Explain the extent to which the organization contributes to unrealistic expectations.

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TRANSCRIPT – Case Studies

Overview of the Organization

Berkshire Community Health (BCH) is a comprehensive healthcare facility serving western Massachusetts. BCH’s central campus consists of emergency services; specialty medical units, including a leading oncology department; a behavioral health therapy unit; and a social work team. Social workers are integrated throughout the facility to support behavioral health and interdisciplinary care. The social work team is supervised by Janell Morris, who is empathetic and supportive. Janell communicates effectively and encourages team-building through regular check-in meetings. The team is close and compassionate with one another. However, social workers often experience conflict with other collegial relationships beyond the team. As they are embedded within various units in the facility, they must work in interprofessional collaboration with other disciplines. Overall, social workers are devalued outside of the social work team. Recently, BCH rolled out a public relations campaign in which they declared the organization to be “trauma-informed.” However, no organization-wide policies or procedures have been implemented that reflect trauma-informed principles, nor were social workers consulted in the development of the campaign. To support the health and wellness of staff, the organization has an employee assistance program that is available 24 hours a day, 7 days a week. The organization also offers premier health insurance for full-time employees. Full-time constitutes working at least 36 hours a week.

Social Worker 1: Tyrone Tyrone is a 41-year-old male social worker who identifies as heterosexual, Black, and Latino. He is a divorced dad to a teenage daughter and shares custody with his ex-wife. Tyrone conducts individual therapy with clients at BCH to address mental health and substance use. In his therapeutic role, Tyrone sees individuals with complex trauma who have high therapeutic needs, compounded by high case-management needs. The expectation for this role is to see seven or eight clients per day, a standard that Tyrone has kept up with throughout his employment over the past 4 years. Substance Use and Work Tyrone, who has no recent history of substance use, has started drinking one to three glasses of wine at night and “nips” of alcohol during the workday. Tyrone explains that he “feels emotionally numb” and has difficulty concentrating and completing tasks at home and at work. He has begun to avoid people, places, and things that remind him of

© 2023 Walden University, LLC

work with his clients, and he has also canceled sessions with clients who have higher levels of trauma to “stop my heart from pounding.” Tyrone complains of decreased sleep due to nightmares, difficulty falling asleep, and experiencing anxiety, but reports that he can “handle it on my own” by “doing what I need to do.” He has also expressed that he doesn’t know why he continues to meet with clients because “I’m not going to help them in the end anyway.” Social Support and Self-Care Tyrone describes limited social support. He declined invitations to social events for months, and, when he did attend, he’d just frustrate his friends by talking mostly about work. He also started expressing the belief that something bad is going to happen and that there is little hope for anything to change in the future. When friends attempted to confront Tyrone about their concerns, Tyrone became angry and irritable. Tyrone stopped attending church 3 months ago because he was “too tired” to go. He had previously identified church as a primary support. Tyrone reports a positive relationship with his ex-wife. He also reports a good relationship with his parents, who live a couple hours away. For self-care, Tyrone attempts to journal 3 or 4 days a week and takes short walks with his dog in the morning and evening. Anxiety Tyrone describes a recent event in which his 16-year-old daughter came home several minutes late from a social event. He began thinking of a client he was working with whose child had been murdered. Tyrone was pacing, looking out the window, and texting his daughter repeatedly because he became extremely anxious about her whereabouts.

Social Worker 2: Mei Mei is a 25-year-old female social worker who identifies as heterosexual and Asian American. She lives with her mother 1 hour away from BHC but is planning to move into her own apartment in an area more convenient to work. In her role at BHC, Mei is an emergency room social worker who performs psychological assessments and manages crises. Mei recently had an annual physical with her primary care physician, during which she complained of gastrointestinal (GI) upset. The primary care physician confirmed GI upset as well as high blood pressure and weight gain due to binge eating. The physician has referred Mei to you for therapy. Work Mei explains that work has become difficult for her, especially the unpredictability of the days in the ER. She is expected to work four 10-hour shifts a week and is also expected to take additional shifts as needed, due to a high rate of staffing turnover. Mei finds it

© 2023 Walden University, LLC

difficult to separate personal and professional life as a helper, often thinking about her cases on the commute to and from work. On one morning’s commute, a car veered into her lane, and she was slow to react. She regretted that it did not result in an accident because then she “wouldn’t have had to go to work.” Mei reports feeling trapped by her job and that the work no longer satisfies her. She had thought she was doing what she wanted, but is now feeling like she made a mistake in choosing this line of work. Despite feelings of avoidance, Mei has difficulty setting boundaries with work and often stays for 12–14 hours. She feels as though the job is never finished. Her behavior is reinforced by colleagues in the ER telling the team to be “like Mei.” Physical Health Mei’s physical health has declined over the past year. She has gained 50 pounds because she often eats fast food, as it is “easier and more satisfying.” When Mei returns home after work, she eats several snacks and watches dramas on a streaming video service and “zones out.” She does not feel that she has the energy to exercise. Social Support and Self-Care In this same timeframe, Mei has felt herself losing a sense of connectedness to others, both personally and professionally. She has two childhood best friends who hold her accountable and are expressing concerns. However, she has reduced her time engaging socially with her friends and with her younger cousins, who are like siblings to her. In the early mornings at work, Mei feels particularly bad in her stomach and has been avoiding completing assessments in the ER at that time. Mei continues to engage in faith-based practices and has a good relationship with her mother, even though her mother is often already asleep when Mei returns home from work.

Social Worker 3: Destiny Destiny is a 52-year-old female social worker who identifies as queer and White. She lives with her partner, Candace. At BHC, Destiny serves as a case manager on the specialized oncology interdisciplinary team. Destiny and Candace have been fighting, with Candace reporting that Destiny’s mood is unpredictable and that she gets upset “over the littlest things all the time.” In a recent argument that became particularly hostile, Candace broached the subject. “Hey, I’ve noticed that you are more irritable lately…. What can we do differently?” Destiny denied being irritable. She yelled and threw her phone, and then said, “All you ever do is point out what I do wrong! What about what you’re doing?” Following the argument, Candace urged Destiny to see a therapist.

