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Social Work Fellowship in Cognitive Neurology

BACKGROUND

The Post-Master's Fellowship in Cognitive Neurology Social Work was originally developed at Beth Israel Hospital by a group of senior clinical social workers who were committed to teaching advanced level specialty skills of working with the elderly in a health care setting. The Program design is based on the philosophy that advanced practice with the elderly requires looking at the elderly individual in the context of his or her family, community and the developmental and physiological forces that impact on his or her wellbeing. The Fellowship trains social workers who will assume clinical and programmatic leadership in the field of aging.  The Fellowship is a ten-month, 32 hours per week program, which typically begins mid-September and finishes mid-June. However, a Fellow may opt to begin prior to September, if this is preferable. The Fellow is paid a stipend of $15,000.  Applicants must have a Master's degree from an accredited School of Social Work; preference will be given to applicants with health care experience.

Over the years, Fellows have entered the program with different backgrounds; some had just completed their Master's program, some came to the fellowship having worked in the field but wanting to hone their clinical skills, while others used the fellowship to make a shift in their practice areas. Importantly, the teaching philosophy embraces the "adult learner" model which stresses individualized learning needs, autonomy and self-determination. While the basic structure of the program is in place, there is flexibility to accommodate the learning goals for each Fellow. The program's clinical coordinator works with the Fellow to custom-tailor the specifics of the program experience. The Fellowship benefits by input from the Fellowship Planning Group, which involves senior level social work staff at Beth Israel Deaconess Medical Center (BIDMC).

PROGRAM DESCRIPTION 

There are three cornerstones to the Social Work Fellowship Program in Cognitive Neurology:

  • clinical experience
  • academic component
  • writing a scholarly paper

CLINICAL EXPERIENCE

The "home base" for the fellow and one of the major job training sites is the Cognitive Neurology Unit (CNU) at Beth Israel Deaconess Medical Center. In the Cognitive Neurology Unit the fellow will gain expertise in working with dementia patients and their caregivers. The fellow participates with the interdisciplinary healthcare team, which consists of neurologists, neuropsychologists, neuropsychiatrists and clinical social workers. The Fellow will formulate psychosocial assessments and treatments plans for patients diagnosed with a range of diagnoses, including dementia, stroke, Parkinson's disease, ALS, MS, and depression. Family caregivers, "hidden patients" themselves, are also a focus for attention. The Fellow will have the opportunity to speak with community groups to educate health professionals and the elderly about psychosocial issues related to aging, driving safety and the elderly and caregiver issues related to neurological illness. An exciting CNU program in which the fellow will be active is DriveWise: a driving safety evaluation program for patients with medical problems that could compromise driving skills. The clinical social worker plays a key role in this assessment process. Depending on the wishes of the Fellow there are opportunities to spend time on various inpatient units at BIDMC working with hospitalized elderly patients and their families around clinical issues relating to adjustment to illness. The Fellow will be exposed to working with the elderly in the community as well, since this represents an important component of the continuum of care. Utilizing the adult learning model, this aspect of the Fellowship is tailored to meet the needs and interests of the Fellow.

THE ACADEMIC COMPONENT

Lectures, Teaching Rounds, Continuing Education

The Fellow has ample opportunities, within this Harvard Medical School teaching hospital, for exposure to formal learning. BIDMC's Social Work Department has a monthly lecture series, "Social Work Grand Rounds", that the Fellow is invited to attend. Another lecture series, "Topics in Gerontology" is offered yearly and it is targeted to clinical and social policy issues that relate to the elderly. There may be other Departmental offerings that are part of the Department's Continuing Education program that are of interest to the Fellow - a brochure of the year's offerings will be available in September. Our Psychiatry Department and the Division on Aging offer regular lectures that the Fellow may wish to attend if they are relevant. The Fellow will periodically review the schedule with the Fellowship's Coordinator to make sure that there is a good balance between the clinical and the academic components.

Tutorials

Tutorials are another dimension of the academic component. Staff will teach areas of special interest, sharing their expertise. These one-to-one meetings will vary in terms of length and the number of sessions. The Fellow may be asked to read relevant journal articles for some of the tutorials.

