Resilience is a hot topic right now in Social Work due to the profession being known for high levels of stress and social workers are increasingly keen to be resilient for personal and professional reasons. In this article we broaden the topic to include resilience, wellbeing and peak performance.
Why specifically is resilience a hot topic right now? The most recent 2019 HSE study(1) has estimated that stress, depression or anxiety is on the rise and is most prevalent in the public service industries, notably health and social care is the second most stressful after after public administration and defence. There have been a plethora of research reports on stress in social work over the years, which are referred to later in this report. The reality is that many social workers are grappling with recurring ill-health, burnout or considering leaving their jobs or career earlier than expected. The average duration of a social work career is now 7-8 years(2). An indicator that something needs to change.
First we overview what is resilience, wellbeing and peak performance followed by the different types of stress. Then we overview the research findings on stress in social work before exploring the concerns and dynamics of dis-stress and moving onto the options available to address it. The emphasis here is on the personal techniques and tools social workers can use to let go of stress, rather than work related strategies.
So what is Resilience? It is the capacity to sustain and return to an optimal state of mindset, notably hope, optimism and self-efficacy as well as a state of resourcefulness and capability despite adverse environmental challenges or after a set back. Wellbeing, on the other hand, is the state of being comfortable, even when being stretched personally and professionally, as well as healthy (physically, mentally, socially) and authentically happy. Peak Performance, or flow, is when a person is performing to the maximum of their ability, and stretching slightly above with an equal amount of support to match, and characterized by subjective feelings of confidence, effortlessness and total concentration on the task. Time slows down yet somehow flies by.
A key difference between resilience and peak performance is duration and internal and external resources. Peak performance is often referred to in sport. When professional sports people are in a state of flow or ‘in the zone’ for a game or match, for a limited period of time, they increase their likelihood of achieving their best performance. Afterwards they experience a period of rest and recovery until their next game or match. The capacity to be resilience enough to sustain peak performance over the long haul of a stressful professional role, with all its demands, fluctuates with limited resources, is the key difference.
The sport metaphor can teach us something about different kinds of stress. Eustress, or positive stress, most often relates to short term pieces of work, is perceived as within our coping abilities, motivates and focuses energy, tends to feel exciting and improves our performance. On the other hand, dis-stress, or negative stress, can be short- or long-term, it Is perceived as outside of our coping abilities, can cause anxiety or concern and feels unpleasant, hence it interferes with our capacity to deliver performance and can lead to mental and physical problems.
The research is indicating that social work as a profession as a higher incidence of professional distress than most other careers. An article by The Guardian(2), in 2016, reported job turnover rates in social work of 25% as opposed 15% average across other sectors. It posited the average length of a social workers career being just 7 years. A Plymouth University study (2017)(3), since then, cites a multitude of personal impacts of social workers due to work stress, finding a shocking 55% of the 1600 responders intend on leaving the profession within 15 months. In 2018 a study by BASW(4) and the Social Workers Union (SWU) found 61% of the 3000 responding children’s Social Workers wanted to leave the profession within 16 months. Such a shame after the 3 or 4 years of time and money in their social work education and it disrupts the professions capacity to develop the confidence and capabilities it needs to tackle societies increasingly complex issues.
Another annual study, based on 3000 participants, Bath Spa University reports (2018)(5) reports a multitude of issues faced by children’s and adults social workers. In general it found ‘high work loads and a lack of resources to help service users were the main stressors contributing to poor working conditions’. The General secretary of the SWU, John McGowan, said: ‘If this is not addressed then we will be facing a crisis; impacting on the loss of skilled, well trained and necessary staff who impact daily on our lives from the work social workers do covering all ages and backgrounds’
Given the preoccupation with austerity and Brexit since these reports it’s hard to see how figures could have improved much. The Guardian (2) article suggests that increasing flexibility is the way to resolve this problem but it is also how social workers use their time, and their associated lifestyle and self care choices that will also make the difference.
The following presents a summary of the survey findings including some factors around personal and self care and finally a new, less than obvious, factor that I bring to this topic.
The amount of work there is all too often intense and relentlessly demanding resulting in working lunch breaks and longer hours than one is paid for. Yet some social workers and teams draw a line under sticking to core work hours and still do great work.
Due to the pace of change and high expectation to get on with the job social workers find themselves learning on the job. This works well with supportive managers and teams but less so when managers or colleagues are over-worked and stretched themselves
Due to excessive demand social workers often find themselves working when they are sick. While some supportive managers are clearer than others that sick means sick this can place a strain on the team due to low staff numbers
It is a challenging job working with people’s life problems day in day out, which increasingly seem to be becoming more complex, yet it is also rewarding work too.
