How do I become a travel social worker when my background is only mental health?

I think we can all agree that social work is a broad field, right?  And most social work skills are very transferable from one setting to another.  Mental Health care to medical care can be a rough transition, though.  Here are some of my thoughts on why:

1)      Modern day acute medical care is not set up for long-term planning, in-depth interventions, and rapport building.  It’s set up to move people to a lower level of care as quickly and safely as possible.  This means it has become more difficult to do good quality planning for long-range outcomes in an acute care setting.  So the skills that you have gained doing individual and family therapy in an outpatient or even an inpatient behavioral health hospital are less likely to transfer to modern day medical inpatient social work.  I think an exception here would be your skills working a psych ED – and this is because the goal of a psych ED is to assess quickly and move to the next level of care, whether that’s in the behavioral health hospital where you work, or finding an in-network behavioral health hospital with an open bed for the patient you’re triaging/assessing.  There are a ton of great skills you can pick up in a psych ED that are very usable in medical acute care settings!

2)      I’ve noticed that it’s difficult for those with mental health backgrounds who transition into medical social work to not go digging for backstory, history, etc that isn’t necessarily relevant to the patient’s elevated troponin levels that bought them an OBS stay in the hospital.  When you have more time with a person in an outpatient setting as their therapist, it’s appropriate to do the background digging into their psychological whys, but in a medical setting there are only a few scenarios I can think of where these skills are really appropriate:  end of life discussions and helping families process traumas and sudden traumatic deaths.

3)      This one may seem silly, but: the acronyms are all completely different.  You’ll need to know essentially how long you have to intervene with someone on OBS vs inpatient.  Is there a clinical decision unit?  Are you going to be dealing with ONC?  Ordering DME?  SNF?  LTC?  Foster Home?  Care Home?  POLST/MOLST/MOST?  AHCD?  DPOA?  FPOA?  Decoding MD and RN notes in a medical setting can take time if you don’t know what you’re looking at.  As a traveler, that’s really the one thing you don’t have:  Time.  You are being put in to that situation as someone who requires less training and oversight than a permanent staff member – you are meant to jump in and take on a caseload as soon as possible from your start date.  Having to decode everything you read will be time consuming.

4)      I thought I had seen everything you could see in psych and that anything after that would be ok.  But friends, wounds.   My second internship was in a medical setting in 2004.  Wounds sometimes still get me.  They smell, they sometimes have maggots.  People are all too obliging to show you their wounds.  And you must stand there and be okay with it.   You need to be okay with someone’s face being partially gone; their eye bandage leaking through the gauze, walking in on someone just as their bandage fell off their foot after a recent digit amputation, or BKA, or AKA.  And it won’t make sense to you that they’re okay with this new amputation, but when you’ve been around the block enough, you know that it took years, if not decades of not following a diabetic diet, controlling their sugar levels for that to happen.  Sometimes they have been preparing for this mentally for quite some time.

Where you will shine:  like I mentioned – connecting with families at End of Life, helping them process.  But you have to be comfortable with death.  It’s super helpful to know what that looks like, end of life.  You have to be comfortable with the family who wants everything done despite medical futility.  Despite knowing that CPR will cause their loved one's ribs to be cracked, that it’ll be more painful…but you will be the advocate for their rights and then be there when their loved one is gone.  Those moments are so important, and your mental health background is very transferable there.

Traumatic events and new life-altering diagnoses.  This is another place where your mental health background will really be an asset.  Hospitals are scary places for most people; and depending on how urban or rural things are, you'll be faced with people in their most vulnerable life-altering scenarios.  You will sit with the family who just found out that their loved one died in the traffic accident they saw on the news.  You will sit with the patient who just heard from the doctor that they want to do a biopsy, "just to see."  You'll sit with them again when after they receive the results.  You'll be the ear they need.  But even then, those skills are short-term intervention skills, and you'll have to study up on how to intervene in one shot.  That's all you get sometimes in this business.

It'll be a tougher road with no medical experience, and I want you to be aware of that.  But anything is possible, you just have to be willing and show the recruiters before hand that you know the terminology, that you've thought through discharge planning.

And just in case you want to hear me talk about the same thing:


What questions do you have about how to gain experience?  What are your concerns?

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