How do I navigate myeloma with good mental health?

[Music] how do i navigate myeloma with good mental health hi my name is Kristina Bach and I am an oncology social worker I've been asked today to talk a little bit about what social work is and how you can maybe use them in your cancer experience a social worker is somebody who has some advanced training intending to what we call the psychosocial spiritual aspects of care so that sounds really tricky to understand but what it means is an healthcare environment we are attending to your needs that may have to do with things like how you're coping with your diagnosis are you suffering or dealing with depression or anxiety or worry in regards to being sick and coping with your family telling people about your diagnosis may be talking to your employer we also do a lot in terms of accessing resources and linking nations to various services that could help them along the way so that could be anything from helping you get FMLA paperwork completed so that you can take time away from work and that goes for patients or caregivers or perhaps you need help applying for disability or sort of navigating that environment insurance issues financial issues keeping your lights on if you've had to stop working and you're having an income change it's hard sometimes to ask for help and can be humbling and it's a very vulnerable position for people but I want folks to know that it's totally normal and to know that it's okay to say to somebody do you have someone here who can help me with my bills um a lot of patients don't want to talk about financial stuff I know I talking about video to stop and then we don't know there's a problem and maybe then you're not filling your prescriptions and taking your meds as you need to be and we do want to know if you're struggling with filling those prescriptions so I really want to if I can just commute you know communicate one thing it is let us know that you're struggling that you need help with things because we do really want to help you we also do things like help you get to your appointments so we deal with transportation maybe it's that you need help with meals so we might refer you to a local agency that does home delivered meals so there is a huge huge umbrella over what social workers and healthcare settings and in particular in cancer settings do but really what we want patients to know is that were there in most larger academic treatment centers and cancer centers and even in community-based cancer centers there are social workers that are available to help you and guide you through some of these things and link you to resources that you might not even know are available to you that may help you along your journey that really depends on the treatment site typically if you want to ask to speak to a social worker just ask your provider ask someone at the front desk where you're being treated do you have a social worker can I make an appointment with them can I have their contact information every treatment center and every social worker looks a little bit differently but you don't need actually a formal referral from your physician to be seen by this you can always ask to be seen by a social worker and we don't need to wait for a consult or anything like that it's really depending on your needs but I will say that if you are being treated at a center that is accredited by the American College of Surgeons Commission on cancer one of their requirements for accreditation is something called distress for you so you may have seen that at your cancer treatment site and part of that accreditation is that all patients must be screened for distress related to their cancer at at least one point during their cancer treatment at that Center what we found in the psychosocial research is that most cancer treatment centers are choosing to screen that patient for distressed on the second or third visit to the oncologist so as to rule out those false positives that are associated with that first visit where everybody's really ramped up and they're going to see their oncologist for the first time and they're learning about this treatment that we're going to have we expect there to be a fair amount of distress associated with that visit you're not being spayed for distress you couldn't really drive the bus in terms of how often you think you need to meet with the social worker and the social worker and you may work that out as part of your treatment plan when I was working in the clinic I oftentimes would see patients and perform a psychosocial assessment which is basically an interview where I get to know you and your family a lot better and maybe try to get a sense of areas where you might be struggling or having more needs that need attended to and then we would make a plan together about how I was going to follow up things I was going to do the things you or your family we're going to do and then make a plan for follow up here that is sort of a difficult question because it depends on what kind of service you're getting from a social worker social workers are also therapists and many settings where clinical clinically training iemon I'm a clinical social worker which means I could hang out my shin bone and in those cases that is a fee-for-service type of benefit it is counseling I might see you for that hour where I'm providing that kind of service so in that case it may be something that you need to investigate mental health insurance coverage and if the provider who's providing you with those counseling services is with the network with your insurance company or can provide you with the documentation to submit to your insurance company so you can be reimbursed for services that being said most social workers that work and cancer centers you just get us we are part of the treatment team there isn't a cost associated with our services we are built into that care model so if you were seeing more patient or your physician or your nurse practitioner in your care center and they have a social worker on staff there is typically not a fee associated with saying can you help me now my bills can you make a referral to XYZ organization so I can get home delivered meals we are just part of the services that you get what I used to say to my patients is you're here you get me you get to use me however you want to do that but just make sure you know that they have that differentiation and you know what services that you're getting but at most places Social Work is just part of what the service that you're provided as part of the team there's a couple of national organizations that do provide telephonic based support there is Cancer Care they're based out of New York but they provide services to patients all over the country they're on the web at Cancer Care org and I think they're fantastic they are staffed by an oncology social workers they provide resources including financial resources copay assistants an extensive amount of online support groups and telephonic support groups so you may be even though you may be isolated rural II and not have access to a social worker in your treatment site you can't pick up the phone or get online and connect with an oncology social worker through cancer care and also the Cancer Support Community which is a nationwide organization with various branches all over the country and in many areas where there aren't oncology social workers and social workers at the treatment sites the Cancer Support Community is really this community-based organization that is providing those services for patients who are coping with cancer so those are two great places that I would refer folks to who don't have access at their treatment centers there are not a lot of oncology social workers or oncology trained social workers there are more medically trained social workers so if we think about this in terms of the framework of illness and I think a lot of cancer patients are struggling with issues of grief and loss there are really really great specialized bereavement counselors out there and I know a lot of people think they only associate bereavement or loss with death and dying but cancer patients suffer all sorts of classes throughout the trajectory of their illness whether it's the loss of their ability to go to work the loss of their hair the loss of relationships and so I often times when I'm making referrals for counseling really try to get at the heart of the patient's needs anxiety and depression related to illness is something that comes up quite frequently and there are a lot of really skilled therapists out there that provide that kind of treatment ask us for referrals to local therapists and folks that we know who have that specialization I've also used Psychology Today has a therapist finder on their website and I'm even then have looked in phases there to see if I could just identify someone with medical counseling types of tree of training and then I might call them and say how do you feel about working with cancer patients remember that you are employing the therapist and so maybe your first appointment with them is like their job interview and if you don't like them you don't have to go back sometimes finding the right therapist does require a little bit of work but I think that effort is really worth it if you're really trying to attend to those psychological needs through the use of therapies it's okay to ask for help and to let us in and to help us guide you through this and to link you with resources that you might not even know exist in your area that's what we're there for and I'm hoping that this will help folks feel more comfortable with thank hey can I talk to somebody about all of this because it's more than just about getting treated it's also like how am I gonna deal with this in my life after when I go home tonight and I'm tired and I'm crabby and my spouse wants to go out to the movies and I just can't possibly deal with that those are the types of things that we really want to help people sort of feel comfortable with balancing their life and their treatment and being okay with talking about the things that they're going through [Music]