Compassion Fatigue in Child Welfare

By: Stephanie. Rakoczy, BSW, MSW, LSW

Imagine for a moment you are a police officer on a call in which violence is occurring. The people involved have been reported to have a history of drug use. On your way to this call, you are thinking about the potential dangers, including people who could currently be under the influence of a substance and physically harming others. You find out along the way that among the individuals included in this call are children on the scene who reside in this home. Upon your arrival on this scene, one of the individuals displays a weapon.

    Although this scenario doesn’t always occur when you go into a situation, you have been trained and have the means to protect yourself. As a police officer, you are able to carry a gun and sometimes other weapons such as a taser gun and mace. Now imagine you arrive at this scene to discuss how this situation affects the safety of the children. You have no weapon as you did as a police officer, yet the same safety concerns are present. If you have not yet guessed, you are not the police officer—you are a child welfare social worker. You work in some of the most dangerous situations and touch on some of the most vulnerable issues with parents—their children. You do all of this and, yet, you are ultimately defenseless.

    Sadly, this situation is more common than one would hope. The concerns in this field became a reality with the death of West Virginia social worker Brenda Yeager, who was sexually assaulted and killed as she made a visit to the home of a family. It can also be seen in the death of Teri Zenner, a social work student from Kansas who was killed while making a routine home visit. Anecdotal observation and discussions with caseworkers reveal that the apparent perceived powerlessness that they feel and the way this job affects their families, coupled with the perception that they have no support or understanding in regard to their job and the work they perform on a daily basis, creates an untenable and intolerable situation for many workers.

    Many social workers, administrators, lawmakers, and state policy makers question why there is such a high turnover rate for child welfare employees. The average length of employment in the area of child welfare is said to be approximately one year. Compared to years of social work accomplished in other areas of the field, why is the retention rate of social workers that come into the job with enthusiasm, excitement, and a hope to help someone falling at such drastic rates?

    This article will explore the current literature that studies the problem of compassion fatigue in child welfare, what the causes are, the consequences, and what can be done to address the problem.

Causes

    Compassion fatigue, which can include Secondary Traumatic Stress (STS), has been documented fairly frequently and experienced by many child welfare workers. What is not as common, however, is the number of studies that appear to have been completed researching what can be done about this problem. When describing secondary traumatic stress, Nelson-Gardell, Harris, and Deneen (2003) state that STS presents a risk of negative personal psychological consequences. They also describe STS as a reaction in a person who has empathetically listened to the bad things that have happened to other people. Stamm (1999) defined STS, in an article titled Childhood Abuse History, Secondary Traumatic Stress and Child Welfare Workers, as “a syndrome of symptoms nearly identical to PTSD except that exposure to a traumatizing event experienced by one person becomes a traumatizing event for the second person.”

    Child welfare work is typically omitted when it comes to being listed as one of the top stressful jobs of society, as evidenced by the lack of media coverage. This can be evidenced by viewing the Web site of a popular television network, ABC, at www.abc2news.com, whose list of most stressful jobs did not even include social worker.

    Many researchers attribute this oversight to ignorance about the responsibilities and job duties of a child welfare worker. The Child Welfare League of America (2007) describes the job duties as utilizing the ability to engage families through face-to-face contacts, assessing the safety of children at risk of harm, monitoring case progress, ensuring the essential services and supports are provided, and facilitating the attainment of the desired permanency plan. Each caseworker in the area of child welfare maintains what is known as a caseload and a workload, which is the amount of time that workers devote to direct contact with clients and the time required to perform tasks associated with the families. The Child Welfare League suggests that the maximum number of families that a caseworker works with during a 30-day period is approximately twelve cases. The reality is that caseworkers carry caseloads much higher in number.

    Unlike any other “caring professional,” child welfare caseworkers have the burden of assessing whether abuse or neglect has occurred, as well as the responsibility of confronting the alleged perpetrator and having to deal with, and possibly testify against, the perpetrator should the allegations be determined to be true. Nelson-Gardell, Harris, and Deneen (2003) pointed out that an assessment can mean the difference between life and death for a child. The National Council on Crime and Delinquency (2006) stated that three out of four (75%) caseload-carrying workers said that their caseloads were too large. The average daily caseloads for caseworkers ranged from one to 89 families with an average of 31 families. Along with the high caseloads and workloads, many caseworkers in the child welfare field do not appear to be getting paid accordingly.

