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Cosmic Care

News from the Johns Hopkins Department of Psychiatry and Behavioral Sciences

Grethen Withrow
Gretchen Withrow is no stranger to challenge.

There's a move afoot lately to uncover underpinnings, to explore what keeps things going. Consider dark matter. The cosmic material has kept a low profile, but we now know it makes up some 90 percent of the universe.

On a quieter scale, it's not an artifice to see what Gretchen Withrow and her colleagues do in that light.

“Psychiatry values its social workers greatly—it’s always done so—while it demands a high standard of care,” says Withrow, who directs Hopkins Psychiatry Social Work. It's because of that, she says, that the staff of 17 is woven tightly into the fabric of the department. “Every psychiatry patient is routinely seen by a social worker,” says Withrow, and doctors seek out their insights daily.

  Mental illness, however, makes unusual demands. Because patients are so very environment-sensitive, for example, Withrow's staff works overtime to ease stress. They wrestle insurance plans “with near-abysmal mental health benefits” and form part of Psychiatry’s pushback to the pressure to discharge patients prematurely.

Social workers conduct individual and group therapy.  But the staple of their work, Withrow says, is holding family meetings. Such sessions open a window on a patient’s illness in a social context—that’s critical to plan treatment before and after discharge. And they also demand finesse. “Just as patients need outside help most, their illness can alienate a family or friends.” Then Withrow’s staff finds themselves holding a thread of a support system. Still, they persist, finding alternate housing or programs. What emerges more often than not is follow-up care with a chance.

“I’m proud of how we’re able to help our very complicated patients,” she adds. “It takes a skill set that’s extraordinary.”

Spring/Summer 2007 Index | Hopkins Newsletter Archive