Discussion: What would you do the same or differently as the social worker?

Home Echo Discussions Module 2 Discussion Discussion: What would you do the same or differently as the social worker?

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    I thought the social worker had a nice lead in, expressing regret and concern that the patient had not been told about fertility impacts or preservation options. However, while well intended, I suspect the lengthy lesson on options may have been overwhelming. I would have liked to see the social worker ask more open-ended questions about what the patient’s concerns are. She may have also asked what the patient already knows. Finally, there were some assumptions made about the patient’s partner’s involvement; I would have liked to hear more from the patient before assuming he would want his girlfriend to be involved.


    I would agree. While there was appropriate expression of regret & empathy around the pt’s perspective & alliance building, there needs to be an exploration of what the pt’s specific concerns were, as well as what they know about options at this point. This would avoid the “lecture” on fertility & ART, instead meeting the pt where they were at & allowing for more open, back-forth conversation. The pt mentioned his girlfriend & it would be prudent to explore their relationship – how long have they been together, what are their future plans for their relationship & parenting, does she know of &/or share his concerns around reproduction, what is his/her history with reproduction, etc. This exploration would allow for a more individualized discussion around fertility & options with this pt.


    I agree with both of what has previously been said in this post. I would also add that if the patient is willing, and depending on the amount of time before treatment, relationship length/goals, and the clinical setting, it might be prudent to offer a joint session between the patient and their partner. That session would then allow for joint discussion around values and meaning of fertility, family, and childbearing, which could be helpful in fostering enhanced patient-partner communication and expectations around oncofertility.


    I would have used some different terminology or made sure the patient knew what the medical terms I was using meant. Words such a fertility and contraception seem to be medical terms that may need explanation. It may have been better to say options for having children or if you are able to have a child or if your sperm are healthy.


    I really liked the way that the social worker acknowledged that the pt wasn’t counseled prior to treatment, apologized and brought their conversation to the present. I would have used the same empathetic approach. I also really liked that she pointed out that both the pt and his partner had neither been tested for fertility prior to his treatment & the average statistics of infertility regardless of cancer treatment. I am not sure I would have thought of that, but I really liked that she was able to frame their conversation in this way.

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