Newell2019ProfessionalResilenceinSocialWorkPractice.pdf

Newell2019ProfessionalResilenceinSocialWorkPractice.pdf

An Ecological Systems Framework forProfessional Resilience in Social Work Practice

Jason M. Newell

The cumulative effects of chronic work-related stress pervasively and persistently affect thewell-being of the human services workforce. As a preventive measure, the ongoing commit-ment to self-care strategies and resources is essential in maintaining a healthy and resilientprofessional quality of life. This article describes a holistic approach to cultivating profes-sional resilience through the ongoing practice of self-care. A model for self-care using anecological systems framework with activities across the biological, interpersonal, organiza-tional, familial, peer-related, spiritual, and recreational aspects of the biopsychosocial self isproposed. Within this model, emphasis is placed on the role of compassion satisfaction andvicarious resilience as key components to fostering meaningful and rewarding careers forsocial workers.

KEY WORDS: burnout; compassion fatigue; compassion satisfaction; professional resilience;self-care

F or those who self-select the pursuit of acareer in human services work, social workis far more than a career path, it is a call toembrace a professional life of deep, meaningful, andrewarding service. Congruent with the mission,values, and humanitarian spirit of the social workprofession (National Association of Social Work-ers [NASW], 2009), social workers dedicate theirprofessional lives to providing services to thosewho are poor, vulnerable, underserved, underpriv-ileged, or otherwise suffering in some way. Yetmany social workers find themselves unpreparedfor the chronic day-to-day exposure to clients andthe emotionally distressing narratives of their myr-iad psychosocial problems.

The implications of nearly three decades ofpractice research have demonstrated that the emo-tionally challenging aspects of direct social workpractice have potentially deleterious and some-times consequential psychological effects on socialworkers themselves. This research bears particu-lar relevance for students and newly degreed socialwork professionals pursuing careers in child wel-fare, clinical social work, disaster mental health,military social work, and other forms of trauma-related care (Gilin & Kauffman, 2015; D. Greene,Mullins, Baggett, & Cherry, 2017; Knight, 2010).It has been suggested that stress-related condi-tions such as professional burnout, secondary trau-

matic stress, vicarious traumatization, and compas-sion fatigue may be underestimated “occupationalhazards” for those providing social work services(Pryce, Shackelford, & Pryce, 2007).

The wealth of evidence in the literature onthe emotional effects of direct social work prac-tice clearly implies the need for well-developedand comprehensive training and education on thepractice of self-care as an ongoing professionalbehavior for all social workers (Strand, Abramovitz,Layne, Robinson, & Way, 2014). Yet the emotionaland psychological risks associated with being indirect practice with vulnerable populations, and theessential utilization of self-care strategies to addressthis important aspect of human services work, hasbeen an overlooked issue in the academy of socialwork education (D. Greene et al., 2017; Newell &MacNeil, 2010). The need for continued studenteducation, training, and professional developmentat the undergraduate and graduate levels is sup-ported by NASW, which encourages

the recognition by social work education pro-grams of their critically important roles in edu-cating social work students about the practiceof professional self-care by integrating suchcontent into existing student standards, poli-cies, foundation and advanced curriculums,field practicum, and assignments and projects.(NASW, 2009, p. 270)

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Notwithstanding the evidence in the literaturesupported by NASW, the most recent revision tothe Educational Policy and Accreditation Stan-dards by the Council on Social Work Education(CSWE) makes no direct mention of the im-portance of including material on the practice ofself-care in social work educational curriculum orcourse content (CSWE, 2015). The lack of re-quired content on self-care as a component ofsocial work education at the BSW and MSW lev-els of practice may be a contributing factor to thehigher rates of indirect trauma and professionalburnout in social work practice. It has been notedthat some social work students graduate from theirprofessional training programs with little knowl-edge or ability to appropriately use self-care as anongoing and essential practice behavior (Gilin &Kauffman,2015;Newell,2017).Furthermore,manysocial work students may be exiting their programsand entering the workforce without the profes-sional training to recognize or address the signsand symptoms of professional burnout, compas-sion fatigue, and the indirect or vicarious effects oftrauma-related care (D. Greene et al., 2017).

