The role of the social worker in the adult critical care unit: A systematic review of the literature

Social workers provide care to patients and families in the adult critical care unit. We conducted a systematic review of the literature to more clearly identify the role of the social worker practicing in the intensive care unit. We conducted a comprehensive search of the literature using the Pubmed, Embase, ISI, Scopus, and Social Work Abstracts databases using the terms "intensive care," "critical care," and "social work." Articles were selected for review if they met the following criteria: formal studies or opinion papers whose primary focus was the role or scope of practice of the social worker in the adult critical care unit. Articles were selected and reviewed independently by two social work investigators. Our search retrieved 550 potentially relevant articles. Twelve full-text articles were deemed eligible for abstracting. Three of the articles were studies that examined different aspects of social work practice including implementation of a family assistance program, social work response to anxiety levels of families in critical care and common activities of critical care social workers. Nine articles were primarily opinion pieces. All of the opinion articles described psychosocial support and counseling as a primary role of critical care social work. Other frequently identified roles were crisis intervention, psychosocial assessment, facilitating communication, end-of-life care, and practical assistance. There is little empiric data describing the role of the critical care social worker. Consistent themes from the articles identified include the role of social workers as counseling professionals, facilitators of communication, and resource agents. Further research to identify formal assessment tools and outcome studies of specific counseling techniques will provide important information for best practice guidelines in this area.