Our Social Work Team connects providers and patients to comprehensive social work services, including assessment, engagement, intervention and evaluation addressing the psychosocial needs of referred patients, especially as they relate to the overall health of the individual patient.
- Comprehensive Assessment – Assessment of social determinants of health and behavioral health using validated screening tools. Social Work also assesses patient strengths, barriers and readiness for change.
- Patient Engagement – Social Workers engage in a therapeutic relationship with patients and when appropriate, family members. This patient-centered and collaborative process is focused on identifying, planning, advocating and supporting patients in meeting health goals.
- Complex Case Management – The Social Work Team is integrated with the Case Management Team to provide inter-professional care coordination that optimizes patient care. This may also include communication with family members, providing caregiver support and advanced care planning.
- Brief Interventions – Use of evidence-based, brief interventions for integrated behavioral health, such as Motivational Interviewing, SBIRT, Cognitive Behavioral Therapy, Problem-Solving Therapy, and supportive counseling.
- Education, Information & Referral – Social Work also assists providers and patients as a community engagement specialist, with deep knowledge of eligibility and application processes for community resources, public health programs and specialized services.
For more information, please email us at firstname.lastname@example.org