6.5 Working in Health Care
Remediating problems, intervening in problems, and preventing problems are three ways that human services professionals help others. When working at an organization or with a specific population, you may be involved in all three activities, or you may be focused primarily on one of these actions.
Remediation, Intervention, Prevention
Let’s start with remediation, which is the correction or reversing of behaviors. This is needed when a problem is chronic and when prevention and intervention have not worked to solve it. There are settings specifically situated to remediate and rehabilitate, which helps people to relearn or reform their behaviors. These include correctional facilities, probation offices, and addiction centers. In many cases, individuals are mandated or required to these kinds of settings, though in the case of someone with substance use disorders, that person might self-enroll.
In these settings, the problem is often chronic and has been assessed and identified, so the focus is on changes in thinking and behavior. Some patients or clients will be motivated to change, and others will be resistant. In addition, correctional and probation settings can contain a mixture of personnel and ideologies. While people coming from human services and social work education and philosophies are most focused on rehabilitation, other ideologies that focus more on punishment will also be present. This is a tension within the society of the United States, including the workplace.
Interventions, which help people address problems as they occur, typically precede remediation and may prevent someone from needing a more intensive treatment. When intervening, professionals help people solve problems as they occur. Intervention services take place in a wide variety of settings, including those that focus on remediation. For example, someone at an outpatient center for their addiction who is also experiencing food insecurity might be given referrals and access to food banks, food stamps, or other services.
When you work in human services, it is always important to see your clients as whole people who have multiple strengths and needs. Be prepared to support their efforts to solve life problems, even if this is not the primary purpose of the organization you work with or service that you provide. Other common intervention services include:
- employment offices
- food banks
- juvenile probation services
- resource centers that coordinate a variety of services such as childcare, food access, shelter, counseling, and others
- child abuse, domestic violence, and intimate partner violence services
- relief nurseries
Intervention is often paired with other interventions as well as with prevention services, like the Drug Abuse Resistance Education (DARE) program pictured in figure 6.5.
Prevention services that help people develop healthy life strategies may involve education, counseling, or planning. These can occur in a variety of settings, including schools, public health agencies, mental health programs, and hospitals. Prevention work also includes helping individuals prevent the recurrence of problems by giving planning, budgeting, problem-solving, or counseling support.
Prevention services may be paired with other services, such as child care. For example, some child care centers offer parent education, home visits, and other child safety course opportunities. Providing a structure for education, networking, and support can give parents the opportunity to build their own social support structures. They can also learn from people with child development and learning strategy expertise, then apply that knowledge to their own parenting. Preventative work involves helping people build on their strengths to prevent recurring problems or new problems and can be very rewarding.
Human services workers can work at any level within prevention, intervention, and remediation services. In other words, human services professionals work one to one at the micro level with clients in all realms: incarcerated prisoners (remediation), people experiencing houselessness (intervention), and new parents (prevention). They also work at the mezzo level with groups like people convicted of intimate partner violence (remediation), support groups for people with substance abuse disorders (intervention), and communities working to solve a local problem, such as creating safe places for their children to play (prevention). And macro-level program and policy work is needed in all sectors. Examples include planning and advocacy for the incarcerated or formerly incarcerated (remediation), structuring and planning of government programs such as child welfare (add type here), social security and unemployment insurance (intervention), and creating health structures and systems such as parent education, community centers, and health care (prevention).
Human Services Jobs in Health Care
There are many different types of healthcare jobs and careers for human services practitioners. Some require specializations and a Masters degree in either social work or counseling. However, opportunities in health care for non-licensed or non-graduate-degree career choices continue to grow. Following is a sample of the jobs and careers for helping professionals work in health care.
Medical Social Workers
Medical social work is a specific form of specialized medical and public health care that focuses on the relationship between disease and human maladjustment. Medical social workers practice in a variety of healthcare settings, such as hospitals, community clinics, preventative public health programs, acute care, hospice, and outpatient medical centers that focus on specialized treatments or populations. These professionals help patients and their families through life-changing and sometimes traumatic medical experiences.
