Resilience Building in Child Protection Social Work: Findings from Doctoral Research Northern Ireland and Beyond

Transcription

1 Resilience Building in Child Protection Social Work: Findings from Doctoral Research Northern Ireland and Beyond Dr Paula McFadden Queens University Belfast September 2014

2 Overall Aim of the Investigation To examine factors related to resilience and burnout in child protection Social Work in statutory and voluntary sector provision in Northern Ireland.

3 Methodology of the Study Mixed methods Quantitative questionnaires 79 items (n = 162) with validated psychometric tests including a burnout measure (MBI), resilience measure (RS14), organizational factors (AWLS) and demographic variables. Questionnaire also included qualitative questions on burnout and resilience 5 HSC Trusts + Vol Sector Regional response rate 43 % 30 Semi-structured interviews (15 In Post, 15 Leavers )

4 3. Impact of Current Economic Downturn Motivation for job can be purely economic opposed to professional Can Result in undesirable retention Feelings of being stuck Vacancies sometimes filled with underpaid agency staff Individuals unable to move job due to lack of job alternatives (Westbrook, 2006, Burns, 2012) Exit strategies cost of absenteeism, sick leave, maternity cover (found to be an exit strategy) Team cohesion diminished due to individuals not being happy uncommitted and strong desire to leave Team leader role put under stress trying to manage this group of staff

5 Maslach Burnout Inventory Results 22 items measuring 3 subscales Emotional Exhaustion (EE) Depersonalisation (DP) Personal Accomplishment (PA) Results 41% (n =66) scored high EE 33% (n = 54) moderate EE 26% (n =42) low EE Therefore almost three quarters of the sample (74%) scored moderate to high in EE. This subscale measures feelings of being overextended and exhausted by ones work.

6 Resilience Scale - 14 and Areas of Work Life Scale RS14 14 items measuring Resilience Scores range Greater than 90 is high resilience moderately low to moderate resilience 60 or below indicate low resilience Results 17% (n=27) High Resilience (more than 90) 79% (n=128) Moderately low to moderate 4% (n=7) Less than 60, low resilience AWLS Used in the measurement of work engagement (opposite of burnout) Six subscales, scores range from 1-5. Less than 3 = Incongruence / Burnout More than 3 = Congruence / Job Engage Workload 83% Incongruent/17% congruent Reward 45% Incongruent/55% congruent Values 35% Incongruent/65% congruent Fairness 43% Incongruent/57% congruent Control 54% Incongruence/46% congruence Community 13% Incongruence/87% congruence

7 Predictors of Resilience Multiple Regression Analysis Negative result between emotional exhaustion and resilience. Therefore as emotional exhaustion increases resilience decreases and as levels of emotional exhaustion decrease resilience increases. Personal accomplishment is also a significant predictor of resilience. When personal accomplishment increases resilience levels also increase. Gender is also significant as females are significantly more resilient than males. In relation to post qualifying awards, those who are qualified at levels 2-6 and other specialist level awards are significantly more resilient than those with no post qualifying awards. The other post qualifying award levels were found to have a non significant effect on resilience levels.

8 Predicting Emotional Exhaustion Workload does predict emotional exhaustion. Individuals who score low (>3) on the AWLS workload scale (which is associated with incongruence and burnout) score high on emotional exhaustion. For every unit increase in the workload score emotional exhaustion decreases by This means that as workload scores indicate congruence (increase) or a fit between an individual and their workload demands, emotional exhaustion decreases significantly. Depersonalisation also predicts emotional exhaustion. As depersonalisation scores increase emotional exhaustion increases. For every one unit increase in depersonalisation, emotional exhaustion increases by This means that the when individuals score high on depersonalisation (reduced feeling for service recipients) their scores on emotional exhaustion also increases. Resilience was also found to be a predictor of emotional exhaustion. As resilience increases, emotional exhaustion decreases. Those who score high on RS14 indicating high resilience, score significantly lower on emotional exhaustion. People who are more resilient are less prone to emotional exhaustion.

