more dysfunctional families and providing family conferences to facilitate discharge and treatment planning in complex cases (Miller & Walsh, 1991). In this way we demonstrate the quality social work adds to medical services. We hope others will follow the foundation laid by this study with research that continues to clarify our changing tasks in a health care industry in constant flux. JOHN W. SHARP SUSAN ZETTLER Cleveland Clinic Foundation Cleveland
References
Cowles, L. A., & Lefcowitz, M. J. (1992). Interdisciplinary expectations of the medical social worker in the hospital setting. Health and Social Work, 17, 57 65. Miller, R. D., & Walsh, T. D. (1991). The role of a palliative care service family conference in the management of the patient with advanced cancer. Palliative Medicine, 5,34 39. Sharp, J. W., Coleman, E., Starling, N., Cline, J., & Rehm, S. (1991). Hospital utilization for AIDS: Are all hospital days necessary? Quality Review Bulletin, 17(4), 113 119. -
-
-
Editorial's Viewpoint Is Strongly Supported I read with interest your recent editorial "Clinical Supervision: Key to Effective Social Work" [Health and Social Work, 17 (May 1992), pp. 83851 discusring the importance and efficacy of clinical supervision within a hospital-based practice, and I strongly support your viewpoint. Interestingly, just prior to the publication of the editorial, I had read an article by JamesRogers, Widrow, Schwankovsky, & Rasgon (1992) that reported that in a study of communitybased nephrology social workers, the percentage of time devoted to counseling patients decreased markedly as the number of years in practice increased. One conclusion was that the absence of professional validation may lead to an inability to retain a clinically oriented focus,
thus contributing to worker burnout. Good supervision can provide that validation that is particularly essential if the medical social worker is to remain a dynamic member of the multidisciplinary team with an ability to provide an effective social work perspective to the decisionmaking process. In the May 1992 issue of Social Work, Kurland and Salmon wrote that the intractability of today's problems creates unusual stress for social workers and a perceived sense of hopelessness that can be mitigated by effective supervision that encourages practitioners to set realistic goals and to value small successes. Surely the development and maintenance of clinical practice skins related to the crisis intervention approach needed to work successfully with hospitalized patients, families, and significant others can be enhanced by skilled clinical supervision in which discharge planning and counseling are not polarized. Most departments of social work monitor patient delay days and I assume that a significant number of those delays are related to "difficult families." Families and patients are indeed "difficult," because they are having to make increasingly complex decisions within shorter and shorter time frames, often with fewer and fewer community resources at their disposal. Because these delay days can be readily understood by hospital administrators in terms of "real dollars," can we not justify the saving of some of these dollars by advocating for supervision geared to improving the worker's skills in complex crisis intervention, which helps patients and families move ahead at a faster pace in their decision-making process? Also, the core of successful crisis intervention is surely an extremely accurate differential diagnosis requiring the sophisticated skills of a knowledgeable medical social worker. I suggest that the development and maintenance of these assessment skills can be linked to a positive supervisor-supervisee relationship. In an informal poll in our own department last year, 10 out of 11 workers responded that supervision was essential and that the continued growth and advancement of clinical skills should be the primary goal of supervision.
LETTERS
Downloaded from https://academic.oup.com/hsw/article-abstract/17/3/239/632459 by Rutgers University Libraries/Technical Services user on 12 January 2018
239
The concept of "supervision" is often misunderstood by our administrators. Possibly the word "consultation" should be used. In any case, it must not be viewed as an anachronism or a system that fosters dependency, but as an ongoing, time-effective means to empower staff and improve patient satisfaction, which also has positive financial benefits for the hospital. LOUISE COOPER Mount Sinai Medical Center Cleveland
References James-Rogers, A. L., Widrow, L., Schwankovsky, L., & Rasgon, S. A. (1992). Analysis of nephrology social workers tasks and functions. Dialysis and Transplantation, 21, 293 298. Kurland, R., & Salmon, R. (1992). When problems seem overwhelming: Emphasis in teaching, supervision, and consultation. Social Work, 37, 240-244. -
WRITE TO US! Discussion in the journal will help keep all of us up-to-date on what is happening in the field. We encourage readers to write letters to the editor. Your comments need not address material that has been published in the journal; instead, you may wish to write about new developments or directions in health and social work. Send your comments to "Letters," Health and Social Work, NASW, 750 First Street, NE, Suite 700, Washington, DC 20002-4241.
