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  • While in undergraduate Cabot met Ella who was a member of a prominent Boston family which attended King's Chapel (Unitarian)
  • The two were Married in 1984 at the Swedenborgian Church in Waltham, Massachusetts.
  • Ella wanted to have children but Richard opposed the idea,
  • believing that resisting bodily instinct would lead to a "more abundant life", focused on service to God and society."

Within a decade Richard Cabot had developed a fledgling social work program that he funded himself, into a full department with fifteen staff that where paid by the hospital. This department became a model for hospitals across the nation. Richard Cabot lectured extensively and brought his beliefs to many hospitals in the United States which helped with the implementation of standardized training for social workers. As stated on the Massachusetts General Hospital web site:

“Dr. Cabot and Ms. Cannon successfully collaborated at Mass General for 40 years. They created a department that combined sound clinical practice with political action and community service. Dr. Cabot and Ms. Cannon traveled extensively throughout the United States and abroad, lecturing on their seminal work. They were both instrumental in the establishment of several national health-care and social service organizations.”

In addition, Richard Cabot promoted maintaining case files and treatment plans for each individual patient stressing the use of scientific method. He would then follow up with the patients for years after their initial treatment to determine which methods were the most effective and employ them. He also innovated the practice of doctors making rounds to see each of their patients. Not only did this help prevent mistakes in individual patient care, it also lead to the review and use of best practices in many fields of human service today. The effect of his work not only helped improve the individual care of patients but also protected the public at large.

Richard Cabot’s belief in treating patients with respect regardless of their background, economic or social status was perhaps the most important contributions to the field of social work and humanity. He supported the doctrine that even the least of us are deserving of equal access to the principles of liberty that were often not shared with the vulnerable populations of his time and ours today.

Oria Kunin was born in Atlanta in 1970 and was a former GSU student in the ‘90s. She was active with the Georgia Environmental Project in her twenties where she managed the first environmental products store in the Southeast. She also worked as a community organizer to promote public awareness of local environmental issues, and lobbied to implement curbside recycling and a phosphate ban on the Chattahoochee River. In 1996 Oria moved to upstate New York to assist her Grandmother who was suffering from dementia. While there Oria began working with youth at the Glove House and started to focus her education on learning skills to promote the care and welfare of the children she worked with. She returned to Atlanta and continued working with disadvantaged youth at CHRIS Kids. Oria started as a direct care staff and became an interim social service treatment supervisor, a certified trainer of nonviolent deescalation techniques and taught technology skills. She worked on the quality assurance team, and was a representative for the Atlanta Task Force for the Homeless. She is currently a full time student at Georgia State University where she is on the President's list and is pursuing a Master's Degree in social work.

Tracye's Conclusion

During my research I learned that the discrimination that was faced during Dr. Cabot's time is pretty much the same as it is today just in a different form and fashion. The individuals receiving the least or barely adequate amount of care were and still are minority women. I feel like Dr. Cabot's greatest strength was also his weakness, his Unitarian beliefs. They motivated him in his pursuits of social ethics and hindered him in his personal life. While Dr. Cabot was working in the right direction with his views on patient/social worker interaction, there were several set backs in the implementation of his ideas. Like today there were not enough qualified social workers or enough funding to hire them. Most of the staff that worked at MGH were volunteers. Regardless of these set backs I would consider Richard Cabot the father of Medical Social Work who paved the way for patients of every socioeconomic background to be treated with the respect and outpatient care that they deserve. The many rules and regulations that we have in place today would not be possible if it wasn't for Dr. Cabot. I had no ethical concerns when researching this project and find none probably because Dr. Cabot was such a religious man.

Conclusion

Brianna's Conclusion

Richard Cabot was an extraordinary man. He thought very differently and more advance for someone in his time. Cabot had strengths in realizing people’s needs, and how to take care of those needs. Strengths of Cabot would be the fact that he was able to establish social work in the hospitals. By beginning social work in hospitals, Cabot opened the doors for a lot of people in today’s society. Patients are now able to get the proper care and services are available to help assist their needs. Before there was medical social work, patients were just being treated and sent back home. Now, social workers are there to make sure that treatments are done right, the patient is cured, their homes are safe, and much more.

