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Health social work has been historically associated with environmental, sociopolitical, and economic context of the society. With the industrialization, urbanization, and global warming, health social workers are combating poverty, environmental degradation, natural disasters, and health inequity. Health social work in this research paper is defined as a subcategory of social work profession that includes medical social work and public health social work. Health social workers serve to humanize the health and social care system, emphasizing the importance of the holistic psycho-social-spiritual needs of individuals and groups when they experience distresses of illness, trauma, death, or disabilities across the life span. Health social workers practice in hospitals, communities, health departments, nongovernmental organizations, and international bodies. Advocacy, self-help, psychosocial education, and community organization are commonly adopted strategies of patient empowerment for health social workers. International organizations are active in promoting reform in the global environment so as to make the world a better place.
- Overview of Health Social Work
- Development and Transformation of Health Social Work
- The Nineteenth and Early Twentieth Century
- Occupational Social Work
- Global Scene
- Health Social Work and Environmental Challenges
- Health Disparity and the Roles of Health Social Work
- Major Areas of Practice
- Medical Social Work
- Public Health Social Work
- Public Health Social Worker and Disaster
- Core Competencies
- Challenges and Opportunities
- Challenges in Health Social Work Practice
- Challenges in Health Policy
- Challenges in Ethical Issues
- Opportunities in Education and Knowledge Development
Overview of Health Social Work
The development of health social work was closely linked to global development of social work in the Europe and North America through history. With the industrialization, urbanization, and global warming, health social workers are combating issues such as poverty, environmental degradation, natural disasters, and health inequity. They are increasingly specialized in providing support and services to specific disease groups and treatment interventions such as cancer and organ transplant in hospitals and clinics.
Health social work is defined as a specialization of social work that includes medical social work, rehabilitation social work, and public health social work. As rehabilitation social work can also be grouped under medical social work, this research paper will mainly discuss health social work under the context of medical social work and public health social work. The former primarily uses professional activities to help individuals, families, groups, or communities related to certain medical conditions to “restore, retain, and enhance” (Council on Social Work Education, 2009: 7) their well-being, while the later adopts “an epidemiological approach” (Practice Standards Committee, 2005: 4) to address social problems affecting health and social functioning.
Development and Transformation of Health Social Work
The Nineteenth and Early Twentieth Century
Health social work was initially developed in the nineteenth century in the United Kingdom (UK) and the United States (US) in response to the social needs. The first professional health care social workers were employed as ‘hospital almoners’ in UK. They took care of patients with disease-related, social, and family issues under the London Charity Organization Society (COS). In the US, the first social worker was hired in Massachusetts General Hospital in 1905 (Gehlert and Browne, 2006: 6–7). As the profession developed and matured, hospitals have remained a key source of employment for social workers.
One of the major public concerns during the nineteenth century was urban poverty and related issues such as infectious diseases. While the health almoners under COS focused on helping the poor, a group of settlement house workers were more active in promoting social reform, initiating the Settlement Movement (Hick, 2002: 41–42). The Settlement Movement first begun in London to assist young well-educated people to serve in poor neighborhoods and to provide moral models for social improvement (Payne, 2005: 37–39). It had quickly spread to countries such as Canada and the US and brought a broad range of development in vital aspects including education, political action, and youth work (Payne, 2005: 46–47). Some social workers became involved in initiatives to influence policy and legislation as they found the coverage of the Poor Laws in Britain to be insufficient in combating poverty during the Great Depression. At approximately the same period of time, there is also a need for the US to address issues such as poverty and unemployment, where community development programs naturally grew.
Occupational Social Work
With rapid industrialization and economic development, new workforce including women, minorities, and people with disabilities emerged in the nineteenth century. Occupational social work, also referred as industrial social work, started to develop in the 1970s, catering to the needs and protecting the rights of the working populations (Kurzman, 2008: 314). Programs were introduced to ensure needs of daycare, occupational safety, equal opportunity, and quality of life of workers are protected. Early occupational social work programs targeted at alcoholism, with funding largely coming in from the National Institute on Alcohol Abuse and Alcoholism. Nowadays, as the field gets more mature, occupational social workers respond to more needs, often in union counseling and advocacy programs in the US (Kurzman, 2008: 312). Their duties cover individual counseling with employees in need, training relevant staff for referrals to social services, initiating programs to promote health, and advising on affirmative action plan, especially when vulnerable populations are involved.
