Monday, May 19, 2014

Self-care: Stress and anxiety in social work

Stress and anxiety in social work: reflective supervision can help


With high levels of vicarious trauma and burnout in the profession, social workers need more support

Niven, D. (2014). The Guardian.

Taking care of social workers' mental health should be a high priority, especially in the current climate of high vacancy rates, large case loads, and great public pressure. Over the years the social work profession has failed – in my view – to fully support its workforce with the kind of supervision and support designed to keep staff healthy and as stress free as possible. The anxiety generated in their work has to be addressed. Most social workers' resources are between their ears, and if staff are burning out then those they work with are not getting the best service.

When delivering a training course called Empowering Social Work, I always mention the condition of vicarious traumatisation. This is experienced by professionals who are regularly exposed to other people's distressing experiences, and by empathising with them, are themselves affected by the trauma. This is a common condition among social workers, and can affect stress and anxiety levels. As Babette Rothschild said: "All emotions are contagious … both the ones that are pleasant and the ones that are unpleasant." People on the frontline experience this regularly.

Each day brings a regular diet of traumatic events, abusive behaviour towards the vulnerable, frustration at lack of resources, and guilt at your inability to fully service your workload. Work-related stress and anxiety has insidious, sometimes chronic effects on health and social interaction. Noticeably, sleep patterns change, enthusiasm for the job wanes, you regularly feel tired and are more accident prone, and have negative feelings towards colleagues and managers. All of this and more can lead to a creeping progression from feeling fed up to experiencing clinical depression. And all the above leads to an increased number of sick days, creating extra burdens on colleagues and the start of what can be a vicious cycle.

Many other professions insist on personal supervision time to look at the worker's feelings, health, and state of mind, as we know the negative outcomes of over-burdening staff with the work of absent colleagues or vacant posts. Secondary traumatisation is often a well hidden factor that takes skill to both uncover and work with.

There is thus real value in making time for reflective supervision. A personal example of this occurred with a member of staff called Alan (not his real name). He had been working with a family who were known to social services, but not considered particularly at risk or difficult to manage. Then the young mother died suddenly, leaving the father with two children under five. Following the bereavement his ability to care for the children and his own health and hygiene deteriorated. The children were more and more difficult for him to manage, and he developed a substance misuse problem, as well as being on prescribed medication for depression. In a short space of time the situation became highly risky for the children, even with considerable support going in to the house.

Alan himself had just separated from his partner and was showing all the signs of bereavement in his own right. He began to display a lack of energy and awareness, his analytical skills became blunted and he began to function on a formulaic basis. It later transpired that he too was on anti-depressive medication. It wasn't that he didn't recognise the weakening of his professional ability; he did, but was unable to ask for help. He started feeling increasingly angry and impatient towards his clients, and thought he was failing as a professional.

All through this, his manager didn't recognise the depth of trauma Alan was experiencing and beyond superficial enquiries did not instigate proper reflective practice. It illustrates how important maintaining the emotional health of workers is as their own state of mind is crucial to providing the best service.

It may be that their immediate manager, for whatever reason, is not the best person to offer supervision. In an incredibly busy team environment it is difficult to strictly ring fence time, but other professions are much more rigid about the opportunity to engage with a trusted person and examine their own emotional health. It is unsurprising that the level of burn out is high in social services, especially for frontline workers dealing with the most vulnerable and damaged people.

Social work stress and anxiety has to be reduced. It is partly a resource issue: the profession needs much more funding in order to employ more workers and reduce individual caseloads. Perhaps this would help counter the negativity towards social work from sections of the media determined to always blame, rather than understand.

David Niven hosts a weekly social work podcast, which can be downloaded here. You can follow him on Twitter @DaveNiven.

Friday, May 16, 2014

Global Social Work: Rural China's "barefoot" social workers

Highlighting rural China's "barefoot" social workers

Xu, B. and Yang, Liu (2014). Shanghai Daily.

BEIJING, May 15 (Xinhua) -- The young girl talking on stage appeared nervous, but her words attested to the impact that a social worker has had in turning her life around.

"My new aunt helped me a lot in study and daily life," Cun Xiangliu told the audience at a forum held in Beijing on Wednesday to discuss rural social work, an under-developed field in China but one which is getting increasing attention.

The "aunt" is Ban Xiaolian, one member of a small army of "barefoot social workers," an informal position tasked with providing a safety net of childhood welfare in the vast and under-resourced Chinese countryside. Ban is involved with a project that has designated a social worker in 120 pilot villages across China.

Based in Jinghan, of Longchuan County in China's southwestern Yunnan Province, Ban first met Cun in 2010. She found the youngster of the Dai ethnicity to be quiet, sometimes depressed, living a desperately harsh life.

Cun's mother has HIV. Her parents divorced and both left home, leaving behind two children and their sick grandfather.

"HIV is a stigma. Other villagers, even their relatives, stayed away from them," explained Ban.

Cun's family has 0.27 hectares of land, but nobody was strong enough to plough and sow.

