Practicing at the Top of My License: A Day in the Life of a BHCM in Oncology Care

No Two Days Are the Same

My mornings often start with reviewing patient charts and assessment scores from the previous week. These tools give me a snapshot of how my patients are doing and help guide the conversations we’ll have. From there, I dive into patient calls. Some days I’m helping someone newly diagnosed work through shock and fear. Other days, I’m checking in with a patient who’s starting chemotherapy and helping them manage the fatigue, both physical and emotional, that comes with it.

Much of what I do involves brief, focused, and supportive interventions. We talk about how to manage anxiety between scans, how to stay grounded during long treatment days, or how to communicate more effectively with care providers. Sometimes I introduce mindfulness strategies or offer a space for grief and meaning-making. I utilize clinical frameworks that have been proven to be effective with cancer patients, like Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT), to teach tangible skills to help my patients get through their cancer experience. And sometimes we talk—about grandkids, memories, hopes, or fears—because being heard is also healing.

Embedded in the Team

But my work isn’t limited to one-on-one time with patients. In the background, I’m in regular communication with oncologists, nurses, social work colleagues, and other members of the care team. If a patient mentions new financial stress or food insecurity, I’m looping in the oncology clinic and collaborating on resolving those stressors.

I meet weekly with our consulting psychiatrist to review my caseload, raise clinical questions, and discuss patient progress. If medication is recommended, I help bridge that recommendation—coordinating with the patient’s oncologist and checking in with the patient as they start the new medication. This kind of continuity and follow-through is a defining feature of the Collaborative Care Model—and a big reason why it works.

Feeling Valued and Fully Utilized

There’s something incredibly energizing about being part of a model that sees your role as central, not supplemental. In past jobs, I’ve sometimes felt boxed in—limited to discharge planning or pulled into a role that didn’t quite match my clinical skill set. But in this role, I get to draw on all parts of my training: the clinical, the systemic, and the relational.

Research supports what I’ve experienced firsthand. A 2020 study by Courtnage and colleagues found that oncology social workers who were embedded in collaborative care teams reported higher levels of job satisfaction, describing how the model allowed them to feel more effective, better integrated, and more valued as professionals. They emphasized that the role allowed them to practice at the top of their license—not just responding to crises, but proactively supporting patients' mental health and wellness in meaningful, sustained ways (Courtnage et al., 2020).

That resonates deeply with me. The autonomy, structure, and support I have in this model create space for real therapeutic relationships. And that, in turn, leads to better outcomes—for patients and for me.

The Power of Showing Up

At its core, this work is about showing up consistently for people who are facing some of life’s most difficult moments. It’s about building trust in small conversations over time. It’s about advocating for patients behind the scenes, even when they don’t know we’re doing it. And it’s about collaborating—not just with providers, but with patients themselves—to make sure their voice is central in their care.

This model reminds me, every day, why I became a social worker. It honors the complexity of our patients’ lives and the depth of our training. It gives us the space to be both skilled and human.

I’m grateful to be doing this work—and hopeful that more social workers will have the opportunity to practice in models that truly reflect the heart of our profession.

Citation: Courtnage, T., Conlon, A., Kent, E. E., et al. (2020). Integrating Oncology Social Work into a Collaborative Care Model. Journal of Psychosocial Oncology, 38(6), 715–729. https://pubmed.ncbi.nlm.nih.gov/33098206/