With the passage of time, health social work has gradually developed across the globe, in European as well as Asian countries (see Table 2 for a summary of health social work development and world events). Professional social work organizations and training institutions began to emerge across countries such as UK, Europe, and North America. The colonization movements of these countries, together with the establishment of international philanthropic nongovernmental organizations (NGOs), brought health social work to other countries including Australia, India, Singapore, China, Taiwan, Africa, South America, as well as their other colonies in different parts of the world. The rapid development of health social work in countries such as Bulgaria, China, and Estonia slowed down, when the communist parties came to power in 1940s. The tasks of social workers to provide welfare and address social problems were taken over by socialist states (Payne, 2005: 72–75) and social development was prioritized over social work. Health social work did not regain its role and significance until the breakup of the USSR and Eastern Europe as well as the opening up of China and other communist regimes in the late 1980s to harmony, and integration of individuals and families in societies (Payne, 2005: 74).
Health Social Work and Environmental Challenges
At the dawn of the twenty-first century, social work profession increasingly realized the importance of environmental protection when large-scale natural disasters such as flood, forest fire, earthquakes, and volcano eruptions were seen everywhere across the globe as a result of climate changes and environmental degradation (Gray et al., 2013: 4). As early as in the 1970s, social workers started to take initiatives in environmental issues and showed interests that range from ecologic perspective to environmental justice movement (Gray et al., 2013: 11). More recently, social workers advocate for best practice and policies to reduce carbon footprint, preserving sources of clean water and forests, and raise global awareness about environment protection. The three leading social work organizations – International Association of Schools of Social Work (IASSW), the International Federation of Social Workers (IFSW), and International Council on Social Welfare (ICSW) – explicitly announced their support toward the extension of the UN Kyoto Protocol to protect the environment and to reduce the effect of climate change. They have also presented in UN conferences, such as the Climate Change Conference in Copenhagen in 2009 (Dominelli, 2012: 85–86).
Health Disparity and the Roles of Health Social Work
At the turn of the twenty-first century, health disparities are becoming an international problem for industrialized and industrializing societies. The World Bank recognized poverty and social disparity as major threats to social development in the contemporary era (World Bank, 2012). Low-income populations are less accessible to health care and social care. Industrialized countries such as the US, Canada, UK, and Finland invest more on health compared with industrializing countries such as Niger, Nepal, Kenya, and China (Karki et al., 2013: 214–215). The situation is clearly indicated by health indicators including tuberculosis (TB) prevalence, human immunodeficiency virus (HIV), and relation of life expectancy to health expenditure.
Poverty and the insufficient investment in health and social care have lead to a variety of health problems in industrializing countries. Over 2 billion people live on less than US$2 per day and they cannot even afford for the basic medical care. Malnutrition, infant deaths, neonatal deaths, and stillbirths are taking more than one-third of the lives of global newborns and putting 20 million pregnancies at risks (IFRC, 2011: 13). Battles against communicable diseases such as TB, hepatitis, malaria, simple bacterial infections, and diarrhea are on-going. HIV/AIDS, as a global epidemic, has brought tremendous challenges for children, youth, adults, and their families. The estimated population who are living with HIV worldwide is 40 million according to UNAIDS (Newman, 2008: 357).
Facing the challenging situations in health care, health social workers can take active roles in leading and coordinating the interdisciplinary healthcare team. For example, health social workers can assist in reducing infant deaths and pregnancy risk through mobilizing community health workers, midwives, and doctors to provide home visits and cost-effective interventions such as immunization, micronutrients, treatment for diarrhea, malaria, and acute respiratory infections, as well as improved prenatal and delivery care in the rural areas (IFRC, 2011: 13). They can help to fight against communicable diseases with the promotion of environmental cleanliness, health, poverty reduction, and gender equality. Moreover, they may also contribute to HIV testing, early intervention, treatment adherence, case management, and care coordination, as well as research and community engagement (Newman, 2008: 360–361).
Health social work has been historically associated with environmental, sociopolitical, and economic context of the society. While psychosocial and environmental aspects of deprivation and trauma are often closely related to illness and death, physical illnesses can also elicit emotional distress, and socioeconomic relationship breakdowns such as divorce and bankruptcy may result in somatic problems. Health social workers play vital roles in providing direct services, as well as promoting advocacy in research and policy practices.
Major Areas of Practice
Medical social workers, rehabilitation social workers, and public health social workers are the three main categories of social workers working in the healthcare system in serving individuals, families, communities, and societies. The following discussion will be focused on the two of the three categories: medical social work and public health social work. Rehabilitation social work will be excluded from the following discussions as there is a section on social work and disability; besides it can also be regarded as one of the subcategories under medical social work.
