Tackling Stress and Resilience in Social Work

Most of what follows is a piece written for the National Centre for Post-Qualifying Social Work and Professional Practice. I have edited it to include some more up-to-date reflections which will hopefully help many of us navigate the unchartered waters we now find ourselves working in, regardless of sector.

Tackling Stress and Resilience in Social Work

High case loads, administration demands, inconsistent supervision, high vacancy rates and low morale it could be argued have become the “new normal” for those working in social care. This is causing unprecedented levels of stress, depression and anxiety –health and social work reporting one of the highest rates of total cases of work-related stress (Labour Force Survey) (Health and Safety Stress Statistics).

Emotional exhaustion, burnout, presenteeism, turnover and poor performance are commonplace, so common perhaps that they have become accepted practice. A study of 240 trainee social workers in 2010 found that 43% had scores of psychological distress high enough to warrant psychological intervention (Kinman & Grant, 2010). Building the resilience of the sector in order that it can cope with such high levels of stress could be one of the most important challenges it now faces.

However difficult the situation appears, new insights discovered by bio-psycho-social research related to stress management, along with extensive use of experiential learning so essential to learning skills linked to emotion, can help individuals cope in environments where pressure has simply exceeded a perceived ability to cope – at individual, team and organisational level – enabling individuals to perceive their situation differently, and respond in a constructive and controlled way when under pressure.

These insights include:

A field of social science – positive psychology which has shifted the traditional approach of psychology and its focus on fixing things that are wrong, to learning what helps us flourish, resulting in techniques that can be used to increase psychological resilience.
Human Givens, described by the New Scientist as a “quiet revolution”, the principle that all of us have emotional needs, and the innate resources to meet those needs, insights which can be harnessed to help build resilience with great effect.
Mindfulness meditation which helps people stop overthinking problems and remain calm by learning how to perceive things as they really are in the moment, not catastrophising about what might be or what was.
Personality Theory based on Jung’s insights which can provide some important clues as to the different triggers, preferences and ways of adapting that different personality types can use to minimise the risk of pressure becoming so overwhelming that it results in stress. This also links to the value of Mindset Theory which identifies two mindsets: growth and fixed, each group responding differently to praise, setbacks and responses to challenges which provide important clues as to how to help those in both groups deal with adversity.

Developing resilience may not directly address some of the factors contributing to stress in social care: receiving limited support, poor resources, competing demands between the client and agency, culture of blame, work overload, high staff turnover and shortage of skilled workers, or restructuring and bullying. What it will however result in is increased sense that it is possible to make changes that will make a difference, to improve judgement ability and adopt a solution focused approach in the face of adversity. This will not only improve the health and wellbeing of the workforce, it will also increase its capacity to challenge the status quo, and consider alternative actions where ordinarily workers may have taken sick leave, looked for a new job, or withdrawn emotionally.

Resilience is described as the positive psychological capacity to rebound…“bounce back” from adversity, uncertainty, conflict or failure. Research has found a strong correlation between social worker resilience and emotional intelligence (EQ), the set of attributes that determine EQ, for example, self-awareness, self-management, social awareness and relationship management skills, requiring an ability to notice and control emotions and understand how these drive behaviour, key factors in determining resilience.

It therefore follows that in addition to helping individuals become more resilient, this same learning, linked inextricably to the management of emotions, can also be used to help individuals build their EQ, bringing with it the significant opportunity to improve performance.

This supports findings that show a strong correlation between EQ and performance in other sectors, with between 80% and 90% of the competencies differentiating top performers residing in the domain of emotional intelligence.

Building EQ capability also underpins the development of important leadership and management skills needed in social care such as the ability to create independence in others, manage conflict and create a questioning environment (Holroyd & Brown, 2011), resilience, optimism, empathy and ability to handle the emotions of others.

The need to tackle stress

Social care can often be a stressful sector in which to work given the high caseloads, excessive administration demands, inconsistent quality of supervision, high vacancy rates and low morale, coupled with the continually changing environment in which those working in social care find themselves it is no surprise that social workers report higher levels of work-related stress and burnout than many other occupational groups.

