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A Study of Voluntary Self Care

A Study of Voluntary Self Care Practices
by

Tara Wallace

on 13 September 2013

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Transcript of A Study of Voluntary Self Care

According to Barak, Nissley and Levin (2011), unattended high stress levels in helping professionals result in negative impacts to the quality, consistency, and stability of service to clients. (p. 626) Helping professionals often find themselves mentally and emotionally committed to the needs of their clients with complete disregard for their own need to engage in self-care.
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The National Association of Social Workers defines professional self-care as, “personal health maintenance activities which result in improving or restoring health, or treating/preventing disease.” (NASW, 2008, p. 268)
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According to the NASW effort towards the practice of self-care is the responsibility the practitioner, organizations, administrators, supervisors, educators and researchers.
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Considerable attention has been given to identifying factors which influence the development of conditions such as vicarious trauma, secondary traumatic stress and compassion fatigue. One such factor is the need for helping professionals to maintain a certain level of empathy towards the client’s problems. The difficulty of this approach lies in the indecisiveness of the helping profession to outline an operationalized definition of empathy.
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Empathy and compassion in helping professionals come with steep physical, mental and emotional costs. These costs were recognized indirectly in the 1980 publication of the Diagnostic and Statistical Manual of Mental Disorders when it recognized the diagnosis of Post Traumatic Stress Disorder. Its definition identified the impact of secondary traumatic stress and compassion fatigue in individuals whose job it is to help the suffering.
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Damage to client relationships, professional reputations and the therapeutic process represent only a few unintended consequences of a helping professionals’ inability to maintain professional and personal balance.
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Very little research explores the depth of secondary traumatic stress or PTSD in those who help individuals suffering from traumatic events. Bride’s research revealed that the experience of secondary traumatic stress is believed to be the cause of burnout and the departure of quality workers from helping profession agencies.
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Collings and Murray (1996) identify several non-client specific components resulting in increased stress and a need for more focus on self-care. Those components include professional expectations of the agency and a lack of team interaction or program support. (p. 385)
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These factors are compounded by the lack of acceptance or understanding of the roles that helping professionals fill in society. According to Rapoport (1960), helping professionals represent the “social conscious” of society.
(p. 63) This lack of acceptance and recognition is based therefore on the stark reminder that at some point society failed to acknowledge the value of human beings.
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Current research indicates these factors impact not only helping professionals but students preparing to enter the workforce as helping professionals. According to Barak, Nissley and Levin (2001) young, educated helping professionals who lack social support feel their agency forces them to choose between program policy and effective service to clients. Those who do not have a sense of partnership with their peers are more likely to experience burnout and leave.
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The end result of this burn-out induced migration is a lack of quality and consistency as agencies then must engage in a cycle of hiring, training, minimal productivity and resignations. With federal funding historically declining for many agencies this unproductive and time consuming cycle is one few can afford.
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The Council on Social Work Education defines self-care as, “the utilization of skills and strategies by workers to maintain their own personal, familial, emotional, and spiritual needs while attending to the needs and demands of their clients.” (Newell and MacNeil, 2010, p. 58)
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The intent of the CSWE is not just to protect the professional but to maintain the integrity of the profession by ensuring that individuals practicing social work avoid 1) a loss to their sense of personal accomplishment, 2) emotional exhaustion and 3) depersonalization.
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Moore, Perry, Bledsoe and Robinson (2011) note that purposeful efforts on the part of educators are effective in teaching helping profession majors the importance of self-care. (p. 545)
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Newell and MacNeil (2010) identify education as the best defense to prevent helping professionals from being overwhelmed and ignoring the need for self-care. Their research suggests the regular use of assessment tools to determine increased levels of stress as well as encourage increased use of self-care as a coping mechanism. (p. 64)
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Killian (2008) suggests individual resiliency and emotional self-awareness are responsible for helping professionals maintaining appropriate levels of balance, not the use of self-care or the inclusion of self-care curriculum. Jenaro, Flores and Arias (2007), agree indicating individual characteristics and personal resources such as personality hardness defend against stress and burnout, not self-care.
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Killian notes that often times awareness of self-care and the desire to engage in it results in additional stress when the demands of helping professions increase. (p. 36)
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A survey of Washburn University students in helping profession majors (social work, nursing, psychology and human services) indicated that a majority of those surveyed (88%) consider the practice of self-care to be important. Of the 58% employed, interning or involved in a preceptorship as a helping professional, only 32% are required to engage in self-care activities as part of their connection to a helping profession.
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When asked to identify hindrances to engaging in self-care, 92% report time as a major contributing factor followed distantly by motivation (40%) and cost (30%). These findings support the limited research of Moore et al. (2011) which notes the difficulty of college students in finding time to engage in self-care practices not included as academic requirements. (p. 550)
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This research exploration outlined a self-care definition which speaks to the need for everyone to be concerned with self-care. The practice of self-care benefits t the practitioner, the client and the agency.

