A Call for Hope-Centered Work: A Preliminary Study of Oncology Social Workers’ Perceptions of the Role and Value of Hope at End-of-Life The original version of the article unfortunately contained an error in a couple of sentences. In ‘Personal Views and Experiences’ section, percentage value ‘98’ is missing in the sentence ‘Nearly all of participants ((* %) said that they thought of solutions to reach their hoped-for goals, agreeing or strongly agreeing with the statement: “When I have faced difficulties that couldn’t be solved right then, I thought of solution for the future.” and it should read as below.

Introduction to “Best Practices in Psychosocial Healthcare: Complexity, Compromise, and Innovation”

A Commentary on Compromise Abstract This commentary invites reflection on the origin stories of health and palliative social work, considers the essential congruity of social work values with the principles of palliative care and explores the impact of minority status within health care systems. Rather than compromise, the suggested vision is one of health social work asserting voice and values as leaders toward the goal of patient-centered, family-focused care across diagnoses and settings of practice.

Support is a Complicated Concept: A Social Work Practice Reflection on Support and Anxiety Abstract This paper is a practice reflection by two medical social workers. It describes insights from interviews with older adults recovering from illness. The clients were 32 survivors of hospitalization for critical illness and 50 home health patients. Our practice discussions explored a counterintuitive concept: patients with more sources of support reported more anxiety during their illness recovery. Patient anxiety was measured using the DSM-5 and HADS-A criteria. A brief literature review describes the difficulties of quantifying and defining support. Case vignettes are presented to describe three categories of patients who experienced anxiety connected to their support systems. The importance of a social work approach to understanding and individualizing client supports is highlighted. Practical practice suggestions and interventions are provided.

Children’s Perspectives on the Experiences of Their Siblings with Chronic Disorders Abstract Knowledge about the experiences of children with chronic disorders (CCD) is often based on parent-report. Obtaining self-report from CCD may be challenging due to cognitive impairments associated with many disorders. We explored siblings’ perspectives on the experiences of their brothers and sisters with CCD, which represent a unique intragenerational and peer-based viewpoint. Siblings of children with various genetic disorders involving physical and/or intellectual disabilities were recruited from family courses at a specialist center for rare disorders. Participants (N = 58; M age= 11.4 years, SD = 2.4; range 7 to 17 years; 69.0% girls) attended group sessions focused on siblings’ diagnostic knowledge and emotional experiences. We conducted a thematic analysis following guidelines for consensual qualitative research of 20 videotaped and transcribed group sessions for 58 siblings of CCD. We interpreted siblings’ perspectives as indicating considerable efforts to understand and reflect upon the state of mind of the CCD along the following main themes: Abilities; Intensions; Insight; Emotions; Personality, preferences and desires; and Normality versus difference. Siblings emphasized CCD’s physical, cognitive, and social abilities, focusing more on strengths than limitations. A desire to be normal and lack of insight were common inferred reasons for problematic behavior displayed by the CCD. Siblings expressed fears of bullying of the CCD. In conclusion, siblings show psychologically complex insights into the experiences and mindsets of CCD and should be considered as informants in research and in informing practice interventions for CCD, alongside their parents.

The Hidden Cost of Cancer: Helping Clients Cope with Financial Toxicity Abstract Financial toxicity is a term that is increasingly used in the medical literature to describe objective and subjective measures of financial strain that many people with cancer face as a result of costly care and treatment. The author first reviews the literature for evidence of financial toxicity and its impact on quality of life, especially anxiety and depression. Maslow’s (Motivation and personality, 2nd edn., Harper & Row, New York, 1970) hierarchy of needs is then presented as a theoretical basis for the impact of financial stress on clients’ ability to cope with their cancer experience. Finally, a clinical vignette illustrates the double burden of cancer and financial strain, highlighting the need to assess for and address financial hardship as a key part of our clinical practice. Psychosocial interventions—such as problem-solving, cognitive-behavioral therapy, family and group support, and meaning-centered therapy—may be utilized to decrease cancer-related distress, even when financial toxicity cannot be fully alleviated. Once financial obstacles are identified and acknowledged, however, the pathway to effective coping is clearer.