The toll this takes on social workers’ health and on their family life is huge. When social workers are forced to take time off for stress-related illness they are often thrown straight back in when they return. Employers could save millions and give social work departments a huge boost by getting to grips with the underlying causes of stress and depression. These high levels of stress in the sector are likely to impact in the following ways:

Performance

Psychological, physical and behavioural responses that will impact negatively on performance. The brain is less able to make rational, logical decisions when under stress. This has important implications as the ability to make good judgments, so crucial to the successful performance of those working in social care, is reduced.

Turnover

Social workers on average remain in the profession for less time than those working in professions similar to social work such as nurses, with the most common reason given for leaving being the stressful nature of the job.

Presenteeism

The CIPD consistently report an increase in the number of people coming to work ill, particularly where there are concerns over job security and the threat of redundancy. The recent cuts in adult social care budgets are likely to have increased this risk in social care.

Absenteeism

Stress is now the most common reason for long term absence, with Labour Force Survey results showing that human health and social work have one of the highest rates of total cases of work-related stress.

Burnout

Social workers, in common with other “helping professions” have been found to be of greater risk of emotional exhaustion, feeling unable to give of oneself psychologically, depersonalization or feeling cynical and uncaring toward clients, and reduced personal accomplishment resulting in dissatisfaction with ones’ work.

Developing emotional intelligence and resilience

Trainee social workers with more highly developed emotional and social competence are more resilient to stress. Ground breaking research in the fields of Positive Psychology, Human Givens, Mindset Theory and Mindfulness provide inspirational knowledge that combined provide a fascinating new insights into effective approaches which develop these qualities. Combining this knowledge with an understanding of personality along with experiential learning such as role plays, case studies, discussion, stories, visualisation, metaphorical work to engage those parts of the brain responsible for emotional learning, offer an exciting approach that can help the workforce increase their resilience, manage and prevent work-related stress and enhance performance.

Whilst some techniques used to help build resilience are quick to learn and apply, some require a more carefully considered approach that helps learners grasp more than an intellectual understanding of the topics considered. To be effective this learning needs to:

Match the needs of the role with those of the student to identify their individual needs
Assess existing strengths and limits and allow individuals to choose whether they build on strengths and/or address limits or a combination of the two
Build in sensitivity and care in giving feedback
Ensure that those wanting to build their resilience have chosen to do so and are motivated and ready to change
Ensure support for the continued development of skills in the workplace
Make a clear link between what students find of value and learning goals which could include using the skills at home as well as at work
Address any scepticism that resilience and EQ can be learnt by addressing this head on, providing strong evidence that it can but that it requires motivation to do so
Make sure goals are clear and how they will be achieved is set out using a series of challenging, incremental steps
Recognise the need to practice to reinforce learning and the need to seek feedback on progress
Make use of experiential learning such as role plays, case studies, discussion, stories, visualisation and metaphorical work
Prepare for set-backs, using them as an opportunity to learn

Of most importance is the desire and commitment to making the changes required – changing habits can be hard work. Whenever people try to change habits of how they think and act, they must reverse decades of learning that resides in heavily travelled, highly reinforced neural circuitry, built up over years of repeating that habit- or behaviour. That’s why making lasting change requires a strong commitment to a future vision of oneself- especially during pressured times or amid growing responsibilities.

The use of psychometric tests can also support learning. Having carried out a mapping and review of psychometric tests to support screening in the sector for Skills for Care & Development to inform their “Recruiting a Worldclass Workforce” project, it became clear that there are a great many to choose from, many very costly, but that the reliability and credibility of tests vary significantly. Personality tests, including those that measure EQ and specifically resilience, would be of most relevance to those seeking to build self-awareness, to identify areas for development and to provide a baseline against which improvements may be gauged. The Insights Discovery Model based on Jung’s Theory of Personality I have found overwhelmingly to be of most value. During the pandemic I have delivered numerous sessions virtually to help both leaders and managers and their workforces, recognise the huge value that the results of this highly reliable tool provides in helping grow EQ and with this, resilience.

