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Stress Management in Child Welfare Practice


Stress Management in Child Welfare Practice Trainer: Date: Nelson-Gardell & Harris (2003) found that a personal experience with childhood abuse increased the social ... – PowerPoint PPT presentation

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Title: Stress Management in Child Welfare Practice

Stress Management in Child Welfare Practice
  • Trainer
  • Date

  • As a result of this training, participants will
    be able to
  • Identify positive and negative effects of stress
    and distinguish between them
  • Assess at least two possible sources of stress in
    the workplace as a child welfare worker and state
    at least two strategies to mitigate these
  • Identify the differences between Burnout and
    Secondary traumatic stress

You can't really be strong until you see a funny
side to things." Ken Kesey
and the world laughs with you...
The most thoroughly wasted of all days is that on
which one has not laughed. Nicolas Chamfort
What Is Stress?
  • Hans Selyes view in 1956 was that stress is not
    necessarily something bad it all depends on how
    you take it. The stress of exhilarating, creative
    successful work is beneficial, while that of
    failure, humiliation or infection is
    detrimental. Selye believed that the biochemical
    effects of stress would be experienced
    irrespective of whether the situation was
    positive or negative.

What is Stress?
  • The most commonly accepted definition of stress
    (mainly attributed to Richard S. Lazarus) is that
    stress is a condition or feeling experienced when
    a person perceives that demands exceed the
    personal and social resources the individual is
    able to mobilize.

Is Stress Bad for You?
Some types of Stress Are
The human body chemically responds to emotionally
charged situations
  • When you are under pressure or additional demands
    have been made your body reacts fight or
    flight. Humans naturally want to defend
    themselves in challenging or difficult situations.

What happens when my body perceives changes?
  • Messages travel through the SNS sympathetic
    nervous system in a bi-directional (two-way)
    flow. Efferent messages can trigger changes in
    different parts of the body simultaneously. For
    example, the sympathetic nervous system can
    accelerate heart rate widen bronchial passages
    decrease motility (movement) of the large
    intestine constrict blood vessels cause pupil
    dilation, piloerection (goose bumps) and
    perspiration (sweating) and raise blood

A friend is a person with whom I may be sincere.
Before him I may think aloud."- Ralph Waldo
Friendship is the only cement that will ever hold
the world together"- Woodrow Wilson
Stress Feelings
  • Worry
  • Tense
  • Tired
  • Frightened
  • Elated
  • Depressed
  • Anxious
  • Anger

Internalizing Stress
  • Most of the stress we experience is
    self-generated. How we perceive life whether an
    event makes us feel threatened or stimulated,
    encouraged or discouraged, happy or sad - depends
    to a large extent on how we perceive ourselves.

Ever feel like that straw just landed on your
Types of Stress
  • Negative stressIt is a contributory factor in
    minor conditions, such as headaches, digestive
    problems, skin complaints, insomnia and ulcers.
    Excessive, prolonged and unrelieved stress can
    have a harmful effect on mental, physical and
    spiritual health.
  • Positive stressStress can also have a positive
    effect, spurring motivation and awareness,
    providing the stimulation to cope with
    challenging situations. Stress also provides the
    sense of urgency and alertness needed for
    survival when confronting threatening situations.

  • In chronic stress situations, sufferers enter the
    exhaustion phase emotional, physical and mental
    resources suffer heavily, the body experiences
    adrenal exhaustion leading to decreased stress
    tolerance, progressive mental and physical
    exhaustion, illness and collapse.

Ever feel like you cant believe you made it
through another day?
Symptoms of Stress
high blood pressure
stomach upset
tooth grinding

clenched jaws
back pain
shortness of breath
skin problems
Chest pain
Weight gain or loss
sleep problems
Stress has been related to such illnesses as
  • Cardiovascular disease
  • Immune system disease
  • Asthma
  • Diabetes
  • Digestive disorders
  • Ulcers
  • Skin complaints - psoriasis
  • Headaches and migraines
  • Pre-menstrual syndrome
  • Depression

Cost of Stress
  • Stress helps account for two-thirds of family
    doctor visits and, according to the U.S. Centers
    for Disease Control and Prevention, half the
    deaths to Americans under 65. It has been
    implicated in heart, stomach and mental
    disorders, along with the more ordinary
    headaches, backaches and high blood pressure and
    cholesterol. Kiecolt-Glaser's 10-year study of
    medical students found decreased levels of the
    body's natural killer cells, which fight
    infections and tumors, during even the familiar
    stress periods of exams.

