Social Work Under Pressure – A Review

Jessica Kingsley Publishers sent m e a review copy of ‘Social Work Under Pressure – How to Overcome Stress, Fatigue and Burnout’ by Kate van Heugten  I interviewed the author and the interview is available on the Jessica Kingsley Blog here .  I know I’m biased but I highly recommend reading the interview to put the book into a context.

I was intrigued by ‘Social Work Under Pressure’ and what it might provide that is ‘different’ in the market of text books for social workers. While there are books covering the legalities, theories and policies, I haven’t come across a book that covers the emotional stresses and pressures of social work as a discrete issue.

van Heugten presents issues of workplace stress in social work (although there is no doubt that the issues and learning can be extrapolated into other areas of social care and health sectors) in the context of theories of ‘stress’ and stress management.

The first chapters are a great example of the importance of using theoretical approaches and research, in this case about models of workplace stress and stress management in practical situations.  van Heugten explains and expounds the relationships of vicarious trauma, compassion fatigue and burnout in more details as being issues for which the profession is particularly prone.

Her discussion of the increased stressors relating to bureaucratic tasks and a lack of control seem to have put a lot of my personal experiences of working as a frontline social worker into a context that made me able to understand better where my own reactions were ‘coming from’. As a ‘reflector’ by instinct, having a context within which to place the stresses and difficulties experienced at work helped me to explore how to build up my own resilience and recognise my own needs regarding self-care and support.

Van Heugten does address the issue of self-care and building resources and ‘toolkits’ to resist and overcome from the the stresses at work. Some of the ideas and plans are aimed squarely at managers and systems but there are also ideas there for individual practitioners without managerial control or authority.

Van Heugten looks at some of the specific issues which affect different areas of social work but her book is focussed internationally and she calls on a wide range of interviews and research data to back up her hypotheses about the reasons and solutions for workplace stress.

There are chapters about dealing with violence and aggressive service users and dealing with bullying in the workplace as well as ‘making mistakes’ and an appreciation that humans work in human services and we need to look after ourselves as well as each other in this trade because ultimately, stress and overload lead to poor practice and sick professionals.

I’d definitely recommend this book to managers, practitioners and social work students as it introduces a lot of elements that are fundamental to a successful and long career in social work and social care as well as health services and these elements are very seldom taught formally but rather learnt most frequently from decent managers, supervisors and colleagues.

It is easy to read and there is a good use of quotations and personal experiences, including the authors’ own experiences of personal stresses and combining this with work.  Each chapter concludes with references and it is a very well researched book that allows readers to discover more for themselves about specific issues that might affect them.

It is available from Jessica Kingsley Publishers and costs £19.99

Managing Stress in Social Work

The idea for this post came from a brief conversation on Twitter last night when a social worker asked about how we manage stress at work.

There was a fine Q and A in the Guardian a few weeks ago on their Local Government Network site which collated the opinions of people with a lot more experience than I but I have developed some ideas that I personally use and thought I would share them in more than 140 characters. Twitter, believe it or not, has its limits. I’m sure and hope that people add to my list with their own techniques. This is an entirely personal list!
meditationHaPe_Gera@Flickr

I’m fortunate enough to work in a good, supportive team with excellent managers who have a realistic understanding of workload pressure. It is important for me to acknowledge that my stresses are not about poor management or a difficult team which may lead to a whole different range of tactics about managing stress.

Supervision is, of course, important but I am taking regular, good quality supervision as a ‘given’ as that is my current experience. It is important that supervision is more than a list of updating cases but is a chance to discuss the ways the work impacts us personally and professionally. A chance to both reflect and learn. My supervisor tells me that she gets as much from our supervision sessions as I do and that is entirely right.

Apart from supervision with my manager and my other supervision with a senior social worker in a different team,  I’m very strong on immediate debriefing. I think it is an absolutely necessary part of the job. Without the time and space to debrief, without that immediate opportunity to hold some of those thoughts together and discuss them, you begin to internalise some of the pain, sadness and distress that you inevitably will see at work and more dangerously, you take it home. Stress can’t help but affect your family and those around you if you let it. That’s why it has to be ‘left at work’ as far as possible.

I call ‘debriefing’ the immediate reflection or observation as opposed to the most considered reflection that comes during a ‘proper’ supervision period. Debriefing is often with colleagues who are around in the office. We are good at helping each other out with this.  If there is no-one around in the office that is able to talk, I will tend to write some thoughts down on a notepad I carry around. Sometimes I might do this in a cafe between visits. It helps me detach some of the responsibility I have from a situation and see it through ‘third person’ eyes.

I manage stress much better now. I detach home from work more and I am far less likely to bring the stress and work-related anxiety home. Part of that is because I have space to debrief and discuss while at work. Sometimes you want someone to reassure you outside the managerial system, sometimes you just need to talk about what you have heard and seen and the best people to listen can be those who are attuned to the culture of the same workplace and environment.

