Throughout history, the creation of various groups and movements around social issues has made a great contribution to what is known today as social work and social welfare. The Charity Organization Society (COS) is a good example of this. In 1869 Octavia Hill and Frances Wisebart Jacobs founded The COS in England. They focused on individual factors associated with alcoholism, poverty, and poor work habits. In its work, the COS invited families in need to fill out a form for assistance. Then, a friendly visitor was assigned to the family and tried to motivate them to gain more independence and have a better quality of life. Over time, the organization found it necessary to create the paid position of “agent” to visit those who made the applications. These agents were the predecessors of professional social workers.
In 1877, The SOC was imported from England to the United States, and a few years later in 1889, America’s first school of social work was created: The Columbia School of Social Work. Over the years, social work became related to other disciplines like health, so much so, that by 1905, Garnet I. Pelton was the first Hospital social worker at Massachusetts General Hospital. Since then, the social work field has opened its work area to include health care practices such as public health agencies, private medical practices, and psychiatric practices. From there, social workers began to establish themselves within the hospitals from 1913 and by 1914 to 2000, the number of social workers within the hospitals had increased markedly (Cowles, 2012).
For a long time, health care social workers have been responsible for providing the support necessary for their clients to cope with terminal, chronic, or acute illnesses. Also, they motivate them to self-determination and advocate for their rights to have access to services and resources essential to their support. Some of the services provided by Health care social workers are focused on family care; offering information; promoting health and good habits to avoid illness; and grief counseling and crisis intervention, which are the most common health social work roles.
Social work in health care can be given in different settings. Many health care social workers can work in different places such as hospitals, clinics, intensive care, and rehabilitation. The assistance provided includes trained personnel such as nurses, doctors, or social workers; they also offer facilities for the provision of services such as hospitals or medical centers, and they have specialized spaces and schedules on how to avoid certain diseases. Nonetheless, not all the population is in the same condition to accessing the services of social work in rehabilitation (Cowles, 2012). First, it is necessary to explain what the rehabilitation service consists of, and then to show some shortcomings and obstacles in the provision of this service.
In health care, rehabilitation seeks to bring the person back to the state of normality that the patient had before the injury, illness, or drug problem. Rehabilitation service can be directed towards different groups of people. For example, people with physical, cognitive, and development challenges like spinal injury, muscular dystrophy, paralysis, amputation, and traumatic brain injury have a wide range of rehabilitation and education services. In most cases, the service and rehabilitation administration provide the necessary support to enable their patients to access and maintain employment as they receive job training, medical care, and individualized assistance.
In the same way, people with addiction or substance use problems such as alcohol, tobacco, opium, or recreational drugs which cause fiscal, social, and emotional problems, can be rehabilitated in private centers with the support of nurses, doctors, counselors, therapists or social workers. Also, in conjunction with mental health service, it is possible to rehabilitate patients with mental illnesses such as major depression, schizophrenia, and substance-related disorders. For this group, there are rehabilitation programs aimed at supporting the patient to recover and rehabilitate from mental health and co-occurring disorders.
The role of nurses should be recognized within the rehabilitation process. Rehabilitation nurses specialize in helping people with chronic illnesses or disabilities adapt to a new lifestyle and achieve optimal health. Besides, they set goals and treatment plans according to their patients’ needs to achieve independence. They also provide patient and family counseling, education, and case management. They can also take part in research to improve the practice of rehabilitation (Aadal et al., 2017).
However, as mentioned at the beginning, one very noticeable problem is that not all the population has the facility to access these services. For example, transportation is a problem for people located in rural areas (Smith & Alexander, 1995). They have limited access to public transportation, for that reason, they are forced to rely on family members for the type and level of rehabilitation they require. Also, some groups with ethnic variations do not have the same advantages that others have when applying for these types of services.
Furthermore, the financial problem is another obstacle to the provision of this service. Rehabilitation is a long-term process that generates a high expense for the patient receiving the service as well as for the family. Yet, most groups that need these services do not have the resources to request them (Cowles, 2012). Therefore, lack of insurance coverage or lack of money from beneficiaries is incident factors in the interruption of the rehabilitation process. There are also individual problems for providers, as many of them want to understand the patient’s problem, injury, or illness. They tend to omit their opinion on the subject, turning the conversation into a monologue, and preventing the patient from approaching the therapist or counselor.
Overall, social work in health care has evolved. From its formal appearance in 1905 to the present day. Rehabilitation as one of the services in favor of health care has also had a great expansion in front of the population that can help, starting with people with physical, cognitive, and development challenges, and addiction or substance use problems; to more specialized care to help patients with mental illnesses. Despite this, this area of social work still has several improvements to make, starting with the cost of some services and the attention provided by some employees. Likewise, the location of some of these centers, this, added to the limited access to means of transportation of the populations located in the peripheries of the cities. Eventually, it will be possible to see what changes have been achieved on these issues or whether they have taken a back seat to current priorities.
Auslander, G. (2001). Social Work in Health Care. Journal of Social Work, 1(2), 201–222. https://doi.org/10.1177/146801730100100206
Cowles, L. A. (2012). Social Work in the Health Field: A Care Perspective, Second Edition (English Edition) (2nd ed.). Routledge.
Smith, T. S., & Alexander, I. (1995). Issues and practices across rural rehabilitation in the United States. Technology and Disability, 4(1), 3–10. https://doi.org/10.3233/tad-1995-4103
Aadal, L., Angel, S., Langhorn, L., Pedersen, B. B., & Dreyer, P. (2017). Nursing roles and functions addressing relatives during in-hospital rehabilitation following stroke. Care needs and involvement. Scandinavian Journal of Caring Sciences, 32(2), 871–879. https://doi.org/10.1111/scs.12518
Cox, L. E., Tice, C. J., & Long, Associate Dean of the College of Social Sciences Health and Education and Professor of Social Work Dennis D. (2018). Introduction to Social Work: An Advocacy-Based Profession (2nd ed.). Sage Publications, Inc.
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