Interview with Jessica Beitch, LCSW on Medical and Clinical Social Work
About Jessica Beitch, LCSW: Ms. Beitch is a Pediatric Social Worker at the University of California, San Francisco’s (UCSF) Benioff Children’s Hospital, where she works in the pediatric bone marrow transplant unit, conducting psychosocial assessments and providing support, care coordination services, crisis interventions, and advocacy to pediatric patients and their families. At UCSF, she has also had experience working on the pediatric oncology team, on the medical-surgical ward, and in the pediatric intensive care unit. Additionally, she serves on the Board of Directors at The Women’s Building in San Francisco, an organization that welcomes over 25,000 women and their families each year, connecting them with social services, community involvement opportunities, the arts, wellness and educational events. Prior to her role at UCSF Benioff Children’s Hospital, Ms. Beitch was a per-diem social worker at Kaiser Permanente, where she provided adult social work services and discharge planning on the inpatient hospital and medical surgical floors, as well as in the oncology unit, stroke unit, dialysis unit, neonatal intensive care unit, and antenatal and postpartum floors.
Ms. Beitch earned her Bachelor of Arts degree in Critical Gender Studies from UC San Diego in 2004, and her Master of Social Work degree with a concentration in Direct Practice in Health Settings in 2011 from UC Berkeley. During her MSW Program, she completed her first field internship at Huckleberry Youth Programs, where she helped support homeless and underserved youth, and her second field practicum at UCSF Benioff Children’s Hospital, where she worked at the Mt. Zion campus in General Pediatrics, Teen Services, and the Young Women’s Program. Jessica Beitch was compensated to participate in this interview.
[OnlineMSWPrograms.com] Could you please elaborate on your role and the types of clients you have counseled and assisted in a clinical social work capacity?
[Jessica Beitch, LCSW] As a medical social worker on the bone marrow transplant unit at a teaching hospital, I work with a robust team that includes attending physicians, fellows, residents, nurse practitioners, nurses, nurse coordinators, nurse administrators, patient-care advocates, dieticians, food service attendants, child life specialists, art therapists, music therapists, physical therapists, occupational therapists, speech therapists, lab techs, pharmacists, administrative assistants, medical assistants, medical interpreters, financial representatives, descendent affairs staff, national foundations, community organizations, and other social workers (I’m probably forgetting a few people!). My role among the team is to assist with coordination of services; to relay patient and family questions, concerns, cultural practices and traditions, and other issues that come up with the larger team as appropriate; and to provide education, normalization, and support to the patient and family throughout the transplant admission and on-going. What I love is that I never really know what I’m walking into when I start my day. I conduct psychosocial evaluations of every patient and family that gets admitted to the service, and insurance companies often utilize these evaluations as part of the transplant authorization. In line with general social work practice, I am constantly assessing for safety and risk, access to resources, mental health, financial concerns, and available support networks.
As you can imagine, undergoing a bone marrow transplant–which is both a life-saving and life-threatening intervention–is very intense for the patient and his/her family. That’s why we, as a team, do a lot of preparation with the family prior to the admission, and then continue with daily support throughout their time in the hospital. In general, a patient will stay admitted (and cannot leave the hospital room) for six to eight weeks, barring any complications. Often times, siblings are not able to visit during this time, which splits the family between the hospital and home. And because UCSF is one of only a few medical centers that perform bone marrow transplants, families travel from hours away, or sometimes different states or countries for the procedure. The challenges that arise for our patients and families cannot be listed here, they are so numbered. The biggest risk is that a child dies during the transplant admission, or from a complication associated with and following the transplant. Fortunately, this does not happen regularly and many kids go on to live healthy and normal lives. However, there are just some things that medicine cannot fix and it is tragic and heartbreaking to lose a child.