To address this demanding issue for professionalsocial workers, this article conceptualizes profes-sional resilience using a multidimensional frame-work for the practice of self-care. Grounded inthe ecological systems perspective, a fundamen-tal approach to social work practice, the proposedframework conceptualizes self-care as a broader setof practice behaviors pertaining to the whole per-son, including the physical, interpersonal, organi-zational, familial, and spiritual domains of the psy-chosocial self. The model emphasizes self-care asa holistic set of personal and professional prac-tice behaviors cultivated through the positive andgrowth-promoting aspects of direct practice. Fur-thermore, the model offers an alternative approachto addressing the inherent stress in social workpractice by focusing on the rewarding aspects ofthe work, rather than the potentially deleteri-ous effects, as described in the literature usingterms such as “vicarious traumatization,” “sec-ondary traumatic stress,” “compassion fatigue,” and“professional burnout.”

LITERATURE REVIEWConceptualizing ResilienceHuman resilience is a broad construct that has beenstudied as an adaptive response to stressful external

stimuli and as the use of coping skills as modera-tors or buffers to the effects of stress and trauma(Kent, Davis, & Reich, 2014; van der Walt, Suli-man, Martin, Lammers, & Seedat, 2014; Yehuda,Flory, Southwick, & Charney, 2006). The con-cept of resilience has been examined as a func-tion of healthy development across the life spanin infants, children, adolescents, adults, and fami-lies (Masten, 2001; Walsh, 2015). From a cognitiveperspective, resilience has been studied as the vari-ous ways human beings appraise, process, and regu-late the emotions attached to external stimuli, withemphasis on the application of positive thoughtsand emotions to promote psychological well-being(Duckworth, Steen, & Seligman, 2005; Fredrick-son, 2004). As a function of spirituality, resiliencehas been examined in the form of demonstratingcompassion for the care of others, honoring one’sown personal and spiritual sense of morality, andadhering to personal and professional values andethics (Pyles, 2018; Seagar, 2014; Wicks & May-nard, 2014).

The collective literature on the construct of re-silience reveals no universally agreed-on opera-tional definition for the term “resilience” (R. R.Greene & Dubus, 2017). Studies examining resil-ience often use the term interchangeably withother similar personality attributes or character-istics such as hardiness, personal growth, positiveadaptation, and psychological well-being (Luthar,Cicchetti, & Becker, 2000). The American Psy-chological Association (2016) described resilience as“the process of adapting well in the face of adver-sity, trauma, tragedy, threats or significant sourcesof stress—such as family and relationship problems,serious health problems or workplace and financialstressors” (para. 1). A broader definition describesresilience as a multifaceted process of well-beingdemonstrated by “a sustained adaptive effort thatprevails despite challenge, as a bouncing back orrecovery from a challenge, and as a process of learn-ing and growth that expands understanding, newknowledge, and new skills” (Kent et al., 2014, p. xii).

Professional Resilience in Social WorkPracticeThe term “professional resilience” has been usedacross the fields of human services work includingcounseling, social work, education, psychotherapy,and other health-related professions to describethe process by which those who provide services

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to vulnerable or at-risk populations thrive withininherently stressful work conditions (Hegney, Rees,Eley, Osseiran-Moisson, & Francis, 2015; Hernandez,Gangsei, & Engstrom, 2007; Skovholt & Trotter-Mathison, 2011). A recent shift in the trauma lit-erature indicates a stronger focus on constructsthat define and measure the growth-promotingaspects of both direct and indirect trauma expo-sure, rather than the adverse effects. An exampleof this paradigm shift from the direct trauma liter-ature is the conceptualization of posttraumaticgrowth (PTG) in comparison with posttraumaticstress. Studies examining PTG in survivors of trau-ma emphasize positive changes that occur in thesense of self, in relationships with others, and inoverall quality of life perspective (Easton, Coohey,Rhodes, & Moorthy, 2013; Saimos, Rodzik, &Abel, 2012; Tedeschi & Calhoun, 2004).

