Creating a Specialized
Oncology and Palliative Care
Social Work Training Program
Taryn Lindhorst, PhD
J’May Rivara, LICSW
Lynn Behar, PhD
Robin Kelson, BA
Today’s Agenda
•
Development of Carol LaMare Program
•
Field Placements
•
Survey of Graduates
•
Seminar Case Example
•
Curriculum
•
Q & A
Program Development
•
2005 – began with
$3000 scholarship to
one student
•
2010 – expanded
program to 6
scholarships with 2 x
month seminar
•
2015 – $5000
scholarship
–
49 MSW students
Field Placements
Evolution of Selection of
Scholarship Students
•
Factors to consider
•breadth of organizations •across MSW cohorts•
Competitive process over time
•
Identified sites
: (UWMC, SCCA, SCI, PHOS)•
Other designated settings
(e.g., VA, Evergreen, Overlake,• UW Valley)
Survey of Graduates
Percent
CL students working in medical social work
35%
CL students working in oncology or palliative care
30%
Field placement provided helpful preparation
86.5%
Seminar was helpful
89%
Student Comments
•
The support I’ve received from my CL cohort and other
colleagues who had participated in CL has been invaluable.
I’m hopeful that these relationships will continue through my
SW Career.
•
Being in the seminars has been one of the most difficult
things I have pushed myself to do because of the emotional
nature of the program and our work. . . I’ve been able to
challenge and face my own fears.
•
I have an incredible support network as a result of the CL
cohort.
•
I firmly believe that the CL scholarship, seminar, and overall
community was by far the best part of my MSW program.
Marta -- MICRO
Biological
• Diagnosed with cervical cancer in 2014 at 30 weeks pregnant • Underwent radical caesarian hysterectomy (in which the uterus is
removed at the time of c-section) with bilateral pelvic lymph node dissection
• Received concurrent chemo and radiation; January 2015 presented to outpatient oncologist with difficult/painful urination; workup revealed pelvic mass and multiple lung nodules
• End of March, admitted to MICU with acute renal failure; Nephrology consulted, nephrostomy performed • Diagnosed with cervical cancer in 2014 at 30 weeks pregnant • Underwent radical caesarian hysterectomy (in which the uterus is
removed at the time of c-section) with bilateral pelvic lymph node dissection
• Received concurrent chemo and radiation; January 2015 presented to outpatient oncologist with difficult/painful urination; workup revealed pelvic mass and multiple lung nodules
• End of March, admitted to MICU with acute renal failure; Nephrology consulted, nephrostomy performed
MICRO
Psychological
•
Marta is in great distress and struggling to cope with
her prognosis. She is not comfortable articulating her
fears and concerns
.
•
Marta is in great distress and struggling to cope with
her prognosis. She is not comfortable articulating her
fears and concerns
.
MICRO: Social
• Marta is 28 years old and has 3 children— a son (aged 7), adaughter (aged 5), and a baby boy (6 months).
• Marta and her children live with Marta’s younger sister, Carla (aged 20), and Carla’s boyfriend in an apartment in Renton. • Carla has been the primary caregiver for Marta and her children
since the onset of Marta’s illness. Carla has bonded deeply with the baby in particular.
• Marta is the oldest of 4 siblings. Her parents and two younger siblings live in Mexico.
• Marta is 28 years old and has 3 children— a son (aged 7), a daughter (aged 5), and a baby boy (6 months).
• Marta and her children live with Marta’s younger sister, Carla (aged 20), and Carla’s boyfriend in an apartment in Renton. • Carla has been the primary caregiver for Marta and her children
since the onset of Marta’s illness. Carla has bonded deeply with the baby in particular.
• Marta is the oldest of 4 siblings. Her parents and two younger siblings live in Mexico.
•
Moral distress among hospital staff re ethics of
offering patient chemo at this stage
Emotional difficulty/countertransference for many
nursing staff due in part to patient’s age
•
Particular challenges for palliative care and social
work re patient’s reluctance to discuss issues openly
•
Moral distress among hospital staff re ethics of
offering patient chemo at this stage
Emotional difficulty/countertransference for many
nursing staff due in part to patient’s age
•
Particular challenges for palliative care and social
work re patient’s reluctance to discuss issues openly
MEZZO
•
Impact of national borders and visa restrictions on
ability of family to be united and offer mutual
support at time of death
•
Issue of curative (chemo) option ruling out hospice
referral
•
Impact of national borders and visa restrictions on
ability of family to be united and offer mutual
support at time of death
•
Issue of curative (chemo) option ruling out hospice
referral
•
Aggressive treatment when death is imminent
•
Cultural values and challenges of patient preference
for indirect communication
•
Potentially complex issues re child custody
•
Youthful age of patient and countertransference
issues this raised
•
Aggressive treatment when death is imminent
•
Cultural values and challenges of patient preference
for indirect communication
•
Potentially complex issues re child custody
•
Youthful age of patient and countertransference
issues this raised
Topics Discussed
Overall Curriculum Design
Oncology
Social
Work
Palliative
Care
Sustainability
•
Post-Graduation Involvement
–
Reunion, Breakfast, Special Events
•
Financial support
–
ACS support
–
VA support
•
Linkage to UW Cambia Palliative Care Center
of Excellence