“If they don’t give you a seat at the table, bring a folding chair.” It was the late Shirley Chisolm who famously stated this during her 1972 presidential campaign. As the first African American woman elected to Congress, she is revered as a social justice leader who urged people to join important conversations without waiting for an invitation to do so. Shirley Chisholm’s work embodies the same values guiding the evolution of oncology social work (OSW). This article explores our field’s collective resilience to demand our inclusion at the proverbial table.
As the oncology field endures “a new normal” of moral injury, the social work role pivots to meet the increasingly complex needs of patients and their families. Catalyzed by the COVID-19 pandemic, OSWs have proven to be critical in identifying psychosocial gaps in healthcare delivery, mobilizing high-level patient-centered care by providing telehealth consults and virtual support groups, strengthening community partnerships, addressing social determinants of health (SDOH), and advocating for marginalized populations. Today, as we currently navigate a rapidly shifting political landscape, OSWs are called to support patients impacted by changes in legislation and immigration policies. And so, we are experiencing a shift where the OSW role is increasingly called on to promote DEI advocacy, stepping into a more central role on our teams.
How is the oncology field changing?
Diversity, Equity, and Inclusion (DEI):
The 2025 dismantling of DEI initiatives resulted in the termination of critical research funding, elimination of DEI positions, and restrictions on the provision of anti-oppressive training. The National Association of Social Workers (NASW) views these anti-DEI efforts as direct attacks on the profession’s Code of Ethics. In response, we work to reclaim the narrative that DEI is essential in promoting health equity. We see OSWs seeking closer collaborations with legal experts, joining coalitions, and championing advocacy efforts at the legislative level. Moreover, in the social work education sector, we see ongoing commitments to teaching DEI principles within social work curriculum.
Now more than ever, we also see the population of OSW practitioners shifting to more appropriate representation of Black, Indigenous, People of Color (BIPOC), Asian American Pacific Islander (AAPI), and Hispanic communities we serve. In a 2024 analysis written by a group of AOSW Fellows, Zebrack and colleagues observed that the proportion of AOSW members who identify as BIPOC/AAPI/Hispanic doubled from 10% to 20% from 2016 to 2024. (Zebrack et al, 2024). Moreover, these groups are also represented in various leadership positions across the field.
Technology:
The “Open Notes” provision of the 21st Century Cures Act of 2021 has significant implications for patients’ experiences and level of trust with their providers. While the intention of this federal policy is to demonstrate transparency in care, there are often unintended consequences in which patients perceive these notes as biased and stigmatizing. From this perspective, OSWs are responsible for writing from a culturally sensitive, trauma-informed lens that meaningfully captures interventions, and ultimately communicates respect for patients’ stories.
Separately, in the surge of Artificial Intelligence (AI), patients are increasingly turning to ChatGPT and other language models to understand and manage distress (Cè et al., 2024). We observe an overreliance on the instant gratification of this technology, and over time, patients’ discomfort to seek and trust human connection. OSWs are reminded of the power of bearing witness to suffering, demonstrating that AI cannot replace the value of empathy and navigating complex emotional nuances. While AI can be an effective tool in the administrative aspects of social work care delivery, OSWs are responsible for critically evaluating AI’s output.
Future Considerations
As the healthcare system strains to address disparities, our OSW profession faces a heightened risk of burnout. To mitigate this, literature advises us to engage in self-care and trust that history will recycle towards equilibrium. But what exactly does this look like? In the spirit of creating a seat at the table with interdisciplinary professionals, it is equally essential to have our own table with fellow OSWs. Ironically, due to the fast-paced nature of our work, OSWs are often siloed. More than ever, social workers need to share, teach, and learn from each other’s expertise, connecting with colleagues inside our institutions, within professional networks like AOSW, and beyond.
References
Cè, M., Chiarpenello, V., Bubba, A., Felisaz, P. F., Oliva, G., Irmici, G., & Cellina, M. (2024). Exploring the Role of ChatGPT in Oncology: Providing Information and Support for Cancer Patients. BioMedInformatics, 4(2), 877-888. https://doi.org/10.3390/biomedinformatics4020049
National Association of Social Workers. (2021). Practice alert: New federal rule provides patients with increased access to mental health information. https://www.socialworkers.org/LinkClick.aspx?fileticket=kIuX7JP_Lv4%3D
Zebrack B, Schapmire T, Damaskos P, Grignon M, Smith SK. The essential and evolving nature of oncology social work: Accomplishments and impact, 2010-present. J Psychosoc Oncol. 2024;42(6):739-768. doi: 10.1080/07347332.2024.2404577. Epub 2024 Oct 7. PMID: 39373332.