Similar to the conceptual evolution of PTG,research in the area of indirect trauma exposurehas revealed an attempt to bring balance to theconsequential effects of trauma treatment includ-ing vicarious traumatization, secondary traumaticstress, and compassion fatigue. Such constructshave focused solely on the emotionally challeng-ing aspects of providing direct services to thosewho are vulnerable and suffering (Newell, Nelson-Gardell, & MacNeil, 2016). In contrast, the term“vicarious resilience” describes the process of trau-ma recovery as having the potential to foster resil-ience and growth, not only in the client, but in theclinician as well (Hernandez et al., 2007). The pro-cess of vicarious resilience occurs through prac-tice with clients who, through the healing process,overcome the effects of trauma through their redis-covery of the meaningful aspects of life (Engstrom,Hernandez, & Gangsei, 2008). A more commonlycited term in this area is the concept of compassionsatisfaction, which refers to those aspects of humanservices work that provide professional success,reward, and fulfillment (Conrad & Keller-Guen-ther, 2006; Stamm, 1999). Elements of compas-sion satisfaction include positive interactions withclients such as celebrating client successes, the for-mation of meaningful and supportive relationshipswith colleagues, the personal and spiritual satisfac-tion of being in a helping profession, and the posi-tive professional interactions that occur as benefitsof membership in a helping organization or com-munity (R. R. Greene & Dubus, 2017; Kapoulistas& Corcoran, 2015).

Self-Care as a Holistic Process: AnEcological Systems Perspective

The term “self-care” is common to the discourseof professional social workers; however, the actualpractice of professional self-care has not been oper-ationalized in the ways of standardized approachesto client treatment. Professional self-care has beendescribed as both a process and a defined set ofpractice skills and strategies to mitigate the emo-tionally challenging effects of providing servicesto individuals, families, or communities (Skinner,2015). Although there are no well-established orrigorously tested models of self-care practice orintervention, synthesis of the research literatureanecdotally suggests that the best approach to pro-fessional resilience is an individualized combina-tion of strategies at the personal and the organi-zation levels (Cox & Steiner, 2013; Grise-Owens,Miller, & Eaves, 2016; Lee & Miller, 2013). Theecological systems perspective is useful in concep-tualizing self-care as both a personal and a profes-sional practice that includes aspects related to phys-iological health behaviors, interpersonal coping,organizational strategies, time with family andfriends, recreational activities, and spirituality (R.R. Greene & Dubus, 2017). Taking a holistic ap-proach to self-care allows for the application ofvarious strategies to promote positive professionalquality of life and an overall sense of physical andemotional well-being.

One of the major premises of the ecological sys-tems theory is the idea of homeostasis, which refersto a human system’s drive and collective abilityto maintain its fundamental nature, even duringtimes of sudden or intense change (Payne, 2014;Walsh, 2015). Another principle of systems the-ory suggests that the collective system and all of itsdomains naturally adapt and adjust to maintain bal-ance or equilibrium as a homeostatic state. In termsof self-care, as the occupational domain directlyinfluences all other domains in the collective sys-tem, too much human energy expended in thestress of work activities takes valuable energy andresources away from other areas (positive healthbehaviors, time with family and friends, spiritualand recreational activities). Hence, maintaining anongoing plan of self-care helps to create a healthywork–life balance, which will hopefully recipro-cally contribute to professional resilience and over-all well-being.

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Figure 1: Ecological Systems Framework for Holistic Self-Care

Given the breadth of the concept of stress andits application across micro and macro domains,the ecological systems perspective provides a use-ful way of thinking about, understanding, and con-ceptualizing the impact of stress on the personaland professional lives of social workers. Using theholistic approach proposed in the ecological sys-tems framework, self-care activities across severaldomains consisting of biophysiological, interper-sonal, organizational, familial, peer-related, spiri-tual, and recreational activities all contribute to acomprehensive method of practice. Figure 1 pro-vides an illustration of the ecological systems per-spective as it applies to the practice of self-care.

