Why Robust Wraparound Services Are Important for a Pediatric Cancer Center: A Q&A With Wade Iwata, MSW

Wade Iwata, MSW, is social work supervisor for Seattle Children’s Cancer and Blood Disorders Center

Q: How would you define wraparound services? 

It’s the support we offer to patients within their whole environment. So that’s the patient with their siblings, their parents, their extended family, their school system, and their community. Because cancer just doesn’t affect the child. It pertains to everybody who’s part of their life.

Q: What do you think is the most important thing that Seattle Children’s does for a family that they may not get at another hospital or a cancer center? 

There are a lot of unique benefits at Seattle Children’s that other facilities don’t typically offer.

• For one thing, we have a really large psychosocial team. We have 11 social workers and then two social service specialists who are dedicated specifically to the Cancer and Blood Disorder Center.
• Our social service specialist team is laser focused on concrete needs, like helping families travel from wherever they’re coming from across the country or from across the world, setting up flights, local housing, and really being that support to them in getting to Seattle. They are like a concierge service.
• We provide in-house school services to keep kids engaged and on-track with their learning.
• Families coming from far away feel like they have a connection here, somebody who is on their side really working to support them.

Q: If a family doesn’t have this kind of support, what is that impact to the care or their outcome, potentially?

I think the social work team in particular has a huge impact on outcomes for kids. Our medical teams of doctors and nurses and others do an amazing job of addressing the medical issues patients are facing. We are here to address everything else: the emotional side of things, the school side of things, trying to create as normal of a life as we possibly can.

These kids are plucked out of their everyday life and brought into a new world and a new system. It’s emotionally and physically traumatic for them. Our work is to process that with them and support not only the patients but also their families, their siblings, their caregivers. Just helping them to address this new situation that they’re facing. And I think this support improves outcomes that are huge for the families because, while they know they’re getting great medical care, the emotional toll of having a child diagnosed with cancer is immense. And we need to process that with them and help support them through that process.

Q: Is there any data that shows the impact of social work?   

Several years ago there was a study on national psychosocial standards of care that identified the best outcomes for kids and their families happened when certain psychosocial goals were met. There are 15 goals, and we’re doing our best to meet all 15. And the hospital has really supported us in expanding our social work and psychosocial team overall to address the many layers of needs that arise when kids are diagnosed with cancer.

Q: Can you give an example of what some of those 15 things would be, for instance? 

Some of the psychosocial standards that we look at are caregiver supports. We know that if caregivers aren’t supported throughout this process, it negatively impacts the child. Ensuring that patients are still involved with school is another important aspect. Having schooling available in-house at the hospital helps our patients maintain their education while going through cancer treatment. Sibling support is another major area that we were really trying to build up and focus on, because siblings are often forgotten throughout this whole process. And we now have a dedicated staff that are looking at sibling supports and helping to support siblings through this process, which is a pretty unique offering even for a children’s hospital.

Q: Can you describe the in-house school program?

One of the main benefits of being treated at Seattle Children’s is we have in-house schools. We have a whole staff of teachers that range from elementary school all the way up through high school. They’ll come to a patient’s room and help keep them up-to-speed on their schoolwork so that they miss as little as possible while they’re in treatment. They often will work with the patient’s school teachers back at home, making sure that they are doing the same curriculum, trying to keep them at pace so that once they are able to return to school, they’re not far behind.

Q: Are our in-house school services only available in English?  

Our interpreters partner with our in-house school teachers to provide education services in many other languages.  All of our social work services are available in multiple languages through our video/telephone interpreters (for outpatient families) and in-house interpreters (for inpatients); we also have bilingual social workers on staff. I think one of the benefits of Seattle Children’s is our extensive in-house interpreter team and how they work closely with all medical providers and ancillary services to support the families.  They create amazing relationships with the families since they are our own interpreters.

Q: What have families told you about the impact this has?

I’ve heard many, many compliments regarding our social work team and the supports that families receive. I was just with a brand-new family earlier today whose child is getting ready to start treatment tomorrow. They’re so overwhelmed with all the medical things that are going on with their child, all the concrete things that they need to take care of — their own jobs, the child’s school, the sibling. I sat with them and said, “This is all very overwhelming. Let’s prioritize some of these things. Let me help you with X, Y, and Z.” By the time we were done, the mom expressed how appreciative they were of having somebody guide them through this process who’s done it before. There is no handbook for how to deal with the inconveniences of childhood cancer. So having a social worker help a family organize their thoughts and their lives in the very earliest hours then allows them to come back in the next week or so and let us help them start to address the emotional toll it’s taking.

Q: What special services does Seattle Children’s offer for teens or young adults that are unique to that age range? 

For our adolescents and young adults, we focus on them as individuals.  Developmentally they’re at this unique time in their life where they’re trying to become their own person. We really try to bolster them in taking ownership over their medical care, having a voice in the room, and supporting them all around in taking steps in life that are developmentally appropriate, as they’re supposed to be. We offer adolescent- and young adult–specific support groups with our psychology team. We also have our therapeutic gaming specialists, which I think are a phenomenal support specifically because we’re mindful they’re in a pediatric hospital and they don’t want to be treated like a young child. It’s a really unique experience, I think, for these patients.

Q: What are some of the most unexpected things you were able to provide to a family that was going through cancer treatment here? 

Oh, there are so many unexpected things that come up for families. We recently helped with a wedding. A couple’s daughter was passing away and it was her wish to see her parents married. And so we helped to plan that wedding for them.

Q: What would you want providers to know about the wraparound care we offer? 

I think one of the things I love about working at Seattle Children’s is just the support our community puts into supporting families. I feel oftentimes social workers working in a medical facility are overlooked as a part of the medical team. But the Seattle Children’s faculty and staff and really the whole organization truly believe in the value of social workers and psychosocial providers. And when you would look at other pediatric facilities of our size, what you see is we have one of the larger psychosocial teams specifically for cancer and hematologic disorders. It’s a reflection of the way that Seattle Children’s lives its philosophy that we’re here to support the whole family.

 Q: Why do you think wraparound care is so embraced at Seattle Children’s? 

I think we know it leads to better outcomes. And I think we are invested in making families feel really cared for here.