Social work in health care: do practitioners' writings suggest an applied social science?

There are two sources of literature in social work-one from academics and the other from practitioners. Each group is driven by different motivations to write. Academics seek a 'scientific rationality' for the field, while practitioners assume practical and intuitive reasoning, experience aligned with theory, and the 'art of practice' to guide them. It has been said that practitioners do not write and that 'faculty' are the trustees of the knowledge base of the profession, and are responsible for its promulgation via publication. Practitioners, however, do write about their practice and their programs, and analyze both, but publish much of their work in non-social work media. Their work tends not to be referenced by academic writers. One department's social workers' publications are described. We learn, from their practice writings, what concerns clinicians. Theirs is case-based learning, theoretically supported, in which the organization of services calls for their participation in multi-professional decision-making. There is the growing realization among social workers that practice wisdom and scientific technologies need to be reassessed together to find ways to enhance social work services. Clinicians' knowledge can lead to continuing refinement of practice and enhanced institutional services. If practitioners' writings can be assessed, they may lead to a written practice knowledge base, subject to timely change. Academic and practitioner separateness hampers progress in the field. They need each other, and a shared professional literature. There is beginning indication they are getting together.

Enhancing leadership skills through an international exchange: the Mount Sinai experience.

The development of an international social work educational exchange between Mount Sinai Medical Center and key social workers in health care organizations in Israel and Australia supported the notion that western social workers from different parts of the world, facing comparable social-health problems, can learn from each other, but only if ideas and "methodologies are selectively adapted" (Midgley, 1990, p. 297) to allow for regional and cultural differences. When objectives are comparable, content and experiences can be shared, and knowledge and practice can be adapted to meet social-health needs of given populations, within the context of respective government policies and expectations.

Evaluating the Mount Sinai Leadership Enhancement Program: a developmental perspective.

The principal evaluators of the Mount Sinai Leadership Exchange program used a developmental approach to evaluating the program, applying qualitative and quantitative data within the program as the program developed. Over the course of its development, evaluation, and refinement, the leadership enhancement program emerged as a vehicle for true international exchange of ideas, skills, resources, and collegiality.

Medical care organization and the social service connection.

The medical profession has long dominated the organization of medical care in this country and has inevitably influenced the form taken by social work practice in medical settings. An overview of the forces and events that have shaped American medical care into a pluralistic health care system reveals that social workers will need to increase efforts to strike out on their own in the coming years.

Health care and social work services: present concerns and future directions.

This article reviews eight major social-health care issues of the eighties: controlling costs; access to care; changing organizational patterns; solo versus interprofessional care; regulations and accountability; social reform/special interest movements; ethics and values; and changing urban populations. The author formulates how changes in our medical care systems will affect the practice of social work in health care settings.

Screening for high social risk: principles and problems.

Sound use of hospital social work services is not achieved when workers rely on other health personnel for referrals. The authors propose a screening mechanism to identify patients at what they term high levels of social risk and to restore the initiative to social work staff. Relevant principles and problems are also discussed.

A social work department develops and tests a screening mechanism to identify high social risk situations.

This paper describes a model for developing and testing a screening mechanism to identify high psychosocial risk patient situations in need of early intervention by social workers. Although the criteria developed need further refinement, it was found that multiple criteria are significantly more predictive of high risk than single factors and that three variables, (1) severity of illness: life threatening, (2) severity of illness: physically dysfunctional; and (3) chronic illness were good predictors of need for social work services. It is suggested that similar screening mechanisms be developed and utilized in hospitals throughout the country.