Monday, May 19, 2014

Self-care: Stress and anxiety in social work

Stress and anxiety in social work: reflective supervision can help


With high levels of vicarious trauma and burnout in the profession, social workers need more support

Niven, D. (2014). The Guardian.

Taking care of social workers' mental health should be a high priority, especially in the current climate of high vacancy rates, large case loads, and great public pressure. Over the years the social work profession has failed – in my view – to fully support its workforce with the kind of supervision and support designed to keep staff healthy and as stress free as possible. The anxiety generated in their work has to be addressed. Most social workers' resources are between their ears, and if staff are burning out then those they work with are not getting the best service.

When delivering a training course called Empowering Social Work, I always mention the condition of vicarious traumatisation. This is experienced by professionals who are regularly exposed to other people's distressing experiences, and by empathising with them, are themselves affected by the trauma. This is a common condition among social workers, and can affect stress and anxiety levels. As Babette Rothschild said: "All emotions are contagious … both the ones that are pleasant and the ones that are unpleasant." People on the frontline experience this regularly.

Each day brings a regular diet of traumatic events, abusive behaviour towards the vulnerable, frustration at lack of resources, and guilt at your inability to fully service your workload. Work-related stress and anxiety has insidious, sometimes chronic effects on health and social interaction. Noticeably, sleep patterns change, enthusiasm for the job wanes, you regularly feel tired and are more accident prone, and have negative feelings towards colleagues and managers. All of this and more can lead to a creeping progression from feeling fed up to experiencing clinical depression. And all the above leads to an increased number of sick days, creating extra burdens on colleagues and the start of what can be a vicious cycle.

Many other professions insist on personal supervision time to look at the worker's feelings, health, and state of mind, as we know the negative outcomes of over-burdening staff with the work of absent colleagues or vacant posts. Secondary traumatisation is often a well hidden factor that takes skill to both uncover and work with.

There is thus real value in making time for reflective supervision. A personal example of this occurred with a member of staff called Alan (not his real name). He had been working with a family who were known to social services, but not considered particularly at risk or difficult to manage. Then the young mother died suddenly, leaving the father with two children under five. Following the bereavement his ability to care for the children and his own health and hygiene deteriorated. The children were more and more difficult for him to manage, and he developed a substance misuse problem, as well as being on prescribed medication for depression. In a short space of time the situation became highly risky for the children, even with considerable support going in to the house.

Alan himself had just separated from his partner and was showing all the signs of bereavement in his own right. He began to display a lack of energy and awareness, his analytical skills became blunted and he began to function on a formulaic basis. It later transpired that he too was on anti-depressive medication. It wasn't that he didn't recognise the weakening of his professional ability; he did, but was unable to ask for help. He started feeling increasingly angry and impatient towards his clients, and thought he was failing as a professional.

All through this, his manager didn't recognise the depth of trauma Alan was experiencing and beyond superficial enquiries did not instigate proper reflective practice. It illustrates how important maintaining the emotional health of workers is as their own state of mind is crucial to providing the best service.

It may be that their immediate manager, for whatever reason, is not the best person to offer supervision. In an incredibly busy team environment it is difficult to strictly ring fence time, but other professions are much more rigid about the opportunity to engage with a trusted person and examine their own emotional health. It is unsurprising that the level of burn out is high in social services, especially for frontline workers dealing with the most vulnerable and damaged people.

Social work stress and anxiety has to be reduced. It is partly a resource issue: the profession needs much more funding in order to employ more workers and reduce individual caseloads. Perhaps this would help counter the negativity towards social work from sections of the media determined to always blame, rather than understand.

David Niven hosts a weekly social work podcast, which can be downloaded here. You can follow him on Twitter @DaveNiven.

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