As a social worker, I offer ongoing support and assistance with coping through a variety of different methods, depending on the needs of the patient and/or the family. I assist with submitting grant applications for financial assistance and I write letters to employers and schools about long-term absences. I help explain to the patients with age-appropriate language the reason they are in the hospital and getting this type of treatment, and I also support the siblings. With my Child Life Specialist colleagues, we prepare patients for certain procedures and teach them strategies to reduce anxiety, depression, and stress. I help the medical team understand a family’s cultural perspective; and help a family understand the medical team’s recommendations and treatment plan. After the transplant admission, I provide close and on-going support as the patient and family slowly transition back to home, work, school, and a “new normal” for their lives.
I feel very lucky to meet and work with such a diverse population. As stated above, patients come from all over CA, from the Navajo Reservation in AZ and NM, from all over the nation and even different countries. There are many primary languages spoken by our families and different cultural traditions that they practice. Although my patients are here for the same type of treatment, they are all very different and I learn so much from each of them.
[OnlineMSWPrograms.com] What types of clinical interventions and therapeutic methods do you use with your clients?
[Jessica Beitch, LCSW] In my clinical work, I utilize the techniques and spirit of motivational interviewing. My goal is to stay very patient-focused and draw on the person-in-environment model. If anxiety becomes a problem for a patient, I introduce stress-reduction techniques such as deep breathing and visualization. With parents, I encourage self-care and mindfulness activities to help with the stress and strain of hospital life. Mostly, I engage in active listening, provide emotional support and validation, and bear witness to the challenges and triumphs of our families.
A patient or family member can wax and wane over time with regards to his/her mental or emotional state and practice of healthy coping mechanisms. It is a constant assessment of access to support and healthy coping, as well as development of a trusting relationship, that allows open communication and forthrightness. We occasionally have to involve CPS or other law-enforcement agencies to ensure the safety of our patients (and sometimes the safety of a parent or sibling).
I am lucky to work with a great team of nurse coordinators, nurse practitioners, pharmacists, and school liaison staff to assist with discharge planning and coordination of services. Getting back to school can be a rough adjustment for our patients, so writing 504 Accommodation Plan letters or IEP assessment requests is a regular part of my work. Also, immigration status can become a concern for some of our parents, so I advocate on their behalf. Some case management needs are fun and celebratory as well, including helping with Make-A-Wish plans or other fantastic opportunities like camp, our hospital prom, concerts, and family trips.
[OnlineMSWPrograms.com] What academic and professional experiences brought you to medical and pediatric social work? During your MSW, what specific clinical social work roles did you consider? In what ways do pediatric and medical social work call upon your clinical social work training? Do you stay involved in other types of clinical social work even while working full time at UCSF Benioff Children’s Hospital?
[Jessica Beitch, LCSW] After graduating with a BA in Critical Gender Studies and a minor in Psychology from UC San Deigo, I moved to Washington, D.C. to pursue a social justice fellowship at an international organization. Seeking direct service work, I next became part of a volunteer service corps in Brooklyn, NY. During my year of service, I worked with adolescents from at-risk communities, which was a long-standing passion of mine. This particular program provided non-conventional and off-site education (high school and GED curricula), as well as daily psychoeducational groups to the students. Additionally, each student met weekly with a social worker. This was my introduction to social work and the many different roles, relationships, and opportunities social workers have to influence individual lives as well as communities at large. I worked with similar populations for a few more years in New York before returning to San Francisco and starting an MSW program at UC Berkeley, with an emphasis on social work as it relates to physical health and health systems.
During my MSW program, I interned at the Huckleberry Youth Programs Cole St. Clinic, which was a Department of Public Health clinic for homeless and low-income youth in San Francisco. I provided therapy and case management for teens who were seeking medical services. For my second year internship, I worked at UCSF Benioff Children’s Hospital in the outpatient pediatric clinic, as well as with the Young Women’s Program, which provided mental health support, resources, and medical care for pregnant and parenting teens. During this second internship year, I was fortunate to have an opportunity to participate in the Child Trauma Training Institute with my social work supervisors.
After graduation, I was hired as a per diem social worker at Kaiser Hospital in San Francisco where I covered a variety of inpatient services including labor and delivery, the NICU, pediatrics, as well as adult services: med-surg, the stroke unit, ICU, oncology, and the ER. I learned a lot about discharge planning and the adult hospital world, but my true passion was working directly with children and adolescents. An opportunity arose to become a per diem social worker back at UCSF with the inpatient pediatric population, so I took it.
