Social workers change lives one question at a time

Social workers are professionals who can assist individuals with their problems. However, there is another important perspective to share: the answers we get depend on the questions we ask.

When we ask about problems, then we hear about problems. However, if we ask about life outside of problems, or what life is like when problems are less onerous, we hear stories of resilience, hope and aspiration. Brief and narrative therapy approaches are intentional in asking about people's lives beyond the problems they bring to a therapeutic conversation.

Why is this important?

The brain has a well-documented negativity bias. Says Rick Hanson, PhD: “The mind is like Velcro for negative experiences and Teflon for positive ones.” When we experience difficulties in our lives, they can overshadow the non-problem areas of our experience, obscuring the myriad ways people are responding to problems – or even doing well in the face of difficulties they are experiencing. When we make sure to ask, we often hear rich stories about what people value, the skills they have that might help them in the face of problems for which they sought counsel, and what they want for their life beyond the problem. After all, the problem is the problem. The person is not the problem.

These kinds of conversations can support people in taking even one small step towards making a change they desire and can certainly be useful in a hospital setting. Families facing a medical challenge can feel it ripple into many other parts of their life: from school, to family relationships, to work, to financial stress and to the emotional impact of a new diagnosis. In social work, we provide patients and families with a wide range of supports and resources to navigate these challenges. A recent pilot study found that placing social workers in two hospital EDs during peak period of use led to the prevention of repeat ED visits and avoidable admissions, which translated into an estimated savings of $1.4M a year and 1,700 inpatient days avoided across both hospitals.  

The Neurology Social Work Single Session Clinic (NSWSSC) and the new Brief Therapy Clinic are two initiatives at SickKids that are unique to a paediatric hospital setting in Canada. These clinics support families through facilitating intentional conversations that bring forward rich stories of how people are responding to challenges they are facing. We work from the assumptions that people already possess skills and abilities to take steps towards change, and that one session can often be enough to support people to take a step towards bringing that change to life. In our NSWSSC and Brief Therapy clinics, we are so often moved by patients’ and families’ stories of how they manage to put one foot in front of the other in the face of daunting challenges, and what these stories say about the qualities they possess, as well as what they hold dear.

Whether it be brief therapy, psychosocial support, psychotherapy, advocacy, or case management, social workers provide essential mental health supports to patients and families at SickKids. March 5 to 11 is Social Work Week; this year’s theme is “Social Workers: on the front line of real issues.” Social workers have a lot to celebrate: in December 2017, the controlled act of psychotherapy was proclaimed. This represents a huge victory for social workers because we are now entitled to use the protected term “psychotherapist” to represent our work. While not all practicing social workers provide psychotherapy, this proclamation is a monumental success in the recognition of the full scope of mental health services social workers can provide.  

If you know a social worker, Social Work Week would be a great time to let them know they are appreciated. And, if you like, perhaps take a moment to reflect on these questions when considering a small challenge you are facing:

• What is the smallest thing you could do in the next 48 hours to move you in a helpful direction?
• What does this action say about what’s important to you?

For more information on social work at SickKids, please visit Social Work.

Sara Marlowe is a social worker in the Division of Neurology.