Medical Social Work
Health social workers practice in hospitals, communities, health departments, NGOs, and international bodies. Health social workers serve to humanize the health and social care system, emphasizing the importance of the holistic psychosocial- spiritual needs of individuals and groups when they experience distresses of illness, trauma, death, or disabilities across the life span. Those serving in hospitals and clinics are known as medical social workers. In face of diseases and illnesses, patients often experience distress including anxieties about the tests before the diagnosis, worries about loss of income or functioning due to the disabling effects of illness and/or treatment, grief over the loss of health and sense of control over one’s life, frustration over social discrimination due to physical disfigurement or intellectual limitations, and disorientation with the world and feeling overwhelmed by the sense of vulnerability.
Medical social workers work flexibly as case managers, service coordinators, patient advocates, health educators, counselors, family therapists, and pastoral and spiritual care providers in helping patients throughout their course of illness. They serve patients through assessment and enhancement of their bio-psycho-social functioning, discharge planning, case management, or group intervention to facilitate their adjustment to illness and loss, strengthening their support networks, connecting them with necessary community resources for rehabilitation and long-term adjustment to chronic illness or disabilities, and building of self-help and survivors groups. They also mobilize volunteers to serve as patients’ advocates, peer counselors, and expert patients.
In addition to the multiple roles, medical social workers in hospitals often work closely with the medical teams and are also becoming increasingly specialized. Some of them specialized according to disease groups and target patient groups such as oncology, cardiology, gynecology, geriatrics, and pediatrics and some specialized by settings such as social workers in clinics, intensive care unit, hospice and palliative unit. Others specialized by tasks including prenatal diagnosis, genetic counseling, case management, organ transplant, and infection control.
There is increasing research evidence supporting the importance of health social work in the healthcare system. For instance, Egan (2010) summarized research evidence of effective social work interventions for five diseases and found that health social work brings multiple positive effects including improving patients’ knowledge, adherence, and competence in disease management, while enhancing their quality of life and self-esteem. More recent evidence sheds light on the integrative approach toward health and social work practices, suggesting the use of Eastern health models of body–mind–spirit (IBMS) intervention such as Taichi and qigong exercises, massage, meditation, mindful practices, yoga, meaning-making, resilience training, and spirituality of suffering and growth through pain to enhance holistic wellness (Lee et al., 2009: 217). Evidence has also been accumulating for positive- and strength-oriented intervention programs on forgiveness, gratitude, generosity, compassion, social support, and transformation (John Templeton Foundation, 2010).
Medical social workers participate not only in providing direct services to individuals and families, they also advocate for social and legislature change. An example would be the social workers in oncology and palliative care. Apart from playing a vital role in meeting the needs of clients with life-limiting illnesses and their family members, they also engage in education, navigating through and advocating the medical and social systems (Blacker and Christ, 2011: 21–23).
Public Health Social Work
Public health has emerged to promote health by preventing, limiting, and stopping the spread of disease (Keefe and Evans, 2013). As one of the members of the multidisciplinary settings, public health social workers address health from a broader perspective (Practice Standards Committee, 2005: 4), focusing on promoting healthy lifestyle to individuals, families, and groups; preventing illness; and reducing unhealthy behaviors such as smoking, the use of drugs and alcohol, physical or sexual violence, promiscuity, gambling, drunk driving, self-harm, and suicide. In countries such as Canada, social workers are hired as ‘health promoters’ (Raphael, 2000: 356–357) to identify key factors for health, promote activities to improve individuals’ health conditions, reduce high-risk behaviors, and evaluate program effectiveness.
Public health social workers adopt a community development approach to mobilize resources, cultivate collective problem-solving, as well as improve health and resilience among underprivileged groups. Raising awareness for disease prevention, health promotion, improvement in nutrition, and access to immunization can enhance social development of the society. The short-term voluntary program for at-risk mothers and newborns offered by a Philadelphia interdepartmental collaborative in the US would be an excellent example. The program was established in response to the amendment for the Federal Child Abuse Prevention and Treatment Act, which mandates a system for the mothers who are identified to have used illegal drug during pregnancy. The Philadelphia Department of Human Services and Philadelphia Department of Public Health, Division of Maternal, Child and Family Health expected law changes at the state level, and they developed this home-based program to serve the mothers who have used illegal drugs during pregnancy to ensure their health and a healthy environment for the development of their newborn babies. Safety of children is the top priority in service delivery. With a clear protocol, social workers, behavioral health specialists, and nurses work with the mothers closely for assessment, brief intervention plans, and referrals as needed. Encouraging outcomes have been reported in terms of mothers’ action plan and capability of parenting (Claxton et al., 2010: 291–303).