All medical social workers must familiarize themselves with cross-cultural knowledge in order to provide effective health care. They do this by familiarizing themselves with an array of different ethnicities, cultural beliefs, practices, and values that shape the clients’ family systems. In addition, they must practice cultural humility, as described in Chapter 1, to learn about each client, their family, and their culture. Medical social workers must have the ability to recognize how oppression can affect an individual’s bio-psycho-social-spiritual well-being.
Emergency Room Social Workers
Within hospitals, social workers may focus on several specialties. They may work in an emergency room to provide services to triage patients. One of their main functions is to diagnose and assess patients who show signs of mental illness. The medical social worker also performs discharge planning as a means of assurance that every patient will have a safety plan when discharged from the hospital (Fusenig, 2012).
The following is a list of tasks that emergency room social workers may perform:
- stress, mental health, and suicide assessments
- death notifications to family members
- counseling and other referrals
- child and adult protective service reporting
- domestic violence and sex trafficking screenings
- discharge planning
Hospice and Palliative Care Social Workers
Palliative care involves a team of professionals who provide comprehensive wellness services, including physical and mental health care, to patients with terminal and chronic illnesses. This is closely related to hospice care, which is specifically for those with a terminal illness. This is why figure 6.6 shows that these two fields share a professional organization and community.
The main idea of this treatment option is to provide respectful and compassionate care for patients to create as balanced a perspective as possible on the life they have remaining. Care can take place in a hospital, an assisted living center, or a patient’s home.
The following is a list of tasks that hospice and palliative care social workers perform:
- ensure that patients and family members have access to resources that will provide physical comfort
- provide emotional and spiritual support to patients and their family members
- lead support groups for family members and in-service trainings to nurses, physicians, and other social workers who are involved in the treatment process
- ensure proper medical transitions from palliative care to hospice care if needed
- act as care coordinators by providing treatment planning with other members of the patient’s treatment team (SocialWorkLicensure.Org, 2017).
Pediatric Social Workers
Another kind of specialized care involves working with children and their families. Children who are experiencing chronic or terminal illnesses need support related to their mental health. A knowledge of overall child development, as well as family systems, is important to be able to perform this job. Pediatric social workers provide emotional and planning support to children and families in hospital, outpatient, and home settings.
Public Health Work
Public health work addresses communicable diseases, poverty, sanitation, and hygiene. It is defined as a collection of human service programs with a common goal: identify and reduce or eliminate the social stressors among the most vulnerable populations. A public health worker’s main role is to establish preventative measures and intervene in the health and social problems that affect communities and populations.
Roles that helping professionals play in public health include:
- find people who need help
- assess the needs of clients, their situations, and their support networks
- create with plans to improve their overall well-being
- help clients make adjustments to life challenges, including divorce, illness, and unemployment
- work with communities on public health efforts to prevent public health problems
- assist clients in working with government agencies to receive benefits
- respond to situations of crisis, including child abuse or natural disasters
- follow up with clients to see if their personal situations have improved (Allen & Spitzer, 2015)
Public health work is also critical at the macro level where prevention, health equity, and building evidence are core principles (CDC, 2014). At the national or state level, this can improve access to quality care for those marginalized in society. Strategies focus on community resources, many of which are nonprofit agencies, to address behavioral aspects contributing to overall health.
Community Social Workers
Community social workers are key constituents in implementing these efforts. While programs and strategies might vary, social work practice in community health and prevention can focus on a wide variety of topics, including smoking, family nutrition, teen pregnancy, drunk driving, and sexual health to name a few. These problems can impact the overall physical and mental health of the community and its members’ quality of life. Unlike primary care and mental health settings that address health care concerns aligning more with the medical model, community health and prevention follows the wellness model to identify and prevent physical and mental health problems on a broad scale.
Healthcare and Community Partnerships
There is a common misconception in health care and human services that work is confined to formalized settings. This is not the case, especially as the field evolves to meet the changing needs of communities, budgetary constraints, and technological advances. One such example is the BIKETOWN program in Portland, Oregon.