In August 2010, however, Jinghan was selected for the pilot scheme being run by the Ministry of Civil Affairs and UNICEF. It was at this point that things began to look up for Cun, now 13, as well as many of her peers.

In Ban's village, there were more than 1,300 children, 180 of whom had special needs. Many were left-behind kids. Others were orphaned, carried HIV or had disabled parents struggling to bring them up.

"I didn't know Cun Xiangliu before, and didn't notice her on my first visit to her house," Ban recalled. But the presence of the social worker lent Cun a glimmer of hope.

Several weeks later, she called Ban, telling the new friendly contact how her younger brother wanted to go to kindergarten. In Yunnan, children aged three are entitled to go to kindergarten, but it is not free of charge. Cun's brother was due to turn five in 2011, but his family could not afford the nursery fees.

Ban went to the local civil affairs bureau and applied for basic living allowances for them. She then contacted the kindergarten, and the young boy was soon accepted.

The other thing Ban did for the girl's family was talk to their relatives. The nephew of Cun's grandpa now farms the 0.27 hectares, with both households splitting the yields.

Other help has been psychological and educating, addressing the discrimination leveled against Cun. Ban began to gather kids together at the children's center she runs. Gradually, Cun made friends there and no longer feels abandoned.

According to Huang Xiaoyan, associate professor in social work and policy with Nankai University, the idea of barefoot social workers stems from China's experience of "barefoot doctors."

In the 1960s, to meet farmers' demand for healthcare, educated locals were trained in medicine and sent to work in villages. In this way, the majority of rural residents were covered by a health network that was low-cost and easily accessible.

More recently, Chinese media have brought increasing attention to the situation with HIV/AIDS in the country. Social workers were selected to work in the worst-hit areas.

But it's not just children affected by HIV who need care.

In the drive for urbanization, migrants have flooded into big cities, leaving behind their kids. UNICEF estimates that across China, 70 million children, or a quarter of the total, don't live with their parents. Many face risks as a result.

"Social workers are not yet common in China, but we cannot let the children wait," said Huang. But who could provide rural children with essential welfare? The answer was someone from their local communities.

"They have similar cultural backgrounds to the kids, they are educated,can speak Mandarin and can use the Internet. And above all, they love children," she said. "With some training, they can play the role."

These barefoot social workers -- offered a monthly subsidy of 300 to 800 yuan (about 48 to 128 U.S. dollars) in lieu of an actual salary -- keep records of their charges' physical condition and education, and are supposed to visit them periodically. They help with birth registration, vaccinations and school enrollment. For those with special needs, they contact government units for specialist help.

Rural social workers' tasks vary from area to area. In Yunnan, Sichuan and Xinjiang, where drug abuse has resulted in the spread of HIV/AIDS, the priority has been disease control.

Elsewhere, problems can be more specific. "In Luoning County of Henan, a big problem was children drowning," said Xu Wenqing, a project officer with UNICEF. The river running through several villages in the county used to claim several lives a year.

Barefoot social workers gave warnings to local people, patrolling when the river was swollen, and set up a protective net along the banks. In the past two years, no drownings have been reported in Luoning.

Daniel Toole, UNICEF regional director for East Asia and the Pacific, told Xinhua that the project from which Cun has benefited has been a success because it "started from community level.

"They recruited local people to do the job, because they know better about the culture and problems in the area."

As barefoot social work gets more attention, one of the biggest improvements has been a change in the status of those caring for rural kids. Though barefoot social work is still not recognized as a bona fide profession, the workers are getting more plaudits.

"I am now one of the most respected people in the village," said Li Zhengchuan, a social worker in Yunnan Province's Guangpa Village. Li is now a representative to the local committee of China's Communist Party. However, more needs to be done to guarantee the welfare of youngsters away from cities. Toole believes that the number of social workers is not yet big enough.

Ban Xiaolian, for example, is always busy visiting children. The farthest mountainside home requires her to ride her motorbike for 20 minutes, before walking for another 40 minutes. During weekends, she sometimes wants to close the children's center, but only finds her home filled with kids when she does.

Ban said she is not afraid of hardship, but her biggest headache is how to communicate with the teenagers. She worries about cases like that of a 13-year-old son of a handicapped mother and an alcoholic dad. The boy wants to quit school and "won't listen" to Ban's advice against doing so.

When barefoot social workers have problems, they resort to academics like Huang. The latter provide training.

But Xu Wenqing believes that some problems can only be resolved by professionals. "Sending professional social workers to the countryside is our next step," she said. "If we could have one in each county, that would be a big progression."

Maybe Cun Xiangliu could be one of them when she grows up. She has already been helping out in Ban's children's center. Although determined to "work hard and go to a university," she plans to return to Jinghan.
"East or west, home is best," she said. "And I wish I could do something for my hometown in the future."

(Zhou Ting, an intern to Xinhua, also contributed to the story.)

Sunday, May 11, 2014

Social Work Activism: B.C. must act to save women, kids, from domestic violence

My letter in the Province. It is heartbreaking that on the eve of Mother's Day another mother lost her life to a male attacker in B.C. We cannot be silent about violence against girls and women. Social workers are on the front lines of this war and we have opportunities to intervene to support women and their children. 


