Academic journal article Journal of Social Work Education

Analysis of End-of-Life Content in Social Work Textbooks

Academic journal article Journal of Social Work Education

Analysis of End-of-Life Content in Social Work Textbooks

Article excerpt

INADEQUATE CARE FOR THE DYING, documented in a number of influential studies (Hanson, Danis, & Garrett, 1997; SUPPORT Principal Investigators, 1995), has precipitated a national movement to improve end-of-life (EOL) care practices and policies. An important step in this movement has been to enhance the knowledge and skills of physicians, nurses, social workers, and other professionals (Field & Cassel, 1997). At the National Social Work Summit on End-of-Life and Palliative Care, held in the spring of 2002, items relevant to educational resources and the preparation of social workers in EOL care emerged as a top 10 priority from among the 232 options that were generated by the experts in attendance (Blacker, Christ, & Bloom, 2002).

This article reports on the findings from the first two goals of an undertaking funded by the Open Society Institute, Project on Death in America, titled "Strengthening Social Work Education to Improve End-of-Life Care." The three project goals were to (1) develop EOL- and grief- or loss-related content guidelines for the social work profession, (2) use these guidelines to conduct a critical review of 50 textbooks frequently used in social work education, and (3) write a text that will address some of the gaps identified in this review to enhance the educational resources available to educators, students, and practitioners.

Relevance of EOL Care to the Social Work Profession

Healthcare social workers serve important roles in the provision of EOL care in many varied settings. Examples of these settings include home healthcare (Egan & Kadushin, 1999), palliative-care units or freestanding hospice units, the emergency room (Lauria, Whitaker, & Coleman, 2001), intensive-care units (Mosenthal, Lee, & Huffman, 2002), hospital obstetrical (Pauw, 1991), and neonatal intensive care units (Silverman, 1992), pediatric settings and critical-care units (Dungan, Jaquay, Reznik, & Sands, 1995; Papadatou, 1997), pain clinics, community-based substance abuse and health agencies, and nursing homes (Kruzich & Powell, 1995). Social workers in many other domains of practice who work with individuals and families at all stages of the life span have the potential to confront EOL issues, including suicide or death, and must be prepared to assess and intervene appropriately in these circumstances. Social workers in school settings often work with children and teens that have experienced death of friends, family members, or teachers and offer support relevant to stress debriefing, suicide prevention, and bereavement support. Child welfare workers commonly address loss, separation, anxiety, and bereavement in the child-welfare system and must assess and intervene to prevent child-maltreatment fatalities. Social workers are unexpectedly called upon to respond to national disasters and crises such as the Oklahoma City Bombing and the September 11th terrorist attacks (Webb, 2002). Social workers have a commitment to serve poverty-stricken urban communities that are exposed to chronic violence and the resulting complicated bereavement (Van Epps, Opie, & Goodwin, 1997) and to advocate for policy change to address disparities in the provision of EOL care. In sum, the role of social work in EOL care extends across many practice settings.

Several research initiatives reveal a striking gap in attention to the educational needs and competencies related to EOL care in social work. From a national survey of medical, nursing, pharmacy, dental, and social work schools, Dickinson, Sumner, and Frederick (1992) reported that 64% of 270 baccalaureate social work programs, and 60% of 98 graduate social work programs integrated general content on death and dying into the Human Behavior and the Social Environment (HBSE) course or into gerontology courses. The authors also noted that courses offered on the broad topic of death education are generally electives that are taken by fewer than 25% of students. …

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