By: Shannon Alther, MSW
Workplace safety is a significant concern for many social workers. According to a study by the Center for Health Workforce Studies and the National Association of Social Workers (NASW) in 2004, 10,000 licensed social workers were surveyed on workplace safety, and 44% of the respondents felt that they were “faced with personal safety issues in their primary employment practice” (http://workforce.socialworkers.org/whatsnew/safety.pdf). Another national study of NASW members in 2005 indicates even more disturbing results for social workers (http://www.naswma.org/displaycommon.cfm?an=1&subarticlenbr=51). Of 1,029 NASW members surveyed, “62% had been subjected to psychological aggression within the previous year, with 85.5% experiencing this at some point in their careers; and 14.7% had experienced physical assault perpetrated by clients in the previous year, with 30.2% having experienced it at some point in their career” (http://www.naswma.org/displaycommon.cfm? an=1&subarticlenbr=51).
Other studies have shown rates indicating that 50-88% of social workers have experienced violence in the workplace (Spencer & Munch, 2003). These rates are alarmingly high, especially throughout the course of a social worker's career (http://www.naswma.org/displaycommon.cfm?an=1&subarticlenbr=51).
Discussion
As a master’s level, second-year social work student researching this issue, I kept coming back to several questions. If workplace safety is such a concern, why hasn’t my field agency taken time to train us on safety matters more thoroughly? Why hasn’t this issue been addressed at school in our curriculum? Why haven’t we learned skills to keep clients and ourselves safe? Why don’t we have stronger penalties for crimes committed against social workers? And why isn’t there more literature and research addressing workplace violence for social workers?
My thoughts on these questions initially led me back to the core values of social work.
We are trained as social workers to look for our clients’ strengths, to advocate for them and to offer hope, but we are not trained to assess the client’s potential to harm us and to advocate for our own safety needs. Is it that we overlook ourselves to better serve our clients? One possible answer to this question, according to Weaver, is that social workers are in denial about the potential for violence, because it allows them to do their jobs without being fearful (Blank, 2005).
My research on this topic shows that there are a variety of factors that contribute to social workers not advocating for their safety, particularly within the agency setting. As Spencer and Munch (2003) discuss, there are several studies that show that social workers underreport incidents of client violence. There are many factors that may lead to underreporting, including agency attitudes about safety, agency reporting requirements, and social worker beliefs about the nature of the job (Spencer & Munch, 2003). Many agencies do not give workplace safety a high enough priority by developing a safety plan, or by training staff on risk assessment skills, verbal de-escalation techniques, and non-violent self-defense (see http://www.naswma.org/displaycommon.cfm?an=1&subarticlenbr=51).
My own experiences and research indicate that social workers receive little training on workplace safety and crisis management, compared to other professions. For example, when I was working in a rural elementary school last year for my field placement, we participated in regularly scheduled lock down drills to practice what to do in the event of an intruder entering the school or a violent encounter. In contrast, my current mental health agency placement does not have a “violence plan,” nor do we practice what to do in a violent encounter. The most training I have received at my agency is instruction to find a supervisor in the event that a client escalates or becomes aggressive. There has been virtually no communication on basic safety practices, such as de-escalation skills, non-violent forms of self-defense, risk reduction, or a safety plan of action, and to my knowledge we do not have a safety manual, even though we have a safety committee (Saturno, 2012; http://www.socialworkers.org/profession/centennial/violence.htm). In my field placement, I have had more instruction on what to do during a fire than I have had on what to do when a client escalates or becomes aggressive.
Another profession that receives a significant amount of training on mental health crisis situations is law enforcement. In some jurisdictions, police officers receive 40 hours of training in de-escalation skills and managing crisis situations, through the Crisis Intervention Team (CIT) training curriculum (Oliva, Morgan & Compton, 2010). CIT focuses on effective communication, which includes de-escalation skills such as active listening, using open and closed ended questions, using mirroring and summarizing statements, and role playing. In addition, the police officers are observed and reviewed during role plays by an expert panel, to improve their skills. Even though police officers may encounter more mental health crisis situations than social workers, the disparity in training is significant.
Social work schools could use training techniques in their practice courses to enhance their teaching, by utilizing the skills already learned of active listening, using questioning, mirroring and summarizing statements, and applying them to crisis situations and role playing. De-escalation skills would be useful to help students learn how to defuse anger with clients before the situation potentially becomes violent.
Even though social worker safety is not really addressed in schools, a study by Criss (2009) indicates that of 595 social work students surveyed, “41.7% directly experienced client violence during their practicum. The highest rate of the violence reported by students was verbal abuse (37.5%) while the lowest rate of reported violence was physical assault (3.5%).” In another study by Agbai-olunkwa (2002), data indicate that 42.9% of MSW students felt that “they were inadequately prepared by classroom experience to handle threats to their personal safety in field placement.” Social work schools leave the responsibility of teaching workplace safety up to placement agencies (Spencer & Munch, 2003). However, not all agencies have good safety policies and worker training in place.