The ethical principle of social justice guided Richard Cabot to create medical social work. He felt that all people, both rich and poor, should be provided public healthcare in the proper way. Every patient should be treated fairly as well. Completing this assignment opened my eyes about medical and clinical social work. Cabot had the drive and motivation to help improve the lives of people and this is the intuition for any social worker. I always wanted to work in the medical social work area, and learning about Cabot’s journey encourages me more.

Social Service Analysis

Oria's conclusion

It is astonishing that there is so much controversial political and moral debate today on how to deal with the needs of the vulnerable populations in our society, just as there was over a hundred years ago during the turn of the century when Richard Cabot began his career. Although there have been many gains in social justice, such as women having the right to vote, there is still the ethical dilemma of a great divide between the number of those who have and those who have not. As bad as conditions are now for the poor and disenfranchised they were much worse then. There was no established minimum wage, child labor laws were just beginning to be debated-not to mention the lack of legal guidelines for safe working conditions or equal protections under the law for all people regardless of race or gender. Today vulnerable populations have a lot more advocacy than before but the underlying problems remain. Despite great improvements in social justice there are still far too many poor, undernourished, and disenfranchised among us and not enough money to provide necessary services to those who need it most. Richard Cabot did not hold with the prevailing notion of his time that there were those deserving and undeserving of help. Everyone was entitled to the best care that was available. He was an exemplary example of how perseverance can create great change. He had the advantage of notoriety and was esteemed in the medical field for his work in hematology. Being held in high regard was a strength which likely assisted in his obtaining support for his social work efforts. The undaunted perseverance that Richard Cabot exhibited in trying to cope with social problems that were so wide spread gives me hope that we can also actualize major progress. It is hard not to be overwhelmed by the breadth and complexity of the problems facing the needy today. However when one thinks of the challenges that were faced in the past it does not seem quite as impossible to make meaningful improvements. This assignment has made me realize that a few good people with a good plan can have a lot of influence on others to evoke progress that will reverberate for generations to come. Working diligently to change ineffective policy is not easy, but in the long run bears so much benefit to so many people that it is well worth the effort.

20th Century Problem

Jarae's Conclusion

As chief of staff at Massachusetts General Hospital, Richard Cabot established medical social services as a part of the treatment for patients. In response to ineffective practices and poor conditions, Richard Cabot employed social workers to assist in the medical treatment of patients. He transformed therapy by addressing economic, social, and psychological issues that were factors that affected patients' health.

The oppression and discrimination during this era is extremely similar to current times. Our focus on Richard Cabot and medical social work exposed discrimination in the form of classism and racism due to poorer populations and immigrants not having the proper resources to meet their needs outside of the medical setting. We run into similar issues today in the medical field which is why social workers are needed in hospitals to address psychological and social issues that may be affecting the patient. Richard Cabot’s strengths were his passion that drove him to becoming the “father of medical social work.” This allowed him to realize the issues within the hospitals and take action to make sure needs were met. His response was strong because he had such a great support team, from colleagues to his wife. Without the contributions of others Cabot’s efforts to better society would not have been as strong. He implemented the field of social work into the medical field creating an example for hospitals across the country. He brought attention to the psychological and socioeconomic issues that may affect a patient along with their sickness. I found no ethical concerns in his practice, if anything; Cabot allowed ethics to be practiced better because now patients concerns and needs were being voiced. Social justice and equality guided the development of his strategy because he recognized the disparity among patients and realized they needed more than to be diagnosed and treated with medication. Completing this assignment gave me a better understanding of the background of social work and put into perspective that there were people who had to pave the way to make things right for others. It makes me ponder on the thought that there are many issues today that need to be addressed and someone has to take the initiative to put action into place.

He also wrote extensively on medical ethics. Dr. Cabot's mission was supported by the assistance of other individuals like Ida Maude Cannon who promoted his work by recruiting volunteer social workers to help in the medical field. Their work inspired the expansion of the social work role in the hospital and the presence of the social perspective as a regular part of the medical treatment plan.

He emphasized the importance of ambulatory medicine, advocated for group practice, and founded hospital social work. He lobbied for preventive medicine and created the Clinical-Pathologic Conference which is the model used to evaluate cases in order to find errors.

