Moral distress among social workers: The role of insufficient resources

The present study examined moral distress among Finnish social workers and the role of perceived resource insufficiencies in explaining it. The aim was to shed light on this understudied phenomenon in the field of social welfare. The study focused on work‐related moral distress, defined as impaired wellbeing that is connected to the continual inability to implement actions that one considers morally appropriate. The survey data were collected with an electronic questionnaire between the years 2011 and 2012. The respondents (n = 817) were social workers in the public social welfare services and the overall response rate was 46.5 per cent. Nearly 11 per cent of the respondents reported experiencing moral distress and perceived resource insufficiencies strongly explained this experience. Moreover, social workers with moral distress reported that they were less willing to continue in their post, were more frequently on sick leave and had positive work‐related experiences less often than their colleagues who did not experience moral distress. Key Practitioner Message: ● The concept of moral distress is useful in describing the experiences of social welfare workers when they are unable to practise their profession according to their moral code and the emotional burden related to this inability; ● Perceived resource insufficiencies are strongly associated with experiences of moral distress among frontline social workers; ● Social workers experiencing moral distress are less willing to continue in their work, take sick leave more often and less frequently have positive experiences related to their work.     

The Work Experiences of Social Workers: Factors Impacting Compassion Satisfaction and Workplace Stress

Abstract

In 2015, over 6,000 licensed social workers in 13?US states responded to an online survey regarding perceptions and feelings about their work, as well as numerous personal and practice issues. Specifically, this study examined participants’ levels of compassion satisfaction and workplace stress, and then determined through multivariate analyses what demographic factors, behavioral and physical health problems, practice issues, fields of practice, and workplace environment issues impacted these two variables.

The findings indicate that participants demonstrated high levels of compassion satisfaction, with a wide range of workplace stress levels. Workplace environment issues had the greatest impact on both variables, with social workers’ mental health problems, physical health status, and certain demographic factors such as race also influencing them. Over 82% of respondents expressed agreement that they were glad that they chose social work as a profession. The results appear to demonstrate that despite being a potentially stressful occupation, licensed social workers tend to experience significant emotional satisfaction from their work. On the other hand, the results also highlight the need for further research to determine how to enhance support for social workers in the workplace in order to not only reduce workplace stress, but also to increase compassion satisfaction.     

Association of Personal Distress With Burnout,Compassion Fatigue,and Compassion Satisfaction Among Clinical Social Workers

ABSTRACT

Studies of empathy and empathy-related responding show that while some people respond to observing the suffering of another with a prosocial concern and urge to help the suffering person, others have an aversive, avoidant response that is primarily self-focused and aimed toward relieving their own distress rather than helping the other person. This self-focused response, labeled personal distress, is associated with various social and psychological problems. This article discusses the concept of personal distress and describes a study of licensed clinical social workers (n = 171) that examines the relationship of personal distress and three other aspects of the empathy construct with compassion fatigue, burnout, and compassion satisfaction. Results of ordinary least squares multiple regression analyses indicate that the model of empathy components and control variables explain 20% to 23% of the variance in the dependent variables. Personal distress is the only component of the empathy construct with significant associations with the dependent variables. Higher personal distress is associated with higher compassion fatigue and burnout and lower compassion satisfaction among clinical social workers. Implications for future research and for social work education are discussed.     

Compassion Satisfaction Among Social Work Practitioners: The Role of Work–Life Balance

Abstract

Previous research has established that social work practitioners are especially vulnerable to work-related psychological distress and burnout due to the high-stress nature of the profession, yet less research has focused on examining factors are associated with social worker retention. Emerging research on compassion satisfaction suggests that this factor could mitigate professional burnout, yet there is a gap in research focusing explicitly on examining compassion satisfaction among social workers. To address this gap in knowledge, this quantitative study collected survey data on practicing social workers who were alumni from a large southeastern university (n?=?120) to examine individual and organizational factors associated with compassion satisfaction. Multiple regression analyses revealed that higher levels of emotional intelligence, perceived work autonomy, and perceived work–life balance were associated with an increase in compassion satisfaction among experienced, licensed social work practitioners. Findings have implications for how social work employers can promote compassion satisfaction through cultivating emotional intelligence among practitioners, allowing social workers autonomy in decision making, and providing supportive work environments. Recommended directions for future research include longitudinal studies with large sample sizes that expound research on compassion satisfaction by examining the role of additional factors, such as client population, job role characteristics, and supervisor support.     

