MODULE 5 Weeks 12–14 • Practice Settings, Field Problems, and Capstone |
Ptra. Kathryn B Santiago, RSW MSW MMin
Instructor
MODULE OUTCOME Develop the capacity to perceive the relation of environment and socio-cultural and psychological factors in the causation, treatment, and prevention of diseases — and demonstrate skills in real practice settings. |
Intended Learning Outcomes
1. Compare medical social work practice in hospitals, OPD, emergency/crisis care, hospice, special clinics, and community health.
2. Explain the use of volunteers, social support, and self-help groups as part of the care system.
3. Identify problems commonly encountered by medical social workers and propose ethical, practical responses.
4. Prepare a comprehensive Mental Health Wellness Plan as a medical social worker (psychomotor outcome of the course).
Pre-Assessment
1. If you were the only social worker in a busy emergency room, what would you refuse to let your job become?
2. Name one self-help or support group you already know (in health, recovery, grief, or disability).
Lesson 5.1 • Practice in Different Settings
Hospitals (in-patient)
High acuity, rapid turnover in some wards, long stays in others. Work is organized by referral and rounds. Strengths: team access, records, chance to see family dynamics at the bedside. Risks: being used only for indigency papers, noise, no privacy.
Out-patient departments
Shorter contacts, chronic follow-up, chance to do groups and education. Missed appointments are data: transport, wages, fear. OPD is ideal for adherence counseling and connecting hospital to RHU.
Emergency / crisis care
Minutes matter. Tasks: psychological first aid, locating family, protection assessment, coordinating with police or WCPU when needed, and stabilizing social chaos so medicine can proceed. Documentation must be factual. After the spike, arrange continuing care—ER is not a complete intervention.
Hospice and palliative settings
Goals shift from cure to comfort, meaning, and family preparation. Presence, family meetings, bereavement follow-up, and volunteer coordination are central. Silence is a skill.
Special clinics
Dialysis, oncology, HIV treatment hubs, rehabilitation, diabetes clinics allow deeper program knowledge and peer-group work. The worker can build clinic-specific pathways (transport day, medicine access, school re-entry).
Community health
Home visits, barangay partnerships, outreach, and prevention campaigns. The environment is visible: the open canal, the workplace, the isolated older person. Community practice completes the hospital story.
Lesson 5.2 • Volunteers, Social Support, and Self-Help Groups
Social support is the practical and emotional help available through family, friends, church, neighbors, and organizations. The worker maps it (ecomap) and strengthens it rather than replacing it. Volunteers extend reach—ward companions, hospice sitters, community educators—but they need screening, training, confidentiality rules, and supervision. They are not unpaid social workers.
Self-help and peer groups (cancer survivors, persons living with HIV, stroke clubs, parents of children with disability, AA/NA-type fellowships) offer identification that no professional can fake. The medical social worker may initiate, advise, or refer, then step back so the group owns itself. Token groups that exist only for a hospital accreditation visit help no one.
Lesson 5.3 • Role in Hospital Settings and Problems in the Field
Hospital roles recap: psychosocial assessment, counseling, crisis work, group work, resource mobilization, discharge planning, education, advocacy, documentation, and team consultation.
Problems frequently encountered
• Role distortion: treated as a cashier of charity rather than a clinician.
• Late referral: called on the day of discharge when no plan is possible.
• Caseload overload and paperwork that crowds out counseling.
• No private space; interviews in corridors.
• Team disrespect or exclusion from rounds.
• Compassion fatigue, vicarious trauma, and moral distress.
• Ethical binds: false indigency claims, pressure to discharge unsafe patients, family-versus-patient conflicts.
• Weak community follow-up after discharge.
Responses include written referral protocols, visible documentation of psychosocial outcomes (not only pesos facilitated), regular case conferences, supervision, peer support for staff, and professional assertion grounded in RA 9433 and hospital policy. Students should learn early that saying “that is outside my competence” and referring is ethical strength.
Lesson 5.4 • Capstone: Mental Health Wellness Plan
The syllabus requires students to prepare a comprehensive Mental Health Wellness Plan as medical social workers. Mental health is part of medical social work, not a separate universe. Hospitalization, chronic disease, trauma, poverty, and stigma all affect mental wellness. RA 11036 directs health facilities to integrate mental health services.
Required parts of the plan
1. Title, target population, and setting (example: family companions of ICU patients in a provincial hospital; or adolescents with newly diagnosed diabetes in OPD).
2. Rationale using bio-psycho-social and local data or reasoned estimates.
3. Goals and SMART objectives.
4. Assessment tools you will use (brief scales, interview guide, risk screen for self-harm—refer immediately if risk is present; students do not manage active suicidal crisis alone).
5. Interventions at three levels: individual, family/group, and setting/community.
6. Staffing, partners (DOH, LGU, church, school, PDAO), and timeline of 12 weeks.
7. Ethical safeguards: consent, confidentiality, referral pathways, cultural and faith sensitivity.
8. Monitoring indicators and a simple evaluation method.
9. Resource budget (even if in-kind).
10. Personal wellness note: how the worker will protect her or his own mental health while implementing the plan.
FAITH INTEGRATION The Great Commission in the College Outcomes is not a substitute for professional skill, and professional skill is not a substitute for love of neighbor. In hospital corridors the gospel is often heard as competence plus kindness. Finish this course able to do both. |
Learning Activities
Activity A • Setting contrast
In pairs, contrast ER social work and hospice social work on five dimensions: pace, goal of care, typical interventions, family work, and success measure. One-page table.
Activity B • Field-problem clinic
Each group draws one field problem from Lesson 5.3 and presents a 6-minute response protocol.
Activity C • Capstone workshop
Draft the Mental Health Wellness Plan in class workshops during Weeks 13–14. Peer review using the ten-part checklist.
Assessment Tasks
1. Setting-contrast table.
2. Comprehensive Mental Health Wellness Plan (group or individual, as assigned). This is the major project of the course. Late submission: minus 5 points from the project score, per syllabus.
3. Final reflection paper (600–800 words): growth in knowledge, attitude, and skill across the five modules, with one concrete practice commitment.
4. Final examination covering Modules 1–5.
Module 5 References
• Sheafor & Horejsi (2003). Techniques and guidelines for social work practice.
• Theoretical perspectives for direct social work practice: A generalist-eclectic approach (2nd ed.).
• Global Agenda for Social Work and Social Development.
• GRCM Manual; Review notes in social work (as internally assigned).
• Republic Act No. 11036 (Mental Health Act).
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