There is a rise in the number of aggressive clients making lonesome working social workers feel increasingly unsafe
The support social workers get from management doesn’t always create an ideal working environment and it can make all the difference having a great manager and supportive team
The management of change in some, to many, working environments is poor yet social work itself is about managing personal change and some organisations or teams do get it right
Due to working longer hours, less time at home and heightened stress levels there is an increased likelihood of meals being ‘chucked together’ and comfort eating resulting in a poor nutritional diet over time
The incidence of social workers using caffeine, alcohol and substances are relatively high as a way of managing stress levels and keeping up the tempo but not all social workers do
Sleep is often poor due to excessive and intense levels of work and professional risk being on their minds which is somewhat reduced depending on the work environment and lifestyle practices
A pervasive low level of anxiety can become a normal feeling which can be alleviated through practices like meditation, yoga and fitness yet many social workers do not engage in such and would be considered as having a sedentary lifestyle.
So I ask: What if social work was to become a more sustainable career through one’s working life time? A career path that is not only good for the service users and employer but also good social workers wellbeing, despite the challenges, so they happily stick around for longer, whilst doing an even better job of helping society’s increasingly complex issues.
In my experience as a social worker, I have worked across all of adult social work for the last 20 years, working in mental health and safeguarding, mostly as a senior practitioner as well as team manager level. However I actually left social work after 12 years and I’m glad to say I returned 3 years later. I left for a change, after a period of time enduring fluctuating stress levels impacting on my mood and relationship. I periodically took time out of work as a way of managing my stress, not that anyone would have noticed. Stress is so often a silent condition. Upon returning back to social work I started to develop a range of physical conditions including an auto-immune condition called psoriasis and a multitude (10 in total) of other physical symptoms including cracking skin and nails, dandruff, acute intermittent wrist pain, gum disease, bad breath, a numbing down the right side of my jaw and bruxism - I was deemed a master night time teeth-clencher. I had an associated list of prescriptions, health products and routines, including a strong topical steroid cream for flair ups, medicated shampoo, and a mouth guard that I would have to wear every night, apparently, for the rest of my life. All of which was a concern for me, in light of the side effects of these products(7) when used over time, and also due to the risk that these symptoms could be a warning sign of a system that was under too much stress.
Refusing to accept these symptoms I instead chose to view them as a biological sign that something needs resolving in my life. There is the notion that our bodies give us biological feedback, rather like an inmail, a message that something is wrong. But we first have to listen. If dis-ease is the unspecific inmail that is telling us something is wrong and we use products for too long to alleviate the symptoms, aren’t we at risk of ignoring the message? And thereby leaving the underlying internal or external causes to fester, not to mention the impact of side effects which is fast becoming known for being a major cause of ill-health in and of itself.
Evidence now suggests that it we do not manage our stress and associated lifestyle habits well enough it can have a detrimental impact on our wellbeing in our working and later years. Heart disease, stroke and dementia are in the top 3 conditions that result in death(8). According to Dr Amen(9), who has completed over 126,000 SPECT scan, cites a history of dementia in the family as well as stress and stress related lifestyle behaviours, all contribute to increasing ones risk of dementia in later life. So, not surprisingly, it does concern me that my grandma has Dementia and how I manage stress in my life. Dr Amen goes onto state the risk of dementia can be significantly reduced by taking measured positive lifestyle steps, particularly if taken in ones 40’s and 50’s. Since coming to this realisation and concern I have been pursuing ways to upgrade my lifestyle habits. To listen to my bodies informal and formal biofeedback with the objective to reduce toxic stress hormones. Measuring my brain waves, diet, fitness, quality rest and letting go of inner stress has been my method.
In my resilience, wellbeing and peak performance workshop for social workers many participants confirm the aforementioned issues, and that social work is under chronic stress. I go through the research collected by Plymouth university(2), which is more about the personal impact of workplace stress on social workers, and generally speaking participants agree with the findings.
I also tend to find that at least 50% of people in the room have experienced some kind of trauma in their own childhood lives which contributed to the decision to become a social worker. The question is whether this then makes them more or less vulnerable when enduring persistent and chronic workplace stress? The answer is that it depends. Research about Wales found that 47% of the country have endured an Adverse Childhood Experience. The health outcomes from just one ACE are obesity, diabetes, depression, suicide attempts, STDS, Heart disease, Cancer, Stroke, COPD, Broken bones. The associated lifestyle behavioural outcomes in adulthood are a lack of physical activities, smoking, alcoholism, drug use, missed work. Having an ACE doesn’t always result in these outcomes but there is an increased propensity for them. So my question is what came first the ACE or the workplace stress?