Helping Vulnerable Youths Runaway & Homeless Adolescents in the United States Deborah S. Boss, Principal Investigator
T
1t is like water to a parched throat
his monograph reports on an intensive, year-long investigation undertaken by the National Association of Social Workers, with support from the Family and Youth Services Bureau of the Administration on Children, Youth, and Families, Department of Health and Human Services. Provides hard data, practice-relevant information, and innovative suggestions and recommendations for social workers and others who serve at-risk adolescents. Price: $16.95 Item #2219 ISBN: 0-87101-221-9
240
NASW PRESS
to see NASW seriously addressing services to youths in this country. Helping Vulnerable Youtbs
offers a fresh look at critical issues in the rumway and homeless youth field. The recommendations for action are focused and relevant to the state-of-the-art in programming in the 1990s. Della M. Hughes, Executive Director National Network of Runaway and Youth Services, Inc. Washington, DC
Send $19.95 (Includes $3.00 postage and handling) to :
NASW Distribution Center P.O. Box 431 Annapolis JCT, MD 20701 or call 1-800-227-3590 HVY-5
HEALTH AND SOCIAL WORK /VOLUME 17, NUMBER 3 /AUGUST 1992
Downloaded from https://academic.oup.com/hsw/article-abstract/17/3/239/632459 by Rutgers University Libraries/Technical Services user on 12 January 2018
References
Cowles, L. A., & Lefcowitz, M. J. (1992). Interdisciplinary expectations of the medical social worker in the hospital setting. Health and Social Work, 17, 57 65. Miller, R. D., & Walsh, T. D. (1991). The role of a palliative care service family conference in the management of the patient with advanced cancer. Palliative Medicine, 5,34 39. Sharp, J. W., Coleman, E., Starling, N., Cline, J., & Rehm, S. (1991). Hospital utilization for AIDS: Are all hospital days necessary? Quality Review Bulletin, 17(4), 113 119. -
-
-
Editorial's Viewpoint Is Strongly Supported I read with interest your recent editorial "Clinical Supervision: Key to Effective Social Work" [Health and Social Work, 17 (May 1992), pp. 83851 discusring the importance and efficacy of clinical supervision within a hospital-based practice, and I strongly support your viewpoint. Interestingly, just prior to the publication of the editorial, I had read an article by JamesRogers, Widrow, Schwankovsky, & Rasgon (1992) that reported that in a study of communitybased nephrology social workers, the percentage of time devoted to counseling patients decreased markedly as the number of years in practice increased. One conclusion was that the absence of professional validation may lead to an inability to retain a clinically oriented focus,
thus contributing to worker burnout. Good supervision can provide that validation that is particularly essential if the medical social worker is to remain a dynamic member of the multidisciplinary team with an ability to provide an effective social work perspective to the decisionmaking process. In the May 1992 issue of Social Work, Kurland and Salmon wrote that the intractability of today's problems creates unusual stress for social workers and a perceived sense of hopelessness that can be mitigated by effective supervision that encourages practitioners to set realistic goals and to value small successes. Surely the development and maintenance of clinical practice skins related to the crisis intervention approach needed to work successfully with hospitalized patients, families, and significant others can be enhanced by skilled clinical supervision in which discharge planning and counseling are not polarized. Most departments of social work monitor patient delay days and I assume that a significant number of those delays are related to "difficult families." Families and patients are indeed "difficult," because they are having to make increasingly complex decisions within shorter and shorter time frames, often with fewer and fewer community resources at their disposal. Because these delay days can be readily understood by hospital administrators in terms of "real dollars," can we not justify the saving of some of these dollars by advocating for supervision geared to improving the worker's skills in complex crisis intervention, which helps patients and families move ahead at a faster pace in their decision-making process? Also, the core of successful crisis intervention is surely an extremely accurate differential diagnosis requiring the sophisticated skills of a knowledgeable medical social worker. I suggest that the development and maintenance of these assessment skills can be linked to a positive supervisor-supervisee relationship. In an informal poll in our own department last year, 10 out of 11 workers responded that supervision was essential and that the continued growth and advancement of clinical skills should be the primary goal of supervision.
LETTERS
Downloaded from https://academic.oup.com/hsw/article-abstract/17/3/239/632459 by Rutgers University Libraries/Technical Services user on 12 January 2018
239
The concept of "supervision" is often misunderstood by our administrators. Possibly the word "consultation" should be used. In any case, it must not be viewed as an anachronism or a system that fosters dependency, but as an ongoing, time-effective means to empower staff and improve patient satisfaction, which also has positive financial benefits for the hospital. LOUISE COOPER Mount Sinai Medical Center Cleveland
References James-Rogers, A. L., Widrow, L., Schwankovsky, L., & Rasgon, S. A. (1992). Analysis of nephrology social workers tasks and functions. Dialysis and Transplantation, 21, 293 298. Kurland, R., & Salmon, R. (1992). When problems seem overwhelming: Emphasis in teaching, supervision, and consultation. Social Work, 37, 240-244. -
WRITE TO US! Discussion in the journal will help keep all of us up-to-date on what is happening in the field. We encourage readers to write letters to the editor. Your comments need not address material that has been published in the journal; instead, you may wish to write about new developments or directions in health and social work. Send your comments to "Letters," Health and Social Work, NASW, 750 First Street, NE, Suite 700, Washington, DC 20002-4241.
Helping Vulnerable Youths Runaway & Homeless Adolescents in the United States Deborah S. Boss, Principal Investigator
T
1t is like water to a parched throat
his monograph reports on an intensive, year-long investigation undertaken by the National Association of Social Workers, with support from the Family and Youth Services Bureau of the Administration on Children, Youth, and Families, Department of Health and Human Services. Provides hard data, practice-relevant information, and innovative suggestions and recommendations for social workers and others who serve at-risk adolescents. Price: $16.95 Item #2219 ISBN: 0-87101-221-9
240
NASW PRESS
to see NASW seriously addressing services to youths in this country. Helping Vulnerable Youtbs
offers a fresh look at critical issues in the rumway and homeless youth field. The recommendations for action are focused and relevant to the state-of-the-art in programming in the 1990s. Della M. Hughes, Executive Director National Network of Runaway and Youth Services, Inc. Washington, DC
Send $19.95 (Includes $3.00 postage and handling) to :
NASW Distribution Center P.O. Box 431 Annapolis JCT, MD 20701 or call 1-800-227-3590 HVY-5
HEALTH AND SOCIAL WORK /VOLUME 17, NUMBER 3 /AUGUST 1992
Downloaded from https://academic.oup.com/hsw/article-abstract/17/3/239/632459 by Rutgers University Libraries/Technical Services user on 12 January 2018
