Sliding Doors: Exploring Transitions as Threshold Moments

The mission and values of social workers practicing in healthcare and palliative care can be overshadowed in systems where administrative pressures, changing health status and evolving goals invite or force transitions of varied kinds: from health to illness; from one setting to another; and from life to death. Transitions impact patients and families and often staff, many of whom have not contributed to these decisions. Transitions can also reflect inequity and biases, often unrecognized yet contributing to clinician distress and unarticulated harms.

The goal of this class is to explore the therapeutic opportunities implicit in the pivotal moments in transitions. We will use the diagnoses of cancer and dementia and the intensive care and hospice settings to discuss the opportunities and challenges faced during varied transitions, 

As social workers, we participate in and translate systems issues to patients and families and deepen these discussions with colleagues by sharing information about the history, culture and needs of individual patients and families that brings unique meaning to transitions. We will present transitions as part of the larger tapestry of patient, family, and clinician experience where we might see therapeutic opportunities that change transitions from an event, chosen or not, to a threshold experience of meaning.  

We will integrate Aaron Antonovsky’s theory of coherence, and Milton Erickson’s therapeutic messaging as useful constructs to offer additional structure and clinical awareness to how we view and engage with transitions and introduce cognitive transformation and response shift as constructs that complicate and enrich care over time.

Terry Altilio LCSW is a Palliative Social Worker with over 30 years of direct practice in acute care setting.  She is a recipient of a Mayday Pain and Society Fellowship Award 2006 and a Social Work Leadership Award from the Open Society Institute’s Project on Death in America to support a social work post graduate fellowship and a social work listserv that currently networks over 900 social workers.  In 2013, Terry was selected to receive the Project on Death in America, Career Achievement Award from the Social Work Hospice and Palliative Network. She lectures nationally and internationally on topics such as pain management, ethics, palliative care and psychosocial issues in serious illness care, teaches in post masters programs at NYU, Smith and is guest faculty in an online course sponsored by the Shiley Haynes Institute for Palliative Care, California State University. In addition to co-authored journal publications, she is co-editor with Shirley Otis- Green and John Cagle of the Second edition of the Oxford Textbook of Palliative Social Work, 2022 and co-editor with Bridget Sumser and Meaghan Leimena of Palliative Care – A Guide for Health Social Workers published in 2019.  Most recently she has co-edited Mirrors and Windows Reflections on the Journey of Serious Illness Practice and in 2025 shared in the launching of the website “Palliative Social Work.”

Vickie Leff is a Palliative Care Consultant and an Adjunct Instructor at the Wurzweiler School of Social Work. With over thirty-five years of clinical practice experience in oncology, palliative care, and hospice, Vickie presents on topics such as moral distress and sustainability to several national educational organizations and institutions. She has served as the Executive Director of SWHPN and prior to that as the Executive Director of the Advanced Palliative Care & Hospice Social Work Certification (APHSW) board. Vickie’s work has been published in Health Affairs, the Journal of Pain and Symptom Management (JPSM), Journal of Palliative Medicine and other journals with a focus on moral distress, debriefings and sustainability. She is a member of the Board of Directors for the Center for Practical Bioethics. She is an editor of the book Mirrors & Windows: Reflections of the Journey in Serious Illness Practice and co-author of Helping Children Cope when someone they Love has a Serious Illness. Vickie earned her Master of Social Work from Simmons School of Social Work. In 2025 shared in the launching of the website “Palliative Social Work.”

Continuing Education Hours

Completion of this class will result in the receipt of two (2) continuing education hours. CEHs are not awarded for partial completion of the class.

You will receive the Zoom link for joining the class by the day before the class. IF YOU HAVE NOT RECEIVED THE LINK BY THIS TIME, PLEASE CHECK YOUR SPAM FOLDER. 

You will need a computer and a reliable WiFi connection. The computer may be a desktop or a laptop. It may be an Apple or Windows computer.

If you have never used Zoom before, you will likely be prompted to download an applet, which is a small program that allows Zoom to communicate with your computer. This is safe and you will need to do this to join the class.

It is NOT advised that you participate using a table (e.g., an iPad) or a cellular phone. The software is not optimized for these devices.

Please plan to join the online class 15 minutes before the start time to be sure that you don’t have any problems connecting. We cannot provide technical support to you and refunds won’t be offered if you have technical problems. If you have any questions or concerns about this, please contact us at [email protected] at least a few days before the class.

Please contact [email protected] if you have questions, concerns, or grievances about this course, or if you need ADA accommodations.

Course Interaction and System Requirements

This live webinar takes place on Zoom and is fully interactive. Attendees may ask and answer questions throughout the presentation and participate in instructor-led discussions.

Operating systems

• Windows:
  • Windows 11
  • Windows 10
    Note: Devices running Windows 10 must run Windows 10 Home, Pro, or Enterprise. S Mode is not supported.
• macOS:
  • macOS X (10.15) or later
• Linux:
  • Ubuntu 20.04 or higher
  • Mint 20 or higher
  • Red Hat Enterprise Linux 9.0 or higher
  • Oracle Linux 9.0 or higher
  • CentOS 9 or higher
  • Fedora 32 or higher
  • OpenSUSE 16 or higher
  • Debian 11 or higher
  • ArchLinux (64-bit only)
  • Other Linux OS with GCC 9.4 or higher

Internet Browser

• Desktop
  • Chrome: Within the current and past 2 versions
  • Firefox: Within the current and past 2 versions
  • Edge: Within the current and past 2 versions
  • Safari: Within the current and past 2 versions
• Mobile
  • Safari: Within the current and past 2 versions
  • Chrome: Within the current and past 2 versions
  • Firefox: Within the current and past 2 versions

Broadband Internet connection

Cable, High-speed DSL & any other medium that is internet accessible.