9 Predicting Depersonalisation As emotional exhaustion increases, depersonalisation increases. For every one unit increase in emotional exhaustion, depersonalisation increases by This means that DP predicts EE. (As feelings of depersonalisation increases, emotional exhaustion increases). Gender is also a significant predictor of depersonalisation. Females have lower depersonalisation scores than men (p < 0.05).

10 Predicting Personal Accomplishment These results show that being female predicts personal accomplishment in that females have higher levels of personal accomplishment than males. Higher levels of resilience predicts higher personal accomplishment. Going from no post qualifying award status to post qualifying award credits (2-6) predicts higher personal accomplishment.

11 What does this mean? There are a chain of events that are interlinked and predictable High incongruence with workload leads to EE Depersonalisation is associated with EE. This means that as feelings of depersonalisation increases, emotional exhaustion increases. Those with high resilience are less prone to EE High levels of resilience predicts higher personal accomplishment. High levels of personal accomplishment is associated with being female and going from no PQ to PQ 2-6

12 Some Qualitative Findings Good management support, particularly in the first year of practice is a significant source of resilience for staff. Peer support and cohesive teams an important factor for individuals who wish to remain in child protection. The absence of this makes workers consider job alternatives and wish to leave. Some social workers reported commitment to the job. A degree of commitment which is not sustainable over time. Social workers estimated that 75-80% of the job is paperwork and bureaucracy.

13 Significance of Manager Experience Qualitative responses to question regarding experiences of resilience and burnout 72 % mentioned experiencing some level of burnout at points in their career More than 50 % (54%) said that resilience was down to relationships with manager One in three said that burnout was due to lack of support from their manager Some experienced a burnt out manager

14 Love the buzz from the job.. More than half of those in post interviewed (n = 8) said they loved the job. Jane Family Support SW 2 years + I do think to work in family and childcare you have to be someone that works well under stress and to be honest that s one of the things I love about the job, the buzz. Because no matter how worn out you are if there s a crisis you respond to it because you just get a buzz from it It s energising to know that your work makes a significant difference to peoples lives.

15 Commitment to the Profession Making a difference in peoples lives. Two thirds (n = 10) In post interviewed reported a commitment to the job because of the importance of role. Janet, almost 6 years qualified and working with Family Support The fact that you re making some small difference to some of the families and I think that s the most important thing for me

16 Staff Turnover Two thirds in post (n = 10)made reference to turnover and poor retention of experience in teams. Charlotte, Senior Practitioner Family Support, 4 years+ But I mean I think it s just at a point that people accept that this is childcare and you do it for so long and you have to get out. Y know, three and a half years do it, get out, cos it s never going to change. People are not listening to us that we need more staff on the ground and, y know, it s sad because what happens is experienced staff are being lost Ciara, AYE SW Family Intervention Team I was willing to leave with nothing to go to. I was willing to become unemployed because I just thought I just can t actually do this anymore.

17 Personality Differences It is clear that personality differences impact on whether the individual will be able to cope with the demands of child protection social work. More than half of leavers (n = 8) and almost a third of those still in post (n = 4) acknowledged that personality differences are important to consider in light of those who stay or leave child protection. Costa and McCrae (1992) developed the big five personality trait theory that contends that there are five broad personality traits that are fixed and measurable that can be identified. These are openness, conscientiousness, extraversion, agreeableness and neuroticism. In relation to burnout, the only consistent findings are derived from the big five personality dimensions which have found a link between neuroticism and burnout. Neurotic individuals are emotionally less stable and more prone to psychological distress (Deary et al 1996; Perrewe & Hochwarter 2000).

18 Dangerous Practice A minority of in post social workers (one fifth) expressed concern about dangerousness due to poor management and leadership in practice. The concern around safe practice was particularly expressed by early career social workers who felt unsupported in their new role. Poor confidence levels were expressed about the quality of management support and peer support available due to the high turnover of staff in some teams. The levels of inexperience in some teams was a concerning finding.