    According to The National Council on Crime and Delinquency (2006), the average full-time caseworker earns an annual salary of $45,097. Bedford County (PA) Children and Youth Services starts employees with a salary of $20,900. Whereas this seems like a far cry from the annual average salary given, most studies have concluded that most of the child welfare workers cited that salary was not one of the main causes of their departure from the job. According to Russell and Hornby (1987), states that minimally require a BSW or an MSW degree experience far lower turnover and vacancy rates than do other states. Furthermore, they reported that individuals with degrees in social work are better prepared than others for work in child welfare.

    A sample taken by the National Council on Crime and Delinquency (2006) showed that the most common motivation for leaving was the feeling that work was never done, heavy caseloads, lack of promotional opportunities, not feeling valued within the agency, and incompetent administration. Workloads were cited as one of the major causes of stress in the child welfare workforce. Those caseworkers who received flex time as opposed to being paid overtime reported that gaining flex time was useless because it just created more work. This work piles up and they cannot get their jobs done, which in turn causes more stress. Not only does that cause stress to the caseworker, but client families suffer, because they are unable to spend quality time with them and effectively help them to become better, more healthy, and educated families.

    According to Flower, McDonald, and Sumski (2005), recent research findings have shown that worker turnover rates in child welfare are negatively related to achieving permanency for children. Another surprising finding of the study done by the National Council on Crime and Delinquency (2006) was that unsupportive agency management practices were a leading cause of burnout and compassion fatigue. As reported by Ellett, Ellis, Westbrook, and Dews (2007), there are some organizational factors that contribute to employee turnover and burnout. One factor is the extremely large caseloads that require caseworkers and supervisors to work 50-60 hours, and at times, 70 hours per week. Other factors are that the salaries in child welfare are not competitive with other social and human service agencies, and employees are not valued by policy makers or the general public.

Consequences

    In a study by Jo Ann Jankoski (2002) on the impact of secondary traumatic stress on the Pennsylvania child welfare system, many of the same factors appeared. In this study, Ms. Jankoski went to numerous child welfare agencies in Pennsylvania and interviewed the caseworkers, and at times the supervisors, within the agencies. These interviews showed the stressors that caseworkers feel; the emotional state that they are in; and the lack of hope, pride, and enthusiasm they have for their jobs. The employees spoke of how the job affected their personal lives and the lives of their families and the strong emotions this produced, including anger, fear, paranoia, and sadness.

    One job stressor that Landsman (2007) pointed out that may not be evident to outsiders is the number of ineffective staff. In child welfare in Pennsylvania, the only requirement is that the employee has taken the civil service test and has a degree in any field. This leaves room for much inexperience in the area of child welfare, child development, family relationships, and so forth. Landsman (2007) pointed out that ineffective staff place burdens on the rest of the staff, the supervisor, the agency as a whole, and the agency’s clients.

Cure

    The cure for this serious problem can be summed up in two points. The first point would be to change child welfare at a higher level, including passing current legislation like the Teri Zenner Social Worker Safety Act. This particular Act would set up a grant program that would provide workplace safety measures, as well as equipment and training for social workers and others who work with potentially dangerous clients (NASW, 2007). In conjunction with the passage of this law, there should be focus on the changing of civil service requirements. For example, the current requirements in Pennsylvania for a beginning level caseworker in the field of child welfare include having a bachelor’s degree in any field with the condition that the applicant has taken at least twelve credits in sociology, social welfare, psychology, gerontology, criminal justice, or other related social sciences (PA State Civil Service Commission, 2006).

    By hiring caseworkers who have an education from an accredited social work school, the competency in the field and the training dollars will decrease for training in basic social work skills. Many child welfare agencies feel that the training that child welfare employees receive is substantial enough to produce a competent worker. As Curry, McCarragher, and Dellman-Jenkins (2004) point out, some studies indicate that only ten to 13 percent of learning transfers to the job, thus resulting in a skill dollar loss of 87-90 cents of each training dollar. According to Cornerstones for Kids (2006), “if replacing a frontline worker who makes $27,000 per year costs $10,000, the price of the current turnover rate is enormous.” In a government relations update, NASW (2003) lists some fast facts of the child welfare workforce. Among these fast facts are that turnover is consistently higher in states that do not require any kind of degree for child welfare positions and consistently lower in states that require a master’s degree in social work. The update also points out that the child welfare staff with BSW and MSW degrees were found to be more effective in developing successful permanency plans for the children who were in foster care for more than two years.

    Currently, NASW has succeeded in helping to get a bill enacted in Pennsylvania that protects the title of “social worker” by allowing only those with a degree in social work to work under that title. This new law defines a social worker as “a person who holds a current license under this act or has received a bachelor’s, master’s, or doctoral degree from an accredited school or program of social work or social welfare” (Act 68 of 2008). By helping to get this law passed, the state forms the beginning of a “clean up” of the system that has continued to fail Pennsylvania for years.

