Catherine Canfield
Athens,PA
Summary
Diligent licensed social worker dedicated to forming trusting relationships and advocating for the best interest of clients. Eager to contribute to team success through hard work, attention to detail, and excellent organizational skills. Clear understanding of care coordination and case management. Advanced training in Motivational Interviewing, Cognitive-Behavioral Therapy, Solution Focused Therapy, and Crisis Intervention. Motivated to learn, grow, and excel in the field of Social Work.
Overview
8
8
years of professional experience
Work History
BHIP CARE COORDINATOR
Syracuse VA Medical Center
Ithaca, NY
08.2023 - Current
- Ensured that Veterans receiving MH care on a BHIP team had continuity throughout their mental health care and afforded Veterans a consistent POC and clinical resource that promoted treatment engagement, especially during care transitions along the MH continuum of care.
- Executed comprehensive mental health care coordination needs assessments.
- Developed initial MH Care Coordination interventions plans, including intended frequency of contact, as part of the overall care plan.
- Monitored MH Care Coordination and treatment needs and adjusted the MH Care Coordination interventions plan, in collaboration with BHIP providers, as needed over time.
- Documented needs assessments and interventions plan in the electronic health record (EHR).
- Executed follow-up and outreach initiatives to enhance proactive personalized care.
- Monitored dashboards (PDE-1 Discharge Dashboard, Flow Dashboard, MHTC Care Coordination Dashboard) to promote population management of veterans on BHIP team.
- Communicated with the Patient Centered Management Module (PCMM) coordinator to ensure all MHTC assignments were current and visible in the EHR.
- Streamlined team communication by organizing agendas for daily and weekly meetings. Enhanced team collaboration through effective meeting planning and execution.
- Provided information/education to other healthcare and service providers to facilitate recognizing and respecting the Veteran's needs, strengths, and goals.
- Responded to critical events (e.g., ED visits, inpatient stays, suicide behaviors etc.) as they were known by gathering information, updating the team, coordinating any additional care or changes to care, and following up with the Veteran as needed.
- Facilitated communication with veterans to address inquiries regarding needs, upcoming visits, care plans, and unresolved questions from BHIP treating providers.
- Provided same-day access and walk-in services
- Facilitated crisis intervention during mental health emergencies, addressing suicidal and homicidal ideation effectively.
- Educated the Veteran on the team model and the Veteran's active role on the BHIP team.
- Provided individual and family counseling as was appropriate.
- Facilitated discharge planning with inpatient psychiatric team ensuring that discharge plans were executed in a manner that was timely and promoted care continuity.
- Collaborated with the Suicide Prevention Team to identify Veterans at risk for suicide and others with complex needs to increase monitoring or enhance care with targeted suicide prevention strategies as indicated.
- Utilized knowledge of human development and behavior (physical and psychological) and the differential influences of the environment, society, and culture.
- Utilized knowledge of community resources to make appropriate referrals to community and other governmental agencies
- Exercised independent judgment and expertise in applying supportive problem-solving and evidence-based crisis intervention techniques.
- Utilized expertise in DSM-5 mental health diagnoses to enhance diagnostic accuracy and treatment planning.
Dialysis Social Worker
Fresenius Kidney Care Dialysis
Nanticoke, PA
07.2022 - 07.2023
- Collaborated with the patient and health care team to identify effective interventions that will help the patient meet rehabilitation, treatment goals, and improve quality of life.
- Utilized patient education programs, established social work theory and methods, social work focused interventions, and quality of life measurement instruments as part of the assessment and care planning to address barriers and meet patient treatment goals.
- Provided monitoring and interventions for the patient to adjust to dialysis and achieve optimal psychosocial status and quality of life.
- Assessed patient knowledge of kidney disease for barriers that may affect adherence to treatment.
- Provided motivational interviewing, cognitive behavioral therapy, and solution-focused brief therapy to patients.
- Provided information and assisted the interdisciplinary team and patient with referrals to community resources (home health services, vocational rehabilitation, etc.) to facilitate optimal treatment outcomes.
- Maintained current knowledge regarding local vocational/educational rehabilitation programs and assist patients with referral and access to vocational rehabilitation to enable them to remain employed, become employed or receive education.
- Assessed patient awareness of advance directives; assisted with accessing advance directive forms/information and facilitates discussion of advance directive wishes, if necessary, with the healthcare team and the patient's family/support persons.