Positive Psychology

This learning focuses on one of the three pillars of positive psychology: the study of positive emotion – what makes human beings flourish and how this knowledge can be used to help individuals become more resilient. By examining what research tells us about the science of positivity and the factors within the control of each individual that enable them to feel more positive, more in control, it is possible to develop an approach which develops optimism which achieves a solutions focused approach, a nurturing environment which encourages professional learning and development, and builds the confidence needed to challenge the status quo. This includes the actions that can be taken to develop the culture of openness and equality in the organisation that empowers social workers to make appropriate professional personal judgements within a supportive environment.

Positive psychology helps us understand the concept of ‘failure’, and how setbacks, competition and challenge which help individuals learn how to persist and overcome difficulty can become accepted practice in a sector bound by regulation and the need to minimise risk. This includes how the knowledge can be applied to leadership, especially in social care where there is an increased call to make informed choices and judgements, and be creative and innovative despite the risk of failure.

Positive psychology tells us that only 10% of optimism is determined by circumstances such as looks, money, health, and where the remaining 90% lies, including the importance of learning how to accurately perceive adversity, a key resilience skill. This links strongly to the reflective thinking ability, a key factor relating to EQ.

Fascinating studies can help build an understanding of what individuals need to flourish, in particular the importance of identifying and utilising character strengths, and how this can be applied to building resilience. Identifying character strengths should form part of any programme focused on building resilience and EQ as these provide a rich opportunity to use skills individuals already hold to help them develop the coping strategies required.

Thinking styles and how they impact on resilience are also important factors – the extent to which a person believes a situation was “all my fault”, that the impact will “last forever” and that it will “effect everything” determines mental toughness. Being able to notice and change these less helpful thinking styles is an important step in building resilience.

It might also be possible that social workers, particularly those working on the front line, experience high levels of stress due to “emotion contagion” – the process whereby emotions are transferred from one person to another “we catch feelings from one another as though they were some kind of social virus”. Positive psychology can help build the resilience of those who are particularly at risk of experiencing empathetic distress, the anxiety and distress experienced when faced with the negative experience of others.

Human Givens

The New Scientist described Human Givens as “A quiet revolution”. Based on new bio-psycho-social research highlighting the emotional needs and resources individuals have at their disposal to meet those needs, the principles offer scientific insight and practical techniques that it is believed could completely revolutionise our approach to parenting, teaching and education.

There is a strong link between the emotional needs identified by Human Givens, and the Management Standards for Stress developed by the Health and Safety Executive (HSE) to reduce workplace stress. These cover six areas of work design:

Demands – workload, work patterns
Control – how much say a person has about the way they do their work
Support – encouragement and resources available
Relationships – positive working and minimal conflict
Role – whether this is understood and/or any conflicting roles
Change – and how this is managed and communicated

Human Givens provides an insight into how these needs may be met by the individual using their own innate resources such as imagination, problem solving, self-awareness, memory and thinking styles.

In addition to highlighting the emotional needs of individuals and the innate resources they have at their disposal to meet those needs, Human Givens uses knowledge that informs us how the emotional brain influences how we think, including the APET model (A = Activating agent (the cause), P = Pattern matching, E= Emotional Response, T = (Thinking), suggesting that emotional responses often colour thoughts.

The APET theory is based on an understanding that human beings, form birth, pattern match to previous events in order to assess threats in the environment. Stimulus which previous experience has taught could be threatening, causes significant emotional arousal in order to galvanise the body into action to fight or flee. This call to action bypasses the thinking brain, the neo cortex. A threat is responded to in 50 milliseconds, before a thought has been consciously recognised.