Source Sickness Can Be Price of Unbridled Stress
By Kevin Lamb
with friends and family
Secondary Traumatic Stress, Compassion Fatigue,
Vicarious Trauma Burnout
Do they mean the same thing?
How are they different?
Compassion Fatigue
  • Although often used as a synonym for Secondary
    Traumatic Stress, it is different.
  • The combination of burnout and Secondary
    Traumatic Stress results in Compassion Fatigue.

Vicarious Trauma
  • Can be used interchangeably with
  • Secondary Traumatic Stress

Does Secondary Traumatic Stress Burnout?
ActivityDifferentiating STS from Burnout
Does Secondary Traumatic Stress Burnout?
The time to Relax is when you dont have time for
it. Unknown
Tension is who you think you should be.
Relaxation is who you are." Chinese Proverb
  • Gradual Onset
  • a state of physical, emotional and mental
    exhaustion caused by long term involvement in
    emotionally demanding situations.
    (Nelson-Gardell, 2003)
  • the index of the dislocation between what people
    are and what they have to do. (Maslach, Leiter,
  • describes a syndrome that goes beyond physical
    fatigue from overwork. Stress and emotional
    exhaustion are a part of it, but the hallmark of
    burnout is the distancing that goes on in
    response to overload. (Maslach, 1997)

Burnout Indicators
  • Erosion in values, dignity, spirit and will-an
    erosion of the human soul
  • Over time imbalance of what you can give and
    provides less than what you need
  • Feel overworked, undervalued, no longer in
    control of the job you do
  • Presence of negative emotions and the absence of
    positive ones

Sensibilities, Inc. 2005
Secondary Traumatic Stress
  • The pain and helplessness of the children we come
    into contact with can be passed on to those
    around them
  • A trauma is a psychologically distressing event
    that is outside the range of usual human
    experience. Trauma often involves a sense of
    intense fear, terror and helplessness
  • Trauma is an experience that induces an
    abnormally intense and prolonged stress response

Source Child Trauma Academy
Secondary Traumatic Stress
  • Sudden Onset
  • The response a person experiences after listening
    empathetically to the traumatic events in someone
    elses life. (Nelson-Gardell, 2003)
  • 38 of Social Workers experience moderate to high
    levels of secondary traumatic stress. (Cornille
    Meyers, 1999)

?Contrary to popular belief it is not just the
horrendous cases of abuse, like child deaths or
serious injuries, that are secondarily
traumatizing for caseworkers. Secondary trauma is
cumulative. Even the small things, like seeing
sadness in a childs eyes when a home visit ends,
can be traumatizing for a caseworker. Witnessing
these events over and over again can have a
negative effect on even the most compassionate
and resilient caseworkers.
Who is at risk of Secondary Trauma?
  • Historically
  • Emergency Services Professionals
  • Police officers
  • Fire fighters
  • Emergency Medical Technicians
  • Nurse Crisis workers
  • Recently
  • Professionals who work with children families
    in crisis
  • Pediatricians
  • Psychologists
  • Psychiatrists
  • CPS Social Workers
  • Juvenile Probation
  • Foster Parents
  • Teachers

Source Child Trauma Academy
A smile is something you cant give away, it
always comes back to you. Unknown
Start every day with a smile and get it over
with. W.C. Fields
Wrinkles should merely indicate where smiles have
been. Mark Twain
  • There has been a great deal of research on the
    effects of listening to other peoples traumatic
    stories as it relates to mental health
    professionals, post 9/11 service personnel,
    crisis counselors, doctors, and nurses. But only
    recently have researchers begun to look at the
    phenomena of Secondary Trauma and how it effects
    Child Welfare Social Workers

  • Child Welfare Social Workers are exposed to
    different forms of traumatic events on a daily
    basis. They are required investigate child abuse,
    remove children from their homes, interact with
    angry, hostile parents, the court and all the
    while be supportive and nurturing while listening
    to horrible stories of child abuse and neglect.

Why are you at risk?
  • Empathy Social Worker internalization of the
    childs trauma related pain
  • Insufficient Recovery Time Listening to
    children describe horrific situations over and
    over again without enough time to process
  • Unresolved Personal Trauma Your own traumatic
    experience can be re-activated when working
    with someone in a similar circumstance
  • Children are the most vulnerable members of our
    society At times, the senseless nature of some
    of the trauma inflicted on children shakes ones
    sense of humanity
  • Isolation Systemic Fragmentation Individual
    service delivery vs. team oriented practice and
    high turnover decreases your ability to handle
  • Lack of Systemic Resources Lack of economic and
    personal investment in front line services

Source Child Trauma Academy
Risk Factors-Child Abuse History
  • Personal history of child abuse increases the
    risk of a social worker experiencing secondary
    trauma (Nelson-Gardell, 2003)
  • Personal choice to enter social work after being
    abused as a child might indicate overcompensation
    (Adler, 1917, 1927)

