Social Work Generalist Practice Generalist Practice is the application of an eclectic knowledge base, professional values and ethics, and a wide range of skills to target any size system for change within the context of three primary principles, and four major processes.

Three Primary Principles Emphasis on empowerment, strengths, and resiliency. Importance of understanding how human diversity characterizes and shapes the human experience and is critical to the formation of identity. Advocacy for human rights, and the pursuit of social and economic justice

Four Primary Processes Assumption of a wide range of roles Application of critical thinking skills throughout the intervention process Incorporates research-informed practice to determine most effective/best practice principles Follow a planned change process.

Social Work Generalist Practice Eclectic Knowledge Base Strengths Perspective Systems Theory Ecological Theory Common Generalist Skills Planned Change Model

Holistic Assessment Micro Concerns Mezzo Concerns Macro Concerns Strengths Issues related to Diversity that must be accounted for in planning/intervention: - Gender - Ethnicity - Sexual Orientation - Age - Culture - Disability - Social/Economic Status - Religion

Social Work and Health Care Mental Health – 60 % of mental health professionals are social workers (NASW) In Patient Out Patient Partial Hospitalization Emergency Services

Suicide In 2010 Idaho had the 6 th highest suicide rate in the nation – 49% higher than the national average (latest data available according to the Suicide Prevention Action Network of Idaho) In 2011 – 284 people committed suicide in Idaho There is a significant increase in the suicide rate among farmers; higher than the suicide rate among the general male population. (Idaho Suicide Prevention Research Report)

Social Work and Health Care Discharge Planning Hospice/Palliative Care Emergency Room Care Suicide Substance Abuse Trauma Triage Oncology

Social Work and Health Care Obstetrics Surgical Intensive Care Rehabilitation Programs Health Literacy Community Health Clinics Nursing Homes

Social Work and Health Care Home Health Care Veterans Service Networks

Discharge Planning Assessment Coordination Documentation Counseling Linkage

Assessment Assessment: >Bio/Psycho/Social/Spiritual/Financial resources for discharge planning > Interviews with patient and family members/caregivers and engages family in decision-making process > Assists medical teams understanding of patients bio/psycho/social/spiritual/financial needs

Coordination > Activities concerned with exchanging information with hospital personnel or the patient and the family to facilitate discharge planning.

Coordination > The availability, willingness, and ability of family/caregivers to provide care. > Advise patients and family/caregivers about appropriate discharge options addressed in bio/psycho/social/spiritual/financial assessment

Documentation Activities concerned with producing a written record of discharge planning process. Checklists, Narratives, Forms, Summaries, etc. Record of required information provided patient or individual acting in patients behalf

Counseling P rovision of information and intervention to bring about change in clients feelings, behaviors, attitudes, activities Assist family with adjustment/adaptation to changes Referral Follow-up

Linkage Activities focused on obtaining services for patients and families after discharge Include patient and family wishes wherever possible

Hospice/Palliative Care Counseling for individuals, couples, and families Psychosocial education to patents and families/caregivers about coping skills and adjustment to anxiety relative to death, suffering and related stressors. Crisis Intervention Mediating conflicts within families, between clients and the interdisciplinary team, and between service organizations

Hospice/Palliative Care Advocacy Facilitating psycho/educational support groups Facilitating advance planning Work closely with interdisciplinary teams Access needed equipment, services, etc. for patients and families

Emergency Room Care Connecting patients to services they need at home and in the community avoids unnecessary hospital admissions and reduces insurance costs. Over 80% of patients seen by social workers in emergency departments were not admitted; rather, they were referred to community services (2007) Crisis Intervention Patients with a mental disorder Counseling victims of violence, sexual assault Child Protection Counseling with patients and families

Emergency Room Care Suicidal Ideology – or attempted suicide Substance Abuse One in eight adults in Emergency Departments present with a mental disorder, substance abuse, or both. (Agency for Health Care Research and Quality, 2007) Address acute grief reactions for family members and mobilize support systems.

Health Literacy Health Literacy is the degree to which an individual has the capacity to obtain, process, and understand basic health information an services needed to make appropriate health decisions (Ratzan & Parker, 2000) More than 1/3 of adults in the U.S. do not have adequate health literacy to manage their own health care needs (Kutner, Greenberg, Jin, & Paulsen, 2006) Low health literacy coexists with other social disadvantages such as low levels of education, lack of medical insurance, and poverty, often exacerbating its effect on vulnerable populations.

Health Literacy Low health literacy is associated with increased emergency department visits, higher rates of hospitalization, longer stays (by an average of two days) (Nelson-Bohlman et al, 2004) and poorer self- reported health. (Kutner et al, 2006). The estimated cost of low health literacy ranges from $106 to $238 billion each year (Vernon, Trujillo, Rosenbaum, & DeBuono, 2007).

References Accordino, M.P., Porter, D.F., & Morse, T. (2001). Deinstitutionalization of persons with severe mental illness: Context and consequences. Journal of Rehabilitation, Vol. 67, No.2. Allen, H. (2012). Is there a social worker in the house? Health care reform and the future of medical social work. Health & Social Work, vol.38, No. 3, Druss, B., Bornemann, T., Fry-Johnson, Y., McCombs, H., Politzer, R., & Rust, G. (2006). Trends in mental health substance abuse services at the nations community health care centers: American journal of public health, 96, Hollman, D., Dzieglewski, S.F., & Teare, R. (2003). Differences and similarities between social work and nurse discharge planners. Health and Social Work, Vol. 28, Number 3,

References Johansen, S., Kaasa, S., Lorge, J.H. & Materstvedt, L.J. (2005). Attitudes towards and wishes for, enthusiasm in advanced cancer patients at a palliative medicine unit. Palliative Medicine, 19, Kirst-Ashman, K.K,. & Hull, Jr., (2012). G.H. Understanding generalist practice. Sixth Edition. Brooks/Cole, Cengage Learning. Kutner, M., Greenberg, E., Jin, Y., & Paulsen, C. (2006). The health literacy of Americas adults: Results from the 2003 National Assessment of Adult Literacy. Washington, DC: U.S. Department of Education, National Center for Education. Liechty, J.M. (2011). Health literacy: Critical opportunities for social work leadership in health care and research. Health and Social Work, Vol. 16, No. 2,

References Mcoyd, J.L.M. (2010). The implicit contract: Implications for health social work. Health and Social Work. Vol. 35, No. 10, Nielsen-Bohlman, L., Panzer, A.M., & Kindig, D.A. (Eds.). (2004). Health literacy: A prescription to end confusion. Washington, DC: National Academics Press. Robertson, M. (2008). Suicidal ideation in the palliative care patient: Considerations for health care practice. Australian social work. Vol. 61, No. 2, VanPelt, J. (2010). Making caring connections, cutting costs – Social work in the emergency department. Social work today. Vol. 10, No. 6, Vernon, J.A., Trujillo, A., Rosenbaum, S., & DeBuono, B. (2007). Low health literacy: Implications for national health policy. Retrieved from