No-0ne quite  understands some of the pressures of the job or at least it can feel that way, if they aren’t doing it themselves.

I have also tried meditation and mindfulness techniques which personally, I’ve found very very helpful. My interest in mindfulness actually started when I was writing about it on this site and I thought it sounded useful personally so I bought some books and MP3s (I was going to write ‘tapes’ there but that dates me!). I then attended a short day course locally to see if ‘proper’ instruction would be useful. I find taking the time each day to relax actively has really helped my mindset. It also helped me a lot when I was recovering from surgery.

MIND have a good resource page and details of courses both online and local. I’d really recommend it, even if you are normally quite sceptical of some of ‘these things’. I was.

Exercise is a classic one. I have been a member of a gym in the past but I didn’t stick with it. It works for some people. I like swimming but I find it hard to build in before work and after work I get tired. But I do like walking. I can walk for hours and days. Nothing ‘releases’ me as much as a long walk. Sometimes in the city and sometimes in the park. I can be alone with my music or in company. I always find it helps me to gather my thoughts.

Most important as well is to have interests and involvements outside work. They can be work-related. I write a lot about social work and social care and read a lot of related books but I still see that as a ‘discrete interest’ as it helps me in ways beyond work.  There are other things I enjoy though whether it’s cooking or playing my ukulele or playing on my Xbox (wow, I LOVE the Kinect), I could also possibly be the only person who plays ‘Lips‘ while on my own at home (it’s one of those karaoke singing games – enormous fun!).

I also have taken many evening classes over the years, from ukulele playing to Art History to Spanish to Greek to Basic HTML to Creative Writing.  I enjoy learning new things and I enjoy meeting new people who work in completely different areas.

I also like to take advantage of being in London and am a member at the British Museum, Kew Gardens,  South Bank Centre … and London Zoo but we have a wealth of museums, galleries and theatres which can be accessed relatively cheaply if not free of charge. I need to look after myself build and work on an identity that is more than ‘work’. So when the stresses build up at work I have other aspects of my life to build on.

What about you? What do you do to work on stress?

Thinking forward

I realise that I might have been a bit more stressed than usual of late. This is due to a combination of factors. It has been a long time since I’ve had any kind of break from work – probably more than is usually the case. I have also had a rush of work to do that seems to be time-limited and am not feeling totally comfortable with the quality of the work that I’m doing at the moment.

I’m rushing some things and being a little less mindful than I would like to be. My excuse is workload and pressure of emergencies that are immediately prioritised but in some senses I am also finding it difficult to concentrate as much as I would like.

I’m trying to spend as much time in the office this week as I can – in the hope of clearing a lot of the backlogged paperwork. I do not take naturally to paperwork but sometimes I feel exceptionally guilty when I neglect it for too long and need – as far as possible – a few days to catch myself up so that I can feel a little more like I’m on top of things.

I have a short weekend break planned. It will be the first time I’ve been away since November which might not seem like that long ago but it is probably the longest period I’ve taken between ‘breaks’ since I’ve been back in the UK.  I have no doubt that it is related to my general stress levels.

I have mentioned our wonderfully cohesive AMHP rota where between myself and one other person, we cover one-week-on, one-week-off. By the luck of fate, I have a Mental Health Act Assessment booked for 9am of the day I return from my break.  That’s something that should help my mind settle while I’m on holiday!

I am trying to think positive though. It really does help me. So in the spirit of positive thinking, a reminder that for all the grumbling and rumbling and brief looks through the relevant jobs pages when they find their way to my desk – there really isn’t anywhere else I’d rather be working or anything else I’d rather be doing – and that’s not a bad place to be!

image aussiegall at flickr

Tips for Good Mental Health

The Mental Health Social Worker pointed me to a campaign being run in the US by Mental Health America to ‘equip people with tools to deal with stressful times’.

The campaign is called ‘Live your Life Well’ and has a nicely designed webpage with some surveys, tips and ‘success stories’.

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I took the ‘stress screener’ myself and came out it told me ‘I could be doing better’. I guess no surprises there because I do have a fair bit going on at the moment!

They explain that

The Live Your Life WellSM program details the 10 tools and many of their benefits, including:

  • Connect with Others. Research suggests that people who feel connected are happier and healthier – and may even live longer.
  • Stay Positive. People who regularly focus on the positive in their lives are less upset by painful memories.
  • Get Physically Active. Exercise relieves tense muscles, improves mood and sleep, and increases energy and strength.
  • Help Others. Research suggests that those who consistently help other people experience less depression, greater calm and fewer pains.
  • Get Enough Rest. People who don’t get enough sleep face a number of possible health risks, including weight gain, decreased memory, impaired driving and heart problems.
  • Create Joy and Satisfaction. Positive emotions can boost a person’s ability to bounce back from stress.
  • Eat Well. Eating healthy food and regular meals can increase energy, lower the risk of developing certain diseases and influence mood.
  • Take Care of Your Spirit. People who have strong spiritual lives may be healthier and live longer. Spirituality seems to cut the stress that can contribute to disease.
  • Deal Better with Hard Times. People who get support, problem-solve or focus on the positives in their lives are likely to handle tough times better.
  • Get Professional Help if You Need It. If the problems in life are stopping a person from functioning well or feeling good, professional help can make a big difference.
  • The site goes through each of these points and explains some pretty substantial and extensive tips so it’s well worth going to the site and having a nose around!