    Would you seek the treatment of a doctor who hasn’t completed his education? Would you allow your child to undergo a surgical procedure by someone who hasn’t touched an instrument more than a few times, if at all? In beginning the process of lowering compassion fatigue in child welfare, the system needs to start by putting social workers back in the roles for which they have been trained and educated.

    The second point would be the safety of the social workers in child welfare. By passing the Teri Zenner Social Worker Safety Act, child welfare workers should use that grant money to attend mandatory safety trainings and to purchase equipment in order to ensure their safety. As evidenced from the deaths of social workers Brenda Yeager, Teri Zenner (a social work student), and Boni Frederick, within the last 10 years, safety is a growing concern. The suggested usage of this grant money would be to train child welfare workers working in the field to protect themselves, along with giving them the equipment to protect themselves, such as taser guns and pepper spray or mace. Just as police officers are trained everyday to use the least restrictive force by using their verbal skills, they are also enabled to protect themselves should the need arise and all other skills have failed. The skills that social workers are trained with, such as empathy, understanding, and a systems approach, create a much greater ability to de-escalate situations. This method, however, is not “fool-proof” protection, especially for clients with violent histories or using or abusing substances.

    One can see that by integrating social workers back into an area of the field from which they seem to have been removed and ensuring that they can do their jobs safely, the child welfare system can improve greatly. Allowing social workers to work with families while utilizing the empathic and ethical practices on which their education was based will not only create a better system in which to work, but a better system for the families that are involved.

References

ABC News. (2008). Most and least stressful jobs. Retrieved from http://www.abc2news.com.

Commonwealth of Pennsylvania State Civil Service Commission. (2006, November 9). County caseworkers job requirements. Retrieved from http://www.scsc.state.pa.us/.

Cornerstones for Kids. (2006, February). Job turnover in child welfare and juvenile justice: The voices of former frontline workers. National Council on Crime and Delinquency.

Curry, D., McCarragher, T., & Dellman-Jenkins, M. (2005). Training, transfer, and turnover: Exploring the relationship among transfer of learning factors and staff retention in child welfare. Children and Youth Services Review.

Ellett, A. J., Ellis, J., Westbrook, T., & Dews, D. (2007). A qualitative study of 369 child welfare professionals’ perspectives about factors contributing to employee retention and turnover. Children and Youth Services Review, 29, 264-281.

Flower, C., McDonald, J., & Sumski, M. (2005). Review of turnover in Milwaukee County private agency welfare ongoing case management staff. Retrieved from http://www.uky.edu/SocialWork/CSWE.

Jankoski, J. A. (2002, August). Vicarious traumatization and its impact on the

Pennsylvania child welfare system.

Landsman, M. (2007). Supporting child welfare supervisors to improve worker retention.

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National Association of Social Workers. (2003). Government Relations Update: Child Welfare Workforce Fast Facts. Retrieved at www.socialworkers.org/advocacy/updates/2003/082003_a_asp.

National Association of Social Workers. (2007). Legislation on social worker safety: Contact your U.S. representatives. Retrieved from http://www.socialworkers.org/advocacy/alerts/2007/072707.asp.

Nissly, J. A. (2005). Stress, social support, and workers’ intentions to leave their jobs in public welfare. Administration in Social Work. 29 (1), 79-100.

Perry, B. D. (2003). The cost of caring: Secondary traumatic stress and the impact of working with high-risk children and families. The Child Trauma Academy. Retrieved from http://www.ChildTrauma.org.

Pines, A., & Aronson, E. (1988). Career burnout: Causes and cures. New York: Free Press.

Nelson-Gardell, D., & Harris, D. (2003, January-February). Childhood abuse history, secondary traumatic stress, and child welfare workers. Child Welfare, (82) 1, 5-26.

Robison, S. (2006, April). Cornerstones for kids. Toward a high quality child welfare workforce: Six doable steps.

Stamm, B. (1999). Secondary traumatic stress: Self-care issues for clinicians,

researchers & educators. Sirdran Press.

(2007). Social workers, marriage and family therapists and professional counselors act of 1987, H.B. No 1963.

Stephanie. Rakoczy, BSW, MSW, LSW, received her master’s degree from Temple University-Juniata Campus and her bachelor’s degree from Slippery Rock University. She has been employed by Bedford County Children and Youth Services in Bedford, PA since 2004.