By choice or by chance, many jobs involve conscious language, such as writing, copyediting, parenting, teaching, managing, training, customer service, marketing, negotiation, persuasion, counseling, law, and meditation. In our “Conscious Language at Work” Q&A series, we spotlight people in our community who use language mindfully to support and enhance the work they do.

Mia Scanlon, LCSW, is a pediatric social worker who works with families whose child has a hematology or oncology diagnosis. She studied at the University of California, Berkeley, for her bachelor’s degree in psychology and went to Columbia University in New York for her master’s degree in social work. Since 2006, she has worked as a hospice, home health, or medical social worker for Kaiser Permanente, AIDS Project Los Angeles, and others.

Tell us about the social work you do.

We’re licensed clinicians, so providing emotional support is a huge aspect of our job. The other part is referring and coordinating community resources, helping families deal with the bureaucratic minutiae, things like Family Medical Leave and Medi-Cal, arranging for home instruction if the kid’s going to miss school because they’re going through chemo.

Sometimes, we also act as child life specialists. We provide distraction activities or physical comfort to a child, like holding them while they receive treatment. Basically, social workers do everything from soup to nuts.

What are the main messages you want to get across when working with a family?

As social workers, we validate parents’ fears and anxieties and try to provide reassurance during a very challenging time. We want to let them know that they are under exceptional circumstances but they are not alone. We are here to help.

I use humor a lot, whenever I can find the room to stick it in there. A lot of people, they don’t like somebody very clinical and cold or distant. A sickle-cell family came in today, and the first thing I do is start with a big hug and acknowledging that they’re here and it’s so wonderful to see them.

When communicating to families and patients, how important is timing?

Timing is very important. As medical providers, we need to be very clear about the parent’s role and our expectations of them. We need to set the parameters from the beginning and reiterate them throughout a child’s treatment. If there is hardship with bringing their child in, we assess those needs as soon as possible and connect them to appropriate resources. Every treatment, every lab value, every test result—they have to be timed precisely. It’s always a moving target, depending on how patients react to the treatments. The communication is always ongoing.

Starting from a place of empathy is important.

When it comes to telling the family the prognosis, is it usually done by a physician or is it a team effort?

The initial diagnosis and prognosis is relayed by the physician. When we move into talking more in depth about the treatment plan, it is done collaboratively with the doctor, nurse, social worker, and child life specialist. We work as a team to talk about our role in the treatment process and how, as specialists, we can help the family collectively.

How else do you use language consciously with the families?

When I talk to families, starting from a place of empathy is important. And, also, finding out from their perspective what the challenges are versus saying, “You’re failing to X, Y, and Z”—then they are automatically in a place of defense. Encouraging families to incorporate their own solutions to the problem is also effective in gaining their “buy-in” to the medical plan. So rather than saying, “You must come back at this date, at this time,” we can give them an array of options.

Is it easier dealing with the kids?

Kids are really great patients. Because they’re like, “OK, this is my new normal, and I just get used to it.” And they do. It’s harder for parents, who not only have to cope with their own feelings of their child being sick, they still have to manage everything else in their life because life doesn’t stop just because your child has a chronic illness. We work by supporting the entire family.

What do you keep in mind when talking to kids?

We often use developmentally appropriate language. We may say to a child, “You’re getting a poke today. It’s going to happen in your arm and it’s going to feel like a pinch.” Describing the process in words that they can understand can greatly ameliorate their anxiety. Needle phobia is not uncommon for children if they’ve received complex medical care in the hospital. If a child needs ongoing treatment for many months, like cancer patients, we use a central line catheter to minimize the pokes.

So it’s important to tell kids what’s happening.

People think that if we withhold the information from a child, they are able to cope with it. And maybe initially you’ll get their cooperation for them to come to the clinic, but it’ll be much more difficult for a parent to bring them back. I had one child screaming “I don’t trust you!” for thirty minutes at his mother when he realized that he was coming in for treatment. You need to communicate to the child what they’re expecting and where they’re going and who they’re seeing. It’s about building trust with providers as much as getting them the actual treatment. So yeah, most definitely.

We never want to use euphemistic language when it comes to death.

Do the children have trouble understanding?

Sometimes the oncologist uses really colorful language. Like, this child was really into playing with toy soldiers. He’s only six, so the oncologist said, “The soldiers who are your blood cells are down right now, and they need some help, so we’re going to give you chemo, and that’s going to give them more ammunition to help your soldiers.”

We never want to use euphemistic language when it comes to death. Euphemisms tend to confuse younger folks, especially kids. Like, we don’t want to say, “We lost someone.” Well, you go find that person. We generally use concrete terms, like death and dying.

Which situations are challenging for you when it comes to finding the right words?

I deal with some parents who really get lost in their cognitive distortions, even if their child’s prognosis is great. In one case, a child had a less than four percent chance that he’s ever going to get the same disease again. However, this parent kept perseverating on the four percent. I’ve said to her, “I want you to stay in the moment with your child, because he’s doing wonderfully. I want you to use that time to embrace and celebrate his life now that he is finally done with his treatment.” And her response to me was, “Don’t tell me to celebrate the moment. That means that I’m not going to see him tomorrow, so I should just be thankful for today.”

If that’s their process, I’m not going to change it overnight. For a lot of people, everything is catastrophic or they have all-or-nothing thinking. And for us to reframe those negative thoughts is one great way we use conscious language.

What about the language you use with the staff?

It’s funny—if you’re accommodating and sweet and collaborative, you almost never get heard.

What other language issues do you encounter as a social worker in this setting?

I feel like the one issue that I’m always struggling with is providing full transparency with the family versus letting denial act as a coping mechanism for them. That’s a balance and it’s different for every family.

It’s a job that leads with the heart.

I personally feel that denial has its role in helping families deal with the shocking news of a life-threatening illness. I often joke that I’m not the truth police. I’m OK with easing families into the reality so that they are better able to cope with their situation. Some providers may not feel the same way, and it can be a push-pull between the members of the team.

Who would you recommend this profession for?

A person who is flexible and can roll with the punches. Because I take on so many different roles, depending on the needs of the families, my responsibilities can be all over the map. Anyone who loves working with people and cares deeply about the families’ experience in this dynamic and oftentimes stressful setting would be a good fit. It’s a job that leads with the heart.

Anything else you would like to share with the readers?

I’d like to end with a paraphrase of a quote from Cheryl Strayed, since it resonates with my work:

Grief is tremendous, but love is bigger. You are grieving because you loved truly. The beauty in that is greater than the bitterness of death. Allowing this into your consciousness will not keep you from suffering, but it will help you survive the next day.


 

You can contact Mia Scanlon at moc.l1490582759iamg@14905827597noln1490582759acsm1490582759.

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