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Mood Destiny and Candace have been fighting, with Candace reporting that Destiny’s mood is unpredictable and that she gets upset “over the littlest things all the time.” In a recent argument that became particularly hostile, Candace broached the subject. “Hey, I’ve noticed that you are more irritable lately…. What can we do differently?” Destiny denied being irritable. She yelled and threw her phone, and then said, “All you ever do is point out what I do wrong! What about what you’re doing?” Following the argument, Candace urged Destiny to see a therapist. Work Destiny reports that she has been calling out from work on a regular basis. She is enraged by the policies of the organization that require taking on additional shifts due to staffing turnover. Additionally, Destiny had a recent conflict with colleagues in oncology regarding how they treat her and “talk down to her” as the social worker on the team. She made an initial angry comment, but now feels it is “pointless” to try and find a resolution because “it won’t make a difference.” Destiny states that day after day, she sees suffering and pain, and for the past 10 years she’s seen more people die than in all the previous years of her life. Social Media Use Destiny’s partner, friends, and colleagues have all commented on the excessive use of social media. Candace states that Destiny feels the phone is more important and only wants to connect with people who “are social media friends.” Coinciding with the increased use of social media, Destiny has started to withdraw from her partner. When she does communicate with Candace, the communication is filled with anger, yelling, and frustration. Destiny displays limited insight into why she might be irritable or avoidant. Social Support and Self-Care Destiny draws on the supportive relationships with her parents and in-laws and the bond she has with her supervisor, Janell, as they have worked together for 10 years. In the past, Destiny has enjoyed hiking and reading mystery novels. She also loves playing with her cat.

(Illustration by iStock/ALAA ASHRAF)

Health

Burnout From an Organizational Perspective Instead of pressuring already-stressed individuals to fix themselves, true wellness requires organization-level interventions.

By Leah Weiss Oct. 20, 2020

The term “burnout” �rst came into use in the early 1970s

in the context of air tra�c control, after an increase in

human error-precipitated collisions was linked to

frustrations with increased tra�c, poor human-machine

interfaces, and the general monotony of the work.

Described by the WHO as “resulting from chronic

workplace stress that has not been successfully managed,”

burnout is characterized by “feelings of energy depletion

or exhaustion, increased mental distance from one’s job, or feelings of negativism or cynicism related to

one's job; and reduced professional e�cacy.” But just as the early research on burnout showed it to be a

fundamentally systemic problem—since the air tra�c controllers being studied were extremely well-

trained in coping with stress (many were military veterans)—more recent researchers also describe the

causes of burnout as collective, and impossible for an individual to �x without a systems perspective.

Factors like overwork or insu�cient resources play a role in burnout, but according to Christina

Maslach, of University of California, Berkeley, and Michael Leiter, at Saint Mary’s University, it’s at least

as important to focus on fairness, transparency, and purpose in the workplace. Comparing workers to

cucumbers in vinegar, Maslach said: “We should be trying to identify and analyze the critical

components of ‘bad’ situations in which many good people function. Imagine investigating the

personality of cucumbers to discover why they had turned into sour pickles without analyzing the

vinegar barrels in which they had been submerged.”

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Burnout is undeniably costly. While individuals with full-blown cases can lose months and years of

wages and carry the burden of expensive mental health interventions, more than half of all professionals

fall somewhere on the burnout continuum. Burnout increases risk of coronary disease and type II

diabetes, is associated with lower heart rate variability—generally understood to be indicative of reduced

worse health and aging—and there have been studies of telomeres (protective caps at the end of

chromosomes) that indicate telomere shortening usually associated with biological aging. Burnout has

neurological implications, associated with thinning in the prefrontal cortex, larger amygdala, and

smaller caudate, giving people less capacity for decision-making and implicating memory, attention, and

emotion regulation. And beyond the physical implications of burnout, there are signi�cant economic

and social costs: Beyond the cost of treating burnout, research indicates severe consequences for

burnout on relationships, especially our closest relationships. A partner of someone who burns out is at

higher risk for burnout themselves, especially given compassion fatigue. Burnout costs organizations

$120-190 billion a year, a rate comparable to cancer, at $172.8 billion in losses a year.

How can we stop blaming cucumbers for becoming pickles? How to mitigate the acidity in the

environment? Individuals can’t yoga or meditate their way out of burnout. Indeed, heightening pressure

on already-stressed individuals to “�x themselves” only perpetuates the cycles of stress. Organization-

level interventions are needed.

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The Causes of Burnout

If we can better understand what causes burnout, we can detect it before it unfolds into complete

mental and physical collapse. This means learning how to recognize an early phase symptom like

“workaholism” for what it is, before it blossoms into a crisis.

Causes of burnout can appear at all three levels of an organization:

Individual Causes

Personal predispositions and character, such as perfectionism, and positive a�ect

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Personal situations, such as the stress we experience, the support networks we have created for

ourselves, or the type of job we are in

Personal coping and regulation mechanisms, such as how well we are able to self-regulate our

emotions and process them

Team-Level Causes

Underlying team structures, such as the size of the team, how they collaborate, and how they get

things done

Atmosphere created within the team, such as the degree to which people communicate openly

and are able to take risks

Organizational Causes

Level of transparency in the organization, such as how readily leadership shares salient

information with employees

Organizational structures, such as vacation time and other bene�ts and role clarity

Wellness Is Not the Answer

Wellness in the workplace is an $8 billion industry in the United States, and forward-thinking

workplaces may think they are doing a great service by o�ering yoga, meditation classes, and other

wellness services. But the research reveals that those e�orts are not working. A 2019 Harvard Medical

School study published in the Journal of the American Medical Association (JAMA) shows that

workplace wellness programs had no impact on overall health, sleep quality, nutrition choices, health

markers, or health care usage, failing to move the needle on the very issues that they claimed to redress.

The programs also failed to improve basic workplace metrics such as absenteeism, performance quality,

and retention of key employees.

The current spend on wellness is not �xing the problems it targets. So what can? First, we must broaden

our de�nition of the term and better understand that burnout is not a yes or no (you have it or you

don’t) condition.

Burnout Is a Spectrum That Can Be Measured

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With a broader view of what burnout is—less like an o�/on switch and more like temperature-taking—

we can begin to measure burnout. As the saying goes: “If you can’t measure it, you can’t improve it.”

New de�nitions of burnout have allowed us to recognize that:

Burnout is not binary. Most believe that one has the condition or does not have it. Yet it is actually

a spectrum and one that starts with seemingly harmless symptoms.

Burnout is distinct from depression and anxiety. Although it has some overlapping symptoms, it

de�nitely manifests di�erently and is often caused by a broader set of environmental factors.

Burnout should not be con�ated with compassion fatigue. Compassion fatigue is a speci�c

subset of burnout—associated with medical professionals, teachers, and social workers—which

relates to the diminishment of empathic response over time. But it’s a misnomer in the sense

that compassion does not become depleted whereas empathy does. Compassion activates the

reward response in the brain, but empathy �res the pain response, mirroring the pain of the

person being supported. Burnout is primarily a response to job demands, fairness, transparency,

and other issues beyond responding to pain over time.

