians providing care for those coping with eating disorders. It was founded by Kathleen Burns Kingsbury of Easton.

Kingsbury is a mental health counselor and co-authored the book, “Weight Wisdom: Affirmations to Free You From Food and Body Concerns,” with fellow Easton resident and SSEDC member Mary Ellen Williams.

To promote National Eating Disorder Awareness Week, (Feb. 27- March 5) the members of SSEDC have built and designed a paper mache statue of Barbie who will travel from Easton to Boston Children’s Hospital, and then on to schools and hospitals throughout the South Shore area.

Get Real Barbie

The statue, dubbed “Get Real Barbie” encourages the public to “get real” information, “get real” expectations and “get real” help for eating disorders.

The first thing anyone looking at “Get Real Barbie” will notice is that she does not look like a “real” Barbie. The truth is, this life-size figure is actually as “real” as Barbie gets.

Inspired by a proportion lesson in her geometry class, Easton resident Kristine Alach, 14, decided to calculate Barbie’s life-sized proportions. (more…)

Click here to read a Q&A interview about divorce and domestic violence with NASW member Katherine van Wormer, PhD, the author of a number of books including Women and the Criminal Justice System (2007, co-authored with C. Bartollas) and books on addiction and human behavior. Dr. van Wormer teaches Social Work at the University of Northern Iowa.

Dr. van Wormer has published seven articles on www.HelpStartsHere.org http://www.helpstartshere.org/Default.aspx?PageID=1217