Helping the helpers: Post‐traumatic distress and need for help among Israeli social workers in foster care agencies following armed conflict

This study examined the associations between exposure to armed conflict, perceived support, work experience, needing help, and post‐traumatic distress among Israeli social workers in foster care agencies based on Conservation of Resources theory. The study used a mixed‐methods design. Six months after the end of an armed conflict, 82 social workers responded to a web‐based questionnaire with closed‐ and open‐ended questions. Results showed that exposure to the armed conflict was moderately associated with post‐traumatic stress symptoms and functional impairment. Only the workers' perceived need for personal help (but not help for professional matters) was positively associated with their psychological distress. The qualitative analysis suggests that social workers showed strengths and wanted help mainly to improve their professional skills. Yet they also elaborated on the complexities involved in conducting their professional work, especially home visits, because such visits put their own lives in danger and meant deserting their own families. Practice implications are as follows: Foster care agencies should make greater efforts to provide knowledge and skills, support, supervision, and a “safe haven” for their workers, in the context of armed conflict.     

Preventive therapy and resilience promotion: an evaluation of social work led skills development group work

Concerns have been expressed for some time about a decline in emphasis on therapeutic work in social work, notably articulated in the Munro Review. Further concerns have been expressed in child care that social workers have increasingly had to focus on child protection work rather than earlier stages of prevention. However, there remain opportunities for social workers through the development of new programmes. One development has been that of Behaviour and Education Support Teams: multi‐professional teams, containing as a key element social workers, and encouraging novel practices designed to help emotional stability and improved behaviour and education performance. This study reports on an evaluation of a social worker delivered school‐based social skills programme, which can contribute to the important area of resilience. This showed significant and sustained improvements in pro‐social behaviour and friendships. The implications of this for the therapeutic potential and professional role of social work are discussed.     

Mosaic of Difference

Summary

The professional literature has not adequately addressed the behavioral and social factors that contribute to different coping outcomes for African American elder caregivers as compared to non African Americans. Awareness and understanding of these unique experiences would better prepare professionals to work with such clients. This study examines the predictors of emotional distress among 46 African American women who provide care to dependent elderly parents. Multivariate statistical analyses show that elder caregivers' rating of quality of life, their years of caregiving, as well are their poor heath constitute significant predictors of risk for depression. The results of the study provide support for the inclusion of more culturally appropriate measures of caregiver distress, and provide insights to inform social work practice, policy and research concerning African American female elder caregivers in the 21st century.     

Critical Incident Debriefing and Social Work

ABSTRACT

A debriefing is a structured group process that responds to the cognitive, emotional, physical and social reactions resulting from disasters and other traumatic events. This article describes debriefings and reviews research critically examining their effectiveness. The author proposes ways that social workers can contribute to theoretical frameworks, expand debriefing models, contribute to skill development and advance debriefing research and scholarship.     

Hispanic Hospice Patients’ Experiences of End-Stage Restlessness

ABSTRACT

End-stage restlessness, or terminal agitation, is experienced by some patients during their final days and is characterized by physical, emotional, or spiritual distress, agitation or anxiety. End-stage restlessness negatively affects the patient’s death experience and can be distressing to the family and care team. Using the 2007 National Home and Hospice Care survey, this study examined factors associated with experiencing end-stage restlessness among non-Hispanic white and Hispanic hospice patients deceased at time of discharge. Results showed that being Hispanic/Latino, experiencing dyspnea, pain, and receiving palliative sedation treatment were risk factors for experiencing end-stage restlessness. The association between pain and restlessness was stronger for Hispanics compared with non-Hispanic whites. The Hispanic population remains underrepresented and little is known about the patient-centered experiences of Hispanic hospice users. Findings indicated that dying Hispanic patients continue to experience pain and other negative symptoms, even when hospice care is in place. Thus, it is important that social workers provide education to interdisciplinary team members about culturally competent practices, and advocate for a patient-centered approach to care.     