There are various measures of burnout: the MBI (Maslach Burnout Inventory), the CBI (Copenhagen

Burnout Inventory), and Freudenberger’s 12 stages of Burnout. But current measurement tools here are

limited in three main ways:

�. They often confuse symptoms of burnout with risk factors of burnout, which is like equating

someone having genetic predispositions to a condition with having it.

�. They are designed to be measured at an individual level only, despite the fact that most causes of

burnout are either outside an individual’s control or informed by their environment.

�. They do not segue easily into action-taking, which is particularly problematic for a condition

whose de�nition includes a lack of personal e�cacy. Providing results without providing

immediate assistance in action-taking is at best careless, and at worst irresponsible.

Organizational Awareness

Early intervention o�ers the possibility to mitigate damage. While it takes an average of 14 months to

two years to recover from full-blown burnout, catching burnout upstream in an earlier phase can reduce

cost and length of interventions. To do this requires organizational awareness from leadership and

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managers, and requires regular collection of data at the individual, team, and aggregate levels of

burnout.

I argue for the imperative to create action-oriented, team-based diagnostics, since it is easy to miss

burnout at the individual level. It’s hard, if not impossible, to self-assess because early stages of burnout

masquerade as workaholism and believing you aren’t at risk is a risk factor. The causes of burnout are

social, and its measurement should re�ect that. It is critical to understand how clusters of people are

faring with burnout in order to lead to interventions that work. Individual-level action-taking is hard

because it’s hard to stay accountable and often stigmatizing. But change can be harnessed at the team

level. By going to the team-level, you spread the responsibility out and make it easier to stay accountable.

Team action-taking is also more nimble and can happen more quickly versus trying to change an entire

organizational culture at once, which can be quite complicated.

A better diagnostic approach would ask questions at all three levels—individual, team, and organization

—to understand both the cucumber and the vinegar it �nds itself in:

“Do you see the world as a place full of opportunity?”

“Do you feel a sense of autonomy and voice in your team?”

“Do you feel that reward systems in your organization are fair and transparent?”

In case studies we’ve done with medium and large organizations, diagnostic tools have helped

organizations determine where they are on a burnout spectrum and take e�ective actions: what gets

measured can be improved.

With Entrepreneurs Organization we worked with a team of 150 people that completed full burnout and

resilience diagnostics, which included 33 risk factors that contribute to burnout risk. We were able to

extract the three major themes for the organization to focus on, and to sequence action-taking based on

their scores and organizational needs. This burnout work will be embedded in their strategic planning

at the highest levels for cultural change, bene�t change decisions, and training budget decisions. In

addition, each of their 11 teams received customized action-planning support based on their results

which included: team coaching with highly quali�ed and trained coaches, and nudges that are

customized to each team’s chosen course of action. 

At Space Center Houston, we worked with a team of 50 who completed diagnostics to assess their

burnout risk factors. In 2020, Houston has been speci�cally hit hard by both the COVID-19 pandemic

and natural disaster damage caused by Hurricane Laura, so organizations in the area have been

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incredibly sensitive to burnout within their teams. The data from our diagnostic outlined patterns of

risk factors that recurred across individual, team, and organizational level. The results of those will

allow for more thoughtful decision-making around bene�t, training and culture change decisions for

the organization today and in the future.

There are also lighter lift entry points for getting started. For example, Stanford Hospital sta� members

were given a two-minute quiz (link here) to better understand their resilience typologies as a group,

helping them understand what might make them more or less at risk of burnout as an individual and as

a team. They also got a snapshot of their motivational styles and coping strategies that set them up for

conversations on how they could support one another more e�ectively.

How to Create a Burnout Shield

While it may be frustrating to know that more meditation won’t necessarily save individuals from

burnout, there are organization-level strategies that companies can take up to safeguard their greatest

resources, their people. Programs that are directed at individuals can have an impact, but only for about

six months or so. But when the intervention targets the organization (e.g. task restructuring, evaluation

changes, supervision shifts impacting job demand, and ability to in�uence decision-making) the impact

lasted up to a year. When the personal and organizational are combined the impact is longer and

stronger. But it is critical to realize that burnout work can’t be done as a one-o�; it needs to be a constant

e�ort over time.

Examining Managerial Behavior. Research shows that bad relationships with direct managers account

for 75 percent of turnover. Too often, managers are incentivized to focus on short-term productivity

metrics and are not trained to understand what is needed for sustainable individual and team

performance. Extensive research by the military on sustainable performance in stressful conditions

teaches that leaders should become champions of health, rather than taskmasters that drive teams and

organizations to burnout.

Upholding Fairness and Transparency. There are some interesting pieces of research on the fact that

even monkeys value fairness. We are wired this way. As a result, when promotions are distributed

unfairly, it contributes to burnout. This is especially true for groups that experience bias and

microaggressions daily, who see themselves, and people who look like them, sidelined from

advancement in the organization. People need coherence, purpose, and fairness to be healthy. Managers

must understand that the behavior they model and the way they distribute work steers their team

toward health or dysfunction and determines the ensuing human and organizational cost.

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The Role of Health Intrapreneurs. Health intrapreneurs are essentially educated champions (often self-

designated) who take a leading role in building sustainable workplaces, a strategic component of their

role and their company’s edge. Health intrapreneurs understand the interplay between the workplace

and its impact on employee health and vice versa. From an organizational perspective, health

intrapreneurs support engagement and retention, both key bottom line metrics across sectors. The

steps toward becoming a powerful team health intrapreneur in an organization often include intrinsic

interest in the subject, early adoption of best practices, and experimentation with ways to enlist

employees in the vision of creating energizing workplaces. Intrapreneurs, or health champions, are

leaders (often self-designated) who spark social innovation within their companies. They can a�ect

change in an incredibly powerful way because they are close to the problem and can recruit agents of

change such as managers and team leads into their e�orts.

Focusing on the Four Pillars of Team Resilience. The four pillars are designed to instruct organizations

on how they can begin to make lasting change at the cultural and organizational level, rather than

putting the burden on individuals alone. These four keystone components are critical to moving toward

a culture that’s more protected from burnout and its resulting churn. The four pillars of Team

Resilience are:

Self-Awareness. Teaching individuals to know their triggers, needs, and their sense of purpose.

Ensuring that within teams there is enough vulnerability for people to share what they see as

their purpose, strengths, and values is essential.

Autonomy. Team members must have an appropriate balance of autonomy and support in the

work they do.

Structured R&R. The team needs guard-rails on intensity and quantity of work. Managers need to

ensure workloads are evenly distributed, and that time for rest is protected and even encouraged.

Community. For burnout to be truly guarded against, team members need to feel a sense of

community, collaboration, loyalty, tolerance, and psychological safety.

