Keeping an Eye on the Whole Person at Long Island Jewish (LIJ)

For this post, we asked Tracy Schachter, LMSW, to tell Accord Alliance's readers about the DSD team at Long Island Jewish Hospital/Steven Alexandra Cohen's Children Medical Center. Tracy describes here the make-up of the team, the team's approach, and her role as the social worker. 

I'm excited to have recently become the social worker on the DSD team at Long Island Jewish Hospital/Steven Alexandra Cohen's Children's Medical Center. Our active and well-integrated DSD team is expertly coordinated by Heather Appelbaum, MD, Program Director/Pediatric and Adolescent Gynecology. Our team includes: Phyllis Speiser, MD, Pediatric Endocrinology; Jordan Gitlin, MD, Pediatric Urology; Lane Parlmer, MD, Pediatric Urology; Nelson Rosen, MD, Pediatric Surgery; Joyce Fox, MD, Pediatric Genetics; Carmel Foley, MD, Pediatric Psychiatry; Carol Adelman, DSW, Social Work NICU; and me, Tracy Schachter, LMSW, Social Work Gynecology.

It is great to work with physicians and nurses who value the social work perspective – a perspective that takes into consideration what patients and families need before and after they walk through the door. We are concerned about how patients are doing as individuals and how they are doing within relationships and within their social networks. We are dealing with uncertainty, anxiety, shame, grief, love, and growth.

As the social worker on the team, my role is to conduct psychosocial assessments that encompass religion, ethnicity, and environment. I work on developing a rapport with families that will ultimately lead to sharing their confusion and concerns. With parents of small children, I try to help address anxieties about diagnoses, interventions, and prognoses. With affected teens, I do a lot of active listening and offering support, with a focus on body image and providing the coping tools necessary for them to feel good about themselves. When our patients are young adults, decision-making is really in their hands. I try to offer direct support; I find out where they are in terms of their physical and mental growth, and provide them assistance with planning for today and for the future.

It is especially satisfying to work with a team that recognizes that sometimes an immediate surgical "fix" is not always the best long-term option. Our team takes seriously options like pressure dilation for vaginal expansion, a non-surgical option. We work to try and make sure patients leave our clinic feeling good about themselves, their bodies, and their lives.

I am now working on putting together a local support group for girls with vaginal agenesis. We are currently offering peer support to mothers of affected daughters, because they clearly experience a lot of anxiety and stress when their daughters' reproductive capabilities are diminished by their conditions. I believe that it helps to bring in affected adult women to speak to these mothers, so that they could meet successful, well-adjusted women who started off in the same place as their daughters. This kind of "mentoring" can be so valuable.

My main goal within our team is to make sure we keep focusing on the whole person, and not forget the whole person when we're dealing with genetics, anatomy, and hormones. That job is definitely made easier by working with physicians and nurses who share the same objective.

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