During the early 1900’s, America was experiencing the Progressive Era. This period was defined as a time of social, political, and economic reformation. Instead of society running smoothly and America reforming into a perfect place, problems erupted. One major social concern during the Progressive Era was inadequate healthcare. Public health was at its worst and hospitals were being filled with sick people. The problem with public health was largely caused by poor sanitation. Cities were becoming overcrowded because of the large wave of immigrants moving in. Housing and street conditions were both dirty and nasty. People were living in overcrowded tenements, and there was no running water. Diseases, such as, tuberculosis, were spreading rapidly. Society often blamed the immigrants for this bad situation.

Richard Cabot had a lot of notoriety as one of “America’s best known physicians” (Dodds p.417). Cabot was working and participating in laboratory research while the cities were experiencing high risk health problems. Hospitals were overwhelmed by the sick, and many poor were sent home as out patients. Cabot was working at Massachusetts General Hospital in the outpatient department (OPD), he realized that to solve the communities health dilemmas, patients needed more than just to be diagnosed and sent home. He developed the distinction within the medical profession by using the practice of medical science (Dodds p.418). He realized that the issues with public health were affecting the hospitals and individuals. Individuals were being treated in the hospitals, but were still returning back to the communities with out addressing the causes of their illnesses, such as poor sanitation.

Outraged with what was happening with healthcare, Cabot decided to be the first to use social workers in the hospitals to help patients in their communities. His idea of medical social work was inspired by a good friend of his, Dr. Joseph Pratt. Dr. Pratt had instituted the “friendly visitor” in 1905 as a part of his treatment of tuberculosis patients (Dodds p.419). Cabot expanded this idea of having an advocate for each patient into what we now know today as medical social work. At first, Cabot placed social work as a “near-equal partner to physician care” (Dodds p.419). He saw social workers working close together with doctors, curing both bodies and minds. Cabot also believe that medical social work would promote public health safety in the communities, and created an individualized case review for each patient. This would improve the patient’s health and help make society better. Medical social work was offered to the wealthy and poor alike.

Medical social work had a positive impact on public health. Cabot was able to redefine the way healthcare was being managed. The medical social work practice soon began to spread to other hospitals all over America. Social workers began working parallel to doctors distinguishing the underlying environmental factors that caused sickness for each patient.

Richard Clarke Cabot:

The Father of Medical

Social Work

"Ethical action is what we do while we are building up our chance to voice somewhere

and sometime our thankfulness that we were born and reared on a planet that can show us such wonder, such beauty, such devotion."

Introduction

Social Service Effects

  • Nurtured in a rich spiritual and intellectual home environment, Richard Clarke Cabot became a physician, philosopher, educator, and social work pioneer. He was strongly influenced by the work of his cousin, Joseph Lee, who led a campaign to establish urban playgrounds. The positive impact this had on communities helped steer Cabot's career into the social work field. Richard Cabot's prolific medical career began at Massachusetts General Hospital.
  • He began his journey into social work in 1905 at MGH when he decided to bring social services to his clinic patients.
  • In 1919 he influenced the medical profession to redefine social work with an emphasis on honesty, developing channels of communication and lightening and simplifying the hospital's workload. He envisioned social ethics as a graduate level requirement in the school of social work, and in 1924 developed a clinical year for theology students where they practiced pastoral counseling in medical institutions at Harvard University.
  • After retiring from Harvard at the age of 65, the year that his wife passed, Cabot continued to work becoming a Professor of Sociology and Applied Christianity at Andover-Newton Theological School.

Over 100 years ago Richard Cabot’s innovations in medical treatment and training established the foundation for which the field of social work is currently practiced. He turned his back on cultural prejudices and worked diligently to care for the poor and vulnerable who could not afford inpatient treatment at Massachusetts General Hospital. He was one of the first practitioners to understand that socioeconomic and psychological factors had to be considered in treating patients. This non-judgemental methodology permeates the field of social work today. He stated in his book Social Service And The Art Of Healing that “If we are to truly treat the patient, and not merely smother one of his symptoms under a dose of medicine, we must push on into the background of his case, and see what disease in the body politic-perhaps in the body of industry is behind his individual suffering.” He goes on to argue how the hospital will pay to treat a baby but that unless the mother is taught how to properly care for it the same costs will be born again and again. In 1905, paying out of his own pocket, Richard Cabot hired the first social worker to go into the homes of their patients. Assessing environmental and educational factors that affected the well being his patients proved to have much better results. Root causes off distress were addressed rather than just treating the symptoms. This method of treatment lead to healthier patients and safer communities and was more cost effective than past practices.