Where We Go From Here

The ubiquity of toxic organizations can and must end. We are in the right moment of history to make

major changes to what we expect from organizations, even as COVID-19 is rede�ning the barriers of the

home and work. We have massive, irrefutable data that catalogues the downside of ignoring workplace

health, including the organizational costs and the ensuing human misery.

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Too often, the onus for well-being is placed onto the individual for issues that are, by their nature,

systems-level issues and often occurring at the team level as well. Until we reframe the conversation, we

can’t make critical changes to workplace culture and team structure, and the very real human pain and

economic damage that burnout leaves in its wake will continue to proliferate. We need a wellness 2.0

approach that takes into account the implications for individuals, teams, and systems. It is time for a

complete overhaul of how we understand workplace health based on research and data. From this

starting point, changes that move the needle can be implemented for the individual, the team, and the

organization.

Support SSIR’s coverage of cross-sector solutions to global challenges. 

Help us further the reach of innovative ideas. Donate today.

Read more stories by Leah Weiss.

Dr. Leah Weiss supports teams and leaders to implement data-driven approaches to resilience through her

teaching at Stanford Business School and with her company Skylyte Inc. Her book How We Work: Live

Your Purpose, Reclaim Your Sanity, and Embrace the Daily Grind has been translated into seven

languages and received acclaim by everyone from the Dalai Lama to The New York Times.

DOI: 10.48558/9cv0-c436

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Self-Care in Large Organizations: Lessons Learned at a U.S. Department of Veterans Affairs Residential Program.

Alenkin, Nikola R (AUTHOR) [email protected]

Social Work. Jan2020, Vol. 65 Issue 1, p91-94. 4p.

Article

*Psychological adaptation *Corporate culture *Job stress *Health self-care *Social workers *Human services programs

United States

United States. Dept. of Veterans Affairs

The article explores self-care for social workers working in large organizations, focusing upon conditions at the U.S. Department of Veterans Affairs (VA), the largest employer of master's-level social workers in the United States. Particular focus is given to the VA Greater Los Angeles Healthcare System (GLA), which serves more than 1.4 million veterans, and to a residential program there. The article delves into how occupational settings impact stress levels for social workers, housing for veterans within the GLA and the prevention of secondary traumatic stress (STS) for mental health professionals.

West Los Angeles VA Medical Center, Department of Veterans Affairs, Los Angeles, CA

2476

0037-8046

10.1093/sw/swz041

141313816

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1

1

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SocINDEX with Full Text

Self-Care in Large Organizations: Lessons Learned at a U.S. Department of Veterans Affairs Residential Program

As the largest employer of master's-level social workers in the United States, the U.S. Department of Veterans Affairs (VA) employs more than 12,000 social workers. In addition, the VA provides clinical internships for more than 900 graduate-level social work students from more than 100 graduate schools of social work ([14]). The VA Greater Los Angeles Healthcare System (GLA) main hospital and services center is located in Los Angeles and is also referred to as the West Los Angeles VA Medical Center (WLAVAMC). There are other satellite and ambulatory clinics within the GLA located in downtown Los Angeles (Los Angeles Ambulatory Center), in Sepulveda (Sepulveda Ambulatory Care Center), and in other parts of Los Angeles County ([13]). The Los Angeles County area has the largest concentration of veterans of any county in the United States, with over 1.4 million veterans within the service area ([13]). WLAVAMC provides a broad range of medical, surgical, and psychiatric care in areas such as internal medicine, cardiology, and infectious diseases. WLAVAMC also offers major surgical subspecialties including orthopedics; urology; neurosurgery; ophthalmology; plastics; ear, nose, and throat; podiatry; and cardiac surgery ([13]).

To complete the continuum of care, there are two 120-bed community-living centers located on the grounds that are offered to veterans. Also on-site is a residential-care 289-bed Domiciliary Residential and Rehabilitation Treatment Program (DRRTP) that provides rehabilitation programming in a therapeutic environment to prepare veterans for reentry into the community ([13]). WLAVAMC employs more than 500 social work staff, which includes more than 30 graduate social work student interns from the local social work graduate programs (for example, University of Southern California; University of California, Los Angeles). It also employs more than 100 psychologists whose primary duty is the psychological testing and diagnosis of veterans, along with individual and group therapy.

Role of Occupational Setting and Stress and Coping The occupational settings in which social workers operate may affect how much stress they experience; consequently, development of self-care within these settings becomes vitally important. Social workers are employed in various practice settings within health care, including inpatient hospital settings (for example, primary or acute settings), skilled-nursing facilities, residential settings, and outpatient care settings ([ 6]). Social workers perform a variety of tasks within these specific practice settings, from assessment of the patient's needs to advocacy for end-of-life issues. Within health care settings, inpatient care has historically been the single largest employer of clinical social workers ([ 8]). Social workers who practice in inpatient settings are tasked with screening for admissions, psychosocial assessments, discharge planning, and postdischarge follow-up ([ 5]). However, in more recent years hospitals have moved toward expanding the role of social workers to providing services in outpatient settings. Social workers in outpatient settings provide services such as group facilitation, case management, and crisis intervention to help stabilize clients while they

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are in the community. This often means collaborating with physicians and community health organizations outside of the hospital setting ([10]).

The health care setting creates greater occupational stress as role ambiguity and ideological work philosophies become sources of conflict for social workers. Social workers struggle to work in an environment that relies on medical-model approaches to work when their own training and education ask them to work within psychosocial models ([12]). The increased stress as a result of this role confusion can exacerbate stressors and, without development of self-care by the individual or organization, can be detrimental to social workers and the clients to whom they provide services. Other organizational characteristics of the health care setting that may increase occupational stress include high caseloads; a sense of "devaluation" of the social worker; a quick turnover in patient populations; and ongoing exposure to patients who may have experienced traumatic accidents, acute or chronic illness or injury, and psychiatric conditions ([ 3]; [ 4]; [ 7]).

Stress As Experienced by Social Workers within a VA Setting The DRRTP is the largest residential program on campus, housing 289 veterans, with seven interdisciplinary teams. Each team comprises social workers, addiction therapists, psychologists, and vocational rehabilitation specialists. These teams are tasked with case management services, discharge planning, and linkage to other services respective to individualized treatment plans. Each team is tasked with caseloads of 20 to 60 veterans; as is typical of the veteran population, many present with posttraumatic stress disorder (PTSD) symptoms, substance abuse issues, and other psychosocial concerns. In 2011 I conducted a study that found at least 50 percent (n = 63) of social workers rated their secondary stress symptoms as "mild" or "moderate" and 9.6 percent (n =12) rated them as "high" or "severe" ([ 1]). Social workers were also asked to report "belief in" and "time spent" on coping strategies such as self-care (for example, engaging in exercise, eating well), supervision (for example, access to supervision), and research and development (for example, engaging with other professional social workers, conducting research). Self-care such as meditation and exercise has been shown to be helpful in mitigating stress for social workers. A recent National Association of Social Workers (NASW) study found that 70 percent of social workers who worked in an identified health practice area described "fatigue" as a stress-related health concern, and 74 percent of the participants also reported exercise as a useful coping strategy ([ 2]). This coping strategy was rated highest among both genders and several ethnicities ([ 2]). This same study also found that exercise was the highest-rated coping strategy (75 percent) for those in a health practice area. Other notable coping strategies identified by social workers in this study were meditation and therapy ([ 2]).

