Final Preparation for SW 5376 Flashcards
What is the continuum of care?
Continuum of care is a concept involving a system that guides and tracks patients over time through a comprehensive array of health services spanning all levels and intensity of care. The continuum of care covers the delivery of healthcare over a period of time, and may refer to care provided from birth to end of life.
HIMSS
What are examples of community care?
Pre-primary care
Ambulatory care
Primary care
What are examples of acute care?
Acute care settings
Hospital
What are examples of post-acute care?
SNF (Skilled Nursing Facility)
IRF (Inpatient Rehabilitation Facility)
Home care
Hospice
What is Medicare?
health insurance coverage for persons who have paid into the Social Security System for a minimum of 44 quarters and who are older adults and/or who are disabled 30 months and more (6 months without social security disability payments and a minimum of 24 months on social security disability)
What are some of the gaps in Medicare Coverage?
What is the benefit of a supplemental or secondary insurance when you are on Medicare?
What is Medicaid?
health care coverage for persons whose income and assets qualify them for government assistance for health care.
What is a key goal of health insurance?
prevent financial destitution when persons experience serious or catastrophic health care needs. Assessing the patient’s care plan, the anticipated expenses compared to coverage, and maximizing coverage as possible are important goals.
What is the level of health care that is provided universally in the United States?
Emergency Care - at the most expensive level of care
What is eligibility for Medicaid?
What coverage is provided for those on Medicaid?
What is the eligibility for Medicare?
What type of coverage is available to those on Medicare?
What is COBRA Insurance?
Who Qualifies:
Why would or would not someone convert their employer-based insurance under COBRA?
Medical care is based on….
on scientific and developing evidence of treatments that are effective. An important variable is patient participation in their health, adherence to medical treatment protocols and investment in healthy behaviors.
Social workers typically see patients that are in what type of health condition?
dealing with serious illness events
What disparity impacts access to prevention and intervention?
There is an increasing awareness of and focus on health wellness and disease prevention, though that is more challenging for persons and families in lower income brackets, and those who may not have a primary care provider.
What is a developing area of patient ownership of health outcomes and health care workers intervention to maximize healthy behaviors?
Behavioral health
What are some common evidence-based approaches to behavioral health in medicine?
Motivational interviewing and CBT
What is the distinction between physical and mental health?
(sorry trick question…) The distinction between physical and mental health is in many ways artificial. The brain and central nervous system are part of the body and critical to both physical and mental health. Trauma and stress are implicated in many health conditions. As Bessel van der Kolk says: The body keeps the score.
Types of Medical Interventions for Physical and Mental Health:
assessment, diagnosis, planning, intervention, and evaluation of efficacy. Intervention often includes medication, behavioral change (diet, exercise, etc.) and therapeutic interventions for emotional, cognitive, and psychological illness.
Is medical social work generalist or advanced practice?
The answer is YES. There is much basic case management in medical social work, i.e. social work in health care contexts. This includes participating in care plan meetings, making referrals, following up, etc. Advanced case management includes assessment of strengths and needs over time and across a family or care unit. Family conferencing is an example of an advanced generalist skill in medical settings.
What is an example of an advanced practice skill in a medical setting?
Family Conferencing
Overview of Motivational Interviewing and Effective Patient Population
Stages of Change…
OARS…..
Particularly important in work where adherence is critical…ex. Substance use disorder
Overview of Behavioral Health and Effective Patient Population
Behavioral interventions; Cognitive behavioral interventions; These are often brief interventions. Ex. See the book: 10 Minute CBT for an example. See centering and grounding techniques for anxiety management, for example
Overview of Task Centered Social Work and Effective Patient Population
Overview of Solution Focused Social Work and Effective Patient Population
Overview of CBT and Group Skills Training and Effective Patient Population
Overview of Narrative Therapy
Children :
Adults:
Overview of CBT (PE or CPT or EMDR) for Trauma
Children:
Adults:
Overview of Reminiscence Therapy/ Life Review
Children:
Adults:
Overview of Paradoxical Intention
Children:
Adults:
Overview of Adaptive Information Processing
Children:
Adults:
What is the role of social workers in health care settings?