Applying the Ecological SystemsFrameworkSimple strategies for self-care at the individuallevel range from maintaining positive health behav-iors, spiritual activities, recreational activities, posi-tive forms of self-expression, and connections withfamily members and close friends. With regard to

the physiological domain of self-care, the most log-ical place to begin is with “the basics” by assess-ing activities related to physical well-being. Positivehealth behaviors such as meal planning, sleep habits,regular exercise and physical activity, and leisuretime are essential to the self-care process (Bush,2015; Grise-Owens et al., 2016). If the need for animproved meal plan and exercise routine is an iden-tified area of self-care, it is best to start with onereasonable health behavior goal or objective (thatis, avoid “pie in the sky” goals). For example, settinga goal to complete a marathon is only reasonablefor someone who is interested in training to be amarathon runner. Whereas completing a marathonis a reasonable long-term goal, a reasonable short-term goal is to make time to take a brisk walk atleast once each workday for one month. This isalso true when setting food intake and food behav-ior goals. Healthy eating goals can be as simple asmaking a commitment to buying healthy fooditems and packing a sensible lunch rather thanrelying on vending machines or fast food as daily

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sources of nutrition; substituting water for soda,coffee, or other caffeinated beverages; or leavingone’s office or computer space to eat lunch for amental break in a nonworking space.

Social workers understand the value and impor-tance of human relationships in sustaining personaland professional resilience and well-being overtime. When social workers allow work responsi-bilities to take time away from family and friends,there is potential for adding an additional layer ofstress from the guilt and shame that comes fromneglecting those who are most important in ourlives. In the absence of individual and familial self-care, the chronic emotional demands of social workpractice may result in the depletion of empathyresources to provide care for both the self and oth-ers, leaving an empty reservoir of compassion andempathy for families, friends, and other loved ones.Therefore, part of the practice of self-care is to pre-serve one’s natural empathy by valuing and pro-tecting time for the experience of joy, laughter, andcompassion with family, friends, and other lovedones (Giles, 2014; Pennebaker & Smyth, 2016).The use of social support from family, pets, andclose friends has been shown to buffer the effectsof occupational stress, which ultimately contributesto both the process of self-care and an over-all sense of personal and professional well-being(Grise-Owens et al., 2016; Viswesvaran, Sanchez,& Fisher, 1999).

Organizational self-care begins with simple strat-egies such as avoiding procrastination and allo-cating sufficient work time to complete requiredassignments, reports, or documentation. Protectingcalendar time, which for some is simply learningto control one’s calendar, is an essential time man-agement skill that includes not only setting reason-able deadlines, but also actively prioritizing per-sonal and professional obligations. Social workersmay find that taking a task-centered approach, bysetting specific goals and objectives for each day ofthe week and remaining dedicated to these taskswhen possible, is useful in developing time man-agement skills. A thorough assessment of out-of-office calendar time (meetings, home visits, and soon) and time spent working in the office may proveuseful in determining areas in which time may beused more efficiently.

Before developing a formal strategy for orga-nizational self-care, it is beneficial to examinethe impact of agency philosophy, culture, climate,

administrative structure, policies, and procedureson agency providers and the clients they serve(Lee & Miller, 2013). For example, the presenceof an agency culture that values the use of sup-portive supervision, particularly for those new tothe social work profession, is useful in buildingorganizational resilience and professional efficacy(Cox & Steiner, 2013). Social work practice isgrounded in the ability to develop healthy rela-tionships through effective forms of communica-tion. Supervisors play a vital role in cultivating pro-fessional resilience by providing effective relationalguidance, support, education, and practice wisdomduring times of stress and professional insecurity(Skovholt & Trotter-Mathison, 2011). Social sup-port from professional colleagues through acts suchas assistance with administrative duties, insight intodifficult cases, or comfort during times of crisishave been suggested as helpful for social workers(Maslach, 2003).