Letter of the Week: B.C. must act to save women, kids, from domestic violence

Young, T. (2014). The Province. Retrieved from:  http://blogs.theprovince.com/2014/05/11/letters-b-c-must-act-to-save-women-kids-from-domestic-violence/

How many B.C. women must be bruised, bloodied and murdered by their male partners before the provincial government takes action in this domestic war against women?

How many children in B.C. must face a future where their mother will not get to be there to see them grow up?

In less than a month, numerous headlines have captured the picture of the extreme intimate-partner violence afflicting far too many women and children.

As your article points out, the Provincial Office of Domestic Violence is once again missing in action when it comes time to discuss what the office might be doing and what strategic and concrete action it is taking to make B.C. a safer place for children and women.

PDOV was formed in 2012 in response to recommendations from the Representative for Children and Youth, who completed reports on two cases of domestic homicide. Both of these cases were preventable tragedies if the systems involved had been paying attention and acting with conviction to keep the women and children involved safe from their abusers.

Reviewing the provincial domestic violence plan for 2014-2015, it is clear that there is no real action plan. There is only the appearance of having a plan based on “proposed actions” and scant details about how women and children will be safer.

It is time for the B.C. government to stop with the smoke and mirrors. Abuse, attempted murder and spousal homicide of their mothers should not be the memories children carry with them from childhood.

The dynamics of family violence are complex, but solutions are within reach. Other jurisdictions have seen improvements from taking real action, so it is time for the B.C. government to stop dragging its feet and listen to advocates for women and children and those who have experience in this area who have strategic, concrete ideas about how to improve the safety of women and children.

Tracey Young, Vancouver

Tuesday, May 6, 2014

Letter to the editor: Cops' compassion isn't social work

Cops' compassion isn't social work
Young, T. (2014). Nanaimo News Bulletin. Retrieved from:

To the Editor,

Re: Police forced into social work, Editorial, May 1.

While I appreciate the comments your paper is making about the erosion of the social safety net and health infrastructure as it relates to vulnerable people with mental illness, it is incorrect to say that police officers are being “forced into social work.”

It is heartening to see that compassion and understanding are increasing amongst police officers responding to the socio-economic and psycho-social realities in B.C. The contacts police officers make with citizens should not be described as ‘social work.’ Social work is a profession with a distinct education and a specialized skill set. Social workers have a code of ethics and professional standards that are very different than those of police officers.

Your editorial correctly identifies high caseloads for existing social workers and lack of care available to people with complex health conditions. However there is no mention of the high number of social work jobs that are being eliminated from the health care system in B.C. There is a gap in service delivery that is leaving communities reeling with how to manage the kind of complex problems that people are left to cope with on their own.

Hope springs eternal that the B.C. government will demonstrate leadership, vision and commitment to providing care and services to our most marginalized and fragile citizens before it is too late for some of them to survive their challenging and tragic lives.

Tracey Young
via e-mail


Original Editorial letter:

Editorial: Police forced into social work (May 1, 2014)
Nanaimo News Bulletin. Retrieved from http://www.nanaimobulletin.com/opinion/257402331.html

Saturday, May 3, 2014

Job Posting: Project Director - Child and Youth Mental Health and Substance Use Collaborative

Project Director - Child and Youth Mental Health and Substance Use Collaborative
Doctors of BC 


Opportunity now exists for a proven leader to join the CYMHSUC as its new Project Director. The Project Director, reporting strategically to the SCC and operationally to the SCC Executive Lead, is the primary lead on behalf of the SCC to work with the CYMHSUC Steering Committee and resources such as Impact BC. 

The Project Director’s primary objective is to support the pace of innovation and change experienced by physicians and allied colleagues across program areas, regardless of their sponsorship group. 

Further to this, the Project Director leads the development and implementation of mechanisms that build and sustain partnerships across and within the Collaborative; promote relationships for effective interaction; enhance communication; foster team orientation; and enable the management of complex change.

The ideal candidate brings a degree in Business Administration or Public Administration, or a health-related degree, combined with relevant work experience. Alternatively, an equivalent combination of education and experience will be considered. 

He/she must ideally have an understanding of the health care system including knowledge of health regions and acute based services, or a similar complex public engagement environment in social or public services. Additionally, superior planning, organizational, presentation, communication, and interpersonal skills are critical.

This is an incredible opportunity to help pioneer and steward the emerging collaborative service model for child and youth mental health and substance use in BC.

To explore this exciting opportunity further, please contact Barbara Morrison, Irene Hensel, or Craig Hemer in our Vancouver office at 604-685-0261.

To apply for this position, please email:  vancouver@boyden.com

Please indicate the position title and organization you are applying for in the subject line of the email.

Training: Recovery 2.0 - Beyond Addiction Conference

Recovery 2.0 - Beyond Addiction Conference

FREE on-line conference
Date: May 3-7

Features leading experts in the field of addiction and recovery.

Access it here: http://recovery2point0.com/

Watch the video promotion here: https://www.youtube.com/watch?v=2dmD3QozugU