Abstract
Published by Oxford University Press in June 2022, The Oxford Textbook of Palliative Social Work, 2nd Edition was edited by three pillars of palliative social work. Terry Altilio, Shirley Otis-Green, and John Cagle shared decades of distinguished experience in palliative social work practice, education, and research. With this book, the editors did not just intend to impart evidence-based professional knowledge. More importantly, they reiterated how social inequities were faced in the past and how “both seasoned practitioners and fledgling learners” should persist in addressing them. As prefaced by a handful of respected personalities in the field, the book celebrates the progress of a young discipline, provides a more diverse and deeper dive into its ever-expanding knowledge base, and invites the other members of the interprofessional team to understand and appreciate their multitalented palliative social worker.
Most chapters in the book's 11 sections started with quotes from famous people, such as William Shakespeare, Lou Gehrig, Maya Angelou, and folks sitting in clinic waiting areas or walking in hospital hallways, such as “an inquiring patient,” “40-year-old man from rural India diagnosed with cancer of larynx,” and “daughter of a nursing home resident.” Chapters incorporated segments of patient and/or family narratives highlighting vital points and concepts raised within, and concluded with learning exercises and ideas for future research that dare readers to reflect on what had just been taught, live their daily work lives with a critical mind, and look for answers to questions that may eventually impact care across settings, illnesses, and cultures.
The book's sections could be organized into four themes. In brief, sections 1–3: social worker's environment/milieu, sections 4–7: social work practice in patient populations, diseases, and settings, sections 8–10: tools in the social work toolbox, and section 11: professional issues.
Sections 1 to 3 acquainted readers with the palliative social worker's milieu. Section 1 (“Converging Contexts of Care”) immersed readers in theoretical frameworks, such as the three overlapping spheres of microsystem, mezzosystem, and macrosystem. Section 2 (“Historical Context—Bringing History Forward”) discussed the evolution of social work in health care, including the growth of palliative social work as a distinct field. Chapter 7 in this section explored the concept of “total pain” as written by Dame Cicely Saunders (reprinted from The British Journal of Social Work), widely recognized as the founder of the modern hospice movement and a social worker before becoming a physician. Section 3 (“Collaborative Contexts”) discussed how social workers perfectly integrate with palliative care teams.
Sections 4 to 7 discussed palliative social work practice in different patient populations, disease groups, and clinical settings. Section 4 (“Person-Centered, Family-Focused Practice”) focused on caring for vulnerable populations, such as children, lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients, and immigrants. Section 4's title could have been written specifically to indicate various patient populations, since the next two sections similarly started with “Person-Centered, Family-Focused Practice,” followed by “Across Diagnoses” (Section 5) and “Across Settings” (Section 6).
Section 5 explained the complex challenges posed by different serious illnesses, and ended with Chapter 27 (“Clinical Trials and the Role of Social Work”), a review of historical and ethical irregularities in medical research. This chapter could have found a better home in Section 10 (“Ethical Considerations”). Section 6 detailed how palliative social workers have permeated all corners of the health care system, whereas Section 7 (“Regional Voices from an International Perspective”) described how the field has evolved in other parts of the world.
Sections 8 to 10 described a wide variety of skills in the palliative social work toolbox. Section 8 (“Interventions: Foundations of Palliative Social Work Practice”) explained multiple rudimentary skills possessed by social workers. Strangely, it started with Chapter 56 (“Merging Research and Clinical Practice”), a well-written piece encouraging social workers to engage in research activities, which could have been more cohesively found in Section 11 (“Professional Issues”). Section 9 (“Interventions: Supporting Effective Palliative Social Work Practice”) went through the breadth of clinical tools utilized in daily practice.
Section 10 underscored a host of ethical dilemmas that social workers might encounter, such as foregoing/withdrawing life support, along with approaches to face them head on. Throughout these chapters, authors stressed that palliative social workers, buoyed by their training and natural tendency to be collaborative, are uniquely positioned to address the many threats to the patient–family care unit.
The book's final section complemented the social worker's day-to-day clinical practice, including professional certification, self-care, and leadership opportunities. Chapter 95 (“Navigating in Swampy Lowlands: A Relational Approach to Practice-Based Learning in Palliative Care”) stressed how social workers and their interprofessional colleagues support each other through the “messy, wondrous, challenging terrain” of serious illness care. In Chapter 100 (“Self-Care Practice Wisdom: A Letter to My Younger Self”), a truly inspiring read, the author penned a letter to her “Younger Self,” reinforcing ways to build resilience, such as being present, practicing gratitude, and laughing. The book's final chapter, written by editor Otis-Green, challenged readers to impact health care as clinicians, advocates, researchers, and educators who “ask questions, show up, stand up, and speak up.”
Like all textbooks I read from grade school through specialty training, this one was unavoidably didactic. Unlike any of those tomes though, this one was insightful and unavoidably inspiring. It was entertaining at times, and did not feel like a heavy hardbound textbook. Some of the chapters possessed a conversational tone, written in first-person perspective, and most exuded the charisma of an editorial or a perspective piece. Since the textbook was produced while the world grappled with COVID-19, it uncovered stories of magnified health disparities, as well as tales of determination, connection, and innovation.
In my current practice of palliative care at a large academic medical center, I collaborate with social workers of various expertise—palliative care, oncology, and neurology—each and every day. I seized the opportunity to review this book to know what makes them so good at what they do. After a few page turns, I quickly gleaned that, whether by design or not, the authors aspired to appreciate and inspire, not just educate. Readers will learn the issues that exacerbate the hardships of patient–family units in the midst of serious illness, the interventions necessary to accomplish short- and long-term goals, and the inspiration to conquer adversity, build resilience, and experience joy in helping others.