In November 2014, the European Association for Palliative Care published a new white paper: Core competencies for palliative care social work in Europe. Here, two of the authors, David Oliviere and Pam Firth, recall people who inspired them in developing palliative care social work and explain the background to Part 2 of their longer article published in the January/February issue of the European Journal of Palliative Care.
So many people have made and are continuing to make social work in palliative care what it is today. National pioneers have ensured effective social work in increasing numbers of countries, adapting it to their specific context. Yet the pioneer of pioneers, Elisabeth Earnshaw-Smith, first director of social work at St Christopher’s Hospice in London, set many of us on the path of integrating social work within palliative care’s multiprofessional approach. She developed the ‘family as the unit of care’ in practice and initiated the UK Association of Palliative Care Social Workers.
In my (David’s) first week in palliative care, some 30 years ago, on the multi-professional week at St Christopher’s Hospice, Elisabeth inspired us, “It’s all about promoting people’s strengths and resources”. That has become a sort of mantra for many. She taught us how to focus on the family, away from the patient-clinician relationship, using ideas from systems theory and family therapy; how to think of the context in which the patient and family exist; the external pressures and resources to bring, matching them to the internal resources and strengths they have used in order to live life and face its crises; how to respond to social pain with a relational approach; and that death was a natural event (Oliviere, 2014). All this intricately knitted into the multiprofessional team approach. Elisabeth first introduced using family trees, or genograms, as an assessment and therapeutic tool. This single practice has travelled around the world.
Using a genogram to look at three generations helps us to identify past history of loss. Murray Bowen (1991) suggests that a family bereavement sends a shock wave through the family system, even years later. Many people reading this will be aware of deaths in their own families, which have created this shock wave. In 1917 my (Pam’s) grandfather, a husband and father of five, was killed on the ‘Somme’ along with thousands of others. As a result my father aged nine and his siblings experienced a sequence of losses, father, home, school and money. Like many of us working in palliative care social work I have been able to use this personal knowledge to promote the needs of families facing the death of a family member and, in particular, the needs of children and young people. In 20 years there has been a rapid increase in services and knowledge about bereaved children and their families throughout Europe. Palliative care social workers have made important contributions to research and service development, particularly Christ (2000).
Core competencies for palliative care social work in Europe: an EAPC White Paper, to which we contributed with Dr Sean Hughes, is an important document for all those working in palliative care because it highlights the importance of the psychosocial dimension to death and dying and the need for more integration of the health and social care systems. It also gives guidance for new services.
Read a copy of the full article…
This post relates to a longer article, ‘Core competencies for palliative care social work in Europe: an EAPC White Paper – part 2’ by Sean Hughes, Pam Firth and David Oliviere, published in the European Journal of Palliative Care 2015 (22.1). You can download a free copy of the article from the EAPC website.
Readers with a web-based subscription to the European Journal of Palliative Care can download this issue plus all articles in the journal archive. You can also browse the archive and download articles by taking a 10-minute or 30-minute subscription. Members of the EAPC receive discounted subscription rates to the journal – click here to subscribe online.
Brown M (1991) Family reaction to death in Walsh F & McGoldrick M (eds.) Living Beyond Loss. New York: Norton.
Christ G (2000) Healing Children’s Grief. New York: Oxford University Press.
Oliviere D (2014) Social work – a relational process. In Wasner M and Pankofer S (eds.) SozialeArbeit in Palliative Care. Stuttgart: Kohlhammer.
- See also ‘The art of social work in palliative care’ by Dr Sean Hughes published on the EAPC blog.
- The EAPC Social Work Task Force: To examine the diversity of roles, tasks and education of palliative care social workers in Europe.