If social workers are to effectively engage in work with clients, especially veteran populations that are complex in nature and may present with many psychosocial issues (for example, PTSD, substance abuse, traumatic brain injury), self-care must be accessible at the individual and organizational levels. Organizational values and culture often set expectations for work in social work and how the individual uses organizational supports in their respective settings. It is important that organizations providing services to traumatized populations acknowledge the impact of trauma not only on the individual worker, but also on the organization as a whole. Professionals who experience stress within organizations affect the clients with whom they work; workplace stress can affect social services delivery in the areas of client diagnosis, treatment planning, and patient care, including errors such as misdiagnosis of clients, poor treatment planning, or abuse of patients ([11]; [15]).

Role of Organizations and Stress

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Current trends in organizations to reduce administrative costs have led to increases in paperwork, increased workloads, and further elimination of social supports for mental health professionals. A work environment that is safe and comfortable for both employees and clients can reduce stress responses.

Education about work with traumatized populations can be another possible way to manage or prevent the impacts of secondary traumatic stress (STS). As newer and inexperienced professionals are brought into the organization, [11] suggested that organizations have an ethical duty to warn new professionals about the risks of work with traumatized populations. This may include a discussion about the impacts of STS during employee orientation. NASW also recognizes that self-care can be a strong foundation for a practice that is effective and ethical in nature ([ 2]).

Organizational resources that provide self-care are also vitally important in the management or prevention of stress. Using a self-care framework can allow organizations and administrators to focus on aspects of self-care practices and policies that promote self-care rather than contribute to stressful organizational environments. These aspects are (a) workload and time management, (b) attention to professional role, (c) attention to reactions to work, (d) professional social support and self-advocacy, (e) professional development, and (f) revitalization and generation of energy ([ 9]).

Development of Self-Care Programs within Organizations Within GLA, a renewed emphasis on self-care began in the spring of 2011, with the development and implementation of a train-the-trainer model of mindfulness and compassion practices geared toward providers for use with veterans. This program, VA Compassionate Action Learning Modules (VA CALM), provided clinicians and veterans with the access to learn mindfulness-based stress-reduction techniques with the goal of extending these mindfulness-based practices for use with veterans.

In 2012 the program was expanded to include a full-time mindfulness instructor (a psychologist by discipline), the first position of its kind within the VA system. The program was further enhanced with the development of the first Mindfulness Facilitator Training Certification program within the entire VA system in 2014 to further educate and train clinicians in mindfulness-based stress-reduction techniques and practices.

Within the DRRTP, these efforts inspired our social work services to develop a mindfulness-based stress- reduction "drop-in" session for clinicians in 2017. Every morning, clinicians within DRRTP were offered the opportunity to sit together a set time (8:15 a.m.) to listen to a guided self-love meditation. Clinicians soon began to habituate to this practice and saw it as a part of their daily work, in turn creating a mindfulness practice within the workplace. The elements that led to the development of this practice and the five recommendations that follow may be considered by others within a similar setting to create a self-care program.

Define a space that is used for the practice alone. We use a clinician's office space, but any dedicated space for this practice can allow a unique sense of detachment from the work role into a "mindfulness role."

Work within the organization and not against it. Although the 2011 study I conducted indicated high levels of stress and little in the way of organizational efforts to assist in managing this stress, it was an opportunity. The opportunity became the recognition that programs like VA CALM had utility within the organization, which led to our efforts in 2017 in developing our mindfulness sessions.

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Incorporate a period of trial and error to assist clinicians and organizations in identifying the "best fit" for their program. Starting small with one or two clinicians and expanding to others through word of mouth is the key to growing these programs.

Integrate research efforts to validate and create sustainability for these types of self-care programs. Within the efforts of VA CALM and the Mindfulness Facilitator program, research was done to substantiate their effectiveness, which further enhanced sustainability and expansion of the programs.

Integrate these practices within the role of the work itself. Social workers often face multiple issues of role strain or role ambiguity that create stressors for them, particularly in hospital settings ([12]). When self-care exists within the role of the clinician, it assists in reducing the level and severity of role strain and ambiguity. Starting small is the key to development of larger programs.

Conclusion The demand for social workers and social services delivery will only increase in the coming years. As this demand rises, so too will the stress that these professionals will face. Organizations that can offer self-care methods to their staff can create environments where self-care becomes second nature to the work environment, and the resulting impacts of reduced stress will help in facilitation of service delivery. Organizations such as the GLA, although large in scope, can begin to implement programs similar to this one, with very little cost and time expenditure. Our critical roles as change agents are not only meant to be used toward our consumers and groups, but also within organizations and institutions as well. As we turn to look at ourselves, we can see incremental change throughout these organizations.

Nikola R. Alenkin, PhD, LCSW, is supervisory social worker, West Los Angeles VA Medical Center, and full- time lecturer, School of Social Work, California State University, Los Angeles. Address correspondence to the author at West Los Angeles VA Medical Center, Department of Veterans Affairs, 11301 Wilshire Boulevard, Building 217, Los Angeles, CA 90073; e-mail: [email protected]. This material is the result of work supported with resources and the use of facilities at the West Los Angeles VA Medical Center.