I spent a year covering full time for other social workers that were taking medical leaves, maternity leaves, or vacations. I worked on the pediatric oncology service, neuro-oncology and neurosurgery service, general pediatrics ward, pediatric ICU, outpatient hematology, and was finally hired as a benefitted employee to the bone marrow transplant service, covering both the inpatient service and outpatient clinics. This is a great fit for me. I enjoy the integration of acute illness with the opportunity to establish long-term relationships with patients and their families. I also recently became licensed in the State of CA, which is no easy feat, but I’m very happy to have gone through the process.
My background was initially in the community realm, not the hospital. I actually never thought that I’d work in a hospital! I enjoyed the non-profit experience and getting to engage in grassroots organizing for community change. I’ve also had an interest in community health development and specifically working with adolescents around sexual and reproductive health, substance use, nutrition, and food justice. But it’s hard to get people to visit the local non-profit organization and resources are always scarce. I learned quickly that everyone takes their child to the doctor, and there are so many different ways to intervene and promote health and wellness among a family system within the medical or hospital context.
My MSW program taught me about the health system, the roots of health disparity, how to engage in evidenced-based practices, and how to “read” a research study to best utilize the results and recommendations. My internships were the most valuable part of the program, because that’s where the hands-on learning took place. I would even go so far as to say that my supervisors at my internships were the absolute most valuable aspect of my training, because they were available for support, learning, reflection, and inspiration.
The hospital environment is a fantastic setting, in that there are many opportunities for moving around to different services, as well as moving up in the department. And every day is different, so there is always something new to learn.
In terms of staying involved in other areas of social work outside of my main job, and as a balance to the one-on-one direct service work that I do in the hospital, I’ve also been a member of the Board of Directors for a local non-profit organization called The Women’s Building for almost four years, and served as Board Chair for one of those years. This gives me the opportunity to work for macro-level change in the community that I live.
[OnlineMSWPrograms.com] What are some of the most rewarding aspects of your experiences in clinical social work? On the other hand, what are some of the most challenging aspects of clinical social work?
[Jessica Beitch, LCSW] The most rewarding aspects of my experience as a clinical social worker are the relationships I form with patients and families, who are the strongest people I have ever met, and the lessons they teach me about the true meaningful moments of life. I get to witness and honor their journey, and lift them up when they are weary–or at least hold the emotion for a moment while they take a breath. It is powerful work. I am not meant to spend forever with these families, only to meet them for a short while along their path and then send them back to their own communities of love and support. Death is challenging, but that is not the most challenging for me personally. Encountering instances of neglect, severe mental illness, or the infliction of harm (physical or emotional)–those are the things that are most challenging for me to deal with, and the hardest for me to recover from.
[OnlineMSWPrograms.com] What advice do you have for students considering a career in clinical social work? What challenges have you faced in this field, and how would you recommend students manage these challenges?
[Jessica Beitch, LCSW] My advice is to get out in the world and practice this kind of work before you really commit to it as a career. It is very taxing. Get to know yourself and your triggers and vulnerabilities before engaging in intense relationships where people’s emotions and lives are at stake. In terms of sustainability, I’ve learned that even more important than the population I work “for” is the team that I work with. My colleagues are the ones who will support me day in and day out, year after year. I trust in them completely and feel so fortunate to be on a team with them. Therapy and supervision have been so completely necessary for me emotionally and professionally. And my friends from social work school are my saviors.
[OnlineMSWPrograms.com] Speaking from your personal experiences in clinical social work, could you please provide a definition of clinical social work as you understand it, and the roles and responsibilities that are possible within clinical social work?
[Jessica Beitch, LCSW] Clinical social work is the profession by which self-determination is valued; the client is viewed at the center of his/her own unique environment and the driver of change. A clinical social worker establishes rapport and trust with clients in order to assess for safety and risk, provide appropriate referrals for support, and empower the client to achieve his/her own goals.
Thank you Ms. Beitch for your time and insight into clinical social work.