Reflective Debriefing: A Social Work Intervention Addressing Moral Distress among ICU Nurses

ABSTRACT

Health-care workers may experience moral distress when they are unable to act as they believe is ethically appropriate in their clinical work. A social worker-facilitated protocol called Reflective Debriefing was developed and tested for alleviating moral distress through regular debriefings with nursing staff on an intensive care unit (ICU). Forty-two ICU nurses completed a Moral Distress Scale-Revised (MDS-R) at the beginning and end of a 6-month period, during which time regular debriefings were offered. The overall level of moral distress on the ICU surveyed was found to be low to moderate. The top three most frequent situations causing moral distress reported by most nurses in this study were related to the provision of nonbeneficial care in the ICU. Participants reported gaining the most benefit from feeling empowered to constructively confront other staff members about truth-telling in giving a prognosis. Nurses’ overall response to the intervention was positive, with 100% of participants requesting to continue the Reflective Debriefing sessions either on a monthly or on an as-needed basis. The response to the intervention emphasized the importance of interprofessional collaboration to successfully combat moral distress among health-care workers and may protect them from burnout, detachment, and even quitting their profession.     

The Role of Family in Career Choices among Social Workers in China

Abstract

High turnover rate affects social work workforce development in China. Few empirical studies have been conducted to explore the factors that have influences on turnover intention among Chinese social workers. This study used data from China General Survey on Professional Social Workers to examine the influence of job satisfaction and family attitude on social workers’ career choices. The findings reveal that both job satisfaction and family’ attitude toward the profession have significant effects on social workers’ turnover intention. Family’s support or disapproval of the social work profession has moderate effect on the negative correlation between job satisfaction and turnover intention. The findings could be explained by the familyism culture of Chinese society and unique challenges of professional development experienced by social workers in China. Future studies should consider the influence of family to develop a more comprehensive research framework. Management in social service agencies should help family of social workers to learn and embrace the profession to gain their support of choosing social work as career.     

Social worker trauma: Building resilience in child protection social workers

Abstract

Child protection social workers can experience psychological trauma effects as a result of their work. This article considers the utility of the trauma perspective in understanding and intervening when overwhelming events impact social workers. Psychological trauma theory enhances earlier contributions of the stress and burnout literatures in the effort to increase the efficacy and well‐being of child protection staff. Resilience theories are relied upon to develop strategies for promoting optimal effectiveness of social workers who remain exposed to potentially traumatizing events.     

Importance of Research in Social Work Practice: A Pilot Study From Turkey

Abstract

It is highly important that social work practice be guided by scientific research and the resultant practices introduced to the literature. Social work research in Turkey is carried out by social work academics and practitioners. This dual position they occupy has not been thoroughly investigated in recent years; therefore, the aim of this research was to scrutinize the relationship social workers take when completing research in Turkey. Within the scope of this research, data were collected by conducting an online survey of 365 social workers. Results of the study show that 45.8% of the social workers have conducted research before. Nonetheless, 93.7% of the social work practitioners do feel the need to carry out scientific research in order to shape their professional practices. Considering these results, future research should concentrate on social work practitioners’ problems taking into account their dual position as both the producer and consumer of the research.     

