Scope and Standards of Practice

Scope of Practice in Oncology Social Work

The scope of practice in oncology social work, as identified in the AOSW Standards of Practice, includes:

Services to cancer survivors, families and caregivers through clinical practice providing comprehensive psychosocial services and programs through all phases of the cancer experience
Services to institutions and agencies to increase their knowledge of the psychosocial, social, cultural and spiritual factors that impact coping with cancer and its effects, and to insure provision of quality psychosocial programs and care
Services to the community through education, consultation, research and volunteering to utilize, promote or strengthen the community services, programs and resources available to meet the needs of cancer survivors
Services to the profession to support the appropriate orientation, supervision and evaluation of clinical social workers in oncology; participate in and promote student training and professional education in oncology social work; and advance knowledge through clinical and other research

Oncology social workers are knowledgeable about cancer and about the psychosocial and other effects of disease, treatment, and survivorship. They are generally masters prepared and often have experience and training in oncology and other life-threatening illnesses. They practice in accord with the values of the profession using the guidelines offered in the National Association of Social Work’s Code of Ethics. Oncology social workers have goals in each area of practice and carry out critical functions to achieve those goals. What follows is a listing of common goals and functions.

1. Services to Survivors, Families, and Caregivers

The goals of clinical practice with survivors, families and caregivers are:

Fostering coping and adaptation to cancer and its effects in order to help cancer survivors maintain or improve quality of life
Assisting survivors in navigating through health care systems to help them achieve quality care
Mobilizing new or existing family, system and community resources to provide social and emotional support to cancer survivors
Conducting research to advance clinical knowledge or evaluate practice effectiveness
Advocating with, or on behalf of, survivors, families and caregivers to address their needs or for policies and programs that will benefit them

The functions of clinical practice are:

Use of high risk screening criteria to identify survivors and families in need of Social Work services.
Completion of a psychosocial assessment to determine survivor and family’s strengths and needs relative to coping effectively with cancer diagnosis, treatment and follow-up cares.
Development of a multidisciplinary care plan with survivor and family input and based on mutual goals.
Use of a range of therapeutic and other interventions, including supportive counseling, group work, and education to address issues in each phase of the illness.
Provision of pre-admission, transfer, and discharge planning.
Provision of case management services.
Provision of direct assistance to meet financial, transportation, lodging and other needs.
Advocacy to remove barriers to quality care, to address gaps in service, to help survivors and families secure the protection of existing laws, and to work for any changes needed to policies, programs and legislation.
Involvement conducting and publishing research to advance knowledge about the impact of cancer, refine interventions, and evaluate practice outcomes.

2. Services to Institutions and Agencies

The goals of practice in providing to institutions and agencies are:

To insure that the agencies and institutions are responsive to the needs of both individual cancer survivors, families and caregivers, as well as groups
To contribute the multidisciplinary effort to provide quality medical psychosocial care to oncology survivors
To assist social work colleagues and members of other disciplines to manage the stress of clinical practice

The functions necessary to such services are:

Education and consultation to professionals and staff regarding the biopsychosocial, environmental, spiritual, and cultural factors affecting cancer care.
Collaboration with other professionals in the delivery of quality psychosocial care, education and research.
Recording, statistical reporting, and evaluation to improve services, assist in identifying gaps in services and programs, and assure quality care.
Development of programs and resources to address the needs of cancer survivors.
Provision of support services to aid in stress management.

3. Services to the Community

The goals of oncology social work practice related to the community are:

To assure that community programs and resources address and are responsive to the needs of cancer survivors, families, and caregivers.
To provide oncology social work expertise to communities as they work to assist cancer survivors.

The functions of oncology social workers working with communities are:

Education of communities to increase awareness of the psychosocial needs of cancer survivors, families, and caregivers.
Collaboration with community agencies to remove barriers to cancer prevention, screening and early detection, and access to care.
Collaboration in the development of special programs and resources to address community-based needs.
Consultation with voluntary cancer agencies, such as the American Cancer Society and the Leukemia and Lymphoma Society to provide community education and develop programs to benefit cancer survivors.

4. Services to the Profession

The goals of providing services to the profession are:

To assure that oncology social workers have the necessary knowledge, skills, resources, time, funding and support to deliver quality psychosocial services to all cancer survivors, families and caregivers.

The functions of oncology social workers working to serve the profession are:

Teaching oncology social work trainees in the classroom or in clinical settings.
Orientation, supervision and evaluation of practitioners in oncology social work.
Consultation with colleagues via telephone networking, conferences, or on listservs.
Presentation of or participation in continuing professional education specific to oncology social work practice.
Publishing research findings and clinical observations.
Clinical practice and research in accord with NASW’s Code of Ethics.
Participation in oncology and social work organizations.

Standards of Practice in Oncology Social Work

Oncology social work is the primary professional discipline that provides psychosocial services to patients, families and significant others facing the impact of a potential or actual diagnosis of cancer. The scope of oncology social work includes clinical practice, education, advocacy, administration, policy and research. The standards of practice provided in this document are intended for clinical social workers practicing in the specialty of oncology social work.

The Masters in Social Work degree provides oncology social workers with theoretical knowledge, clinical expertise and practical significant others. In addition, oncology social workers often receive specialized training in cancer care through clinical supervision, continuing education, in-service training and on-the-job experience.

Psychosocial services provided by oncology social workers include individual, family and group counseling, education, advocacy, discharge planning, case management, patient-navigation and program development. These services are designed to maximize the patient’s utilization of the health care system, foster coping, mobilize community resources in order to support optimal functioning, and empower the patient and family to be active participants in health care decisions and management.

