The Profession Must Prioritize Self-Care

woman in work clothes on a treadmill, ballanced on a clif, with papers blowing awayHow much help are social workers to their clients if they are stressed, sick or tired and haven't made time for self-care? Obviously the professional value they have to offer may be compromised, but social workers in particular - professionals who are often trained to focus on the needs of others - often neglect their own well-being. As a result, they may suffer not only in their professional lives, but in their personal lives as well.

Social workers and stress.

In 2004, NASW conducted a benchmark national study that provided a wide range of information regarding social workers' roles and work environments. The findings pointed to an impending shortage of licensed social workers, but there was no clear indication as to why this would occur.

In an effort to better understand what was happening, the NASW Center for Workforce Studies conducted an anonymous online survey in 2007 to which 3,653 NASW members responded. One report from the survey, "Stress at Work: How Do Social Workers Cope?" revealed some important insights.

"We learned that it was not the clients themselves who were causing the major portion of the stress, but the work environment itself," said Tracy Whitaker, director of the Center. "The primary stress social workers face is that they don't have enough time to do their jobs, and related to that, have too heavy a workload. This was true across practice areas."

Thirty-one percent of respondents said they didn't have enough time to do their jobs; 25 percent acknowledged that a heavy workload was a primary contributor to their stress; comparatively, just 16 percent cited their clients as a significant source of their stress.

Although the report indicated that many have found effective ways to help manage stress, especially through exercise, 70 percent of survey respondents indicated they were fatigued on the job. Another 38 percent said they experience psychological problems in relation to their work; and 25 percent of those working in child welfare settings suffer from sleep disorders.

The value of self-care

Sandra A. Lopez is a clinical associate professor at the University of Houston Graduate College of Social Work. She believes education in self-care strategies and their value, both in institutions of higher learning and on the job, is the first step towards creating better work environments for social workers.

"Students studying social work need to develop an understanding of their own physical, psychological and nutritional needs and be prepared for the realities of the workplace," said Lopez. "Additionally, social workers now in the field need to develop skills to use in the moment — not just look to holidays or vacations as time to practice self-care."

According to Lopez, part of committing to a regular professional self-care practice involves stepping back and putting your role in perspective.

"Many people think they are indispensable. For instance, some believe if they take even a five-minute break, turn off their cell phone or eat someplace other than at their desk, things will fall apart," said Lopez. "No matter who you are, this simply is not true."

Lopez is one of the authors of NASW's new policy statement, Professional Self-Care and Social Work, which was approved at NASW's Delegate Assembly in August. The policy formally acknowledges the critical need for self-care and advocates for it among social workers. The document states that NASW supports the practice of professional self-care for social workers as a means of maintaining their competence, strengthening the profession, and preserving the integrity of their work with clients.

The role of agencies. In discussing self-care and stress in the workplace, the conditions and practices of the institutions themselves need to be addressed, along with those of the social worker functioning within the environment.

"It is a two-sided issue," said Sherri Weisenfluh, associate vice president of counseling at Hospice of the Bluegrass in Lexington, Ky., an organization that employs more than 100 social workers. "The social worker has to take responsibility for his or her own needs, but the agency must also work to create a healthy environment, not only for their clients, but for their employees. Also, managers and others in leadership positions need to lead by example. If they don't practice self-care themselves, if they are always working overtime or skipping vacations, employees can feel like they have to follow the same pattern."

If the work environment is less than ideal, a social worker has several choices: try to change the environment, which may take time; leave it and find a new one, which many would prefer not to do; or develop effective self-care strategies that change one's perspective and transform the environment into one that is less stressful. Whatever decision is made, the key is to develop an attitude that recognizes the future, but honors the present.

"In hospice care, we often come across people who have postponed things in their lives. For instance, they didn't travel when they were young, but planned to when they retired, yet now will not be able to do so," said Weisenfluh. "I encourage social workers to learn from their clients. You can't postpone taking care of yourself. You can't postpone joy either — you have to take it when it comes to you."

Professional resilience

Ellen Fink-Samnick is president of EFS Supervision Strategies in Burke, Va., a firm dedicated to enhancing the education, empowerment and professional development of health, mental health and human service professionals. She participated in the development of the NASW Professional Self-Care Policy and advocates for professional resilience, in addition to self-care.

"Professional resilience encompasses self-care, but it is also about promoting one's inner strength and helping you to define a sense of purpose and self-worth," she said. "It facilitates motivation to achieve personal and professional goals which will lead to career longevity. We need to advocate both for ourselves and for our profession in order to go to the next level. Integrating a resilient self into resilient workplace is how that happens."

Fink-Samnick has developed tools to help social workers and organizations assess their professional resiliency. One tool asks the social worker to respond to a number of questions such as, "Which activities in your life do you love?" and "Which do you never find time to get to?" The second part of the tool takes that information a step further by asking participants to comment on the answers to their questions such as, "Which was the easiest question to complete, and why?"

"Who you are at 24 is not the same as who you are at 50," Fink-Samnick said. "Professionals should undergo regular and honest self-evaluation, in addition to practicing self-care, in order to define goals and recognize obstacles." Self-care strategies. Participants in the "Stress at Work: How Do Social Workers Cope?" study indicated several overall strategies for coping with stress that work well when outside the workplace. Exercise is the number one strategy, followed by meditation and therapy. However, just as important is the need to incorporate self-care into one's routine while at work.

"Everyone should develop professional self-care strategies to use while at work," said Sandra Lopez. "Taking deep breaths throughout the day, listening to music and taking a five-minute walk around the building every so often are examples of small things that can make a big difference. Practicing professional self-care in this way doesn't mean you are less dedicated. It means you have made an active commitment and choice to maintain your effectiveness as a social worker."

Fink-Samnick agreed. "There is a huge tendency amongst social workers to say, 'I can't take a break.' But the truth is you always do better when you take a break-you shift the energy."

Fink-Samnick also suggests using a "grounding list" — a list of things that are personal or meaningful to you that you can read as reminders of pleasurable things in your life that are outside the office. Posting a bulletin board for personal mementoes and pictures that you glance at throughout the day also works well, and is another strategy Fink-Samnick advocates. Calling a friend for a few minutes to vent a frustration, chatting with a co-worker about a non-work-related issue and simply grabbing something and tossing it around are other options.

"Also, sometimes people laugh when I suggest using creative visualization, and tell them to 'take a vacation' in their head for 30 seconds and imagine themselves laughing and having fun," she said. "Yet it is a very effective strategy. The work and lives we lead are tough — we were human beings first, and we feel and we respond. We need to replenish ourselves."

Endemic problem

Whitaker believes it is important for social workers to keep in mind that many others in the profession are also having difficulties coping with stress, but there is hope.

"We want to help social workers," said Whitaker. "This problem is endemic in the profession, but there are the coping strategies that have proved effective. It's easy to focus on the fact that people are burning out — but it is better to focus what they can do so they don't burn out. Most social workers have high levels of satisfaction with the work. They don't want to leave the profession. Self-care is not about accepting an unworkable work environment, but rather offers an option and allows social workers to better manage their careers and the stress associated with certain work environments."

If social workers are to thrive in their careers within current work environments, they cannot let their energy be constantly depleted through a lack of self-care. Social workers owe it to themselves first, and their work, clients and families to prioritize a healthy lifestyle and make self-care a part of their regular routine, Whitaker said.