Oncology social work rarely happens in a vacuum. Our patients carry not only cancer diagnoses, but layered histories of loss, trauma, caregiving, identity, and survival that shape how they experience illness. In my first year as the outpatient Supportive Oncology social worker at the Ruttenberg Treatment Center at Mount Sinai, I have learned that my role has evolved less around mastering concrete tasks and more toward integrating diverse training and experience into a cohesive, whole-person practice.
Multiple clinical and personal learning environments have shaped my path. I have taught yoga, mindfulness, and somatic practices since 2018; completed a palliative and end-of-life fellowship during my MSW program; received psycho-oncology supervision as an MSW intern at Memorial Sloan Kettering; led Mount Sinai’s Perinatal and Pediatric Bereavement Program in my first post-graduate role; and completed Prolonged Grief Disorder Therapy training. All these experiences reinforced the central, rather than peripheral, importance of grief, trauma, attachment, and meaning-making in serious illness care.
I recently received a referral from a palliative care physician for a patient with multiple myeloma, navigating the recent death of their 34-year-old son. The patient described intrusive memories of witnessing his resuscitation in the ED and how her grief unfolded alongside cancer treatment visits, caregiving responsibilities, and uncertainty about her prognosis. This encounter reinforced what I see often in Supportive Oncology: cancer brings patients to the clinic, but it is seldom the only force shaping their distress.
In our session, I used grief and trauma-informed frameworks. The patient shared that she spoke to her son and visited his room to feel close to him, practices I normalized as meaningful and adaptive. I introduced the concept of continuing bonds, reframing grief as an evolving relationship with the deceased (Klass, Silverman, and Nickman, 1996). We discussed transitional objects, including her wishes to turn his ashes into a necklace, and to keep some of his belongings as symbolic bridges between connection and physical separation (Winnicott, 1953).
Her description of entering her son’s room to grieve and returning to daily responsibilities demonstrated pendulation, the nervous system’s oscillation between activation and regulation (Levine, 1997). Naming this helped her recognize her capacity for self-regulation amid intense sorrow.
When she recounted witnessing her son receive CPR, her body curled inward. Drawing on Somatic Experiencing’s SIBAM framework, we explored how this memory lived in her body, and the meaning she made of it (Levine, 2010). She identified tension in her chest and shoulders, vivid images of the resuscitation, feelings of helplessness and anger, and the belief that her son was being harmed. We reframed the event, acknowledging its traumatic impact while contextualizing the medical team’s efforts to save his life.
We explored what she needed in that moment but did not receive; she said, “a hug.” I invited her to sit upright with her feet grounded, inhale, open her arms, and on the exhale wrap them around herself. I encouraged her to notice the sensation of this self-hug and allow her breath to lengthen naturally. She remained in this posture for the remainder of our session, noting it gave her a grounding tool when memories of the ED resurfaced.
This encounter crystallized how oncology social work can evolve beyond resource navigation toward integrative, embodied, relational care. Cancer does not occur in isolation from loss and nervous system histories, it may include trauma, attachment, and meaning-making that intersect with symptom management, decision-making, and treatment adherence. Developing my role within the Supportive Oncology team has involved close collaboration with palliative care physicians and interdisciplinary colleagues to integrate psychosocial and trauma-informed frameworks into routine outpatient care. Referrals like this one reflect the growing recognition of the centrality of oncology social work to whole-person cancer care.
As our field grows, oncology social workers are uniquely positioned to integrate grief theory, trauma-informed care, and somatic approaches into clinical practice. This integrative approach draws me to this work: the opportunity to meet patients at the intersection of illness, identity, and meaning-making. Doing so affirms the complexity of patients’ lived experiences and counters systems that can unintentionally reduce people to diagnoses and treatment plans. The evolving oncology social worker is a relational clinician, educator, and witness who can help patients metabolize what illness and uncertainty activates within them.
For those developing similar roles, I encourage embracing interdisciplinary training, seeking mentorship across varied settings, and trusting that integrating diverse experiences strengthens clinical presence. When we meet our patients as whole beings, we expand what cancer care can be and reclaim psychosocial care as central to oncology practice.
References
Klass, D., Silverman, P. R., & Nickman, S. L. (1996). Continuing bonds: New understandings of grief. Taylor & Francis.
Winnicott, D. W. (1953). Transitional objects and transitional phenomena: A study of the first not-me possession. International Journal of Psycho-Analysis, 34, 89–97.
Levine, P. A. (1997). Waking the tiger: Healing trauma. North Atlantic Books.
Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. North Atlantic Books.