With the increasing concerns over environmental issues, public health social work also extends to green social work or environmental social work, to promote a healthy or harmonious relationship between people and environment. Social workers in this field seek solutions to protect the environment and to achieve sustainability (Dominelli, 2012: 15–16). Interdisciplinary interventions at multiple levels (Macro, Mezzo, and Micro) curbing the sources of environmental challenges, including but not limited to industrial pollution, overuse of natural resources, global warming, waste disposal, and disasters are essential. Gray et al. (2013) even proposed the needs to better understand the interactions between human society and the natural environment and to develop case studies on how models of effective practice can be established in this new area of health social work (Gray et al., 2013: 13–16).
Public Health Social Worker and Disaster
In addition to the ‘preventive’ environmental protection work, public health social workers also take part in managing natural disasters such as drought, frost, tsunami, landslide, extreme heat waves, and cold spells as well as ‘man-made’ disasters such as wars, terrorist attacks, as well as nuclear accidents and oil spills. Corruption and the socioeconomic–political oppression of women, religious, or ethnic minorities are creating large refugee populations as they escape from homes ruined by political instability and brutality. These disasters, often accompanied by physical, sexual, and spiritual violence can put large populations under post-traumatic disorders that may bear life-long consequences. Public health social workers are thus playing an important role in the humanitarian actions along with others in the disaster management team (Mathbor and Bourassa, 2012: 294). Social workers serving in disastrous areas are taking on rescue, support, and rehabilitation tasks to minimize the impact of disasters as well as political and societal conflicts on individuals and society. Witnessing forms of human suffering and emotional trauma, they also involved in the development of positive- and strength-oriented approaches such as reconciliation, restorative justice, and forgiveness and hope interventions to assist disaster-affected populations in moving on with life. One example would be the medical social workers in US Veteran Administration hospitals. While providing direct services in meeting the increasing needs of war veterans, they were also actively involved in the interdisciplinary teams in the areas of research and public health (Keefe and Evans, 2013: 11).
Public health social workers play pivotal roles in facilitating communication of rescue information and help victims to identify family members and in managing volunteers and rescue workers in collaboration with the disaster victims on temporary shelters while establishing daily routines and mutual help teams in transient resettlement sites. For example, during the mega Sichuan Earthquake in 2008, Chinese social workers, along with other professionals and volunteers, helped in organizing social and recreational activities for victims displaced from their home and work, mobilizing care for vulnerable populations such as disoriented older adults and persons with disabilities, re-establishing kindergarten and schools for children as well as play groups, facilitating economic activities of shops and cook food stalls plus other necessary services in temporary shelters so as to maintain a sense of normalcy. Self-management teams were also established for hygiene and sanitation. The involvement of social workers does not only provide immediate assistance in disasters management, but also empowered the community with the capacity and hope toward rebuilding their homes in the long run.
Ineffective management of natural or man-made disasters can lead to further disasters, such as an outburst of infectious diseases due to poor management of dead bodies. When large populations are moved into temporary housing or refugee camps, their access to a safe environment, clean water and food, sanitary facilities of waste, and refuse management become crucial. For example, the most common causes for death in Africa are diarrheal diseases, measles, acute respiratory infections, and malaria. Effective prevention includes protection from violence, disease control, immunization, case management, and maternal and child health care (Toole and Waldman, 1997: 283).
Disaster services have grown from treating Post-Traumatic Stress Disorder (PTSD) to “psychosocial capacity building” (Miller, 2012: 12). Public health social workers engage local partners so that culturally relevant and effective interventions can be developed with input from people and resources in disaster communities (Miller, 2012: 50). Evidence-based practice is highly recommended for application of previous lessons learned from emergent contexts, and evaluation processes are crucial to generate evidence for future reference. Handbooks in this field can be found to be referenced in Mathbor and Bourassa’s article and they are particularly helpful in addressing the issues around collaboration in psychosocial responses in emergency settings.