THE SCHOLARY PAPER

This component of the Fellowship is usually anticipated by each Fellow with great anxiety, but the final product - the polished paper - is viewed as the pinnacle experience of the year. The paper represents the blend of the academic and the clinical components of the Program, integrating the fields of social work, healthcare, and gerontology. A writing coach helps to guide the Fellow through the process. At the mid-point of the year (in January) the Fellow and the writing coach meet to discuss options for the focus of the paper. Periodic meetings keep the Fellow "on track" with schedule deadlines for the paper which include the literature search, the paper outline and then the drafts of the paper. Ideally, the theme for the paper develops from an experience the Fellow has had in the program - perhaps from a clinical interaction that sparked an area of interest for further inquiry.

Examples of papers that have been written by former Fellows include: "Home Visits: The Home as a Setting for Clinical Social Work with the Elderly"; "Relational Resilience: A New Perspective for Understanding the Elderly Person's Relationship with God"; "Things Were Different Then: Countertransference Issues for Younger Female Therapists Working with Older Female Clients" and "Journey of Separation: Elderly Russian Immigrants and their Adult Children in the Health Care Setting". Several of these papers have been published `in professional journals. Others have been given as formal talks. The final paper must be submitted to the Program Coordinator early in June in order for the Fellow to successfully complete the Fellowship. In June, the Fellow gives a brief overview of the paper to the Social Work Department at the monthly staff meeting. It has been a tradition for the Fellow to return to the Hospital the following Spring to present the paper, in full, to staff through our continuing education program.

REFLECTIONS FROM GERONTOLOGY FELLOWS

"I see the Fellowship as being a building block on top of a more general social work base. I personally think it's a wonderful bridge from the 'student self' to the 'professional self'."  Mary Ann Maibor, 1990-1991 Fellowship

"For me the Fellowship was a time of intellectual stimulation, a time of professional challenges in a supportive environment, and a time to enhance professional identity and confidence. Completion of the fellowship provided a professional foundation of relationships and skills, extending far beyond the Fellowship year." Gina Bower, 1992-1993 Fellowship

"Since I came to the Fellowship with several years of experience with geriatric patients in an inpatient medical setting, the Fellowship provided an opportunity to hone existing skills as well as expand and formalize an experiential knowledge base. It allowed me to observe the geriatric population through both a wide angle and telephoto lens. The experience of the fellowship had the effect of reinvigorating my sense of competence and commitment to working with this diverse, interesting and challenging population." Lorrie Levine,1992-1993 Fellowship

"The required scholarly paper encouraged me to explore and integrate a nascent interest in quality of life issues for elders with dementia residing in nursing homes. The combination of practice experience and training with the scholarly investigation made this Fellowship a seminal experience in my professional development."  Susan Garland, 1998-1999 Fellowship

"I've been able to both deepen and broaden my knowledge, skills and experience base in a wide variety of health settings (outpatient clinic, inpatient unit, nursing home and community senior center), with a diverse client population contending with multiple and complex health and other psychosocial issues. I've especially appreciated the openness, interest and flexibility of the Fellowship coordination team to work with me on customizing portions of the program to meet my learning goals."  Joanne Hickey, 2000-2001 Fellowship

"The fellowship allowed me to gain clinical confidence and skills and also allowed me to explore different social work skill sets and positions. I was able to gain a better view of the career path I want for myself and also set a very solid clinical foundation for that career. It was only after I finished the fellowship and had started a job that I realized just how much I had learned and the true extent of the fellowship experience. It was a true learning experience and definitely worth it!" Anne Lebowitz, 2003-2004 Fellowship

"It seems that some social workers shy away from working with older adults when they don't have experience with this population. The expertise I gained through the fellowship allowed me to become a resource for these social workers, educating them on the issues facing older adults & the resources available to them." Regina Epperhart 2007-2008 Fellowship

APPLICATION PROCESS

Applicants must complete an  application and submit it to Lissa Kapust, the Program Coordinator. A Statement of Interest must accompany each application. Ms. Kapust coordinates the interviewing process. One Fellow is selected for the Fellowship. Further questions may be directed to:

Lissa R. Kapust, LICSW
Program Coordinator
Ruderman Fellowship in Gerontological Social Work
Social Work Department--East Campus
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215
Telephone: (617) 667-5150
FAX (617) 667-7981
Email: lkapust@bidmc.harvard.edu

Contact Information

Lissa R, Kapust, LICSW
Social Work, Behavioral Neurology
Beth Israel Deaconess Medical Center
Program Coordinator, Ruderman Fellowship in Gerontological Social Work
330 Brookline Avenue
Boston, MA 02215
617-667-5150
617-667-7981
lkapust@bidmc.harvard.edu