Conversely the lack of self-care results in a chain reaction of negative consequences impacting the professional's ability to practice and provide a needed service to the community.
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Exploration of self-care practices revealed a critical need for helping professionals to shift the focus of their efforts to include advocating for their own physical, spiritual, mental and emotional health.
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Not all of the stress associated with helping professions is avoidable however it can be managed under the right circumstances. As society's needs change consideration must be given to the strain experienced by those whose job it is to meet those needs. The most valuable resource to that end is the helping professional and the practice of professional and personal self-care.
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Current research suggests the practice of including self-care curriculum should be revisited to include methods for the implementation of self-care on a regular basis.
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Implications of this and future research can be valuable to agencies restructuring themselves to meet the increasingly complex needs of clients; to institutions of higher education in planning curriculum to evolve with the changing needs of society and better prepare students for the workforce, and to existing helping professionals who recognize increasing demands for their services and must prepare themselves adequately to cope.
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"Exhausted when saying yes, guilty when saying no – it is between giving and taking, between other-care and self-care. This is the universal dilemma in the human drama. It is just more intense for those in the high touch fields. It gets highly illuminated when intense interaction is the occupational care. Here, giving of oneself is the constant requirement for success. Caring for others is the precious commodity." - Thomas M. Skovholt
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A Study of Voluntary Self-Care Practices of
Social Workers and Other Helping Professionals
What is self-care?

Self-care is personal health maintenance activities which result in improving or restoring health, or treating/preventing disease. Health includes mental, emotional, physical and spiritual dimensions of individuals.
Why engage in self-care?

The ability to think critically, reason and make sound judgments is the lifeline of individuals in helping professions. This ability is greatly impacted when individuals in helping professions find themselves under a great deal of physical, mental and emotional distress.
Who needs self-care?

Students in helping profession majors are susceptible to physical, mental and emotional distress as they are challenged to meet academic demands while maintaining employment and being required to transfer their learning from the classroom into a practice setting environment.
References
Barak, M.; Nissley, J.; & Levin, A (2001). Antecedents to retention and turnover among child welfare, social work, and other human service employees: What can we learn from past research? A review and metanalysis. The Social Service Review, 75(4), 625-661.
Bride, B.E. (2007). Prevalence of secondary traumatic stress among social workers. National Association of Social Workers, 52(1), 63-70.
Collings, John A.; Murray, Philip J. (1996). Predictors of stress amongst social workers: An empirical study. British Journal of Social Work, 26(3), 375.
Figley, C.R. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self-care. Journal of Clinical Psychology, 58(11), 1433-41.
Gibbons, S.B. (2011). Understanding empathy as a complex construct: A review of the literature. Clinical Social Work Journal, 39(3), 243-252.
Jenaro, C., Flores, N., & Arias, B. (2007). Burnout and coping in human service practitioners. Professional Psychology: Research and Practice, 38(1), 80-87.
Killian, K.D. (2008). Helping till it hurts? A multimethod study of compassion fatigue, burnout, and self-care in clinicians working with trauma survivors. Tramatology, 14(2), 32-44.
Monk, L. (2011). Self-care: An ethical imperative. Perspectives of the BC Association of Social Workers, 33(1), 4-5, 7.
Moore, S.E., Bledsoe, L.K., Perry, A. R., Robinson, M. A. (2011). Social work students and self-care: A model assignment for teaching. Journal of Social Work Education, 47(3), 545
Newell, J.M., MacNeil, G.A. (2010). Professional burnout, vicarious trauma, secondary traumatic stress and compassion fatigue: A review of theoretical terms, risk factors, and preventative methods for clinicians and researchers. Best Practice in Mental Health, 6(2), 57.
Rapoport, L. (1960). In defense of social work: An examination of stress in the profession. Social Service Review, 34(1), 62-74.
By Tara D. Wallace, MSW
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