Advance care planning: Conversations worth having
The Department of Social Work has licensed clinical social workers who work directly with patients and caregivers as part of the multidisciplinary team. They are available to help patients and caregivers cope with the impact and changes that result from a diagnosis of cancer.
Services are free, can be provided in person or over the phone, and do not require a referral from a physician or medical team.
You may want to speak with your social work counselor if you have questions or concerns about:
- feeling overwhelmed
- adjusting to your diagnosis
- how your life is changing
- advance care planning
- not feeling safe at home
- the financial impact of your illness/treatment
- intimacy, sexuality and relationships
- talking to your children about your diagnosis
- transitions in care
Main Building, Floor 2, near The Park, B2.4650
Hours: Monday-Friday, 8 a.m.-5 p.m.
A cancer diagnosis can mean increased distress for patients and their loved ones. Highly skilled and professionally trained in counseling, clinical social workers provide short-term counseling free of charge to patients and caregivers.
Counseling services include:
- Adjustment to diagnosis and treatment
- Coping with life changes
- Relaxation and mindfulness
- Advance care planning
- Crisis intervention
- Grief and loss
- Sexuality and intimacy
- Relationship safety
- Talking to children/teens whose parents have cancer
CLIMB: Children's Lives Include Moments of Bravery
KIWI: Kids Inquire, We Inform
- Support groups
Advance care planning is a process that helps you express your values, goals and wishes as they relate to your health care. The process involves:
- Thinking about what is important to you
- Discussing your values and goals
- Recording this information
- Requesting that your medical team and your medical power of attorney honor your goals and wishes
- Reviewing this information periodically
Social work counselors provide support and assistance to patients and/or caregivers in several aspects of advance care planning including:
- Communication with team
- Treatment decisions
- Advance directives
- Legacy planning
MD Anderson clinical social workers serve as a liaison between patients, the health care system and the community. Based on your specific needs, your social worker will help identify appropriate resources, including:
- Community resources (including housing, transportation, and other practical concerns)
- Financial counseling
- Health insurance
- Safety (abuse, neglect, exploitation)
Social Work conducts one annual adult memorial service for families, friends, hospital staff and the community to commemorate the lives of those they have lost.
For more information, call 713-792-6195.
The Social Work Internship program offers field placement opportunities to second-year Master of Social Work students. The program provides the highest quality hands-on learning experience, preparing students to enter the social work profession with confidence in their skills and knowledge.
Students pursuing the MSW degree
MD Anderson has both inpatient and outpatient social work settings. Opportunities for enhancing clinical, documentation, and interpersonal skills as a social work practitioner are available in both areas.
MD Anderson also offers practicum opportunities in Social Work administration. These students carry a limited clinical caseload and are involved in areas including program evaluation, policy and procedure development and review, and/or grant location and writing.
All students are required to participate in a departmental orientation program, and are then assigned to the service of their Field Instructor. Students are required to be in the field three days a week for two semesters for a consecutive placement, or five days a week for one semester for a block placement. During their experience, students participate in an interdisciplinary team approach to care, including patient teaching, planning conferences and chart rounds with physicians, nurses and other team members.
Staff development presentations are offered within the Social Work department. Students are expected to present at one staff development meeting. Weekly brown bag presentations on various topics are offered, and there are other opportunities to attend continuing education presentations within the institution.
Students seeking this placement should be independent and able to function with some degree of autonomy once established within their service. We promote the choosing of a learning experience, which would move students toward realizing their professional educational goals.
The Clara B. Smith Training Center
The Clara B. Smith Training Center was established in honor of Clara Blackford Smith of Denison, Texas. Mrs. Smith was a longtime friend and benefactor of the Social Work department, frequently contributing financial support for indigent patients and training institutes for Social Workers throughout Texas.
The grant provides funds for student stipends for second-year Master of Social Work (MSW) or Master of Science in Social Work (MSSW) students who either are in a health care specialization or have a strong interest in health care social work.
*For graduate students only*
Annabelle Bitter, LCSW
Department of Social Work
1515 Holcombe Blvd., Unit 103
Houston, TX 77030
Social Work in Cancerwise
Cancer can be scary, so some parents may avoid sharing their diagnosis with their kids to protect them. But research shows higher anxiety levels in children who aren’t informed of a parent’s condition.