Climate change in Alaska: Social workers’ attitudes,beliefs, and experiences

The average temperature in Alaska and the North American Arctic has risen at twice the rate of the global average due to climate change, causing changes to the natural environment that affect the physical, social, and emotional well‐being of people and communities. Social workers must be prepared to respond. Using a non‐probability, convenience sample, this study surveyed 159 social workers in Alaska to assess their attitudes and their perceptions of the effects of climate change on their clients and constituents. Results indicate that social workers in Alaska believe that climate change is happening, that human activities are responsible, and that it is a large threat to people in Alaska. Over 75% believe that climate change is dangerous for their clients now or will be dangerous in 10 years. Social workers report that in the past year their clients or constituents have experienced multiple climate change‐related problems with community infrastructure, health, and mental health.     

Social Work as an Aspect of Primary Health Care: The Social Workers' View

Summary This study is based on an analysis of social workers' viewsof their work with 168 clients referred over a six month periodin 1977 in a health centre setting. A wide range of referralswas made and there was close collaboration with other primaryhealth care professionals as well as outside agencies. Far morepsycho-social problems were encountered by the social workersin the course of their intervention than were apparent on referral,although most of the work was short term. Social work with theindividual predominated and a variety of traditional socialwork skills were employed, although the elderly received relativelylittle help with emotional problems and were offered mainlypractical help. Social workers' perceptions of their clientsare discussed in relation to their choice of methods of interventionand feelings of efficacy. The attachment scheme emerges as generallyfruitful both in terms of social workers' job satisfaction andclients benefitting from a multi-disciplinary approach; howeverthe need for closer inter-professional collaboration in meetingthe needs of the elderly is highlighted.     

Stress and Coping in Social Workers: A Preliminary Investigation

Correspondence to Dr Paul Bennett, School of Psychology, University of Wales College of Cardiff, P.O. Box 901, Cardiff CF1 3YG. Summary Three groups of social workers (child, adult mental health orhandicap, elderly or physical handicap) completed a questionnaireexamining sources of stress, coping strategies, and stress outcomes(e.g. anxiety, depression). All respondents reported high levelsof stress, although stress resulting from factors intrinsicto the job, relationships with other people, and from the organizationalstructure were greatest among childcare workers. In addition,these workers reported greater emotional involvement with theirclients and higher levels of general anxiety and depression,as well as job related mental distress. The implications ofthese findings are discussed in relation to training, job designand support of social workers.     

Client Perspectives in a General Practice Attachment

Summary In this study, 50 clients of social workers in an attachmentscheme were interviewed and their views compared with the assessmentsmade by the social workers. The results were very favourablefor the attachment; the clients were well satisfied with theservice given and the majority of clients felt that they hadbeen helped, especially with their emotional problems. However,there was much disagreement between the social worker's assessmentand that made by the client, especially regarding the type andnumber of problems helped.     

Social Work as Uncommon Sense

Summary Social work needs to resist pressures to identify itself solelyat a superficial level of common sense responses to social problems.It has to go beyond this to recognize its use of ‘uncommonsense’ as the means by which social workers cross therelationship gap and respond to their client's needs. The importanceof doing this in the early stages of relationship, as in crisisintervention, are considered, and stress is placed on holdingtogether both the explicit task-related aspect of the relationship,and the less obvious emotional interchange. By means of theiruncommon sense, social workers are enabled to reflect for, andshare with clients their areas of pain, in such a way as torender them more tolerable.     

Susceptibility to Emotional Contagion

Abstract

This article reports a psychometric evaluation of a measure of susceptibility to emotional contagion, designed to measure the degree to which a person is vulnerable to “catching” and sharing the emotion experienced by another. The scale was examined to test its application to depression, burnout, and impairment among practicing social workers. Data from a probability sample of 751 practicing social workers were collected in an anonymous survey about social workers' health and work issues. The sample was split to conduct exploratory and confirmatory factor analyses. The factor analyses resulted in a revised scale that demonstrated acceptable internal consistency reliability, good content validity, excellent factorial validity, and preliminary construct validity. Susceptibility to emotional contagion was related to burnout, depression, and professional impairment. Future recommendations are made and this instrument may be a useful tool for the identification, prevention, intervention, and education of social workers at risk for depression, burnout, and professional impairment.