Risk Factors-Coping Styles
  • Defensive Coping
  • Turn away or deny problems exist
  • Self- deception
  • Reality distortion
  • Protect self from emotional pain or trauma
  • Primarily unconscious
  • Not always maladaptive
  • Constructive Coping
  • Confronting problems
  • Realistic expectations of self
  • Recognize potentially disruptive reactions to
  • Protecting self against the physical effects of

(Source Weiten, W. 2008)
Risk Factors-Empathy
  • A key feature of child welfare work is building
    relationships with children and their families.
    Empathy, interpersonal sensitivity and caring are
    crucial to making the needed relationships
    happen. Although necessary, empathy makes the
    social worker vulnerable to secondary traumatic

(Source Educating Child Welfare Workers about
Secondary Traumatic Stress, Pryce Shackleford,
Cognitive Schemas
  • Power
  • Esteem
  • Intimacy
  • Control
  • Safety
  • Trust/Dependency
  • Independence
  • Research shows that the cognitive schemas are
    altered after working with trauma clients
  • These traumatic experiences become integrated
    into the social workers cognitive schemata

(Source McCann Perlmann, 1990 and Bride, 2007)
Signs and Symptoms of STS
  • Tired
  • Less socializing
  • Lower productivity
  • Hopelessness
  • Despair
  • Cynicism
  • Question humanity
  • Persistent anger or sadness
  • Disturbing mental images
  • Anxiety
  • Nightmares
  • Decreased sense of safety

(Siegfried, 2008)
Strategies to Combat Secondary Trauma
  • Activity

Strategies to Combat Secondary Trauma
  • Build Resilience
  • Healthy Self-esteem is necessary to effectively
    work in child welfare and minimize the effects of
    secondary trauma
  • Be open to lifes opportunities.
  • Developmental Psychology

Strategies to Combat Secondary Trauma
  • Build a Supportive Team Environment
  • Reduce caseloads
  • Hire and retain quality social workers
  • Educate on Secondary Trauma
  • Offer mental health services to support social
  • Encourage time off
  • Offer peer support groups
  • Demonstrate support to the community and media
  • Recognize Secondary trauma as a real issue
  • Organizational
  • Psychology

Not an appropriate Organizational approach
Strategies to Combat Secondary Trauma
  • Build a Social Network
  • Spend time with emotionally healthy children to
    encourage hope
  • Maintain friendships outside of work
  • Engage in peer support groups
  • Social
  • Psychology

STS is NOT a sign of Social Worker weakness
  • Secondary Trauma is a real issue for child
    welfare social workers. Although there is likely
    no way to avoid it altogether, there are ways to
    mitigate the effects. Just as individuals need
    take responsibility for their own emotional
    health, organizations need to take responsibility
    for their employees well-being

The soul would have no rainbow had the eyes no
tears. John Vance Cheney
Sometimes you just have to CRY
What soap is for the body, tears are for the
soul.  Jewish Proverb
Tears are the safety valve of the heart when too
much pressure is laid on it.  Albert Smith
When experiencing high levels of stress
  • Make big decisions
  • Blame others
  • Expend energy complaining
  • Try a quick fix
  • Reframe
  • Determine other approaches to the issue or
    concern ask advice from co-workers
  • Think outside the box

(No Transcript)
  • What are some of the things you have done or
    techniques you have used to reduce your stress at

Build on Coping Skills
  • Pay attention to nutrition
  • What are your eating habits?
  • Exercise regularly
  • Consistency vs. intensity
  • Have regular check-ups
  • Medical and dental care
  • Relax, relax, relax
  • Meditation, yoga, reading, taking a nap

Develop Self-Help
  • Social workers frequently ask clients who are
    their support systems when case planning, but do
    social workers think about their own support
  • How often does a social worker rush to say
    something to a client or other collateral parties
    on a case? Do you take time to breathe before

Develop Self-Help
  • Ask for help - express to your supervisor how you
    may be feeling overwhelmed. Top performers can be
    burned out very easily by constantly handling
    complex, emotionally charged cases which can be
    stressful - To de-stress, discuss caseload with
    supervisor and dont be afraid to ask for help.

Develop Self-Help?
Guidelines for Successful Stress Management
  • Establish clear, specific obtainable goals.
  • Start small changes to managing stress.
  • Start from where you are, and build towards your
  • Make one change at a time.
  • Plan ways to manage stress.
  • Reward yourself for good work.
  • Look for ways to control your life.
  • Manage stress on a daily basis.
  • Find humor and laugh.

Stress Management 3 Simple Movements
  1. Step Back
  2. Take a Deep Breath
  3. Dive Back In

(Source Stress Management, Denham, T.)
Some- times we have to be Real !
Thank You!Have a Great Day
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