by Katherine P. Supiano, PhD, LCSW, F-GSA, FT
While all health care professionals ascribe to a code of ethics that supports person-centered care, clinical social workers have a unique perspective that positions them as essential clinicians in comprehensive care of those living with chronic pain. Social workers are equipped to look beyond the diagnoses, the labels and societal expectations to consider the whole person-in-environment, thus the practice of social work is not constrained by biomedical models. As a distinguishing hallmark of the discipline—social workers join with persons who are disenfranchised—that is, persons whose experience is not recognized as valid by a larger and more powerful group—and with persons who are marginalized—that is, persons whose very lives are placed outside of common society.
Persons with chronic pain are frequently labeled as weak, as drug-seeking, as burdens—and social workers not only convey value to these lives, but are capable of gently drawing persons with chronic pain into the societal community through provision of resources and clinical care. Social workers also—not so gently—advocate by challenging social norms and challenging bureaucracies that exclude, label and disenfranchise—and we equip our clients to do the same.
A well-rounded inter-professional team working with and on behalf of persons with chronic pain is not complete without a social worker. We assess for mental health issues that contribute to the picture of the total pain experience—both as cause of pain and as effect of unrelenting pain. We can address the emotional and cognitive strengths and needs of clients and their families.
We can assess and intervene in substance use risk and in treatment of substance-use disorders. We advocate for clients in an often unwelcoming health care and mental health care system—and refer to and arrange many services that are vital for the lives of persons with chronic pain and their families. We are knowledgeable about and supportive of evidence-based complementary approaches to pain, fatigue and other forms of distress—and skilled in the implementation of many appropriate therapies—MBSR, EMDR, solution-focused therapies, to name but a few.
Social workers are collegial by nature and by training—we have much to contribute to the entire team of client, family, pain team and larger health and mental health teams. Palliative care social workers—who have additional specific skills in goals of care discussions, symptom management treating psychological distress—are ideally equipped to support persons with chronic pain and their families.