References 1 Alenkin, N. R. (2011). Secondary traumatic stress: Social workers in a Veterans Affairs health care setting. Loma Linda University, ProQuest Dissertations and Theses. Available at http://search.proquest.com/docview/881096430?accountid=14537

2 Arrington, P. (2008). National Association of Social Workers Membership Workforce Study—Stress at work: How do social workers cope? [Report]. Washington, DC : National Association of Social Workers. Google Preview # WorldCat COPAC

3 Badger, K., Royse, D., & Craig, C. (2008). Hospital social workers and indirect trauma exposure: An exploratory study of contributing factors. Health & Social Work, 33, 63 – 71. Google Scholar Crossref Search ADS WorldCat

4 Dane, B., & Chachkes, E. (2001). The cost of caring for patients with an illness: Contagion to the social worker. Social Work in Health Care, 33 (2), 31 – 50. Google Scholar Crossref Search ADS WorldCat

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5 Diwan, S., & Balaswamy, S. (2006). Social work with older adults in health-care settings. In S. Gehlert & T. Browne (Eds.), Handbook of health social work (pp. 417 – 447). Hoboken, NJ : John Wiley & Sons. Google Preview # WorldCat COPAC

6 Gehlert, S., & Browne, T. (Eds.) (2006). Handbook of health social work. Hoboken, NJ : John Wiley & Sons. Google Preview # WorldCat COPAC

7 Gellis, Z. D. (2002). Coping with occupational stress in healthcare: A comparison of social workers and nurses. Administration in Social Work, 26 (3), 37 – 52. Google Scholar Crossref Search ADS WorldCat

8 Ginsberg, L. (1995). Social work almanac (2nd ed.). Washington, DC : NASW Press. Google Preview # WorldCat COPAC

9 Lee, J. J., & Miller, S. E. (2013). A self-care framework for social workers: Building a strong foundation for practice. Families in Society, 94, 96 – 103. Google Scholar Crossref Search ADS WorldCat

Mizrahi, T., & Berger, C. S. (2005). A longitudinal look at social work leadership in hospitals: The impact of a changing health care system. Health & Social Work, 30, 155 – 165. Google Scholar Crossref Search ADS WorldCat

Munroe, J. F. (1999). Ethical issues associated with secondary trauma in therapists. In B. H. Stamm (Ed.), Secondary traumatic stress: Self-care issues for clinicians, researchers, & educators (2nd ed., pp. 211 – 229). Lutherville, MD : Sidran Press. Google Preview # WorldCat COPAC

Pockett, R. (2003). Staying in hospital social work. Social Work in Health Care, 36 (3), 1 – 23. Google Scholar Crossref Search ADS WorldCat

U.S. Department of Veterans Affairs. (2017). VHA social work. Retrieved from https://www.losangeles.va.gov/about/index.asp

U.S. Department of Veterans Affairs. (2018). VHA social work. Retrieved from https://www.socialwork.va.gov/index.asp