BIKETOWN is a bike-share system launched in 2016 through a partnership between Nike, the Portland Bureau of Transportation (PBOT), and Lyft. The program started with more than 1,000 electric-assist bikes and has since undergone multiple expansions. In 2018, the service area grew to include East Portland neighborhoods, including Grant Park, Creston-Kenilworth, Laurelhurst, Beaumont-Wilshire, Cully, and Hollywood, along the 50s Bikeway. An additional 22 city bike corrals were designated as “Community Corrals,” providing additional places for riders to lock up their bikes for free.
In 2020, PBOT and Lyft launched a fleet of 1,500 pedal-assist electric bikes for BIKETOWN, expanding the program’s service area to 32 square miles. This expansion included the Jade District and portions of Lents, Powellhurst-Gilbert, and the Gateway area. In January 2022, the services area was extended to historically underserved communities in St. Johns and East Portland. A “Super Hub Zone” was created to support this expansion, providing free parking for BIKETOWN bikes.
While using the BIKETOWN program, Nike has also considered accessibility and equity for its audience. They have provided information on their website to help those who require assistance, or reduced or free membership. This includes information on how to obtain prepaid cards and how to qualify for assistance. One of the program’s newest aspects is having bikes accessible to people with different physical needs.
This inclusivity is a testament to the program’s commitment to serving all community members, regardless of their physical abilities. Adaptive BIKETOWN [Website] is Portland’s adaptive cycling resource for people living with a disability or unable to ride a traditional two-wheeled bike. A PBOT partnership with Kerr Bikes, a local bike shop, has made this possible. This includes free one-hour rides on any of the Adaptive BIKETOWN bikes.
The BIKETOWN program is a shining example of how health care and human services can extend beyond traditional medical clinics to promote community health and well-being. By providing a convenient mode of transportation and encouraging physical activity, it actively promotes healthy living. This underscores the importance of partnerships and innovation in meeting the evolving needs of communities, particularly in underserved neighborhoods. The continued growth of the BIKETOWN program is a testament to its value in promoting healthy living and accessibility across Portland.
As a human service provider, consider how you can promote similar initiatives in your community to bring in new and innovative ways of health and well-being that reflect your unique lived experiences in the field. Human Services is an evolving field, and understanding the new ways of meeting community needs with partnerships with government, private, and nonprofit organizations with culture at the center of decision-making for these projects.
Licenses and Attributions
“Working in Health Care” is adapted from “Social Work and the Health Care System” by Katlin Ann Hetzel and Department of Social Work in Introduction to Social Work at Ferris State University and licensed under CC BY 4.0. Adaptations by Elizabeth B. Pierce: updated; edited for clarity, accuracy, and brevity; refocus of content within context of human services. Revised by Martha Ochoa-Leyva.
Figure 6.5. “Master-at-Arms 1st Class Stacey Carfley stands with her recent class of Drug Abuse Resistance Education (D.A.R.E.) program graduates at Pearl Harbor Elementary School” by United States Navy is in the public domain.
Figure 6.6. Social Work Hospice and Palliative Care Network logo is reproduced under fair use.
a professional field focused on helping people solve their problems.
the correction or reversing of actions or behaviors
develop strategies that fend off problems
action taken to improve a situation or address a problem
relearn or reform behaviors
the intentional emotional, negligent, physical, or sexual mistreatment of a child by an adult
any incident or pattern of behaviors (physical, psychological, sexual or verbal) used by one partner to maintain power and control over the relationship
a model that looks at three ways to help people solve problems.
(also known as “homeless”), when a person lacks a reliable place to sleep and care for themselves
well-being
a federal program established in 1935 to provide protection against poverty to older Americans.
an academic rank conferred by a college or university after completion of a specific course of study.
shared meanings and shared experiences by members in a group, that are passed down over time with each generation
a biological descriptor involving chromosomes, primary, and secondary reproductive organs.
the state of lacking material and social resources needed to live a healthy life
provision of what each individual needs in order to receive and obtain equal opportunities.
A physical, cognitive or emotional condition that limits or prevents a person from performing tasks of daily living, carrying out work or household responsibilities, or engaging in leisure and social activities.