19 Fear of Child Death and the Media Fear of child death is a common fear amongst child protection social workers. A number of those interviewed expressed this fear in various ways (n = 7). When there is a national tragedy such as Baby Peter Connolly that they feel strongly that a similar tragedy could be missed in their caseloads due to all the pressures of the role. The media are hard on social workers and there is a feeling that social work can not be defended due to the confidential nature of the work.

20 The Ability to Build Resilience Sir Michael Rutter (2010) According to Rutter, resilience is an interactive concept that can only be understood in relation to risk and protective factors. Rutter draws an example from medicine whereby it is the introduction of vaccinations that acts to prevent further disease, thus suggesting that it is the introduction of adversity that builds resilience. Develop this concept further and one could argue that child protection social work could be a breeding ground for building resilience. However this needs to be viewed in the context of risk and protective factors that sustain individuals in this important and demanding role.

21 Systematic Literature Review 11 Databases Searched ASSIA CINAHL Cochrane Library GS300 Index to Theses Medline Psych Info Social Care Online Social Services Abstracts SSCI ZETOC Relevant Studies Selected 69 (n = 2878 Hits) 10 Themes Emerged Individual Themes Organizational Themes Outcomes (Paper on themes submitted to BJSW)

22 Systematic Literature Review Individual and Personal Themes Personal history of maltreatment. Training and preparation for Child Welfare Coping Strategies Organizational Themes Workload Social Work models of intervention (vicarious resilience) Social support and supervision. Organizational Culture and Climate and intention to stay or leave. Organizational and professional commitment and intention to stay or leave. Outcomes Job Satisfaction/Dissatisfaction Secondary Traumatic Stress, Compassion Satisfaction, Compassion Fatigue

23 A Strategy for Social Work in Northern Ireland Strengthening the capacity of the workforce 1. Valuing the workforce/building confidence: improve employer supports for social workers in carrying out their work; 2. Building capacity/meeting demand: improve workforce planning and deployment of social workers to meet demand; 3. Adding value/delivering outcomes: promote a culture of continuous improvement and a focus on demonstrating the outcomes and learning from practice; and 4. Developing expertise/supporting accountability: support the development of professional expertise and the individual accountability of social workers.

24 Required to Implement change A Mind Set Shift Flow Process Analysis - Follow the individual through the various interfaces of their career from recruitment to Degree throughout their subsequent career. Stakeholders Four Target Audiences 1. NISCC (Regulator) 2. Individual 3. University 4. Employer

25 Flow Process Analysis of the Social Worker Career Personal and Professional Development

26 Phases of SW Career Phases in Flow Process of Social Work Career 1. Point1 - Individual Pre-training 2. Point 2 - Selection on to the Degree 3. Point 3 - Process of Training Theory and Practice 4. Point 4 - Recruitment into Social Work Job Organizational Culture and Climate Point 5 - Assessed Year in Employment 6. Point 6 - Organizational Culture and Climate 7. Point 7 - Workload

27 Phase 1 Pre-Training According to findings from the systematic literature review, workers who have had a personal experience of maltreatment, may be more susceptible to secondary traumatic stress than those who have not (Bride, 2007, Conrad, 2006, Aclaro- Lapidario, 2007, Caringi 2008, and Van Hook, 2009). It is argued that personal experience of maltreatment may contribute to empathic skills of workers who are exposed to trauma in others. It is therefore important to note that the factor that may have motivated staff to enter a caring career may contribute positively or negatively to their practice.

28 Phase 1 Recommendations (Regulators) Renewed emphasis on need for staff care regulation (Individual) Self Awareness and Commitment to Personal Development (University) Recruitment and Selection Issues (Employers) Mindfulness about duty of care to staff

29 Phase 2 Recruitment to the Degree Specialism versus genericism Rotation of contract Introduction of concept at point of recruitment USA Title IV Schemes employer and university partnerships

30 Phase 2 Recommendations (Individual and Employers) Student Selection (personality differences openness to self awareness) Student Willingness to be Self Aware / self care Models from USA and Alternative Models

31 Phase 3 - The Process of Training Recommendations (Regulators) Curriculum Design Personal Development in Curriculum (Individuals) Personal Responsibility (Universities) Teaching and Learning Methods (Links between practitioners and students real life simulations)

32 Phase 4 Employment Selection USA Model Employment Selection Programme (ESP Model, Ellett 2009) Current selection needs to be reviewed Ellett argues that selection needs to be based on knowledge, skills, dispositions and capabilities to be competent at working with child protection cases.