Although talking about cancer can be hard, there are ways to ease the process. We spoke to Shelby Becka, a social work counselor at MD Anderson The Woodlands, for advice on telling your kids about your cancer diagnosis and treatment.
Share your diagnosis before starting cancer treatment
No matter their age, it’s never easy to tell your kids you have cancer. Becka suggests setting aside time with your immediate family and telling everyone together in your home or another private, comfortable space. Ideally, you should do this before you start treatment.
“It’s hard to keep cancer a secret,” Becka says. “Your kids probably already know something’s wrong, so it’s best that they hear it from you.”
Talk about how your treatment will affect their routine
In the early days after your diagnosis, things may be more unsettled. So, it’s important to stick to a routine and let your kids know how your treatment will affect them.
“Help them feel secure by telling them who’s going to pick them up from school or cooking dinner that night,” Becka says.
Use the right language
When talking with your kids, Becka recommends using the word “cancer,” so your kids don’t confuse your diagnosis with an illness that they could potentially catch, like the flu or a cold.
You should also tell them what cancer is and where it is in your body. “For younger kids, you can say, ‘I have cancer in my neck,’” Becka advises. “For older kids, use the specific disease name, like melanoma or leukemia.”
Take an age-appropriate approach
When talking to your child about cancer, honest, age-appropriate communication is best. You should explain your diagnosis to a 6-year-old differently than you would to a teenager.
- Infants and toddlers are too young to understand what’s going on, but experts say they can sense changes in a parent’s behavior or appearance. The important thing is to give them plenty of physical affection to help them feel safe and secure, Becka says.
- Between ages 3 and 5, kids are starting to understand illness. “Kids this age can be very egocentric,” Becka says. “You should explain that they didn’t cause your illness.” Use pictures, dolls or stuffed animals to help you explain in a way they’ll understand. Provide brief, simple explanations and repeat as necessary.
School-age children can handle a more complex explanation of
your illness. You can help them process the information by sharing
books, pamphlets or videos. Your MD
Anderson social work counselor can provide a Kid Kit, a backpack full of resources to help
kids learn about cancer and healthy ways to cope.
Around age 9, children are aware that a parent might die. Even if your child doesn’t bring it up, it’s important to talk to them about death, says Becka. The most important thing is to reassure your children that they will always be loved and cared for.
“You can be honest with them and say something like, ‘Sometimes people with cancer die, but that’s not the plan for me right now,’ then go on to explain your treatment plan,” Becka says.
Teenagers likely already understand cancer, but they’re more
likely to internalize or hide their feelings. “Encourage your
teenagers to talk about their feelings, but understand they may not
want to talk about them with you,” Becka says.
She suggests asking your teens if there’s a teacher or another adult whom they’d be comfortable talking to.
Answer questions with honesty
You can build trust by allowing your kids to ask questions and answering them honestly. “It’s OK to tell kids you don’t know,” Becka adds. “You can always bring their questions to your care team, and follow up when you have an answer.”
Ask older kids how often they’d like you to share information with them and how they’d like to receive that information. “Some kids may only want an update when something has changed; others may want a weekly check-in,” Becka says.
Model healthy coping
It’s normal to feel sad, scared or frustrated, especially when facing a cancer diagnosis. Modeling healthy coping can help your kids learn how to deal with their emotions. “Tell your kids how you’re feeling, and show them how you cope,” Becka suggests. “You could try saying something like, ‘I’m sad because I got some bad news at the doctor today, so I want to watch my favorite movie with you to take my mind off of things and feel better.’”
Encourage kids to talk about their feelings and express them in a positive way. It may help to find a support group so they can share their feelings and connect with others in similar situations. Children of MD Anderson patients can join our CLIMB support groups, which offer weekly sessions for kids ages 6 to 12 and 13 to 17 at various times throughout the year. A separate group for parents meets at the same time.
When to seek additional help
Kids of all ages can have intense reactions to a cancer diagnosis. For younger children, that may mean separation anxiety, bedwetting, thumb sucking or tantrums. Older kids may seem withdrawn, depressed or anxious, or experience trouble at school.
If you notice any of these behaviors impacting your kids’ day-to-day lives or lasting for a prolonged time, Becka suggests seeking help from a professional.