Despite the differences in duties and focuses, there are shared core competencies involved in medical social work (Council on Social Work Education, 2009) and public health social work (Practice Standards Committee, 2005). It is clear that medical social work and public health social work are rooted in the same theoretical base and grounded by the same set of social work professional ethics, values, and code of conduct. For instance, a public health social worker may assist a community development project responding to a collective health issue affecting all the members, especially the vulnerable (Practice Standards Committee, 2005: 12), and a medical social worker may conduct psycho-education with a patient’s family to reduce possible discrimination against the patient’s diseases such as HIV/AIDS. The underlying values for the different services are the same: promoting social and economic justice. Health social workers have to interpret and apply those theoretical foundations and ethics flexibly across different practical contexts, and, therefore, critical thinking and reflection is crucial during their practice. Professional supervision also serves as an on-going support for social workers, helping them to better understand, review, and reflect on their practice.
The two ovals on the top are core competencies, respectively, summarized for medical social work and public health social work. Their domain-specific professional knowledge and skills are listed. It is clear that their emphases are different (see Figure 1). Meanwhile, core components such as assessment, evaluations, creativity, research, advocacy, and policy practice are shared. Health social workers often advocate for access of services, clients’ rights, and justice at multiple levels for the purpose of reducing health disparity (Council on Social Work Education, 2009: 4–7). In policy practice (Practice Standards Committee, 2005: 21–22; Council on Social Work Education, 2009: 8), health social workers actively:
- engage in policy practice regarding agency, regional, or national policy, law, and regulations;
- identify gaps, collect data relevant to particular policy, build coalitions, and plan for action; and
- inform legislators and administrators, and collaborate with others for effective policy actions at the organizational and societal level.
Challenges and Opportunities
Challenges in Health Social Work Practice
There has been increasing pressure on the justification of professional social worker positions. Naturally, a shift of focus flows from macrolevel social work such as community development to more tangible areas in direct services. Therefore, the productivity requirement for frontline social work duties has been raised drastically. Community-based social workers may have to prioritize their time allocated to advocacy as their major duty is specifically tied to the hourly ‘fee-for-service,’ for instance, assessment on whether an adult is eligible for certain benefits. While the waiting list is getting longer, other daily functions of these social workers can be overwhelming. It is difficult, if not impossible, to devote time for research, continuing education, and service improvement, which are vital for creating ‘knowledge-in-practice’ (D’Cruz, 2009: 69–71).
Another challenge is the demand for cost-efficiency and accountability. The call for ‘pragmatic evaluation’ for practice, promoted by the managerialist approach, lead to the use of simplistic performance indicators to guide practice (Payne, 2005: 219, 241). Priorities are given to productivity, data input, documentation, and funding applications, which may ‘squeeze’ the quality of direct client contact to the side. For example, one of the major complaints from mental health social workers working with public medical reimbursement system in the US is their struggle on a weekly basis to meet the demanding paperwork submission.
There are debates and concerns on the use of existing scales and assessment protocols to measure risk and needs, make diagnosis, and determine priority and access to services. For example, despite the fact that DSM-IV-TR and ICD-10 are widely used in the US, some social workers find these mental health assessments disconnected with the clients’ holistic biopsychosocial wellness guided by social work professional values (Dziegielewski, 2004: 235). In addition, current social work assessment in health care settings is often under the pressure for moving clients through the system quickly through discharge planning, to save medical costs by reducing period of stay in hospital. Thus, health social workers will need to develop and utilize more comprehensive psychosocial measures to support intervention plans (Dziegielewski, 2004: 211).
Challenges in Health Policy
As social problems of health disparities, poverty, and ill-health are closely linked, health social workers will inevitably adopt grassroots mobilization and collective community actions to fight system injustice and global inequity. However, it is probably much easier to obtain funding for microsocial work compared to macropractices, such as advocacy for system changes. Under heavy workloads, clinical and medical social workers normally find it very difficult to engage in additional activities, such as policy practice.
Many of the industrializing countries are so poor that there are few affordable and accessible primary health clinics and hospitals services available to the population. Social workers, if any, may be hired only by local or international NGOs. Community leaders and grassroot workers can be trained by social workers to provide disaster relief, refugee camps, community support to reduce maternal and infant mortality, enhance access to clean water, promote self-help nutrition programs, healthy sexual behavior, immunization, and women’s development projects. Unfortunately, funding for community health in these nations, especially war-affected areas, is often insufficient and unstable. Despite, the fact that there are programs that offer joint master degrees in social work and public health (MSW-MPA), the uptake is usually small with few employment opportunities.
