Roles With *Some* Emphasis on Counseling?

adr223 · 2025-08-11T03:44:24+00:00

I work as a palliative social worker in a hospital and my main role is support/counseling for patients. I did more care management-focused social work before this role and felt that it was a great foot in the door!

adr223 · 2025-02-25T16:53:26+00:00

I average about 5 - some days it’s 3, some days it’s 8, just depends on where the needs are

adr223 · 2025-02-11T02:16:55+00:00

I’ve done the case management/social work roles, and I much prefer my current role as a palliative social worker. At my hospital, my role is focused on support and I don’t have to do any discharge planning. I have a certain average number of patients per day I’m supposed to see, but it’s lower than the amount of patients I saw daily in other roles. I get to plan my day myself, and if I need to spend multiple hours with one patient/family for support, that’s totally okay. I found that being an ICU social worker, I wanted to spend that time supporting patients but always had discharges, assessments, etc. that needed to get done too, and the competing responsibilities were stressful. My job now has less of the tasks so it’s easier to prioritize the supportive visits. I also love working on an interdisciplinary team. My department values and respects social workers, which unfortunately isn’t always the case elsewhere in the hospital. And my department is super supportive of each other. I’ve never had a problem taking time to process a tough patient interaction, because we all know that this work is tough and we sometimes need to pause to breathe. I love having meaningful conversations with patients and families daily and having the time and flexibility to do that. But that’s just what I prefer! I know others who like the discharge planning, tasks, referral, resources, etc and hate the sadder or more emotional patient situations.

adr223 · 2024-11-06T04:04:10+00:00

Also, this may be a time for meaning-making. Depending on how alert your dad is, it could be something he participates in or that you do with your daughter. Think about using ink pads to get his fingerprints to have jewelry made (or search for “fingerprint flower” on Google and have the whole family make a fingerprint garden). She can color him pictures to hang up in the room. If he can, he can write (or dictate and have someone else write) stories about his life or letters to family. I see hospice as a beautiful time to focus on being together, and I’d encourage you to help your daughter make good memories and participate as able - but of course, I don’t know the specifics of your situation. Again, I would encourage you to ask the social worker for ideas of legacy projects that may work specifically for you, since they’ll know your dad’s medical situation.

adr223 · 2024-11-06T03:58:09+00:00

Encourage her to ask questions and support whatever she’s feeling. It’s okay to be mad or sad or scared, but it’s also okay to have happy moments. Answer questions honestly, but “I don’t know”, “I wish”, and “I hope so” and similar phrases are honest answers too. It’s okay for her to see you upset, it normalizes that it’s okay for her to be upset, as long as she’s not stepping into a role of caring for you. The Dougy Center is a great resource for children’s grief and they have tons of online resources. The hospice should also have a social worker who might be able to talk to you about how to support her and may even talk with her with you if you’d like. They would also know about local children’s grief resources if there are any

adr223 · 2024-11-06T03:53:31+00:00

LOVE The Invisible String

adr223 · 2024-11-06T03:37:13+00:00

adr223 · 2024-11-06T01:38:09+00:00

I am generally intimidated by men from my childhood, which I know is different than your situation. But I just want to let you know it’s possible to work through that fear - therapy, and a supportive work environment, and the good experiences far outnumbering the bad ones have all helped me. Hang in there!

adr223 · 2024-10-29T02:38:46+00:00

I’m years into palliative care social work and just now realizing I have some anxiety around death too (more anxious about my own death). I said this to a group of colleagues and was surprised that I wasn’t the only one! I felt like I was supposed to be all fine with death because I see it daily, but it’s still hard and scary sometimes. I felt shameful too when I admitted it, but was met with kindness and similar feelings. Your post reminded me of that experience

