Social Work Leader Elizabeth J. Clark, Cohort VI

Building Social Work Practice and Policy Competencies in End-of-Life Care
By Sallie Lynch

Betsy Clark, head of the 150,000-member-strong National Association of Social Workers (NASW) and one of the new recipients of the Social Work Leadership Development Award from the Project on Death in America, sees aging, genetics and end-of-life care as three issues that are of prime importance to every practicing social worker in the next decade. Her PDIA grant should help develop national standards for social work in end-of-life care, building on accomplishments to date. It should tie in SWLDA projects and assist in mapping a future for grantees after the conclusion of the Project on Death in America at the end of 2003.

Betsy got into social work at an early age and has always had an interest in end-of-life care. In fact, as a graduate student getting her MSW, she taught her first class in 1974 called Death and Dying at the University of Pittsburgh. She attributes her early intrigue in bereavement and end-of-life care with the premature death of her father while she was a teenager and the loss of her only sister to cancer. Inspired by her sister's hope, and with the benefit of having Eleanor Cockerel, one of the country's first oncology social workers, as a mentor, Clark went on to write a book called You Have the Right To Be Hopeful. Summing up the message of the book, Clark says, "In end-of-life care, hope is positive no matter how close to death someone is. There's always something to hope for."

Elizabeth J. Clark, PhD, ACSW, Executive Director of NASW

Today, as director of NASW, the largest social work organization with 150,000 members out of the 600,000 practicing social workers in the country, Clark has clear ideas about the future of social work. With her PDIA Social Work Leadership Development Award, Betsy plans to develop both national standards and a policy statement for social work in end-of-life care.

"We are the largest association of social workers in the world, not just in the country, and our standards of care, which we have developed for many areas and are revised on a regular basis, are really used as standards in those areas. So one of the things that we know we can do is to develop outstanding end-of-life care standards," Betsy says. Using NASW's contact with a network of experts in the field, Betsy will allow PDIA and the SWLDA program to take part in the development of national standards of care that are specific to social work.

Every three years, NASW brings 300 delegates together to decide on social work's policy for the coming decade. "One of the things that we want for the next one, which is in 2005," Betsy says, "is a policy statement that can be adopted as social work's policy on end-of-life care, and that is used everywhere, in the classroom, in the press, in the media." With the backing of NASW in implementing those national standards and policy statement for end-of-life care, as Betsy said, "Both the short and long-term impact should be tremendous."

"...I think social work is the only profession that can change the way we die in America... when you look at the fact that we are the largest providers of mental health services in the United States and the fact that we already have the skill set. We just need more specific knowledge to apply..."

For Betsy, the primary concern in the field of social work for integrating PDIA programs is not the student, but the practicing social worker. The field, she says, turns out about 30,000 new social workers each year, and education on their level would require a generation before the standards become a part of social work practice. Through NASW, Betsy aims to offer this training to practicing social workers through a web course that would reach a huge number of people.

With the anticipated conclusion of the Project on Death in America, Betsy's project should provide Social Work Leaders with a support network for sustaining their projects. "There's been so much good work done," said Betsy, "but how do you sustain it? And I think we can take from NASW and make a lot of these projects sustainable by integrating them in what we want to do."

"I think social work is the only profession that can change the way we die in America," Betsy audaciously stresses the importance of social work in end-of-life and palliative care. "Every now and then, I talk with someone who understands how broad that concept is. Social workers are already trained in psychosocial issues. . They have the basic skill set. . .If you took psychologists and clinical nurse specialists and added them together, there are almost three times as many social workers. . .I think that when you look at the fact that we are the largest providers of mental health services in the United States and the fact that we already have the skill set. We just need more specific knowledge to apply."

To push the field of social work forward and sustain the initiative created by the SWLDA projects so far, Betsy Clark's project will enable PDIA Social Work Leaders to better evaluate their project and disseminate their accomplishments to the diverse network made available through NASW. SWLDA is very pleased to welcome Betsy to the program.