For SCI patients, social workers provide critical support for a range of socioeconomic and reintegration issues that will impact the patients overall quality of life as they return to their communities. Recent efforts at utilizing and integrating aspects of the ICF as a framework for social work in rehabilitation reflect this overarching importance and the need to address a multitude of participatory, personal and environmental factors that contribute to greater independence and quality of life. This includes a wide range of responsibilities and issues (that also extend beyond the ICF) including psychosocial well-being, insurance and finance, vocation and local economics, accommodation and housing, and so forth.
Each patient will bring his or her own individual set of environmental facilitators and barriers along with participatory needs that determine which social work interventions are most necessary. Oftentimes, these occur in parallel to other interventions focusing on body structures/functions and activities and will furthermore depend upon degrees of mobility and activities. Thus, a patient’s functional state and general prognosis are related to social work interventions and goals.
For Conrad, vocation, housing and financial security were central and linked issues (arising both in the patient and health professional perspectives) that needed to be resolved in addition to home adaptation - an important aspect of mobility. Thus, vocation was included in parallel to the more physical goals of self-care and mobility. For the social worker, the former cycle goal also necessarily entailed addressing financial security more broadly, involving securing benefits from social security and health and disability insurances. The outcomes of these benefits would have an influence on what was needed in terms of vocation.
Conrad’s case demonstrated the circumstances of one individual patient, and the complexity of the processes supported by his social worker: his age and its impact on possible retirement, the degree of coverage his insurance and social security provided within the Swiss system, and resolving the challenges that his home environment presented. His social worker’s competency at advancing each of these issues - from supporting and exploring a new or former career to facilitating the redesign and construction of an old home - would have real-life impacts. At the time of writing, the final outcomes were still unclear. Nevertheless, the hoped for (and expected) result was a degree of financial security and autonomy through a combination of social security, insurances and if necessary a job. This would offer one of the pillars needed as a basis for Conrad to successfully reintegrate, possibly (or partly) retire and enjoy a greater degree of life quality.