“Start with your kids’ school. Their counselor can be a great resource in helping them cope,” Becka says. Your children’s pediatrician can also offer advice suggestions to help them cope with your diagnosis. If you’re an MD Anderson patient, you can reach out to your social work counselor for additional resources.
“You’re the expert on your family,” Becka says. “If you notice something concerning, don’t be afraid to reach out for help.”
Request an appointment at MD Anderson online or by calling 1-877-632-6789.
A cancer support group is a safe place to share your experiences and connect with others facing the same challenges. It gives you the space to connect with others dealing with cancer, talk openly about your feelings, receive practical advice, share resources and contacts, better understand and be able to describe your experience and develop coping skills.
Studies have shown that support groups can reduce isolation, anxiety and stress. They can also improve mood, self-image and the ability to cope.
With all of these benefits, you’d think that attending a cancer support group would be a no-brainer. But some people find the idea a little intimidating. And that’s totally normal. It can be nerve-wracking to put yourself in new situations, introduce yourself to new people and especially to face experiences you haven’t been able to process yet.
Decide what you’re looking for in a cancer support group
To get the most out of a cancer support group, it’s important to find the right one for you. Here are a few questions to answer before attending one:
- What type of support are you looking for? Some support groups are more social in nature. Their purpose is to connect people with shared experiences in a casual environment. Other support groups are more talk-therapy based, and focus on helping group members process their experiences.
- Who are you wanting to get support from? Some support groups are geared towards patients and/or caregivers dealing with a specific diagnosis, while others are open to all diagnoses. There are also support groups that are for both patients and caregivers, patients only, caregivers only, young adults, kids of patients and patients with metastatic cancer.
- What setting works best for you? Many hospitals and cities offer in-person support groups, but not all of them do. If meeting in person isn’t an option for you, consider an online group. Those may be in the form of a message board, a chat room or even a phone app. You may even consider joining myCancerConnection , MD Anderson’s one-on-one support program for patients and caregivers.
- If you are being treated away from home, what location are you most likely to attend a group in? If you spend most of your time at home, it might be best to find a group close to where you live. If you spend most of your time in Houston or another city for treatment, it might be more convenient to find a group close to that city or hospital.
How to find a support group
Once you have an idea of what you’re looking for, here are a few ways to find a cancer support group:
- Ask your social work counselor. All MD Anderson patients have an assigned social work counselor who can help with all sorts of things, including selecting a support group. In fact, we social work counselors facilitate many of our support groups. If you’ve never met with your MD Anderson social work counselor before, ask someone on your care team to put you in touch.
- Go online. You can find a list of cancer support groups on MD Anderson’s website, or use the American Cancer Society’s online search tool to find programs and services in your area.
- Ask around. Sometimes other patients and caregivers can be especially helpful when it comes to finding support groups and other valuable resources.
Before you attend your first --- or even second or third – cancer support group session, here are a few things to keep in mind.
- Get the scoop from the facilitator. If possible, contact the group facilitator in advance to ask any questions and get a better understanding of how group works. Knowing what to expect will help you feel more comfortable and prepared.
- Attend the same group at least three times. Every group is different and every group meeting is different, so go to the group at least three times before you decide it isn’t a good fit. You might be surprised at how the group grows on you over time.
- Keep an open mind. The other group members may be different from you, and sometimes that’s actually a really good thing. The group may really need your perspective, experience, knowledge, etc. and you could really benefit from theirs. Everyone is unique and has a unique contribution.
- Don’t be afraid to try again. If the first group isn’t a good fit for you, try another one! Every group is so different, so it’s important to keep trying until you find one that provides the support and comfort you seek.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.
Stress is the body’s physical, emotional, and psychological response to any demand. Unfortunately, it’s a part of daily life, especially for cancer patients and caregivers.
But if you don’t actively manage your stress, it can become chronic and adversely affect your health and cancer treatment.
Fortunately, relaxation techniques can help you cope with everyday stress. Meditation is one basic technique that is easy to learn and easy to do.
Meditation can help cope with stress
Meditation is the practice of focusing on what’s going on in the present moment with no judgment and lots of acceptance. It frees us from stress of the past and future by bringing the present moment into focus. When we focus on the present, we are better able to identify what we are feeling, sensing and thinking.