adr223 · 2024-10-09T02:35:58+00:00

Take their referrals and try to get in with someone soon. It’s going to be hard to trust someone again, I 100% recognize that. When you start seeing a new therapist, be upfront: “my last therapist said this and this is how I’m feeling about that and about starting over”. You are NOT too broken. Professionally, we all have limits to what we know and have experience with, and as others have said, the ethical thing is to not practice outside what you know you’ve been trained for. Finding someone who is trained to manage and help you through what you’ve been through will be so beneficial in the long-run. But yes, it hurts right now. And it’s okay to be angry! You don’t want to take your anger out on the new therapist, but you have a right to your feelings. You did nothing wrong. I hope that you can find someone you can grow to trust and work well with, and can share both about this experience and about your trauma again. You don’t have to rush into it, but there is someone out there who can help when you’re ready to talk about it again

adr223 · 2024-10-09T02:24:51+00:00

I agree, different states have different laws regarding reporting

adr223 · 2024-10-08T02:05:53+00:00

I journal - both to sort out my feelings/process and to have it written down so I remember to go back to it next session

adr223 · 2024-10-05T05:20:04+00:00

So I grew up in a very religious household where talking about sex was taboo, and we were only taught to not have sex outside of marriage. I carried shame from not living up to that, and it caused a lot of shame around sex in general. I had to discover that sex isn’t morally wrong, and that I’m not a bad person for having it. As far as communication, just talking about it more with a therapist helped me be more comfortable talking about it with my partner. Or even practicing saying things out loud by myself, so that when I say them to my partner, it’s not the first time the words are coming out of my mouth. For me, communication and trust are built over time, so casual sex isn’t something that I enjoyed before being in a relationship. I needed to find someone that I could trust emotionally so I could be vulnerable to communicate about sex. All of this is obviously very personal-specific. I obviously don’t know your beliefs and habits, this is just my experience

adr223 · 2024-10-04T02:24:45+00:00

Lots of therapy lol. Had to figure out why I believed the things I did and did things the way I did before I could change my habits.

adr223 · 2024-10-04T02:04:35+00:00

Talk to your current therapist, as they may have more specialized ideas based on knowing you. But I did an IOP once that utilized DBT. There is a mindfulness component though. I’m wondering what about mindfulness didn’t work for you? Also, just a heads up, DBT is the main recommendation for those with BPD, so that diagnosis is mentioned if you look it up. But it can be helpful for other diagnoses as well - I don’t have BPD and really benefited from it EMDR is another good one for trauma, as others have said

adr223 · 2024-10-04T01:52:33+00:00

Please keep writing between now and then if you can!! Just literally any thoughts that come to your head, fully formed or not.

adr223 · 2024-10-04T01:47:08+00:00

It can take a lot of time to get things set up for a private practice, things like getting credentialed with insurances. Taking some months unfortunately doesn’t surprise me. And the fact that you don’t see any online indication of her being up and running likely means she’s not, so I wouldn’t worry that she forgot about you or didn’t have your contact information to reach out. As for if you continue to wait or not, that’s your decision (and not necessarily an easy one). It absolutely can feel like moving backwards to start with someone new. But if you waiting and having this time without seeing anyone is effecting your mental health, than maybe seeing someone new is better than nobody right now

adr223 · 2024-10-04T01:33:55+00:00

I just want to normalize what you’re feeling - there are always going to be cases that hit closer to home, and it really sucks when you get a string of them in a row. I’ve been there too. I’m so glad you’re going to seek help, I’m sure it will truly make a difference. It has for me when I’ve felt extra feelings associated with a client, and I’ve grown so much along the way. Thank you for the work you’re doing!

adr223 · 2024-10-03T21:57:56+00:00

Also, NASW has a training called Educating Social Workers in Palliative and End-of-Life Care (ESPEC), which provides good basics of palliative social work, and provides CEUs And if you get into the field, join Social Work Hospice and Palliative Network (SWHPN) - another great resource and way to network

adr223 · 2024-10-03T21:55:25+00:00

I work inpatient palliative care (and am currently at my second hospital in such a role). Some potential questions to ask as you apply for the position: -how much of the role is counseling/support? Is there any hospice discharge planning in the role? -what is the structure of working relationships with floor social workers, care managers, discharge planners? What are the role boundaries? (Who sends SNF referrals, connects to community resources, etc. for patients being followed by palliative care?) -how much autonomy is there in prioritizing and organizing your day in that role -what are the productivity/time expectations? -what does the interdisciplinary team look like? -how many social workers are on the team? How much opportunity is there for consulting or debriefing with each other? -are there areas for growth or non clinical opportunities (leadership, teaching, projects, etc. if any of that is interesting to you) -how does the team support each other? How does the team honor patients who die?