- Participated in the discussion of patient DNR status in the facility to ensure patient and/or family understand and make an informed decision about their care.
- Reported on quality indicators related to adherence, such as missed and shortened treatments, quality of life trends, and service recovery.
- Worked with patient, family and health care team to provide education tailored to the patient's learning style, communication barriers, and needs.
- Provided educational and goal directed counseling to patients who are seeking transplant.
- Facilitated the transplant referral process and collaborates with interdisciplinary team on transplant waitlist management.
- Provided ongoing education to patient/family regarding psychosocial issues related to end stage renal disease (ESRD) and all support services that are available.
- Reviewed patient rights and responsibilities, grievance information (company and network) and other facilities policies with patient and/or the patients' representative to ensure patients' understanding of the rights and expectations of them.
- Provided training to clinic staff pertaining to psychosocial topics as needed.
Substitute Teacher, K-12
ESS
Sayre, PA
02.2021 - 06.2022
- Provided instruction for students in core subject areas.
- Followed classroom plans left by class teacher to continue student education and reinforce core concepts.
- Kept students on-task with proactive behavior modification and positive reinforcement strategies.
- Maintained day-to-day classroom management and discipline to promote learning initiatives.
- Adapted lesson plans and student activities to meet needs of students with special learning needs.
- Kept accurate and current attendance records and assignment sheets to maintain file compliance.
- Organized and cleaned teaching areas after daily use to maintain high standards for returning teachers or other substitutes.
Child Protection Caseworker
Lebanon County Children And Youth Services
Lebanon, PA
06.2019 - 06.2020
- Investigated cases of child abuse and neglect.
- Conducted in-depth assessments to determine if children were safe from harm and abuse at home.
- Interviewed children, members of families, medical personnel and law enforcement to gain valuable information for each case.
- Provided in-home services to families.
- Provided placement services for children deemed unsafe .
- Devised and implemented safety plans for children suspected as victims of abuse or neglect.
- Maintained detailed case histories, metrics and reports to meet strict standards.
- Contributed to court proceedings, advocating for the child's best interests.
- Assisted families in navigating the social services system, including applying for benefits, accessing resources and connecting with other family support services.
- Intervened in crisis situations and counseled children experiencing emergencies and disruptive incidents while in foster care.
Lead Food Service Worker
West Shore School District
Camp Hill, PA
12.2018 - 05.2019
- Processed customer payments and balanced cash drawers.
- Served over 500 students school lunch per day.
- Maintained effective supply levels by monitoring and reordering food stock and dry goods.
- Kept register accurate through correct billing, payment processing, and cash management practices.
- Strictly followed sanitation and food safety guidelines as required by regulatory agencies and company.
- Developed and maintained positive relationships with parents regarding payment concerns, and food allergies concerns.
George Scott For Congress
Campaign Volunteer
Harrisburg, PA
08.2018 - 11.2018
- Prepared materials and signage for distribution to local area.
- Drummed up support for political candidates by canvassing door-to door.
- Traveled with campaign team to help organize support at different locations.
- Ran phone banks taking calls from donors wishing to contribute to political causes.
Education
Master of Arts - Social Work
Marywood University
Scranton, PA05-2022
Bachelor of Arts - Political Science
Elizabethtown College
Elizabethtown, PA05-2018
License
Skills
- Interdisciplinary Team Collaboration
- Active Listening and Communication
- Care Coordination
- Case Management
- Motivational Interviewing
- Cognitive Behavioral Therapy
- Solution-Focused Therapy
- Documentation
- Organizational skills
- Crisis Intervention
- Time Management
Timeline
BHIP CARE COORDINATOR
Syracuse VA Medical Center
08.2023 - Current
Dialysis Social Worker
Fresenius Kidney Care Dialysis
07.2022 - 07.2023
Substitute Teacher, K-12
ESS
02.2021 - 06.2022
Child Protection Caseworker
Lebanon County Children And Youth Services
06.2019 - 06.2020
Lead Food Service Worker
West Shore School District
12.2018 - 05.2019
George Scott For Congress
Campaign Volunteer
08.2018 - 11.2018
Master of Arts - Social Work
Marywood University
Bachelor of Arts - Political Science
Elizabethtown College
License