Sliding Doors: Exploring Transitions as Threshold Moments

Completion of this class will result in the receipt of two (2) continuing education hours.

The mission and values of social workers practicing in healthcare and palliative care can be overshadowed in systems where administrative pressures, changing health status and evolving goals invite or force transitions of varied kinds: from health to illness; from one setting to another; and from life to death. Transitions impact patients and families and often staff, many of whom have not contributed to these decisions. Transitions can also reflect inequity and biases, often unrecognized yet contributing to clinician distress and unarticulated harms.

The goal of this class is to explore the therapeutic opportunities implicit in the pivotal moments in transitions. We will use the diagnoses of cancer and dementia and the intensive care and hospice settings to discuss the opportunities and challenges faced during varied transitions,

As social workers, we participate in and translate systems issues to patients and families and deepen these discussions with colleagues by sharing information about the history, culture and needs of individual patients and families that brings unique meaning to transitions. We will present transitions as part of the larger tapestry of patient, family, and clinician experience where we might see therapeutic opportunities that change transitions from an event, chosen or not, to a threshold experience of meaning.

We will integrate Aaron Antonovsky’s theory of coherence, and Milton Erickson’s therapeutic messaging as useful constructs to offer additional structure and clinical awareness to how we view and engage with transitions and introduce cognitive transformation and response shift as constructs that complicate and enrich care over time.