Abstract
Dear Editor:
The authors of the letter provide an important critique of our series, Psychological Elements of Palliative Care, regarding the omission of a social work presence in our authorship of the series.
As palliative care clinicians, we affirm the importance of the interdisciplinary team in our clinical and research pursuits—and of the core role of social workers in such teams. Our specialty's unique frame of care and encounter is forged by the disparate but collaborative voices that contribute to our approach. The exploratory seminar in 2019, which launched our series, generated new conversations across representatives from psychology, oncology, nursing, psychiatry, medicine, and spiritual care, but regrettably did not include social workers. This does not reflect an intended devaluation of the contributions of palliative care social workers, but rather the strong influences of the clinical researchers and educators from these disciplines. However, this was a missed opportunity to be inclusive of a wider variety of the disciplines that make up palliative care—and for that we are regretful.
We agree that we can and should do better. Thankfully, work on the psychological elements of palliative care is far from over. Our goal is to continue to develop these concepts and integrate them into the work that we do at the bedside as an interdisciplinary team and into the ways in which we teach palliative care to learners from all backgrounds. We hope that this series and the thoughtful yet pointed critique of the missing voice of social work will serve to ignite new discussions and collaborations in our next phase of work.
Our hope is that the vital work ahead of us to make the psychological elements of palliative care represent the breadth of our clinical palliative care teams does not obviate the importance of the concepts we present. We believe strongly that psychosocial expertise—whether in the form of psychologists, psychiatrists, social workers, and other clinical experts—is a key part of palliative care delivery. Unfortunately, data from the Center to Advance Palliative Care show that fewer than half of palliative care programs have complete interdisciplinary teams.
In addition to advocacy for an expanded presence of psychosocial and spiritual clinicians on our teams, we hope to begin a dialogue that deepens comfort with the psychological elements of palliative care for all medical clinicians. We perceive these ideas to be cross-disciplinary, rather than limited to specific team member with expertise. Medical clinicians on palliative care teams need to be facile with “primary psychological concepts” germane to the care of our patients. Our social work colleagues will be key educators of our teams. All of us come into palliative care from diverse training and skill backgrounds and it benefits all of us to have a shared language and framework to think about the psychological elements of our work.
We are so grateful to the authors of the letter for speaking out. Their critique will have a concrete and important influence on the future of our work in this space. We look forward to collaborating with them and other colleagues with social work training to continue moving the psychological elements of palliative care work forward.