Perceived Workforce Challenges among Clinical Social Workers in Hematopoietic Cell Transplantation Programs

Abstract

Clinical social workers are psychosocial care experts who provide interventions that aim to address the emotional, relational, financial, and logistical challenges that arise throughout the hematopoietic cell transplantation (HCT) treatment and recovery process. Interventions that contribute to better patient outcomes can include cognitive behavioral therapy and counseling for adaptation to illness, family planning for 24/7 caregiver availability and strategies to support patient activities of daily living, instruction on guided imagery and relaxation techniques for symptom management and to decrease anxiety, psychoeducation on the treatment trajectory, and linkage with financial resources. A Social Work Workforce Group (SWG) was established through the System Capacity Initiative, led by the National Marrow Donor Program/Be The Match, to characterize the current social work workforce capacity and challenges. The SWG conducted a web-based survey of HCT clinical social workers in the United States. The response rate was 57% (n = 90), representing 76 transplant centers. Survey results indicated that the clinical social worker role and scope of practice varies significantly between centers; less than half of respondents reported that their clinical social work expertise was used to its fullest potential. With an estimated 3-fold increase in HCT patient volume by 2020, the need for specialized psychosocial health services will increase. The SWG makes recommendations to build capacity for the psychosocial care of HCT patients and to more fully integrate the social worker as a core member of the HCT team. The SWG created a Blood and Marrow Transplant (BMT) Clinical Social Worker role description that can be used by transplant centers to educate healthcare professionals, benchmark utilization of clinical social workers, and improve comprehensive psychosocial health programs.

Psychosocial assessment of candidates for hematopoietic cell transplantation: A national survey of centers' practices

“…While most centers assess every patient, some do not. In line with earlier literature, 18 we recommend that every patient undergoes psychosocial assessment. Universal assessment ensures equity in access to psychosocial support and resources.…”

Psychosocial Assessment Practices for Hematopoietic Stem Cell Transplantation: A National Survey Study

“… 32 , 33 , 34 Hence, a one-time cross-sectional assessment will not capture the changing psychosocial needs of patients and caregivers throughout HSCT recovery, contributing to unmet psychosocial needs. Although we did not obtain explicit information about the lack of follow-up care, persistent shortages of specialty mental health clinicians 35 and inadequate clinical social work staffing levels 36 are likely contributing factors. Additional factors not captured from our survey, such as insurance requirements that drive the predominance of pre-HSCT assessments, may also provide clues.…”

Transplantation and Cellular Therapy

“…Social workers or psychosocial clinicians can assist in pretransplant evaluation of donors and recipients, facilitate with lodging, transportation, financial grants, and other social needs of patients, and screen and triage psychological complications. Guidance that defines the role of social workers in facilitating and optimizing the care of HCT recipients has been published [20].…”