Who Cares: A Holistic Approach to Staff Wellbeing in Child Welfare Lesley Harding Staff Care and Wellbeing Practitioner DHS Child Protection SMR George Habib Discipline Senior Psychology ELMHS Southern Health 14 th Nov 2011
The Organisational Context Child Protection Southern Metropolitan Region Low completion rate of DINMAs and Workcover claims within the CP workforce A coping culture?? Low retention rates In 2008/9 losing over 3.5 staff per month. High rates of resignation amongst front-line staff and those with less than 18 months experience Under-utilisation of existing support mechanisms EAP, Human Resources, CIRM Service and generally crisis driven. Minimal understanding within the Program of staff distress as a normal reaction to out of the ordinary events i.e. the context of the work task and dealing with complex and hard to engage families Cultural environment of task based supervision practice and low compliance rates minimal investment in developing capacity and meeting all functions of Supervision practice management, support, development and mediation All these factors indicated a need for change within the Program
Cultural Change The Ripple Effect The Importance of Staff Wellbeing at Every Level Political and Community Understanding of CP
Southern Metropolitan Region Child Protection Wellbeing Strategy Three components to the Strategy built over a two and a half year period Psycho education program Staff wellbeing sessions Peer Support Program
Psycho-education Program Building Resilience and Work Wellbeing Looking After Ourselves Purpose of the Program To deliver information and heighten awareness of the nature and psychological impact of secondary and cumulative traumatic stress, and related themes including resilience, self and team care strategies. Elicit participants views on supports and strategies to manage workplace stresses Consider participants feedback to further inform organisational strategies Contribute to reducing staff turnover
Psycho-education Program Program Development Conducted focus groups with team leaders to elicit staff stressors and potential wellbeing strategies Identified key messages for psycho-education program and developed the program Promoted the program with Regional Management Group to build the case for a preventative approach and enhance staff attendance Scheduled workforce attendance with Work Health unit
Psycho-education Program Participation in Program 13 sessions provided to SMR Child Protection teams in first two months 97 Child Protection staff attended (Approx 50% of region s workforce) Up to 20 participants attended per group Since then, Program is offered to all new SMR Child Protection practitioners
Psycho education Program Key areas included: Wellbeing and resilience; Nature and impact of secondary and cumulative traumatic stress signs and symptoms Influencing risk factors and protective factors Normalising impacts of the work on staff wellbeing Compassion fatigue signs and management strategies Proactive self care and team care considerations
Psycho education Program Program Format 3.5 hour program Interactive discussion based approach Team group exercises and activities DVD on compassion fatigue; normalising effects of the work Workbook, including key reference material Evaluation
Psycho education Program Key Findings Benefits to attending sessions in team groups Smaller groups more conducive to interactive sessions Reflective group exercises well utilised in the sessions and particularly benefitial Representation across teams allowed for comparisons of experiences and sharing of self care strategies Value of ongoing regular team forums for peer support identified
Psycho education Sessions Key Findings (cont) Isolation more likely for those without routine support structures Overall recognition of importance of balanced lifestyle; variable experiences A buddy /mentor experience benefited practice and wellbeing A formal peer support program was viewed as a way to improve practice and wellbeing Benefits identified in the importance of quality supervision and reflective practice forums
Wellbeing Sessions Purpose Provide a regular, contained and safe environment for team members to discuss and reflect on the impact of their work, and to develop and review self care and team care plans Identify individual and systemic factors compounding stress levels Provide education and promote peer support on vicarious trauma, stress management and related areas Increase staff wellbeing and job satisfaction levels and contribute to reducing staff turnover
Wellbeing Sessions Preparation Discussions with relevant managers for workplace themes, team needs and issues that may present Confirm function of Wellbeing Sessions is understood and do not replace other staff supports such as supervision, team meetings etc Ensure communication plan for emerging issues that does not breach confidentiality but provides a conduit for arising concerns
Wellbeing Sessions Structure Commenced with higher need units in March June 2010; units most exposed to highly stressful situations or at risk of cumulative distress 131 participants participated during that period Since then other regional work units have been regularly participating in Wellbeing Sessions Small team groups of 6-8 participants were encouraged Included team leaders, students Sessions were of 90 minutes duration Scheduled 6 8 weekly on average
Wellbeing Sessions Process Facilitated by Staff Care and Wellbeing Practitioner Clear statement of purpose and process Detailed introductions if a new team or team re-forming Semi structured forum. Open questioning by facilitator; opportunity for group to lead the discussion with facilitator focusing on the developmental needs of the team
Wellbeing Sessions Process (cont) Guided discussion - employing activities, questionnaires and individual and common experiences Selected educational material provided e.g. vicarious trauma, anxiety, grief, stress management, mindfulness, meditation Peer support key influencing feature underpinning the Wellbeing Session model
Wellbeing Sessions Preliminary Findings Valued dedicated time and place for staff to engage in own care and wellbeing Sessions seen to complement other existing support structures Provided a contained environment to discuss stressors and develop strategies Reduced isolation Increased self awareness and capacity for self care Experienced significant benefits of peer support and connection
Wellbeing Sessions Preliminary Findings (cont) Team care development promoted team unity and cohesion Increased usage of CIRM service Staff Care and Wellbeing Practitioner utilised in a confidential capacity Discussed common workplace experiences causing distress Valued educational materials Team leaders with practitioners attended to some occupational stressors
Wellbeing Sessions Challenges Achieving regularity in scheduled sessions in high demand operational environment Ensuring function of sessions is achieved in time available Managing group dynamics and group size Maintaining confidentiality and duty of care responsibilities
Peer Support Program Purpose To provide a Peer Support Program for staff of the Southern Metropolitan Region Child Protection Service in order to access support and referrals to other support services through trained peers.
Peer Support Program Benefits of Peer Support Programs Contribute to reducing staff turnover Increase staff wellbeing and job satisfaction levels Impact positively on achieving better client outcomes Build on supportive relationships through training and a coordinated program dedicated to enhance informal support Complement existing support structures
Peer Support Program Planning Researched existing Peer Support models Considered existing practice guidelines and other key sources Identified benefits to the workforce Developed project brief, including communication plan Established Regional Child Protection Peer Support Program Reference Group Promoted Peer Support model and benefits within workforce; focus on managers and key positions in the program
Peer Support Program Planning (cont) Development of practice guidelines Raised profile of program through promotional material and activities Sought expressions of interest for peers according to established criteria Selection process; sought 10% of workforce Development and delivery of a 4 days training program
Peer Support Program Implementation of Program Peer Support Program operational from August 2011 Statistics maintained by Peer Support Coordinator Support for peer supporters Independent evaluation pending (of all three components)
Peer Support Program Emerging themes to date: Clear role definition essential for Peer Supporters Some staff approached peers in separate work units; others in their own Reasons for contacting peers primarily workplace based; some are personal issues impacting on the work Peer support at times is favoured because it is accessible support and less stigmatising Peers are accepted because they understand the work pressures
Peer Support Program Challenges Achieving greater integration of a the Peer Support Program into a high demand operational service Engaging a higher level of proactive management support Recruiting managers as peer supporters Continuing to develop creative approaches to further raise the program s profile and increase utilisation
Conclusion The literature consistently highlights the benefits to practitioners of forums for reflection on the emotional challenges of working with children and families who have experienced trauma and grief. These in turn are seen as more likely to lead to the practitioners becoming more emotionally responsive to children and families and improving the quality of engagement and outcomes with difficult to reach families.