Public health social workers will have to be creative and innovative so to engage the community in social development and poverty alleviation projects. It is essential for social work educators and researchers to generate knowledge in community health promotion, disease prevention, and especially to serve disadvantaged populations who are socially excluded and marginalized. They will have to develop competency models of working with international organizations, mass and social media, as well as to train students in systems change, legislative reform, social entrepreneurship, organization, and project management. There are youth and community social workers who actively participate in promoting a green awareness and lifestyle, as well as engaging themselves in the advocacy to preserve the environment. Such global challenges cannot be addressed by the social work profession alone, as multiple levels of intervention with the involvement of other professions and other sectors will be necessary to tackle such environmental issues (Gray et al., 2013: 12–16).
Challenges in Ethical Issues
Health social workers are often in the midst of ethical debates in their practices. Advancements in medicine and genetics bring along controversial issues in genetic engineering – preserving oocytes and sperms after the death of individuals, gender selection, organ cloning, and transplant. Ethical debates also arise concerning the provision of services and support during life donor organ transplant, adjuvant surgery (such as mastectomy, colectomy) after diagnosis of cancer-prone genes, surrogate motherhood in reproductive technologies, termination of pregnancies when fetus are diagnosed with higher risk of defects, serving persons with different sexual orientations (LGBT) on issues of marriage and child bearing, and serving in disciplinary forces such as prison or refugee camps on management of victims and/or perpetrators of war/violence/ rape who are trapped in social discrimination and political oppression. The dilemma of pro-life versus free-will of woman to decide on abortion appears every time in the US presidential election debates. While medical doctors and nurses can refuse to be involved in abortion due to religious reasons, these moral, ethical, and spiritual issues are less commonly discussed or debated among health social workers.
In resolving ethical dilemmas and debates, compliance and adherence to high ethical standards and code of conduct as well as engagement in advocacy are essential for professional social work organizations. The Association of Oncology Social Workers actively engages its members into advocacy and provides them with toolboxes in lobbying political leaders in the fight for cancer in the US. International social work bodies, IASSW and IFSW, state ethical practice principles together. They explicitly encourage social workers around the world to debate and reflect on the dilemmas and to reflect on and make ‘ethically informed decisions’ in their specific situations.
Opportunities in Education and Knowledge Development
With the importance of health social work being increasing recognized internationally, related social work trainings are offered in many advanced education programs. Most of these programs generally provide specialized courses in medical social work and psychiatric social work. In industrialized countries such as the US, Canada, and Australia where hospital social work is more established, continuing education programs for social workers to be cognized as social work specialist in oncology, pediatrics, gerontology, nephrology, cardiology, palliative care, bereavement, and more, are available. While addressing the needs for cultural sensitive practices, most of these specializations are originated and organized under the Western Medicine framework.
Though conventional training has been based on Western Medicine framework, increasing attention points to the indigenous healing wisdom and practices of the east and south on health social work interventions. There is an increasing proportion of people using Complementary Alternative Medicine in the treatment of pain, insomnia, diabetes, and autoimmune diseases internationally. Based on Eastern philosophical thoughts, Traditional Chinese Medicine, and meridian concepts, Chan and her colleagues established an integrative IBMS social work empowerment intervention in health care since the 1990s (Lee et al., 2009; Chan et al., 2012). Following years of practice and research, evidence for the IBMS model has been accumulating across various populations including cancer patients, women with health issues, and depressed populations (Lee et al., 2009; Chan et al., 2012). A number of randomized controlled studies have highlighted the effectiveness of the IBMS model on improving the wellbeing of participants (Chan et al., 2006; Hsiao et al., 2011; Liu et al., 2008; Yang et al., 2009). The team has also started to test the efficacy of traditional Chinese movement exercises, such as Qigong on persons with chronic fatigue syndrome and Taichi on persons with schizophrenia, and evidence of holistic improvement through psychosocial measures and physiological outcome markers was found (Ho et al., 2012; Ho et al., 2013). Given the increasing evidence, there is an urgent need for social work research and practice on how traditional healing wisdom from Asia, Africa, South America, and the Pacific Islands can be integrated and utilized by health social workers.
As a specialization in professional social work, health social work has been historically closely related to the environmental, sociopolitical, and economic context of the society. Health social work can roughly be divided into the medical stream and the public health stream. While medical social workers provide clinical services and support to patients, public health social workers work on global injustice to build a more socially inclusive and harmonious society. Contemporary changes on sociopolitical environment, medical technology, and poverty have led to new challenges in terms of practice, policy, and ethical issues. Continuing education programs, research for knowledge development, and social and policy advocacy are key in meeting the new challenges in promoting general wellbeing of the populations, as well as the health, harmony, and well-being of society.
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