Richard Cabot was a prolific writerWritten Works

Case Histories in Medicine (1906)

Case Teaching in Medicine (1906)

Social Service and the Art of Healing (1909)

The Christian Approach to Social Morality (1913)

What Men Live By: Work, Play, Love, and Worship (1914),

A Layman's Handbook of Medicine (1916),

Training and Rewards of the Physician (1918)

Facts of the Heart (1926)

Adventures on the Borderland of Ethics (1926),

The Goal of Social Work (1927)

Christianity and Sex (1937)

Honesty (1938).

Here is an example of the issues that Richard Cabot and his staff worked on. Their task list clearly illustrate the social problems that were prevalent at that time and the majority of these still affect many people today:

1906 PRACTICE

Main Divisions of Work

1. “Tuberculosis”

2. “Hygiene teaching”

3. “Infant feeding and the care of delicate children”

4. “Vacation, outings and convalescent homes

5. “The care of unmarried girls, pregnant, morally exposed or feeble minded”

6. “Help for patients needing work or a change of work”

7. “Provision and provisions for patients dumped at the hospital”

8. “Assistance to patients needing treatment after discharge”

His First But Second Love

Ella Lyman (1866-1934)

Pioneering a profession:

A history of social work innovation at

the Massachusetts General Hospital

1905 - 2005

http://www.mghpcs.org/socialservice/Documents/HistoryTimeline.pdf

Brianna Bussey

References

Brianna was born on May 15th of 1992 to a wonderful family. She has lived in a small town in Georgia all of her life. After graduating from high school, Brianna decided to take on a new path by furthering her education at Georgia State University. While at Georgia State, she found a passion for helping people while volunteering at different social service organizations. She is now a Junior , pursuing a Bachelor's degree in Social Work.

Group Members

Oria Kunin

1. Cabot R.C. Case teaching in medicine. Boston, D.C. Heath, 1908.

2. Cabot R.C. Diagnostic pitfalls identified during a study of three thousand autopsies. JAMA. 1912;59:2295–98.

3. Cabot RC. Letter. JAMA. 1913;60:145.

4. Cabot, R. (1909). Social service and the art of healing. New York: Moffat, Yard and Company. Retrieved from http://archive.org/stream/socialservicean00cabogoog

5. Cabot, Richard C. (1912). Social services and the art of healing. Moffat, Yard, & Co. New York, NY.

6. Cabot, Richard C. (1912). Social services and the art of healing. Moffat, Yard, & Co. New York, NY.

7. classicmoodexp (2012 October 12) Music of the era : Top Tracks for Scott Joplin retrieved on November 16, 20012 from: http://www.youtube.com/watch?v=Sc1ThBANwg&list=AL94UKMTqg-9AXCNCGYRntRphyfrZNLqCS&feauture=

8. Dodds, T. (1993). Richard Cabot: Medical Reformer During the Progressive Era (1890-1920). Annals Of Internal Medicine, 119(5), 417.

9. Metteri, A. M. (2004) Social Work Approaches in Health and Mental Health from Around the Globe. The Haworth Social Work Practice Press Inc. Binghamton, NY.

10. Pioneering a profession: A history of social work innovation at Mass General, 1905 - 2005 "History" retrieved on October 12, 2012 from http://www.mghpcs.org/socialservice/History.asp)

11. White P.D. Richard Clarke Cabot 1868–1939. New Engl J Med. 1939;220:1049–52.

Jarae' Clark

Oria Kunin

Brianna Bussey

Tracye Seales

Jarae Clark

Jarae Clark was born November 14th, 1992 in Sacramento, California. She moved to Augusta, Georgia in 2007 with her family. After graduating high school in 2010 she chose to attend Georgia State University to pursue a Bachelor's degree in Social Work after being inspired by the community center she attended as a child.

Tracye Seales

Tracye Seales was born in Izmir, Turkey to Ethelbert and Vera Seales during Desert Storm. Because of the war she was shipped back to her parents native country of Trinidad and Tobago. She spent the next 3 years there with her Grandparents while both of her parents fought in the war. When her parents came home they moved the family to an Air Force Base in Warner Robins Georgia. She graduated from Northside High School in 2003. She attended Georgia State University and Graduated with a Bachelors of Psychology and Chemistry in 2008. Not satisfied with her job decision at the time she decided to go back to school and pursue a career in Social Work at Georgia State University.

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