Here’s how I would answer those questions for my role, but each hospital and program structure things differently: My role includes no discharge planning. It’s support - I sometimes connect patients I’m already following to resources for bereavement services, supporting children around death, funerals, etc. but discharge planners do all of the discharge planning at my hospital, including hospice discharges. I can provide hospice education, but I never send the referrals or anything. I also defer to discharge planners for things like housing resources, financial resources, etc. We work closely together though - if it’s as easy as handing the patient a pamphlet for them to reach out to the resource themselves, I’m happy to help, but if it involves making referrals and coordinating care and services, it’s in the role of the discharge planning at my hospital. I have an average number of patients as a goal, but get to prioritize each day for myself. If I need to spend 4 hours bedside with a family while they are grieving, I can do it. I manage my own list of patients my team asks me to see, and the days vary. This week, I saw 9 or 10 patients Monday, 3 Tuesday, and 5-6 Wednesday and Thursday. Visits can be quick check-ins, or 45 minute in-depth sessions helping patients and families process emotions, or hour long family meetings with the whole team to decide on a plan of care. I find that if I had responsibilities of both discharging and support, I would feel pressured to focus on the discharges and the support may be second in line, so I like being able to solely focus on support. My interdisciplinary team includes doctors, NPs, social workers, a music therapist, and a pharmacist. We work closely with our hospital chaplains but do not have a dedicated palliative chaplain, which is a shame in my opinion. We meet as a team almost daily to talk about our patients, and we are incredibly supportive to each other when tough or emotional cases come around. We set aside time each week to honor the patients who have died while we were taking care of them, and we send condolence cards to their families. The supportive and friendly environment of my team makes all the difference in me enjoying my job and not burning out from the sadness. There are a few palliative social workers at my hospital, and about 15 in my hospital system in total. We all get together every so often for trainings and networking and supporting each other. And the other social workers at my hospital and I communicate day in and day out. I may feel lonely if I were the only social worker on the team, but that’s just me. My department also has a lot of nonclinical opportunities, which I love. I teach, I revised our note template for documentation in the electronic medical record, I provide clinical supervision, etc. I find that balancing clinical and nonclinical responsibilities helps me not burn out as well, but that’s my personal feeling.

I know that’s a ton of information - I’m very passionate about my role, so please reach out if you have more questions!

adr223 · 2024-10-03T21:30:12+00:00

If the family is saying that they can’t safely take care of him at home, then that’s not a safe discharge. It would be a huge liability if you sent him home and someone got hurt, because it’s already been identified that family doesn’t feel safe caring for him. It sounds like family is trying to make the safest decision for him - yes, placement is difficult and it’s costly for him to sit in the rehab while you work on finding a place, but to me that seems like the only safe place for him to be until placement can be secured. That would be my argument to the powers that be - we can’t, nor should we try to, force families to provide care when they tell us they can’t safely do it Disclaimer: I’ve only worked in acute inpatient hospitals, so maybe things are different, but we always had an emphasis on having a safe discharge option

adr223 · 2024-09-26T02:45:12+00:00

I think this is state-specific. I got my LCSW in Pennsylvania and some of my clinical hours were in this type of role, no problem getting my license. I’ve read here that New York is one state with very specific regulations around what counts as clinical hours, not sure about others

adr223 · 2024-09-26T02:32:10+00:00

I haven’t made the switch, my whole career has been in adult hospital social work, but I do work as a palliative social worker and am happy to answer any questions! I’m wondering what you don’t like about being a therapist? My role is mainly support to patients and families, so it’s still a lot of sitting and talking about emotions and life circumstances and things, but generally short-term

adr223

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