Oncology Social Work, Family Systems Theory, and Workplace Consultations

Abstract

Over the past 15 years, oncology social work has become a specialized field of practice with informed and effective methods of working with cancer patients and their families (Stearns, Lauria, Hermann, & Fogelberg, 1993). However, as more cancer patients survive and continue employment during or after treatment, oncology social workers must also help cancer patients and their coworkers cope with changes caused by the disease. This article demonstrates that oncology social workers can meet this challenge by transferring their knowledge and skills in family systems theory to the workplace. It also shows that consultation rather than therapy may be the best way to intervene in the work world on behalf of cancer patients. FAMILY SYSTEMS THEORY AND THE WORKPLACE Work systems can function like I often hear people say about their place of work, We are like a family; everybody is close and concerned. Even in workplaces where people do not experience this caring feeling, employees still function as a family in many ways. Edwin Friedman (1986), an expert on work systems, pointed out that it comes to emotional process, work systems replicate and function like families. Workplaces have their own rules, power structures, and communication patterns. Problems at work can be transferred from one generation of workers to the next. Moreover, transitions and crises that threaten a business or one of its members can make the workplace act like a family. A life-threatening illness such as cancer, for example, can create stress in the workplace and can force members to search for ways to support one another. Family systems theory, which social workers often use in family treatment (Janzen & Harris, 1980), can be useful in the workplace. Especially helpful are conceptual tools such as homeostasis and triangulation. Homeostasis helps social workers understand why problems seem to come from nowhere and keep repeating themselves. For example, by not acknowledging a person's illness and inability to continue work, coworkers often try to cover up and avoid problems but frequently feel overwhelmed and frustrated by the task. Triangulation reflects the importance of bringing in a third person or thing to relieve pressure or tension between two individuals. For example, an employee needing time off for medical appointments may complain to other employees rather than talk directly with the supervisor or employer about the problem. Three other useful concepts from family systems theory are family rules, family myth, and family secret. Family rules are customs that define roles, power structures, and communication patterns. A common workplace rule is that personal problems should not be discussed at work or interfere with job performance. A family myth is a shared belief among all family members that results in automatic agreement without further thought or discussion. One workplace myth is that personal problems such as cancer should not be discussed with the boss because the boss is too insensitive. A family secret is a characteristic of a family member or an event in the family history that is not talked about within the family or outside it. That an employee has a serious illness like cancer may be known by all his or her coworkers but not openly discussed. In light of these factors, oncology social workers are well equipped to help patients and coworkers cope with changes in the workplace caused by cancer. Also, consultation rather than therapy may be the best way to intervene with cancer patients in the workplace. ONCOLOGY SOCIAL WORKER AS WORKPLACE CONSULTANT I work as an oncology social worker at Cancer Family Care, a United Way agency in Cincinnati. Several years ago when I first began receiving requests for workplace consultations, I was unsure how to respond. Later, after several consultations and some library research, I found Systems Consultation: A New Perspective for Family Therapy (Wynne, McDaniel, & Weber, 1986), which helped make sense of my experiences and proved invaluable to my practice. …