Like the other components of the holistic ap-proach to self-care, spirituality or having a spiri-tual life is individually unique. Spirituality has beendefined as a “devotion to the immaterial part ofhumanity and nature, rather than worldly thingssuch as possessions; an orientation to people’s reli-gious, moral, or emotional nature” (Barker, 2014,p. 409). Other components of spirituality includeself-perception, adherence to personal values andethics, belief in the existence and influence of ahigher power, and the formation of meaning-ful relationships with others who are like-mindedsubscribers to a common cause for social justiceand peace, a process described as “healing justice”(Pyles, 2018). The presence of spirituality has beenshown to buffer the effects of workplace stress andcontribute to overall well-being as a vital sourceof resilience and renewal for individuals and fam-ilies (Brelsford & Farris, 2014; Csiernik & Adams,2002).

The practice of spiritual self-care involves thedevelopment and maintenance of spiritually orreligiously based practices as buffers to the effectsof personal and professional stress and as sourcesof self-renewal and overall well-being. Strategiesfor maintaining the religious component of spir-itual self-care include regularly attending faith-based services and activities, participating in reli-gious observations and rituals, and praying (Falb& Pargament, 2014). Nonreligiously based com-ponents of spiritual self-care include engaging in

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Table 1: Suggestions for Developing a Comprehensive Plan of Self-Care

Self-Care Domain Suggested Strategies

Biological Balanced diet and nutrition; adequate sleep schedule; regular exercise regime; moderationin alcohol use; utilization of health and mental health days to recover from physical oremotional illness, including grief work

Interpersonal Maintenance of professional boundaries with clients; creating a healthy balance betweenpersonal and professional obligations; use of adaptive rather than maladaptive coping skills;active engagement of anxiety associated with clients through techniques such asmindfulness, self-talk, and self-awareness; use of psychotherapy, counseling, or supportgroup help (particularly for those with a personal trauma history)

Organizational Seeking out organizations with missions consistent with personal values and careeraspirations; ongoing participation in education, training, and professional developmentopportunities; active participation supervision and ongoing mentorship; engaging insupportive relationships with professional colleagues; setting realistic goals and objectivesfor the workday or workweek; using coffee and lunch breaks for non-work-relatedactivities; participating in the celebration of client success and fulfillment; maintaining arealistic worldview about the impact of client work on the self

Familial Ongoing use of social support from family and close friends; participation in nonstressfulfamily events; engaging in “no technology” dinners and family time; scheduling familyand couples vacation time; participating in children’s activities, school functions, and sportsevents (if applicable); protecting time to celebrate special family events, birthdays, oranniversaries; scheduling nonfamily time to catch up with close friends; caring for andspending time with family pets

Spiritual Attending faith-based services regularly; engaging in positive forms of self-expression andself-revitalization, for example, yoga, meditation, philanthropic activities

Recreational Reading; drawing; painting; sculpting; team sports; cooking; hiking; swimming; movies;other outdoor activities or forms of positive self-expression; any activity personally orprofessionally fostering the use of joy, humor, or laughter

positive forms of self-expression and revitalizationsuch as painting, journaling, inspirational reading,and playing or listening to music (Baldwin, 1990;Gladding, 2011; Pennebaker & Smyth, 2016). Theapplication of activities of healing and self-renewalsuch as the use of conscious relaxation, yoga, andmeditation have also been suggested as positivelyinfluencing spirituality and well-being (Richards,Campenni, & Muse-Burke, 2010). Finally, recre-ational activities that involve separation from thework environment, particularly those involving adeeper connection to a natural environment suchas hiking, swimming, or camping, may also be asource of spiritual healing and self-care for somedirect practitioners (Falb & Pargament, 2014; Pearl-man & Saakvitne, 1995). Table 1 provides sugges-tions for developing a comprehensive plan of self-care across the biological, interpersonal, organiza-tional, familial, spiritual, and recreational domainsof the psychosocial self.