As social workers many of us, I’m sure, would like to think that we have resolved our adverse childhood or adulthood life or work experiences but, despite our efforts, we may still have residual unresolved emotions stemming from these experiences. We may also be experiencing unhealthy background mind chatter and lifestyle habits as a result and/or due to persistent workplace stressors. In other words, we may have an internal landscape which is already generating its own internal stress, and if we then work and/or live in high stress environments they serve to compound internal stress, potentially creating a toxic blend of stress hormones within the system. With so much mental stimulation t’s not surprising that so many people in my workshops say they’re not getting good quality sleep nor waking up feeling invigorated and refreshed in the morning. The purpose of sleep is to help us process the stress of the day before, but if the brain is overwhelmed and overstimulated its is unable to process enough to recover in time for the next day.
We each have a limited internal capacity for dis-stress unique to us, which if reached or breached can result in a recipe for discomfort, distress and/or dis-ease. Our autonomic nervous system, our background operating system, is designed to adjust our mind and body to changing environmental conditions, to ensure our survival. When we’re too cold we automatically shiver to help us warm up. When we’re in danger we automatically become tense or anxious and, before even consciously thinking, our body automatically responds by way of either running away from it (flight), addressing it head on (fight) or shutting down (freeze). Survival is the objective of our autonomic nervous system. Split in 2, 1. The sympathetic nervous system mobilises us in response to danger (aka fight flight freeze) and 2. The parasympathetic nervous system is designed to put the breaks for rest and recover in a system that is otherwise on the go 24/7 (activities like certain stages of sleep, meditation and fitness can help)
When enduring dis-stress our autonomic nervous system works overtime to generate disproportionately high levels nuero-chemicals, including adrenaline and cortisol, preparing our system for responding to danger.
In pre-historic past hunters stress for short periods of time and let go of stress hormones through the physical exertion of fighting or running away from the danger, then they rested afterwards. Professional sports people endure high levels of short term stress and then let go of the stress hormones through physical activity followed by rest and recovery. These can be viewed as examples of positive stress, in that they’re short term and tend to be performance and motivation enhancing. In the ‘always-on’ modern world we’re on the go constantly from the moment we wake up to going to sleep. Social workers confirm, in my workshops, and they tend to leave little time for fitness and eating well. Many of us are not meeting our human needs in balance making us more vulnerable to stress. Stress is the new danger and it is more damaging than we realise. Particularly in persistently high stress work environments we generate an abundance of stress hormones day in day out but we’re not undergoing physical activity to run off the stress hormones. Our heart beats faster and our breathing shallower resulting in less oxygen intake and blood being pumped to the limbs in preparation for addressing the danger. We can also get anxious about it, causing butterflies in the stomach or worry and over thinking. All of which is evidence that the autonomic response is generating adrenaline and cortisol. When at work it’s typically impractical to use the physical exertion, required to let go of built up toxic stress neuro-chemicals in the body. This highlights the high importance of regular exercise. Unfortunately sedentary lifestyles are all too often a risk that people habitually are willing to take in exchange for giving too much to a demanding a job. Workshop participants confirm this and research indicates its on the rise(9).
In my resilience and wellbeing workshops I introduce the use of a brainwave measurement band, called Focusband, and a mobile app called NeuroSelfCare. This technology is designed to help us take a more proactive approach to resilience, wellbeing and peak performance. The app encourages us to evaluate ourselves against the 6 lifestyle pillars:
Mood - relates to letting go of unconscious negative mind chatter to help improve out conscious mood (thioughts and feelings)
Nutrition - relates to improving what we eat to improve ill-health/dis-ease symptoms
Rest - relates to improving the quality of our sleep and adopting other rest and recovery activities
Brain Training - relates to adopting behaviours that bring harmony to the different electrical impulses in the brain
Fitness - relates to ensuring a range of specific activities that bring both fitness and rest
Environment - relates to improving the external environment (life and work) to support out desired outcomes
The objective is to quickly rate yourself daily out of 10 on each of these areas and then document some free text using the journal feature; why you rated yourself that, what can you do to improve the score next time etc
Come back and read more ... these topics are explored in greater dept in future blogs.
Reading/References
(2)https://www.google.co.uk/amp/s/amp.theguardian.com/careers/2016/feb/25/short-working-life-social-worker-flexibility
(5)https://www.communitycare.co.uk/2018/10/30/majority-social-workers-looking-leave-job-within-next-16-months-says-new-research/
(9) Dr Amen (2017) Memory Rescue: Supercharge your brain and reverse your memory loss, and remember what matters most; Tyndale Momentum