psychosocial assessment and intervention. The role of clinical social workers includes providing therapy and counseling to manage anxiety, depression, PTSD, and other conditions that are barriers to living fully. They assist patients in making plans for care needs that arise during illness. This includes referrals and helping to find funding for those services. They engage in family conferencing with families to make care plans for patients who are unable to care for themselves. They engage in active listening to patients/clients to help them express their responses to illness, their concerns about care, and their preferences as well as communicating to patients the realities of care needs and resources and the assessment of viability of care planning. To the extent possible, social workers are advocates for patient independence and choice. Social workers are skilled in managing difficult conversations about end of life decisions and about loss including the losses that come with illness and the loss and grief that comes with death. While the primary focus of work for the social worker is the identified patient/client, the social worker also works with the family and support system and with the physician and medical system. Care planning includes immediate needs, planning for discharge needs, and facilitating planning for long term needs (advanced case management).
What is critical to effective social work in medicine? and why?
Interdisciplinary and transdisciplinary work - For example, social worker’s do not prescribe medication but often provide psychoeducation on the importance of adherence to medication management, communication with physicians about efficacy, side effects, etc., and resources to access medications.
What is NOT the role of a social worker in medicine?
SW role with medicine is not prescription or patient instruction except to refer the patient and family to the instructions from MD, nurse and/or pharmacist.
How can social workers facilitate a client’s access to spiritual care within the client’s belief system/religious tradition?
referrals to chaplains and to the patient’s spiritual care provider.
What is care planning?
Care planning includes immediate needs, planning for discharge needs, and facilitating planning for long term needs (advanced case management).
All social work practice is based on….?
Assessment. Assessment leads to exploration of options and the facilitation of client self-determination and client safety.
When assessing a client, who can the social worker work with?
Social workers work both with patients and with their family members and support systems. This includes assisting with communication between patients and families and medical providers. When patients and/or families speak a different language than English, social workers often work with and through translation services which provide professional interpretation.
Is it permissible to use a family member as an interpreter if your patient does not speak English?
It is NOT best practice to use family members or staff not trained in interpretation.
Cultural assessment includes what…?
Cultural assessment including values and beliefs is important to all phases of the helping process beginning with engagement and assessment. When working with minors and guardians, assessment of the problem bringing the client to you includes cultural assessment, family assessment, reason for the referral, history, contributing factors, and agreements around communication (similar to any situation involving adolescents and young adults with the important added layers of culture and of family systems).
When working with clients and their family support systems, what is required?
cultural sensitivity, humility, and ongoing commitment and work toward competence
What is an example risk factor in patients with clinical depression?
For example, one risk and assessment factor in patients/clients with clinical depression who are treated with medication (especially new or different medications) is the possibility that, as the medication begins to work, a patient/client who has not had the energy/will to complete a suicide may be better enough to make a plan and/or implement a plan and not better enough to have the hope or resilience yet to live. You may develop a diagnostic impression from a generalist practice suicide assessment by looking at risk factors, asking if the patient is thinking of hurting themselves, looking for physical evidence of self-harm like cutting, asking how the client would hurt themselves or perhaps kill themselves. Explore whether or not the patient has the means to implement that method and if so, remove those lethal means and consider that an emergency situation. These diagnostic impressions help us know when to intervene.
A diagnostic impression is only a…
beginning point and you will continue to discover information that might change the initial diagnosis.
What must always be addressed in the treatment plan if mentioned by the patient?
When the diagnostic work up suggests suicidal risk, that is a significant concern which needs to be addressed in the treatment plan. Some patients will at that point decide to tell us what it takes to be released from our care/intervention. They may tell us that they are not thinking of hurting themselves, would never do it, and even make promises not too. If at those points, you have a “gut check”, i.e. feel that the patient/client may not be telling the truth, there are advanced techniques available.
What is Shea’s Skill Set?
for assessment of risk when a client denies thoughts/intent about which you are concerned or uncertain.
What are some Validity Techniques?
for assessment of risk when a client denies thoughts/intent about which you are concerned or uncertain.
What work of children is…
Play