SOCIAL WORK PRACTICE AS SELF-CAREProfessional resilience represents the positive out-comes of social work practice as they balancethe negative and sometimes deleterious effects of

human services work with those who are vulnera-ble or suffering. Social workers garner the profes-sional education, skills, and abilities to practice self-care; it seems the biggest challenge is the pledge toembrace self-care as an essential and ongoing prac-tice behavior. For social workers who have dedi-cated their lives to caring for others, practicingself-care may seem counterintuitive. However, main-taining a plan of professional self-care requires lit-tle more than applying the basic theories, skills, andknowledge used to facilitate consumers throughthe process of case management and treatmentplanning. Therefore, training in the practice of self-care becomes a matter of commitment and culti-vation. For example, fundamental to the practiceof social work is the assessment of human behavioras it interfaces with the social environment; para-doxically, this core competency can be applied tothe practitioner to gain valuable insights into bothpersonal and professional patterns of behavior.Other mainstays of social work practice, such as theutilization of problem-solving and task-centeredapproaches, can easily be applied when creating auseful, functional, and ongoing plan of professionalself-care. The use of strengths-based practice can be

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used to identify areas of professional or client suc-cess as an analytic of the positive aspects of work-ing within human services organizations. Finally,the use of psychosocial assessment skills to com-prehensively examine personal and professionalareas in need of improvement may prove helpful indetermining future self-care goals and objectives.

DISCUSSIONProfessional awareness of the importance of self-care in the practice community has been acknowl-edged and supported by NASW, defining self-care as

a core essential component to social work prac-tice [that] reflects a choice and commitment tobecome actively involved in maintaining one’seffectiveness as a social worker in preventingand coping with the natural, yet unwanted, con-sequences of helping. (NASW, 2009, p. 269)

The practice of self-care has been described asthe “key to professional resilience” (Newell, 2017),generally in the form of “professional” self-care,which fails to acknowledge that self-care is a holis-tic practice with domains that move beyond theprofessional setting. Although there are variousrecommended components to developing andmaintaining self-care, and some suggested formu-lations for how to prepare or construct a self-care plan, the practice and process of maintain-ing an ongoing plan of personal and professionalself-care is subjective to the individual practitioner(Cox & Steiner, 2013; Lee & Miller, 2013). Theterm “self-care” is in many ways defining, mean-ing the approach to this practice is specific to theinterpersonal and physical needs of the individual,the demands of the organization, balancing familyresponsibilities, and other life dimensions. There-fore, finding the right combination of activities topromote a healthy balance between personal andprofessional obligations should be the overarch-ing goal in developing an ongoing plan of self-care. The ecological systems framework describedin this article proposes a practical approach toestablishing, maintaining, and articulating self-carepractices. There is adequate research on the vari-ous approaches to the practice of self-care, but fewmodels of this practice have been empirically vali-dated. This is a logical next step for future researchand training initiatives.

Social work provides the great privilege offocusing practice and research on the well-being

of others, with commitment that is unparalleled inother professions. The reward for providing ser-vices to those who are poor, vulnerable, under-served, or suffering comes in the form of gratitudeand joy in knowing our consumers’ quality of lifeimproves because of the work that we do (Pooler,Wolfer, & Freeman, 2014). The breadth of researchevidence on the effects of social work practice onpractitioners themselves has led the profession toa place of understanding and acceptance that thecumulative stress effects of social work practicemay negatively affect provider well-being. Hence,committing to a plan of self-care as an ongoingpractice behavior is essential for social work profes-sionals, not only for themselves, but for the better-ment of the consumers of their services. Our pro-fession has lost far too many earnest social workersdedicated to the values, mission, and humanitarianspirit of social work to the indirect effects of traumaand professional burnout. To address this issue, thesocial work profession and the academy of socialwork education have a duty to promote the ongo-ing practice of self-care through training and con-tinuing education as an ethical imperative to bothfuture and current social worker practitioners. SW

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Jason M. Newell, PhD, LICSW, is professor and social workprogram director, Department of Behavioral and Social Sciences,University of Montevallo, 737 Main Street, Station 6180,Montevallo, AL 35115; e-mail: [email protected].

Original manuscript received September 12, 2018Final revision received August 12, 2019Editorial decision September 9, 2019Accepted September 12, 2019Advance Access Publication December 8, 2019

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  • An Ecological Systems Framework for Professional Resilience in Social Work Practice
    • Literature Review
      • Conceptualizing Resilience
      • Professional Resilience in Social Work Practice
      • Self-Care as a Holistic Process: An Ecological Systems Perspective
      • Applying the Ecological Systems Framework
    • Social Work Practice as Self-Care
    • Discussion