Williams, M. B., & Sommer, J. F. (1999). Self-care and the vulnerable therapist. In B. H. Stamm (Ed.), Secondary traumatic stress: Self-care issues for clinicians, researchers, & educators (2nd ed., pp. 230 – 246). Lutherville, MD : Sidran Press. Google Preview # WorldCat COPAC

~~~~~~~~ By Nikola R Alenkin

Reported by Author

Address correspondence to the author at West Los Angeles VA Medical Center, Department of Veterans Affairs, 11301 Wilshire Boulevard, Building 217, Los Angeles, CA 90073; e-mail

© 2020 National Association of Social Workers. Copyright of Social Work is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the

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copyright holder's express written permission. However, users may print, download, or email articles for individual use.

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IPRPD

International Journal of Business & Management Studies

ISSN 2693-2547 (Print), 2693-2555 (Online)

Volume 03; Issue no 08: August, 2022

DOI: 10.56734/ijbms.v3n8a2

Compassion Fatigue as an Ethical Threat to Practice:

Supervisor and Agency Responsibilities in Preventing Worker

Burnout

Stephanie Hicks –Pass 1

1 Department of Social Work, Austin Peay State University, USA

Abstract

Social workers are at risk of developing compassion fatigue and burnout due to their professional

responsibilities. Recently, the NASW has incorporated self-care as an ethical requirement for our

profession placing even more emphasis on social workers to care take of themselves as well as care for their clients. However, what are the ethical responsibilities of the employment agencies in the prevention

of compassion fatigue and burnout in the social work profession? This article will explore compassion fatigue and burnout as an ethical dilemma and the subsequent responsibilities employers bear in

preventing burned out in the employee pool in order to avoid unintentional harm to clients.

Keywords: Social Worker, Burnout, Professional, Responsibilities, Emotions

The National Association of Social Workers recently made notable changes to the professional code of ethics of

addressing self-care as an ethical responsibility of social workers and was accomplished this by adding self-care as

a component of the Code of Ethics for the social work profession in 2021 (Murray, 2021). The development in the

most recent revision of the Code of Ethics brings explicit attention to self-care and its importance for all

practitioners. This revision places ethical importance of self-care as well as care for clients on the professional as a

professional and ethical responsibility (Murray, 2021). Historically, social workers have been well indoctrinated

into the concept of ethical responsibilities for client care, however, the NASW now places responsibility for self-

care as a prerogative. It is now time for supervisors and agencies to understand their ethical responsibility in

employee self-care as well.

The high rate of social worker burnout and compassion fatigue has well documented and well researched

in the last decade, and has been especially important to address in light of the last few years of the Covid 19

epidemic. Practitioners have been inundated with techniques and to reduce stress such as mindfulness, mediation,

yoga, exercise, stress rooms at work and while these techniques have benefits, this article will explore the ethical

responsibility of supervisors and the supervisory roles in reducing compassion fatigue. What responsibility do the

supervisors and agencies hold to ensure that workers do not become unnecessarily burned out? It is overly

simplistic to place the responsibility on the individual worker to care take their own mental health when their

employment system is challenging. Thus, what roles do the supervisor and agencies assist in reducing the burnout

threats social workers face in everyday practice settings? What can the agency do to assist its practitioners in

preventing burnout and retaining good workers? Before we get to those concepts, first, let’s explore the issues of

compassion fatigue and burnout.

Review of Literature

Burnout and compassion fatigue are common threats that lurk within the social work field. Charles Figley earlier

has defined compassion fatigue as “the formal caregiver's reduced capacity or interest in being empathic or

“bearing the suffering of clients” and is “the natural consequent behaviors and emotions resulting from knowing

about a traumatizing event experienced or suffered by a person” (Figley, 1995). The definition has evolved over the

last three decades to, however, the intent remains similar, and the reduced ability to cope with caregiving

responsibilities. Figley goes further to explain that compassion fatigue and burnout share similarities and can co- exist but are somewhat different (Figley, 1995). Burnout, while an older term, developed in the 1960s to address

the feelings of distress that free health care clinic workers were experiencing while treating vulnerable patients

(Freudenberger, 1974) The term has been expanded to include any type of employment-related stress regardless of

occupational field.

Vol. 03 – Issue: 08/August_2022 ©Institute for Promoting Research & Policy Development DOI: 10.56734/ijbms.v3n8a2

10 | Compassion Fatigue as an Ethical Threat to Practice: Stephanie Hicks –Pass

Compassion fatigue and burnout share similarities and are often mistaken for the same problem, however, burnout

is often experienced as a type of fatigue that is more specific and often experienced from helping and caring for

others who are in high-stress situations (Brennan, 2020). Compassion fatigue can occur with any helping

professional or caregiver, it carries deep emotional exhaustion, it can ebb and flow daily, and can be the result of

one exposure to trauma (or vicarious trauma) or repeated traumas (Newell and Gordon; 2010). When the provider

begins to feel that nothing they do will help the situation; when their viewpoint of the work is sk, which indicatesr

of compassion fatigue. Distorted thoughts such as feelings of hopelessness, depression, disconnection from reality,

and dissociation may follow the practitioner from the office to home affecting their home-life as well (Heath,

2018).

Burnout, on the other hand, is defined as “a psychological syndrome that involves a prolonged response to

chronic interpersonal stressors on the job” (Leiter & Maslach, 2004, p. 93). Burnout consists of three components,

emotional exhaustion, cynicism, and personal efficacy. However, emotional exhaustion is considered the central

element of burnout resulting in cynicism about one’s work and low efficacy (Leiter, Harvie, & Frizzell, 1998;

Leiter & Maslach, 2004; Maslach & Leiter, 1997). ) The two problems share overlapping symptoms thus for this

article the author has chosen to address the prevention of both issues as an ethical concern.

Unintentional Harm to Clients

While compassion fatigue and its associated burnout cause harm to the social worker in practice, it also

unintentionally causes harm to clients. The National Association of Social Workers recognized this when it added

the self-care component to the Code of Ethics. Compassion fatigue and burnout can present ethical dilemmas in the

workplace for practitioners. Being burned out in practice can result in social workers being distracted, feeling

poorly motivated, or being callous towards clients during the helping process, thus can impacting a social worker’s

engagement, assessment, and intervention with clients (Orpustan-Love, 2014). Recent research on nursing burnout

has found that nurse burnout is associated with worsening safety and quality of care, decreased patient satisfaction,

and nurses’ organizational commitment and productivity (Jun, Ojemeni, Kalamani, Tong, Crecelius; 2021). Like

nursing, the client-social worker relationship is built on trust and collaboration, thus, when the social worker is

distracted, hurried or overwhelmed success is threatened. Evaluation methods may suffer and the client may feel a

lack of rapport with the clinician. Furthermore, the social worker can find it more difficult to utilize a strengths

based approach when their own worldview is complicated by trauma and physical and environmental stress

(Gilbert, 2015). Among social workers, compassion fatigue tends to occur as a result of exposure to client suffering

and can result in the service provider experiencing a reduced capacity for or interest in being empathic (Adams,

Boscarino, & Figley, 2006; Figley, 1995) Compassion fatigue and burnout can result in a lack of advocacy on

behalf of the client as the social worker feels less “motivation to stand in that gap” or add one more task to a

growing list of duties is too overwhelming to even consider. The result of this lack of advocacy is that the client

feels that the social worker’s intention is false or that they lack reliability and connection with the client due to

experiencing burnout or compassion fatigue.

Furthermore, researchers have found when clients receive care from social workers who are burned out

and have plans on leaving their position, the clients report being less satisfied with their care than those with social

workers who appeared with higher reports of self-care (Landrum & Knight, 2011). As social workers become more

burned out, they are more likely to change positions (and/or leave the field) in order to find relief from the stress

symptoms (Heath, 2018). The combination of high caseloads and organizational stress has been cited in research as

reasons why child welfare workers are more likely to leave their positions in search of new ones (APHSA, 2005).

This creates more problems for the remaining workers with higher caseloads to cover the lost worker and a lack of

access for the clients to experienced clinicians (Heath, 2018).

Social workers care for the clients, however, there is a prerogative to also care for themselves. However, if

the agencies social workers employ have a responsibility to protect the employees. If a social worker is

experiencing burnout or compassion fatigue due to high caseloads, this can affect the agency’s mission. In the end,

the agency may lose qualified workers due to turnover. Perhaps, the bigger question is “What can be done to avoid

assist workers from becoming fatigued and burned out?” What role do supervisors play in assisting their workers

to prevent compassion fatigue and burnout?

Understanding Compassion Fatigue, Burnout, and Trauma as a Supervisor

Supervisory relationships have been defined as “a process, activity, and relationship(s), based in an organizational

professional and personal mandate, with designated roles, and boundaries, in which particular functions are

performed to facilitate the best/competent service/practice with clients” (Heath, 2018). In the working environment,

the supervisor is the role model, the mentor as well as the person who monitor the supervisee’s productivity, habits,

attitudes, and any other changes to the professional context. The supervisor is responsible in guiding the employee