This response to threat has served us well for 1,000’s of years. However, it is flawed – often ‘getting it wrong’, something psychologists like to call ‘faulty pattern matching’ – preparing us for fight or flight when in reality the stimulus presents no threat to our survival. In the workplace the top triggers of this emotional response are:

Condescension and lack of respect
Being treated unfairly
Being unappreciated
Feeling you’re not being listened to or heard
Being held to unrealistic deadlines

To become more resilient individuals need to understand how faulty pattern matching may be contributing to stress, and what practical steps can be taken to help remain more in control when faced with a level of pressure that triggers the stress response. There are a number of techniques that can be used at each stage in the APET model to help the emotional part of the brain understand where a stimulus presents no danger, resulting in reduced behavioural, physical and psychological stress symptoms.

There is no doubt that many of those working in social care are under severe pressure, but based on the understanding that it is not external pressure that triggers the stress response, but whether an individual believes that they can cope with a situation that is perceived as important or threatening, techniques that help students keep a sense that they are in control will result in a more resilient workforce, able to manage stress proactively, develop and handle the emotions of others, and manage conflict more effectively.

Mindfulness

Human Givens learning about how to control emotional responses to pressure can be taken a stage further through developing the practical skills needed to use mindfulness techniques, including how it works and why it has proven to be so successful. Mindfulness is of particular use where many stressors have resulted in a continual sense of feeling stressed – white noise that individuals are barely aware of. This might present itself as thoughts constantly churning over, with no solution in sight which may result in sleepless nights further exacerbating the symptoms of stress. It might be that individuals experience excessive procrastination, inability to concentrate, poor self-image, irritability, poor time management. It could be that there has been an increase in some of the physical symptoms associated with stress such as frequent colds, headaches and backaches.

Mindfulness can help break the cycle that has caused these responses. It helps individuals become aware of their emotions as they arise, question why these have arisen and decide whether the emotion is of use. It helps individuals stay in the present moment, not dwell on the past or worry about the future.

The goal of mindfulness is to quieten the chatterings of the mind, to become more aware of emotions, a key skill in both growing EQ and building resilience. Studies by Davidson and Kabat-Zinn have shown that using this approach can bring dramatic impacts:

Promega, a biotech company, found that not only did learning result in a more calm, concentrated and creative workforce, it also resulted in positive changes in underlying brain function: pre and post MRI scans found that parts associated with emotion control and feeling positive become significantly more active.

Mindfulness helps stop the tendency some have to over think problems, a key factor contributing to stress, and in the longer term depression. It helps individuals recognise that feeling calm and in control are not achieved through external factors, that we are not our thoughts, and the importance of seeing reality in the present moment, not what might have been or will be. Finally it helps individuals ‘be’ rather than feel they always need to ‘do’, even when doing does not help solve a problem.

Giving individuals the chance to take part in a mindfulness meditation provides an experience that can be used in day to day life. It is a technique that can practiced anywhere at any time. This approach offers many benefits, not least of all greater self-awareness and empathy. Rather than being at the mercy of emotions, it is possible to learn, with practice, how to master them. This will also have the effect of building energy and enthusiasm, key attributes for leaders.

Mindset Theory

Mindset theory teaches us the importance of self-talk, the ability to motivate others, help deal with adversity and grow and develop.

Carol Dweck who developed the mindset theory, focused in her research on what made people successful, discovering the value of formative assessment and how an understanding of the different responses individuals have to praise, set-backs, and responses to challenges gives important clues to how they deal with adversity and develop.

In her ground-breaking book The New Psychology of Success, Dweck presents the fixed and growth mindset model. The fixed mindset describing a person that believes success is down to talent not effort who are quick to give up, seeing the need to make an effort as a failure in itself, in contrast to those with a growth mindset who believe that challenges and barriers can be overcome with effort, seeing failure as part and parcel of the journey to success.

The danger for those with a fixed mindset, where attention is drawn to ability rather than effort, is the likelihood that they believe success is due to factors beyond their control -their innate ability- rather than the effort needed to be able to do something well.

Dweck’s work found different interpretations of the word “ability”, those with a fixed mindset believing it to be something closely linked to their genetic endowments and how others perceive them, each task therefore viewed as a potential threat to self-image, where ability is seen as something that is fixed, static. Effort on any task, even challenging ones, is correlated with low ability and effort is therefore avoided where possible. In contrast, those with a growth mindset perceive “ability” as something that can be developed and that most things in life can be achieved with effort and determination. Failure is not avoided at all costs, but is seen as an opportunity to learn.

