|Counselor, Advocate, and Educator
The Dynamic Role of the Social Worker
by Nicole Roy, ALB '04
Nicole Roy, ALB '04, sat down with ALB alumna Amie Weiner, MSW, to learn about her career as a hospital social worker.
Amie Weiner and Nicole Roy
As many of you begin to reach the end of your academic life here at Harvard Extension, you may be wondering what to do next. With my psychology field of study, I wanted to enter the human services field where I could make a difference in the lives of others. Although this field offers a variety of options, I was curious to find out more about the role of a social worker. So early this fall semester, I was given the opportunity to speak with Amie Weiner, who is working as a social worker in an inpatient hospital. During our interview I discovered that social work is a dynamic career that can involve group therapy, individual counseling, and inpatient or outpatient services. But what is most unique about the field is that, "you are seeing someone's life at a time that is different from any other time, because they are in a crisis. It is quite a privilege to be in someone's life during that time because you feel like you can be very useful," says Amie.
NR: What prompted you to switch from teaching to social work?
AW: I was a public school teacher for many years and I liked teaching, but I was always more interested in what was going for the students emotionally. While pursuing my ALB degree, I worked at Children's Hospital and did advocacy work with battered women. So I did many different things that were reflective of social work, but I just didn't label it "social work." But when I looked into this career I thought that maybe I should pursue it. I'm glad I did.
NR: Can you tell me about your master's program?
AW: I was a full-time student at the Simmons School for Social Work, which meant two years of full-time study plus an internship. At Simmons, their philosophy is about connecting the practical application to the theory. For me, that was the motivation for choosing that particular program, because I liked the idea of doing hands-on work while I was learning. About three weeks into the program, I started looking for placements, with the help of my field advisor.
NR: Where was your first placement?
AW: I worked at the Ivy Street School in Brookline, which is a residential and adolescent program for students with brain injury aged 16-22. While I was there, I did play and family therapy, worked with classroom teachers to implement learning strategies, and targeted problem areas for each student.
NR: Were you allowed to choose your field placements?
AW: Yes. During your first year, they present you with various placement options from which you may choose. In the second year, you have the opportunity to choose a more specific population that matches your future career interest. Prior to graduate school I worked with children, so I chose to focus my second year on work with adolescents and adults. A lot of people stay with the same population for both years, but it is important to go into that first year being open because you never know what you might enjoy.
NR: Where was your second year placement?
AW: It was at St. Elizabeth's Medical Center. I wanted to work in a hospital setting. The placment involved dealing with both inpatient and outpatient psychiatric populations, making diagnosis, doing family work, and clinical assessments. Now, there has been a shift to a shortened length of stay and the job incorporates a significant amount of case management and discharge planning.
NR: What is involved in discharge planning?
AW: You are assigned to patients and work very closely with psychiatrists, nurses, and other social workers. Some of the patients may have been in the hospital many times and may need a medication adjustment. You might call the family, providers, and have meetings if they were having problems in the community or in their home. Or, you would coordinate a discharge plan, which may include: referrals for therapy, psychopharmacology visits with a psychiatrist, and initiating a referral to a day treatment program. Many times people who come into the hospital may not have structure during the day, so you might consider a day treatment program which could address areas such as: symptom management, vocational training, or socialization. Ultimately, the hope is that this could improve their quality of life. It is not uncommon, however, for patients to decline outside recommendations given by the doctors and social workers.
NR: What is involved in your work with teenagers?
AW: In an inpatient unit I often work with adolescents and young adults who are admitted due to the beginning symptoms of a mental illness. In that case, much of my work consists of psychoeducation around their diagnoses, family work, and medication management. This type of intervention can be very sad because in many ways, it is like doing grief work with the family. For instance, a son who was in college and seemingly high functioning, now faces a diagnosis that not only impacts his life, but also the life of his family, whose expectations may have to change.
NR: Can you describe a typical day?
AW: There really is no typical day. I may be assigned to four or five new patients with very different diagnoses, psychosocial issues, or discharge planning needs. My day may consist of meeting with patients, family and provider contacts, and family meetings. What’s unique about this role is that you can be very autonomous and you can decide how you want to spend that day.
NR: What are some of the inherent challenges in working with this patient population?
AW: In an inpatient unit, the turnaround time can be quick because of insurance, or perhaps the patient does not meet hospital level of care. As a result, it is important to determine what is realistic to address in a short amount of time. The pace is fast and at times I am working with 10 people at a time, which can be stressful. Due to the rapid discharges, I find it imperative to communicate with the psychiatrist, nursing staff, and other disciplines to ensure that the assessments are efficient.
NR: Who handles the official diagnosis of a mental illness?
AW: A lot of times, people who come into our inpatient unit have a long history, so their outpatient psychiatrist has diagnosed them. Sometimes, it's their first break and they have never been in the hospital before. In this case, the attending or psychiatrist who is assigned will make a diagnosis based on the presenting symptoms.
NR: Based on what you know about how their condition will progress, can you help them build life skills that can enable them to manage their illness?
AW: If it is someone who has had multiple hospitalizations and they don't have formal or informal support out there, I might do a DMH (Department of Mental Health) application for them, or other outside referrals if they agree. That way I am planting the seeds for future outpatient treaters and community resources for them. The goal is to decrease the likelihood of future hospitalizations and support the recovery process.
NR: What are some of the rewarding experiences?
AW: There are many rewarding experiences. Currently I am working with a 19-year woman who has been involved in the state system since she was 14 years old. For the past four months, I have had the opportunity to work intensely with her. Given that the length of stay is generally short, it has been rewarding to be able to build a relationship with her and use my clinical skills on a daily basis.
NR: If someone is interested in going into this field, what would they need to know?
AW: You use yourself in ways that can be tiring. You have to learn how to take care of yourself and create a balance in your life that can sustain you when your work becomes overwhelming. Finding time to step away and do things that you enjoy other than social work can help maintain one's passion for the field. Social work is a profession in which one often draws from their personal experience. In doing so, it is critical to examine your own prejudices, biases, and ways of looking at the world when helping others. In addition to doing a self-assessment, you should speak to others who are in the field. I spoke with two people who had gone to Simmons School of Social Work and I asked them questions about the program. In asking those questions, I was better able to determine that social work was right for me.
Copyright © 2004 The President and Fellows of Harvard College.
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