Integrating social work throughout the hematopoietic cell transplantation trajectory to improve patient and caregiver outcomes

Clinical social workers possess a dual skillset of social care and mental health care and are the largest group of psychosocial care providers in oncology. Psychosocial care is an integral component of quality healthcare. The prevailing model of psychosocial care in oncology is a brief consultation for patients who screen positive for distress at a particular timepoint. This model is insufficient for hematopoietic cell transplantation (HCT). Patients and caregivers have evolving needs throughout the HCT process, and psychosocial care models should meet these needs. This white paper, a collaboration between the Association of Oncology Social Work's Blood Cancer/HCT Special Interest Group and the American Society for Transplantation and Cellular Therapy's Social Work Special Interest Group, presents a gold standard model for the integration of social work in HCT. The model structures social work visits in every phase of HCT and integrates social workers within the interdisciplinary team. In this model, social workers conduct assessments with all patients (autologous and allogeneic) at the initial HCT consultation and again during work-up. They subsequently follow all patients and caregivers as they progress through transplant. This ongoing management reduces the burden on other team members to identify and address psychosocial needs. It also creates many organic opportunities to implement interventions to improve outcomes. There is a need to build institutional capacity for psychosocial care. Strategies that centers can use to build capacity are presented. As a complex clinical intervention, the gold standard model is well-suited for implementation research within a quality improvement framework.