Some people think that meditation requires sitting on a mat in a completely quiet room with absolutely no thoughts running through your head. For some people, that is possible. But for the majority of us, that just isn’t realistic. That’s OK because:
- You don’t need to be on a mat. You can be anywhere.
- You don’t need complete silence -- although the fewer distractions, the better.
- Thoughts are always going to be running through your head. Acknowledge them, tell them you will come back to them later, and refocus on your breath and body. Don’t let it discourage you.
As you practice focusing on the present, your sense of awareness both of yourself and of the world around you will also grow. Among other benefits, people who practice medication report that they become more aware of small everyday miracles and the beauty of life.
How to meditate
If you’re interested in trying meditation, follow these five steps.
- Breathe. Simply remembering to breathe consciously in the moment. Take some full, deep breaths. Completely fill your lungs, expand your abdomen, let it out and then do it all again. This is known as belly breathing, and it can help bring your heart rate down to a resting rate.
- Relax. Consciously relax every single muscle in your body, one by one. Your deep belly breathing will support this process. Conscious relaxation helps to break up tightness and resistance in the body and mind.
- Feel. Focus inward, on your body, on all of the sensations you are feeling. Ask yourself, “Where in my body is the feeling or sensation coming from? What does the sensation feel like? Are there any patterns that I recognize?”
- Observe. This is the part where you step outside of yourself and just stand at the center of experience. You just observe without any judgment of what you see or feel. As you become absorbed in being the observer, you allow yourself the freedom to observe your experience from the outside.
- Allow. Now you take everything you have done, and let go. Let go of control and allow life to happen. Jump into the river of life, and let it carry you where you need to go.
No matter what relaxation technique you use, all of them require practice. Some of these concepts are new and take time to absorb, so be patient with yourself.
Make time for meditation every day
Most stress experts recommend setting aside at least 10 to 20 minutes a day for relaxation. If that sounds daunting, remember that you can spread your 10-20 minutes of meditation throughout the day and incorporate them into your daily schedule. Practice:
- In the shower
- On the bus during your commute
- At your desk while eating lunch
- While waiting in the clinic
Next time you’re confronted with a difficult emotional moment, give meditation a try. You’ll be glad that you did.
Get help at MD Anderson
If you are a patient at MD Anderson, our
Social Work Counselors can introduce you to
progressive relaxation techniques, including meditation. We also offer
counseling and support groups at no cost to patients and
For more information on relaxation, counseling, or support groups, contact the Department of Social Work at 713-792-6195, or tell your nurse or doctor that you would like speak with a Social Work Counselor.
Whether you're a patient or a caregiver, cancer treatment is
stressful. But our social work counselors can help.
At MD Anderson, each patient is assigned to a social work counselor. These licensed clinical social workers help patients, their family and friends cope with cancer. They also can help you deal with psychological or social concerns you face during and after treatment.
Here are a few ways our social work counselors can help.
- Navigate MD Anderson. When you first arrive at MD Anderson, it can be confusing to learning how things work and whom to contact for certain concerns. Our social work counselors can help guide and connect you to the right group of people, whether it's your medical team, Patient Travel Services, Case Management or the Business Center.
- Identify financial resources. Our social work counselors can help with locating and accessing financial resources for cancer treatment. This includes programs for dealing with employment concerns during cancer, home care, local lodging and transportation.
- Offer counseling and support groups. Our social work counselors provide short-term counseling free of charge. They can help you cope with your diagnosis, grief and loss, or changes in your life and relationships. They also can help you find a support group that's right for you. MD Anderson offers more than 600 hours of support group time each year. If you don't live in Houston, our social work counselors can help you find a support group close to home.
- Provide counseling for your friends and family. Social workers aren't just here for our patients. In fact, sometimes they spend even more time with caregivers and loved ones. Social work counselors help caregivers with a variety of things, from coping with the patients' diagnosis to making time for themselves to coordinating a support network. Social work counselors also can guide you through talking to children about cancer and cancer treatment.
- Assist with advance care planning. Advance care planning is the process of communicating information about a patient's diagnosis, treatment options, life goals, values and wishes. The only way to ensure that you have a voice in your future care is to talk with your loved ones and complete the legal documents that make your values and wishes known. Our social work counselors are here to walk you through the process and answer your questions.
Contact MD Anderson's Department of Social Work at 713-792-6195,
or tell your nurse or doctor that you would like speak with a social