in the development of self-monitoring skills, time management, and utilizing self-care methods to prevent burnout,

©Institute for Promoting Research & Policy Development ISSN 2693-2547 (Print), 2693-2555 (Online)

11 | www.ijahss.net

it is the supervisor’s ethical obligation to intervene in situations where the well-being of a worker is being

compromised.

Social work supervisors hold an ethical duty to monitor the employment conditions and the employees to

potential areas of concern and make accommodations when possible. Furthermore, it is a supervisor’s duty to

monitor the limitations of supervisees and the potential impact of unintended harm. Beks and Doucet (2000) found

in their study that supervisees experienced fewer episodes of burnout when their supervisor assessed workers’

expectations and beliefs about client outcomes and interventions, as well as developing personal wellness plans,

and staying available for supervisees. It was also found when the supervisees modeled self-care behaviors and

healthy boundaries when the supervisor practiced these behaviors (Beks & Doucet, 2020).

Social work supervisors who understand burnout, compassion fatigue, secondary trauma, and vicarious

trauma can act as a mitigating factor in their supervisees' emotional and mental health and reduce the risk of their

workers developing burnout symptoms. Therefore, one of the many responsibilities of the supervisor is to become

familiar with potential indicators of burnout and compassion fatigue among employees (Kadushin et al., 2014).

Being aware of the physical impact of stress and burnout on employees, and being able to decipher the difference

between stress and burnout/compassion fatigue is an important tool for supervisors and relies on healthy

communication between the employee and the supervisor. For the supervisor, it can be easy to dismiss (or miss)

these symptoms especially as seasonal changes and general stress can lead to the same issues and are usually

temporary. The difference is that in burnout and issues such as compassion fatigue, these physical problems

become chronic. This highlights the importance of being able to observe patterns, which can help supervisors

determine whether office workers are getting sick because there is a virus going around the office, or if workers

have been getting sick every two weeks and showing signs of fatigue resulting from an excessively high and

emotionally taxing caseload.

Similarly, to the symptoms of depression, a person who is emotionally burned out will feel a sense of

hopelessness, feel discouraged and psychologically fatigued, and may feel resentment towards their job (Kadushin

et al., 2014). As a result, the quality of work decreases, and absenteeism and tardiness increase as mental and

emotional strain lead to avoidant behavior toward work (Kadushin et al., 2014). One way to combat these feelings

of hopelessness is healthy communication between colleagues such as through debriefing or clinical supervision

meetings. However, for these meetings to work, there must be a feeling of safety and collaboration between the

participants.

Creating Safe Spaces for Supervisees

Having healthy communication with employees was especially complicated due to the Covid pandemic. The era of

Covid 19 changed how supervision took place for many practitioners. Clinicians went from face-to-face interaction

to remote meetings with supervisors, while some have returned to face-to-face interactions, others may never return

to previous methods. Additionally, the need for services during Covid 19 changed as well, some services need

increased such as mental health and hospital services, while others may have decreased. While supervisors may not

have complete control over caseload levels they can control the quality of their supervision interactions. Research

supports that, regardless of which method of supervision (group, face to face, or remote), creating safe spaces and a

collaborative environment to discuss is of supreme importance. By creating “a safe, collaborative relationship”,

supervisees can “feel safe to explore their own lived experiences relevant to the work” (Krug & Schneider, 2016),

which augments self-reflection and, consequently, emotional intelligence (Ingram, 2013). A collaborative approach

to supervision invariably communicates the expectations of and reinforces trust within the supervisory relationship

(Krug & Schneider, 2016), and fosters trust in the supervisee’s ability to grow and self-direct (CSAT, 1999; Talley

& Jones, 2019). On the other hand, several sources highlighted the fact that though supervision and therapy serve

similar purposes in different contexts, the supervisory relationship must avoid crossing this professional boundary

of providing therapeutic services (Krug & Schneider, 2016; Stargell et al., 2020; Talley & Jones, 2019). The

supervisor must hold space for and support the supervisee, but it is equally important to recognize when the

supervisee’s concerns overextend the supervisor’s scope of practice (Krug & Schneider, 2016). Supervisees need to

feel comfortable in approaching the supervisor for assistance without fear of reproach and retaliation and

alternatively, supervisors must feel comfortable in that position.

Focus on Wellness; Stress Reduction

While this sounds simple in the text this is complicated in reality. The World Health Organization has identified

stress at work as a top concern listing the following problems as risk factors for mental health: inadequate health

and safety policies; poor communication and management practices; limited participation in decision-making or

low control over one’s area of work; low levels of support for employees; inflexible working hours; and unclear

tasks or organizational objectives (WHO; 2022)

Vol. 03 – Issue: 08/August_2022 ©Institute for Promoting Research & Policy Development DOI: 10.56734/ijbms.v3n8a2

12 | Compassion Fatigue as an Ethical Threat to Practice: Stephanie Hicks –Pass

This report goes further to give ideas on how employers can promote wellness at work by implementing and

enforcement of health and safety policies and practices, including identification of distress, harmful use of

psychoactive substances, and illness and providing resources to manage them; informing staff that support is

available; involving employees in decision-making, conveying a feeling of control and participation; organizational

practices that support a healthy work-life balance; programs for the career development of employees; and

recognizing and rewarding the contribution of employees (WHO 2022).

Furthermore, when discussing burnout, Maslach and Leiter (1997) identified six areas of work life in

which mismatches between the person’s expectations and the job are considered to be predictive of burnout,

whereas a match is believed to enhance work engagement. These six areas are defined as follows: Workload or job

demands placed on an employee given a specified amount of time and resources; Control or opportunity for

employees to make important decisions about their work, as well as their range of professional autonomy and

ability to gain access to resources necessary to do their job effectively; Rewards or recognition for work

contributions, i.e., financial, social, and/or internal; Community or quality of the social context in which one

works, including relationships with managers, colleagues, and subordinates; Fairness or the extent that openness

and respect are present in the organization and the decision-making process; and Values or the representation of the

congruence between the organization’s priorities and values and those of the employee (Maslach and Leiter, 1997).

Perhaps by focusing on improving the quality of interactions in these areas, the risk of burnout can be reduced in

the agency overall.

Lastly, becoming an agency that is focused on employee wellness also means incorporating an attitude of

encouraging people to utilize vacation and sick days, to be able to work from home when possible, to have flexible

hours to accommodate family life needs, to hold remote meetings, outdoor meetings, meetings in alternative

settings to meet the need of the group. It is also an agency that encourages the use of Employee Assistance

Programs and normalizes talking of stress coping skills and family life in healthy ways. This is where the

supervisor can set the tone of the office culture. By focusing on stress reduction and wellness the overall health of

the workers can be improved. Wellness is a lifestyle.

Supportive Supervisor and Realistic Expectations

One article published in 2021, found that in particular, supportive agencies and supportive supervisors reduced the

social workers feelings of distress and helped build resilience in more novice social workers (Seng, Subramaniam,

Chung, Syed, Chong; 2021). Previous research supports the findings that organizational support can have a

mitigating effect on psychological distress of workers (Sull and Moore; 2015).

In the era of this busy, understaffed Covid 19 world, it is rather unrealistic to demand that all agencies

lower caseloads, create relaxation rooms and give days off for people’s birthdays. However, creating a supportive

office culture, and a healthy workplace environment usually begins with communication patterns as much as

material items. Pizza days and coffee cups are appreciated, but what is also appreciated is being recognized for the

work done. The ability to utilize vacation and sick days (the ability to have vacation and sick days as a benefit) and

supervisors that make the employee feel “heard” and “listened to”. Healthy workplaces make for healthy workers.

Conclusion

Supervisors are human too, and also prone to being overworked themselves. Thus, the entire responsibility cannot

fall on one level of management. Ethical care of the employees is a “top down” responsibility. However, the

supervisor provides a “cushion” for the employee. They are the advocate for the social worker, while the social

worker is the advocate for the client. The supervisor of the department has an ethical responsibility to protect the

clients and the employees from unintentional harm by safeguarding the department from being overworked and

overextended, thus keeping both parties safe. While compassion fatigue and burnout are both real and ethical

problems, they are not simple to resolve. They are, however, preventable in most cases. With proper oversight and

caretaking of the employees, healthy management, and departments can maintain a healthy workforce even with

challenging circumstances.

Works Cited

Adams, R. E., Boscarino, J. A., & Figley, C. R. (2006). Compassion fatigue and psychological distress among

social workers: A validation study. American Journal of Orthopsychiatry, 76(1), 103–

108. http://dx.Doi.org/10.1037/0002-9432.76.1.103

American Public Human Services Association. (2005). Report from the 2004 Child Welfare Workforce Survey: State agency findings. Washington, DC: Author.

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