by Allison Fine, MSW, LICSW
As social workers, we have the opportunity to work with a wide range of challenged populations. Some choose careers in community mental health. Others work in foster care or child welfare. In graduate school, I gained experience working with vulnerable seniors and those seeking treatment at a community mental health center. During my experience in the working world, however, I've gained experience and have developed a passion for working with individuals diagnosed with chronic illness.
Those with chronic illness, depending upon the illness, are often living with physical, cognitive, and emotional challenges such as fatigue, pain, balance issues, muscle spasms, neurological sensations, vision or hearing challenges, tremors, memory loss, difficulty regulating emotions, difficulty multitasking, depressive episodes, anxiety, and panic episodes...and the list goes on. And again, because these health issues are chronic, these challenges don't go away, and in fact often are progressive and worsen over time.
Many of these illnesses don't wait until someone is aging, either. Often, those in their 20s, 30s, and 40s are diagnosed, with much of their lives ahead of them and at a loss for how to live these now complicated journeys. These individuals have to figure out how to raise families, make friends, run errands, go to school, and work at jobs, all while trying to feel comfortable and healthy in their own bodies.
Chronic illness clients deal with a wide range of issues, including coping with grief and loss, depression, and anxiety about their illnesses (sometimes a symptom of the illness, sometimes a reaction to the illness); communicating with their family, friends, doctors, teachers/employers about their illness; and dealing with the financial realities of having a chronic illness, just to name a few. Although these issues aren't entirely clinical, they have an impact on another significant area of the individual's life – quality of life. The impact is significant. Clients often must make changes to their work schedules or stop working altogether, sometimes causing extra financial burden in the home. Additionally, they are often not able to function at the baseline level where they were before their diagnosis, and now they are relying more on loved ones and other supports to help out with activities of daily living. Often, they do all they can to get dressed, do their house chores, or get through a work day, and little energy is left for anything more enjoyable.
This population and their needs are often forgotten about, as funding and resources are allocated in other areas. Hospital and clinic social workers are often overworked and their duties limited – many hospitals and other medical clinics don't have funding to hire social workers, because many social work services are not billable through insurance companies. Many of the larger chronic illness organizations are focused more on funding research than supportive programs that help those living day to day with these challenges. And although research, for someday hopefully finding cures for many of these illnesses, is incredibly important, it doesn't always cater to those who live day to day with these illnesses right now.
Through my counseling practice, I provide individual counseling and run supportive groups for those living with various chronic illnesses. I am passionate about my work, but I cannot do it alone. I need others to share my excitement about working with this population and understand their complicated needs. I need new MSWs entering the workforce or experienced MSWs who are looking for a path change to find their passion in working with those living with chronic illnesses.
As social workers, we must find a way to provide services to these 117 million plus people who are living with chronic conditions and recognize that they each have individualized and unique needs. We must become trained and skilled at not only increasing the services provided for individuals living with chronic health conditions, but additionally, clinically be able to distinguish between a mental health diagnosis and what is a symptom of a chronic illness that looks awfully similar. We must begin advocating for these services to be provided at no or low cost to clients, because the clients can't afford one more medical bill. We must help chronically ill individuals feel less isolated and give them hope that as a social work profession, we are doing whatever we can to help improve the quality of their lives.
Allison Fine, MSW, LICSW, is a clinical social worker in private practice in Seattle, Washington. Her work focuses mainly on providing support for those living with physical chronic health conditions.