Oncology social work services are available to patients and families throughout all phases of the cancer continuum, including prevention, diagnosis, treatment, survivorship, palliative care, end-of-life care and bereavement. Services are delivered in a wide variety of settings including specialty cancer centers, community hospitals and health systems, ambulatory centers, home health and hospice programs, community-based agencies and private practice settings.

Oncology social workers are an integral part of the health care team and contribute to the development and coordination of the overall treatment plan. In collaboration with the patient and family and other health care disciplines, oncology social workers provide counseling, education, discharge planning, case management and navigation, linking patients with a variety of services necessary to meet the person’s multiple needs.

In addition to services to patients and families, oncology social workers address organizational and community needs through professional practice. Services are provided to institutions, voluntary health organizations, and community agencies with the overall aim of promoting health and safety, and improving the delivery of care to individuals at risk for or affected by cancer.

Oncology social workers embrace patient- and family-centered care at all levels of practice. Social work training and professional values are congruent with this approach at the clinical level and position oncology social workers to substantially contribute the development of a health care environment that embodies the core concepts of patient- and family-centered care organizationally. This approach includes: respect for patients’ values, preferences and expressed needs; coordinated and integrated culturally competent care; timely, affirming and useful information, communication and education; individualized care; physical comfort, emotional support, involvement of family and friends, shared decision-making and collaboration with patients and families in the evaluation, planning and delivery of care.

Standard I. Qualifications

Oncology social workers shall be knowledgeable about oncologic diseases and their treatments, psychosocial implications for individuals and families, appropriate interventions and available community and governmental resources. Oncology social workers must have knowledge of the usual course of cancer and its treatment, including genetics, so that patients and families can be helped to anticipate and deal with changes in individual and family life.

The oncology social worker shall be masters prepared from a graduate program accredited by the Council on Social Work Education. It is preferred that the graduate have had prior employment or field placement experience in a health care setting.

Standard II. Services to Patients and Families

Oncology social work programs shall provide the following clinical and programmatic services:

B. Completion of a psychosocial assessment of the patient and family’s response to the cancer diagnosis and treatment to include:

2. Knowledge about cancer and its treatment including level of understanding, reactions, goals for care and expectations.

3. Characteristics of the patient’s support system, including family, related biologically, legally, or emotionally.

4. Patient and family psychosocial functioning including strengths, limitations and coping skills.

5. Race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex sexual orientation, and gender identity or expression.

6. Identification of barriers to care.

7. The source, availability, and adequacy of community resources.

8. Patient and family level of interest in participation in care and decision-making.

9. Development of a case plan with patient and family based on mutually agreed upon goals to enhance, maintain and promote optimal psychosocial functioning throughout cancer treatment and its outcome.

C. Utilization of a wide range of clinical interventions designed to address current and/or future problems as the patient’s medical and psychosocial needs evolve.

D. Outreach activities to vulnerable populations.

E. Maintenance of knowledge of community resources and governmental programs available from local, state, and national health and social service agencies including expertise in accessing these for patients and families.

F. Organization and facilitation of patient and family education.

G. Utilization of knowledge and clinical skills in assisting the patient and family with advance care planning and advance directives.

H. Pro-active provision of services to at-risk populations, including assistance with negotiating barriers to cancer information, screening, treatment and resources within the institution and in the community.

I. Collaboration with patients and family members who serve as advisors in policy and program development, implementation and evaluation; health care facility design; professional education, and the delivery of care.

J. Collaboration with other professional disciplines in the planning and provision of timely and efficient clinical services to cancer patients and their families.

K. Advocacy for and protection of patients’ dignity, confidentiality, rights, and access to care.

L. Development and utilization of research to improve clinical practice and implement evidence-based psychosocial support programs, services and interventions.

Standard III. Services to Institutions and Agencies

Oncology social work programs shall address institutional and agency needs including the following:

B. Collaboration with other disciplines and staff in the areas of psychosocial clinical services, patient-and family-centered care, research and education.

C. Provision of services to professional caregivers which are designed to assist staff in the management of stresses inherent in clinical practice.

D. Utilization of clinical documentation, statistical reporting, and evaluation to improve services, assure quality and develop programs.

E. The advancement of the practice of patient-and family-centered care at the clinical and organizational levels.

F. Representation on Cancer Care and other related hospital committees.

Standard IV. Services to the Community

Oncology social work programs shall address community needs including the following:

B. Provision of services to at-risk populations, including navigation assistance with access to cancer information, screening, treatment and resources.

C. Provision of consultation and volunteer services to institutions, voluntary health organizations and community agencies to promote health, provide education, and develop programs to better serve the community.

Standard V. Services to the Profession

Oncology social work programs shall address the following needs of the profession and its practitioners:

B. Commitment to continuing professional education.

C. Promotion of professional practice in accord with the National Association of Social Workers (NASW) Code of Ethics.

D. Participation in student and professional training and education in the area of oncology social work.

E. Contribution to oncology social work through participation in professional associations.

F. Contribution to oncology social work knowledge base through psychosocial research, publications, presentations and evidence-based practice.

G. Pro-active provision of patient navigation services to at-risk populations, including assistance.

H. Collaboration with other professional disciplines in the planning and provision of timely and efficient clinical services to cancer patients and their families.

I. Development of research based knowledge that relates to clinical issues, interventions and outcomes.