Poetry Helps

While pondering, among other things

The nature of the day – whether the weather

Will be clement or savage

Whether the year will be kind or cruel

I came upon a tract

From the Telegraph

of all places

I don’t frequent it much – too dry, too altogether

Filled with middle-class smugness

But accessing remotely allows

A more utilitarian approach

Reading on, I see that

Poetry Helps.

Writing it, that is.

It helps with mood, and temper

Emotional regulation‘ so they say.

I used to write more – sometimes

Sometimes easier to write

Emotion in a poem.

Than in prose.

It detaches.

So today and before work I ponder

How will the week greet me

Will colleagues still be sick?

How can I balance

The workload with the crises?

Is my time fairly split or sometimes

Do I cop out and

Spend more time with people I like

And is that irresponsible?

Who knows? Probably

But it is certainly easier to say

Through poetry!

image basykes at Flickr

Apologies to any serious poets but honestly, check the link out. It is really interesting stuff and I really do think I’ll try it (but I promise no more attempts on the blog!).

Sick Days

I have been off work sick this year more than any other year in my working life. I am currently up to six days this year. Four of those days were in a block a couple of weeks back.  Usually sickness makes me feel guilty. I think of the work piling up. I know I shouldn’t but I can’t help it. This time though, I felt less shame than usual. I saw a doctor and was actually signed off sick ‘officially’ for the first time in about 10 years – the last time I was signed off sick with a medical note, I had had an accident that led to it, the day before my two weeks of annual leave and ended up never claiming it back! The other two days this year have involved me actually getting to work – confirmation of the ill-feeling that I had woken up with then driving me back home almost immediately.

mandj98 mandj98 at flickr

There is a reason for me to share this and that is an article that I read in the Times over the weekend.

It is about the stigma that workers feel when producing sick notes that make reference to their mental health or rather, ill-health. Although my sickness related to physical complaints, I still felt a lot of pressure about having to take the time off. I can only imagine it might be more so for mental illness where there is sometimes an undertone of blame attached to those who are not well.

The survey of 1,000 workers by national charity the Shaw Trust found that 18.3 per cent would not reveal a condition even to their HR department and only 17.9 per cent would disclose details of an illness to a colleague.

To be honest, I am surprised it is as low as that. I would have thought it might have been a higher figure would be reluctant to share.

Of the respondents 34.5 per cent said the reason they would not reveal a mental health condition was because they felt worried or ashamed they would be treated differently. This figure rose to 43.3 per cent among 16 to 24-year-olds.

Again, maybe it’s just because I’m overly aware of stigma  but a part of me is surprised the figures here aren’t higher.

The article about the stigma of revealing mental ill-health at work though is one that brought back some recollections of mine when I was in a previous job. A colleague of mine was visibly (to those she was more friendly with anyway) suffering from a massive amount of stress from all angles. I  (among others) spoke to her about going to a doctor because it was very clearly not a ‘usual’ manifestation of work-related stress – which we all suffer from to a degree!

She went but was terrified that she would be signed off sick – as it happens she received a ‘formal’ diagnosis of depression and was initially signed off for two weeks. She begged the doctor to make reference to more vague ‘stress’ rather than putting ‘depression’ on the sick note because she was so concerned about future employment prospect, about how it would be received back at work and possibly more concerning, how the GSCC would respond to it.

He did. She perhaps received support from her managers in a way that might not have been entirely what she needed and ended up being signed off for 8 months after things didn’t get any better for her a couple of months later.

Going back to my own feelings of guilt about taking days off work, I wonder if it is related to that. Especially working in the ‘caring’ professions, you feel you should somehow be better equipped to deal with these things or that you should be immune in some ways, or that admitting an illness will make people approach you in a different way.

Perhaps some of the current climate of uncertainty in the financial markets and the knock-on effects on employment and job security will lead to additional stresses and a few more ‘brave faces’ that cover an enormous amount of pain and turmoil as more people face the stresses and tensions that can trigger mental ill-health as a result of a fluctuating job market. It is perhaps, something to be more aware of.

Ironic then, that The Shaw Trust who have a great website about combating stigma of mental ill-health at work and who conducted the survey referenced above – count – among their supporters and funders, Lehman Brothers. A salutary lesson for all.