33 Phase 4 Recommendations (Regulators, Universities and Employers) Reality Orientation in Recruitment, Preparation and Teaching Strategies Buddying schemes and networking opportunities between student and practitioners Universities and Employers - Lecturers into Industry opportunities

34 Phase 5 Assessed Year in Employment Recommendations (Employers) Early career experiences (Employers) Importance of line manager support (Employers) Significance of supporting managers

35 Phase 6 Organizational Culture As organizational culture and climate is affected by the practices, attitudes, management style and actions of management and staff, it is within the gift of organizations to manipulate the factors that would enhance positive organizational culture. Organizations have a duty to promote positive practices to increase the efficacy in staff and provide the mechanisms for quality supervisory support and management. Culture Vulture Mid Staffs findings duty of candor. Ignore Culture at your peril

36 Phase 6 Recommendations (Employers) Supervision Supportive, quality supervision, consultation, mentoring, and leadership that values employees leads to worker retention (Ellett, 2006). Line managers should be trained in person centred models of supervision that provide workers with a sense of efficacy and personal accomplishment within the job.

37 Phase 6 Recommendations (Employers) Line Manager Supervision Line managers should receive a prescribed level of supervision to support their own support, learning and professional development. They could also benefit from peer supervision and learning as a method of support in their role.

38 Phase 6 Recommendations (Individuals and Employers) Team and Peer Support Peer and team support should be encouraged and staff should be supported to engage in reciprocal and mutually beneficial team work in the process of their role. This can include co-working, buddying and mentoring arrangements from senior to junior staff.

39 Phase 7 Workload Issues Recommendations (Regulators / Employers) job redesign. (e.g. Contact Arrangements Sessional Workers) Caseload Weighting and Workforce Capacity (Time analysis) Strengths Based Models of Intervention (versus Paternalistic models of intervention) Bureaucracy and Paperwork work life balance

40 Recommendations Phase 6-7 (Regulators, Individual and University). Participation in PQ Awards and Other Training workload pressures need to be relieved to encourage staff participation. (Individuals and Employers) Coping Styles Active coping is characterised by assertive employees who are emotionally expressive, positive use of line manager support and supervision, good diet and exercise and healthy sleep patterns. Other active coping methods include the use of holistic therapy and counselling as well as having positive relationships, social networks, spirituality and humour (Raubichaud, 2004).

41 Recommendations Phase 6-7 It is repeatedly evidenced that emotional expressiveness is a strong resilience factor (Gilgun, 1990, 1991, 1992, 1996b, 1999a, 1999b, 1999c.). Team meetings are a good source of shared resourcefulness and camaraderie and meetings should be regular and offer staff the opportunity to contribute to agenda construction. This will facilitate expressiveness and openness about issues that are common and meaningful to staff

42 Conclusion Mindset shift required in order to work towards resilience in child protection social work. Emphasis on self knowledge and individual responsibility to uphold ethical principals of self care Educators and employers have a duty to ensure that those that are recruited into the Degree in SW or employment are fully aware of the demands of child protection social work. Personality type might be used as part of the recruitment process. A shift to rotating contracts would reduce the feeling of being stuck and allow skills and knowledge to become enhanced across a range of practice areas (SW Strategy Work Stream) New emphasis on employers, educators and regulators to create and recreate the conditions for developing the individual throughout their career journey. Ultimately, that children and families are provided with quality service from highly skilled and motivated staff who are engaged in the job (as opposed to burnt out) is the main goal of this research.