This knowledge raised an awareness of the need to praise effort rather than attainment, flying in the face of the commonly help belief that unbridled praise is a good thing. The importance of checking ourselves when we are about to give unwarranted praise is an important consideration for those in supervisory, mentoring or coaching roles due to the negative effective this can have on those with a fixed mindset.

The work of Dweck has implications for building resilience through showing us that those with a fixed mindset may find it difficult to inspire themselves and others in difficult times. They may also have a tendency to see a situation as helpless and themselves with no sense of control – key contributors to stress and burnout, and that those struggling are simply not up to the job, rather than seeing a need for support to develop and improve performance.

Given that one of the key factors during the training of social workers is Critical Reflection and Analysis, it is useful to recognise that those with a fixed mindset are significantly less likely to seek, or act on feedback as part of the process of integrated critical reflection.

Safer social work practice could be achieved by taking a non-judgemental acceptance that errors are inevitable, making it easier to recognise, acknowledge and learn from them. Mindset theory also helps individuals sharpen up their perception skills, recognising that errors provide a rich opportunity to grow and develop, and that they are not to be feared and avoided at all costs. This could help managers at all levels understand what is needed to build a “learning culture” where individual responsibility has to be recognised… a willingness to accept that it was possible for teams and individuals to fail, to learn from their mistakes, and to start again.

Helping those in the social care sector move towards a growth mindset could bring significant benefit.

Proactivity in finding opportunities to consider new ways of developing both the self and teams in response to increased work demands in a sector in which many say their caseloads are unmanageable
Encourage more tolerance and acceptance of failure based on the premise that the single most important factor in minimising errors is to admit that you might be wrong
Increased likelihood of seeking and acting on feedback from others, including service users, and therefore achieving integrated critical reflective practice and exploring how the rights, wishes, feelings and experiences of children and young people shape the provision of services.
Proactivity in acknowledging and dealing with workplace stress

Importantly to consider how those with a fixed mindset:

Could be reluctant to see learning opportunities, including those generated by seeking and acting on feedback as they believe this to a futile as ‘you are what you are’
Fail to acknowledge that there is a need to build resilience, or that there are serious issues that need to be addressed
Blame others rather than seek solutions
Withdraw in an attempt to ‘save face’
Make it difficult to achieve a learning culture and the need to have an ethos of a non-judgemental acceptance that errors are inevitable in order that they can be used as a chance to learn.

A range of knowledge and experiential learning, along with safe opportunities to practice new habits, can help those with a fixed mindset shift to a more positive growth mindset.

I hope this rather lengthly piece provided some good food for thought for any of you out there currently wrestling with the need to consider how to build your resilience or that of your workforce. Do please get in touch if you would like to explore how any of these ideas could be of benefit to your own organisation.

Michelle Spirit FCIPD MSc RMN Dip(Hyp)Psych

Michelle is a Fellow of the CIPD with over 20 years of experience of training, development and mental health. As a qualified and experienced manager, mental health nurse, hypnotherapist, coach and trainer she has extensive experience of the health and social care sector helping many individuals and teams build their resilience. At strategic level she has supported the development of the Sector Skills Agreement for Adult Social Care, led the national evaluation of the Skills for Care funded ASYE Pilots to inform social work reforms and helped produce workforce development plans for the SE ADASS group. She also developed one of the country’s first Building Resilience Masters Unit for Health, Education and Social Work practitioners and a three day resilience programme to support those in their ASYE.

As an Associate for the mental health charity Mind she helped develop and evaluate resilience training for those working in emergency services along with the University of Oxford and works with numerous GP surgery staff, including GPs to increase their awareness of mental health and the practical ways that is is possible to build resilience and tackle mental health problems creatively, without the need to reach first to the prescription pad!

Michelle is also an Insights Discovery Certified Practitioner.