Navigating Psychosocial Challenges in Primary Care with an Integrated Behavioral Health Model Abstract Research has demonstrated that physical health outcomes are often related to behavioral health outcomes. Integrated behavioral health models, particularly in primary care settings, help bridge gaps in care by linking the treatment of physical and emotional problems together. Social workers are a key part of the primary care treatment team because they are trained to assess patients within the full context of their biopsychosocial and spiritual needs. The following article explores the ways in which social workers can engage in integrated behavioral health models as an adaptive healthcare practice, the common healthcare challenges social workers face, and suggested interventions in integrated settings. Implications for practice are discussed including the necessary skills and background social workers in these settings should have, the need to further expand the social work workforce in integrated healthcare, and the role of social workers in the continued development and evaluation of integrated models.

A Call for Hope-Centered Work: A Preliminary Study of Oncology Social Workers’ Perceptions of the Role and Value of Hope at End-of-Life Abstract This paper examines the role and value of hope in the experiences of people with cancer at end-of-life according to the social workers who counsel them. Despite discussion of hope’s value in social work literature, it continues to be de-emphasized in end-of-life (EOL) social work training and discourse in favor of theories of grief, loss and bereavement. In an online survey, social workers affiliated with a national oncology social work organization (n = 67) responded to closed-ended items. They assessed personal views on and experiences of hope, views on hope within the context of EOL and work experiences with EOL patients, felt competency in assessment of and engagement with hopefulness/hopelessness, and related training and support. Several open-ended items were also included and provided supplemental qualitative data. Participants recognized the value of hope hypothetically. However, their responses showed disagreement about the value of hope when it was considered within the context of EOL. They felt comfortable engaging in hope-centered discussion with EOL patients, yet did not routinely assess or encourage exploration of hope or hopelessness. There is a need for qualitative research to further explore social workers’ understanding of hope at EOL and therapeutic engagement related to it.

Research Use and Evidence-Based Practice Among Swedish Medical Social Workers: A Qualitative Study Abstract The aim of this study was to explore medical social workers’ perceptions of evidencebased practice (EBP), including factors relevant for the successful implementation of evidence into medical social work practice. Eight focus group interviews were conducted that included 27 medical social workers. Data were analyzed using qualitative content analysis, which resulted in two categories: “knowledge in practice” and “challenges in relation to the implementation of EBP” and four subcategories: “practice based on research evidence or experience”, “obtaining new evidence of practice”, “research and the social work context”, and “barriers and facilitating factors”. Participants tended to perceive EBP as theoretical and positivistic while perceiving their own knowledge as eclectic and experience-based. Although they perceived the relevance of research findings to their clinical practice, they expressed a need for support to translate research into policy and practice. They also reported that studies about their specific work were scarce. The medical social workers’ suggestion for the facilitation of knowledge exchange needs further investigation.

Demoralization During Medical Illness: A Case of Common Factors Treatment Abstract A serious physical illness can become the defining aspect of a person’s life. If a belief develops that the illness cannot be resolved, either through medical care or one’s own coping efforts, then a person can develop demoralization, which is defined as a pervasive feeling of defeat, hopelessness, and powerlessness. Demoralization involves a depressed mood but differs from a major depressive episode in that demoralization does not exhibit the generalized anhedonia found in major depression. Instead, demoralization has a singular precipitating factor causing the patient’s hopelessness, the illness. A patient’s demoralization typically remits if some form of hope is restored. The experience of being hospitalized for an illness, which is often overwhelming and difficult for patients, can adversely impact hope and foster or exacerbate demoralization, leading to adverse outcomes. A brief approach to treating demoralization in the hospital environment, emphasizing interpersonal engagement over pharmacological interventions, is described through a case example. The approach is based on the common factors approach to effective psychotherapy and is well suited for use within fast-paced medical settings.