Social Work Stories: Shirley


March is Social Work Month. This year’s theme is, “Elevate Social Work.” In honor of Social Work month and in our attempt to elevate our practice, OncoLink is featuring social workers and their own voices. Today we hear from Shirley, one of my (Christina’s) mentors and a force in the field of palliative social work.


This year’s Social Work Month theme is “Elevate Social Work” – a fierce call to action from and for our field. Social work is an advocacy profession-we are at our core, change agents dedicated to empowering the vulnerable populations that we serve. 

But our field is also vulnerable and in need of our concerted efforts to create transformational change. Far too often in healthcare, our services are marginalized. Too often we’re seen as “optional.” We have been described as “guests in a host environment” and categorized as “ancillary.” Clinics that otherwise tout “comprehensive care” are seldom adequately staffed with the full component of the services of a comprehensive team. Yet we are needed if we are to be the voice of those we serve and if our institution’s marketing for “person-centered care” is to be actualized, for it is only in the context of a robust interprofessional team that we might address the symptoms and stress associated with a cancer diagnosis. 

Increased recognition of the importance of addressing the social determinants of health in the provision of whole-person care lays the foundation for the inclusion of social work in the delivery of comprehensive care. The field of palliative care is founded upon the recognition that the multidimensional aspects of suffering associated with a serious illness requires an interprofessional team approach with skilled experts committed to addressing the physical, psychological, social and spiritual domains that make up a patient’s quality of life. 

Palliative care understands that people are more than their disease and that interventions must be contextualized to meaningfully address the values, concerns and priorities of each individual served. The recently updated (October 31, 2018), National Consensus Project (https://www.nationalcoalitionhpc.org/ncp/) lists eight domains necessary for the delivery of quality palliative care. Social work opportunities exist in each of these content areas. 

1.     Structure and Process of Care

2.     Physical Aspects of Care

3.     Psychological and Psychiatric Aspects of Care

4.     Social Aspects of Care

5.     Spiritual, Religious and Existential Aspects of Care

6.     Cultural Aspects of Care

7.     Care of the Patient Nearing the End of Life

8.     Ethical and Legal Aspects of Care

Palliative care is rapidly expanding outside the walls of the hospital and clinic to reach the needs of people in the community. Home-based palliative care offers palliative social workers leadership opportunities as we work together with our colleagues and other stakeholders (including patients and their families) to co-create new systems of care that might better address the quadruple aim of healthcare reform (improved patient satisfaction, improved population health, lower costs of care and increased staff satisfaction).  

To provide quality, person-centered, family-focused, culturally-congruent care we must be committed to elevating our professionalism and increasing our influence. Palliative social workers who have established competence in the field are eligible to sit for an examination to be credentialed as an “Advanced Palliative Hospice Social Worker Certified (APHSW-C) professional (https://www.swhpn.org/aphsw-c-examination). The Oncology Social Worker-Certified (OSW-C) certification (http://oswcert.org/) is another opportunity for us to demonstrate our commitment to “working at the top of our license” – so necessary if we are to actualize the call to “elevate social work” and create systems that more reliably address the needs of those we are called to serve.


Shirley Otis-Green

Shirley’s career is dedicated to enhancing excellence in the delivery of contextualized care to address the symptoms and stress of serious illness.Her education, research and consultation efforts have led her to become an internationally recognized speaker on quality-of-life, palliative care, leadership development, and the creation of meaningful organizational change. 

As Principal Investigator on studies with over $3.5 million in external funding, her work has been recognized with numerous awardsand disseminated through more than 100 publications and 500 professional presentations. She is a California HealthCare Foundation Leadership Fellow, serves on several editorial and professional boards, and is a Distinguished Social Work Practitioner in the National Academies of Practice. 

Shirley was among the first to receive an international, interprofessional Master of Arts in Health  Research ~ Palliative Care from Lancaster University in Great Britain, and is co-editor of the Oxford Textbook of Palliative Social Work.