The emphasis on workplace safety is lacking within our agencies and in our professional organizations. According to the NASW Code of Ethics, there is no ethical standard for social workers to implement workplace safety; however, social workers are ethically bound to “advocate for changes in policy and legislation to improve social conditions in order to meet basic human needs and promote social justice” (http://www.naswdc.org/pubs/code/code.asp). So we, as social workers, are bound to advocate for our clients and the community, but we ultimately ignore our own basic needs for safety and social justice.
According to the NASW, advocating for workplace safety for social workers falls under this standard for Social and Political Action (http://www.socialworktoday.com/archive/exc_032511.shtml). Essentially, by not advocating for ourselves, we are not being ethical.
Even though workplace safety has not taken a prominent role in our professional organizations and many of our work settings, more attention has been given to this issue within the last 12 years (since 2000). According to a library search of peer-reviewed articles using the search terms “workplace safety” and “social workers,” from 1950 to 2012, there was one relevant article published in 2007. Even though articles in the peer reviewed literature are virtually nonexistent, there have been several informal articles written about this subject since 2003 (see references). This shift in focus has occurred as a result of several social worker deaths across the country that were due to client violence from 2004-2008 (http://www.naswma.org/displaycommon.cfm?an=1&subarticlenbr=51).
Currently, there is legislation at the state and national levels that has been proposed or enacted to address safety issues after the deaths of these social workers—the Teri Zenner Social Work Safety Act (national), The Social Worker Safety Bill (West Virginia), The Boni Frederick Bill (Kentucky), and An Act to Promote the Public Health Through Workplace Safety for Social Workers. This legislation addresses issues on several fronts, from increasing penalties for physical crimes committed against social workers to increasing funding to provide safety measures, and requiring workplaces to provide safety plans and conduct risk assessments. The Terri Zenner Social Work Safety Act is still waiting for passage, and currently only three states have guidelines for promoting workplace safety for social workers, notably California, New Jersey, and Washington (http://www.naswma.org/displaycommon.cfm?an=1&subarticlenbr=51).
Conclusion
Violence against social workers is a significant problem and can lead to a social worker being ineffective in practice (Spencer & Munch, 2003). If we truly want to take care of our clients, we must change our thinking to also include taking care of ourselves. Even though the chances of an assault becoming a fatality are low, we must address the emotional and physical consequences to ourselves, particularly with regard to verbal abuse and physical aggression (Sioco, 2010). It is up to us as social workers to advocate for ourselves and to educate ourselves on de-escalation skills, risk assessment, safety planning, non-violent forms of self-defense, and to promote workplace safety within our agencies and advocate for protective legislation.
Our schools need to teach us how to protect ourselves and our clients, so we can continue to help individuals and communities and practice within our knowledge base. We need to give ourselves the same care and attention that we give our clients, and our agencies, schools, communities—and professional organizations need to support us in our endeavors.
References
Agbai-Olunkwa, M. (2002). Female MSW students’ perceptions of personal safety in field placement. Masters Abstracts International, 40 (2), 353-442.
Blank, B. T. (2005). Safety first: Paying heed to and preventing professional risks. The New Social Worker. http://www.socialworker.com/home/Feature_Articles/General/Safety_First%3A_Paying_Heed_to_and_Preventing_Professional_Risks/.
Criss, P. M. (2009). Prevalence of client violence against social work students and its effects on fear of future violence, occupational commitment, and career withdrawal intentions. Dissertation. ISBN: 978-1-1096-2129-7.
National Association of Social Workers. About NASW: Code of ethics. http://www.naswdc.org/pubs/code/code.asp.
National Association of Social Workers. Center for workforce studies. http://workforce.socialworkers.org/whatsnew/safety.pdf.
National Association of Social Workers Massachusetts. Creating a climate of safety. http://www.naswma.org/displaycommon.cfm?an=1&subarticlenbr=51.
National Association of Social Workers Massachusetts. Committee for the study and prevention of violence against social workers: Safety guidelines. http://www.socialworkers.org/profession/centennial/violence.htm.
Oliva, J., Morgan, R., & Compton, M. (2010). A practical overview of de-escalation skills in law enforcement: Helping individuals in crisis while reducing police liability and injury. Journal of Police Crisis Negotiations, 10, 15-29.
Saturno, S. (2012). Violent crime and social worker safety. http://www.socialworktoday.com/archive/exc_032511.shtml.
Sioco, M. (2010). Safety on the job: How managers can help workers. Children's Voice (March/April), 20-23.
Spencer, P., & Munch, S. (2003). Client violence toward social workers: The role of management in community mental health programs. Social Work, 48 (4), 532-542.
Shannon Alther graduated with her MSW in May 2012. She wrote this article as part of her coursework. She has an interest in clinical social work and school social work. She lives with her children and husband in Connecticut. She can be reached at shannon.alther@charter.net.
This article appeared in the Fall 2012 issue of THE NEW SOCIAL WORKER. Copyright 2012 White Hat Communications. All rights reserved.